Well, definitely some lessons learned from Day 1. Similar to Rachel, I also found myself reflecting on the impact of having to turn down food offered to you. My flatmates had made absolutely delicious looking dumplings for Chinese New Year, and it was a real wrench to say no to them.
Being a last minute sort of person, I thought I would be able to get by just taking each meal as it came, but this turned out to be a big mistake. I hadn’t planned on how to get all of the nutrition I needed into each meal and I found it really difficult to fit the diet modifications around my normal routine. A lot of the clients that we see will eventually be returning to work, and yesterday’s experience really made me think about the extra level of organisation required for them to stick to a modified diet, whilst keeping up with all of life’s normal responsibilities.
Breakfast: Porridge with honey and ground almonds. Lunch: Blended parsnip soup fortified with mashed baked potato. Dinner: Puree beany stew, cauliflower mash and creamed spinach.
Breakfast: I struggled with my porridge on day 1. My oats were too chunky, which meant that the whole process of blending down to the right consistency was a real faff. By the time I’d finished, my porridge was cold and unappetising. Learning from my mistakes, today I blended the oats down to a powdery consistency before cooking (note to self, put lid on before blending dry oats), which was much more effective. I love porridge, but I was still jealous of my friend’s buttery toast.
Lunch: I came home for lunch and made a roasted parsnip soup with a baked potato blended in to fortify it. The soup turned out to be rather nice, especially as I added loads of rosemary in. Fresh and dried herbs can be really useful to add flavour for our clients, especially when taste changes following radiotherapy and chemotherapy might mean that salt or spice are too strong to use.
I wanted to make enough food so that I had lunch prepared for tomorrow, and suddenly realised I didn’t have the right Tupperware to be able to take puree consistency lunch and snacks with me to uni. Off to the shops to buy something that hopefully won’t spill all over the place- so much planning is necessary!!
Dinner: I felt a bit bored of eating just one flavour of food, so I thought I would have a go at a few different kinds of puree in one meal. It was a bit more hassle, but I had the help of a willing friend (thank you Naomi). It turned out to be tasty and definitely good to have more than one thing on the plate to look at. Although there were lots of different tastes, not having different textures meant that by the end of the meal, I wasn’t really enjoying it anymore. It’s a tough challenge to keep meals interesting on one consistency. Having smaller portions and a separate pudding might be a better way to get more nutrition in without getting bored.
Swallowing exercises: The swallowing exercises don’t take a long time to do, but they are still somehow difficult to fit in. In the rush to get ready and go out in the morning, five or ten minutes can feel quite precious. I also didn’t feel comfortable completing the exercises in front of other people during the day, so I had to wait until I got home to do them. (see picture for example of jaw exercise- figure-of-eight/chewing like a camel). I set an alarm on my phone to tell me when to complete the exercises in the evening. This might not work for everyone, but it was a useful strategy for me.
Today’s key lesson: Planning makes a real difference, both in terms of meal preparation and completion of the exercise regime. I’m going to continue to work with clients to establish set times in their days to complete exercises, as it really does make a difference in making sure that they get done.
Psychosocial aspect: I really felt like the diet and the exercises took over my day today. It took a long time to cook and blend meals which were nutritious and appetising. Bearing in mind that our client group also have to manage their medications, and in some cases also think about additional enteral feeding throughout the day, I can understand how tiring and frustrating living with all these changes could be.