Day 2: Breakfast: Porridge. Lunch: Carrot, lentil and kale soup and strawberry custard. Dinner: Puree sausages with gravy and swede
Day 3: Breakfast: Porridge. Lunch: Carrot, lentil and kale soup and strawberry yogurt. Dinner: Chicken and mushroom pasta and broccoli. Snacks: Banana and pear milkshake, peach puree.
For starters, I will never ever recommend yesterday’s dinner of pureed sausages and gravy with swede. A friend casually suggested it to me and in my head it sounded pretty good, how bad can adapted bangers’n’mash be? The sausages were so strong and meaty and peppery and were barely edible for me, let alone the clients who we see. Plus just look at it!! The lack of salt, pepper, spice and acidity are really restrictive and make a puree diet even less interesting. As Lucy mentioned, the same consistency throughout a meal can get pretty boring, but the restriction of flavours makes it even harder to get excited about food. The soup I’ve had the past two days is nice, but a kick of chilli would make it really delicious. But instead I blended in some fresh coriander which helped make it feel slightly less stodgy. The milkshake was also difficult to balance as lots of fruits would be too acidic, hence the slightly odd (but actually quite nice) combination of banana and pear.
The washing up and preparation in a puree diet is endless! Alongside the average washing up there’s also all the Tupperware from the day’s meals, the blender and other utensils. It takes a lot of pre-planning and preparation to make meals the night before when you know you’ll be out the next day. I think if I were on this diet for a longer period of time I would find it more and more difficult to understand what the point of making home-made and enjoyable food would be if I then had to put my hard work in the blender and is unenjoyable anyway. Tonight’s dinner was a ready-made sauce and although I didn’t particularly enjoy it, I was just desperate for something to fill me up without taking too much time. I think it would be easy to start drifting towards ready-made sauces and microwave dinners, which in the long-term would have health and financial consequences. Considering that we are giving these people diet advice in a period of uncertainty when they are in shock from the process of going through treatment, they are unsure of the outcomes of their treatment, they may be faced with changes in work or social circles… You can empathise with the fact that all this time, effort and planning put into meal planning may not be their top priority.
Without going into the details, there is another aspect of being on a puree diet which I had never considered: The effects on your stomach. I’ve had a stomach ache for the past two days, which last night was so uncomfortable I found it difficult to sleep. It’s hard to stay enthusiastic about prepping puree meals when you feel groggy and tired. Normally when the dietitian is in our joint appointments, I will tend to look down at my papers and politely not make eye contact as they ask the standard questions of “how are your bowels? And passing water?”. But I can understand how important that is from our perspective now as well. Having a stomach ache and feeling a bit rough makes us all go off our food a bit, but when it looks unappetising, is a massive faff and you know it’ll make you feel worse, you can understand why you might go off the idea of food entirely. Especially when they’re still coping with the nasty after effects of their cancer treatment and feel generally unwell as it is.
Swallowing exercises: Since Day 1 when I forgot to do any of my practice until 8pm and then crammed in two sets before bed, I have had reminders set on my phone telling me to do them. Remembering to do them since hasn’t been a problem, but wanting to do them is a bit different. I live in student halls with paper thin walls and had already had a couple of gentle comments about the loudness and frequency of my blending, I feel really awkward about one exercise in particular: The high ‘eee’. In this exercise you have to produce a high pitched ‘eee’ sound for 5 seconds and repeat three times. I have even started doing this in the shower in the morning or whilst using the hand drier in the toilet cubicles at university in the hope that people might think that it’s a mechanical sound rather than me!! Otherwise I don’t mind doing the exercises, they are quicker than they look on the sheet which is useful information to share with clients.
Psychosocial: Today is pancake day which made me consider the strong social element of a day centred around food. Whilst living at home it was always a social event for everyone in the family to get together, take turns flipping the pancakes, sitting and eating them together… If I had dysphagia and was living with people who were really enjoying this food-driven event, I can appreciate that isolating yourself from the situation would be much easier than trying to participate and feel like it was being rubbed in your face a bit. I didn’t have a go at making pancakes, but I do know that Lucy will be having blended pancakes tonight and the review will follow tomorrow.
Instead of pancake day, I decided to go to a gym class. I generally like to go to the gym 2-3 times a week as a stress buster, so was determined that I would maintain an ordinary week whilst on this challenge. I was nervous as hunger, stomach aches and a work out might not be the best combo. But I kept up with the class and didn’t feel dizzy or nauseous. My stomach even felt a little better for burning off some steam. However getting back home at 9pm and not having an easy dinner to hand and knowing I would have to prepare everything tomorrow was a bit deflating.
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