What to eat after RPLND?

[David1969]

Dr. foster at IU also did not require me to have a fat free diet, I had no problems whatsoever after the RPLND.

[Scott]

In the source that said 1-3%, was that worldwide or within the U.S.? I know there are very, very few RPLND's done outside of the country.

Here's a link to the source. Search on that page for "chylous" to find it. I didn't see on what population the statistic was based.

[Tatt]

well, I'm about 15 months out from my RPLND. Not sure if it's different i nthe UK, but I asked about a low fat diet and they said not to worry. I didn't suffer too many problems - althogh I was feeling fuller much more quickly, and things generally passed through me more quickly. And even mildly spicy foods had an effect (!). But I think in terms of comfor more than anything else, low fat, high fibre would be advisable

[MRMRSU]

Thanks for clarifying that Scott...I knew something was off. I missed the "hospital admissions" part . In the source that said 1-3%, was that worldwide or within the U.S.? I know there are very, very few RPLND's done outside of the country.

[Scott]

I found another source that says chylous ascites occurs in 1 to 3% of RPLND cases.

Maria, the statistic you found is 1 in 20,000 hospital admissions. Keep in mind that people are admitted to the hospital for many things that couldn't possibly cause chylous ascites!

[MRMRSU]

Sheinfelds take was that 5% is meaningless if you're one of the 5%. He ses no reason to take that risk. It would be interesting to find out if Sloans % is lower then the national average.

Quick link to a website that gives an overview... http://www.uptodate.com/patients/con...007&view=print
The stats show 1 in 20,000. Maybe my math is off here, but that's a substantially lesser percentage than 5%, right? Math gurus help!!! I'm getting 0.005%
But on top of that, we also need to keep in mind that the statistic above includes other abdominal surgeries other than RPLND. So the percentage gets even smaller if you think of the rarity of TC.

I agree with Bill that it would be interesting to know MSK's numbers since they deal with so many cases of testicular cancer compared to other hospitals (and definitely compared to hospitals here in So.Cal.)

[dadmo]

Sheinfelds take was that 5% is meaningless if you're one of the 5%. He sees no reason to take that risk. It would be interesting to find out if Sloans % is lower then the national average.

[Scott]

when i had my RPLND i was given no special instructions on diet. i asked my surgeon and doctors about going fat-free and they explained the rarity of chylous ascites. since my surgeon has done many many RPLND's i trusted her word and didn't adhere to a fat-free diet. everything was fine. how common is developing this condition? i was told it was pretty rare so is going on this diet just an extra precaution for people?

It is unusual. My understanding is that it happens roughly 5% of the time. Having experienced it, I would advise doing everything possible to minimize the risk.

[Manny]

MSK told me to go fat-free for 2 weeks. I doubled that and waited 4 weeks because I did not want any risk Chlyous Ascites. MSK said the condition is not very common if you take the appropriate precuations. But a few of the forum members did develop it.

[zoltar]

curious...

when i had my RPLND i was given no special instructions on diet. i asked my surgeon and doctors about going fat-free and they explained the rarity of chylous ascites. since my surgeon has done many many RPLND's i trusted her word and didn't adhere to a fat-free diet. everything was fine. how common is developing this condition? i was told it was pretty rare so is going on this diet just an extra precaution for people?

[MRMRSU]

From the wife of someone who had a lousy bought of chylous ascites, NO FISH!!! Stay fat-free for as long as you're told (maybe an extra week for good measure). Andy was eating salmon and salad with vinaigrette after he was released from the hospital (trying to desperately push for this bowel movement that the docs here seemed to focus on, only they failed to tell us about the fat-free regimen). Disclaimer (especially since NYC Russ is around): Our opinion is based solely on our own experience, check with your doc about your diet.

[Manny]

Smith and Wollensky have great Salmon and Tuna!

[Margaret]

I would say fish is definately an option...would fish be a better selection?

yes. yes, yes

[Boarder]

I would say fish is definately an option...would fish be a better selection?

[Manny]

I had my RPLND surgery on March 26 and I have been recovering well. Dr. Carver from Slan Kettering has put me on a 3 week 5g fat diet. On April 19th I am going out for a friends birthday and we are going to smith and wollinsky's Steak House. Do you think it will be alright to have a steak? Will one steak possibly cause chylous ascites? Please let me know

I would recommend you start by checking with Dr Carver or his staff.

Technically you need to go fat-free for the first 2 weeks, and then build up to your normal diet over a week-long period. You should also make sure the steak is not your first fat meal - start with chicken, pastas, and build up from there. If you got home on April 2nd, you should stay fat-free till 4/15 and then slowly introduce fatty foods. 19th may be a little too quick because it is less than a week from the 15th. Could you do fish instead?