Puree diet challenge – Day 6+7- Lucy and Rachel

Lucy

Day 7:

Brunch: Smoked salmon pureed with cream cheese and milk, pureed avocado, pureed scrambled eggs, breakfast smoothie (banana, blueberries, raspberries, oats, yoghurt, almond milk) Dinner: Pureed beef casserole (beef, onion, swede, carrot, parsnip) with pureed sweet potato fondant and pureed leeks.

Ok, so I decided that as it was the last day of the challenge I would push the boat out a bit for breakfast. The salmon was one beautiful consistency after puree and tasted like something from a posh restaurant. I’ll certainly be recommending it to our clients for a treat (and doing it again myself when I’m feeling a bit less poor).

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A couple of the dinner items got a little burned in the process of cooking, which was unfortunate because when blended everything was a variation on a camel tone. The food still tasted delicious, but looked a bit like a dog’s dinner, probably not helped by my odd presentation. It was really hard to get the beef to a puree consistency so I’ll be recommended to clients that they cook meat for a long time before trying to blend it.

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It’s been so helpful to have the help of a friend in the kitchen. Food preparation takes quite a lot longer, having to cook, puree, scoop out (spatula is a very necessary bit of kit to avoid wastage), clean equipment, blend the next item etc etc. Bigger meals have been a joint effort (and an exercise in patience) so thanks very much Naomi! Working with our clients and their significant others to ensure they are supported is really important.

Exercises: I just about managed to squeeze my 3 sets of exercises in today. Rachel and I had made each other star charts (see bottom of page) to encourage us to complete the exercises each day. Unfortunately I didn’t actually find mine to be that helpful, and it was more of a reminder of the exercises I hadn’t completed, which I found to be a bit demoralising. It just goes to show that different strategies will work for different people, and we need to work closely with our clients to work out what will help them the most.

Rachel

Day 6

Breakfast: Porridge Lunch: Soaking solution pate sandwich and vanilla supplement drink Dinner: Cottage pie and puree mango Snacks: Green smoothie (apple juice, cucumber, carrot, kale) and Nutella and banana milkshake (fortified with ground almonds and coconut)

I found myself really craving fresh vegetables yesterday evening and finding it hard to think of ways to eat them raw but pureed. Green smoothies aren’t my normal preference of drink but it hit the spot nicely. The problem with these though is that I had an entire cucumber and carrot in there, plus a few handfuls of kale, which when eaten whole would be more than enough to fill you up as an 11am snack. But it hardly touched the sides and by 1pm I was starving for lunch (which you can see from Lucy’s blog yesterday wasn’t exactly something to look forward to!). Despite not enjoying the thickness and oral residue of the supplement drink, I can’t deny that it filled me up for the majority of the afternoon. They have over 300 calories in a 125ml bottle which would be important for someone who finds eating and drinking uncomfortable, as it means you can get the nutritional equivalent of a meal without the extended discomfort. On our placement we work closely with dietitians who help the client to work out how much nutrition their body needs to keep healthy and recover from treatment, whilst also balancing what they can manage orally with the Speech and Language Therapist.

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Psychosocial: Throughout this experience, I have reflected on how important it is to have someone to support you to maintain your diet. I wondered how we could try and get families to be included in this change of diet rather than everyone missing out. If the clients’ family and friends still prepared food together or ate some of the same foods (e.g. everyone having soup for lunch), I feel like that would preserve some of the social aspects of eating. I’ve prepared all my meals myself this week and think having someone to share the effort of the planning, cooking, blending and washing up would take away some of the stress which meal times have created. Yesterday my friend Helena made me a Nutella and banana milkshake and she’d even considered fortification for me! It was delicious and was helpful to know I had one less snack to worry about that day.

Swallowing exercises: 3/3, but a real drag. I ended up doing a set in the morning lecture with Lucy as we had both forgotten to do it in the morning; then I also had to do a set after coming back from the pub quite late. I have had my alarm set every day to do one set whilst I’m getting ready for University, one when I get home and one before I go to bed. The most consistent one has been before bed. When the alarm goes off for the other two I regularly hit the snooze button so many times that my phone stops reminding me!

Day 7:

Brunch: Vegetable and cheese omelette (blended with some crème fraiche) with avocado. Dinner: Butternut squash, carrot, lentil and coriander soup. Snack: Yoghurt

It broke my heart putting that beautiful omelette in the blender, so I immediately wanted to dislike it. But it tasted exactly the same as it would have done whole and was one of the most enjoyable meals of the week. The vegetables helped to bulk it out and improve the flavour in comparison to the plain scrambled eggs last weekend. The soup was also tasty and the swirl of crème fraiche made it look and feel like a normal meal. The hardest thing I’ve found this week is not eating chilli. I normally have chilli every single day, so even though these soups are delicious I will be adding some fresh chilli and cumin to the leftovers for next week!

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Psychosocial: Being at home today has made it much less stressful to prepare meals and have an ordinary day despite the diet. Some of our clients are reasonably young and want to return to work after their treatment has finished. I can imagine that maintaining this puree diet long-term whilst having a full-time job or studying would be really difficult and definitely something which would need problem-solving before returning. Really small things which you wouldn’t necessarily think of could become barriers, such as access to a microwave. It’s nearly impossible to have an “on the go”, cold puree option for lunch.

Exercises: Last hurrah, 3/3! I think it’s easier to stay in high spirits about completing these when you know it’s the last time you’ll ever have to do them. I can understand why patients’ tolerance of these exercises wear off after the first few appointments. Even though they are quite quick, they’re also boring, hard to do in a public place and leave your muscles feeling tired and aching afterwards.

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