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I’m working on a way to get enough protein in, as well as more fruits and veggies. When I eat protein (generally dairy of some kind), it has to be OK for my kidneys and gout. That means meat, poultry, and fish/seafood are very limited. Spiraling, a type of algae (common in green and blue smoothies, and blue/green tinted foods), is among the worst for gout, with purine levels way too high to mess with. I’m not supposed to have more than 400mg of purines/day, and even that can be a problem since I can’t take enough gout meds because of my kidneys. So, I’m working on a plan to do about 1/3 of my protein intake with whey protein isolate powder via the nasogastric (NG) tube. I have to get about 1/2 of my fluids in by tube, so I figured that I’d make it worth it even more by tossing in the protein. I can adjust the amount of Isopure Clear (protein powder brand I like) based on what else I want each day… sometimes, produce and a bit of rice are all I want. #IsopureClearLowCarb
Reducing the pressure of protein intake, enables me to eat more produce, which I like and is generally safe. That could change if potassium becomes an issue, but for now, it’s open season on fruits and veggies. The ones I prefer don’t bother my stomach, and when I roast a 9 x 13 inch pan of whatever sounds good (this week it’s zucchini, mushrooms, and Vidalia onions), I have enough for 2-3 days, and can mix them with rice or pasta (still freaked out by those, but rice has gotten easier) or baby potatoes. A sourdough bread roll is also nice sometimes since it’s an individual serving by default, and those are less scary. Toss on a condiment like Korean BBQ sauce (no high fructose corn syrup- that’s bad for gout and triglycerides), teriyaki sauce, or some smoked salt and herbs, and it’s a pretty good meal.
I do have meat/poultry/seafood now and then, but I have to be sure that I measure it out, both for purines and protein. Eighty to 90 grams isn’t a lot, but I am an omnivore and do like fish and chicken (especially smoked), so I just appreciate having them at all. Most of the time, I’m a lacto-ovo vegetarian because of gout. I don’t have the stomach capacity for the fluids I need (if I drink them) AND enough plant based protein, assisted by dairy, so I generally end up deficient in something and feeling like a beached whale with bloating. It’s too miserable to even bother with at this point, but the protein powder via tube has been helpful. Whatever works and doesn’t hurt seems to be a decent way to get enough in.
Eventually, I’m going to have to eat and drink without the tube, but while I’m getting through this rough part of figuring out this recovery stuff with YouTube, books, and other media, this seems to be a solution that reduces stress, and increases the variety of fruit and veggies I can get in. I forget which video I was watching, but it suggested aiming for 15-20 different types of fruits and veggies per week. I’m starting out with 10, and will see how that goes, and then increase the variety that fits with my budget. Produce is very expensive in the US (like $9 USD for a pint of organic blueberries vs $5 for a 300 gram bag of frozen ones; my days of ‘luxury’ organics are over), but I do like some of the cheaper options like apples (about $1 each), pears, clementines, bananas, mushrooms, zucchini, spaghetti squash, and potatoes. The others will be seasonal items, which should help avoid flavor fatigue.
I’ve never been much of a bread eater, but found a very good (and flexible) subscription company for sourdough rolls (they also have bread, but I’d waste too much of it), and different types of croissants. I’ve never really liked croissants because the grocery store ones are full of junk that isn’t needed, to extend shelf life to near immortality, and they taste a bit ’embalmed’. Wildgrain products don’t have unnecessary stuff in them, and bake up in 25 minutes or less from the freezer, so always fresh. The individual servings are also helpful with bread as well. There is a decent amount of protein in the ham and cheese fold-overs, and even the rolls add a little. I’m trying to add more stuff that ‘normal people’ eat.
I don’t like that I have to deal with medical food restrictions while working on not restricting, but all I can do is make the best of it. I don’t like the NG tube, but kidney function has already been stressed twice in the last 5 years when I went into acute renal failure from not enough carbs (once during the time I was supposedly being ‘monitored’ by the ex-therapist). Fortunately, I was able to get it turned around. The dehydration and increased workload on the kidneys from so much protein and ketosis are bad news with known kidney disease, but those with normal kidney function can still be impacted.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10121483/
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