A-ha-ha!
You probably don't actually WANT to do this. It's not on most people's Top 10 lists. But it can be done and it is far, far healthier for the eater (MHO) than a diet totally made up of formulas like Ensure, Jevity, etc. Hospitals and dieticians will deny this; that's okay. You are in charge of your eater's food. (Do see my recent post with a letter from a dietician who gets it...) and see also my sermon* below
About us: A little context always helps. My husband Ken was diagnosed with squamous cell carcinoma of the head and neck in May 2011. It was discovered via biopsy of a lymph node that had been swollen for several months. There was no visible sign of the cancer and he had to have several biopsies to find the primary sites in his right tonsil and base of tongue. We were fortunate it was discovered so early; he didn't need any surgery prior to treatment. He is 61 years old and never smoked, drank moderately, did not test positive for HPV.
I am aware that feeding an adult is entirely different than feeding a child or cognitively disabled person. In the first case, your amounts and possibly foods would vary. In the second case, if the person were not cooperating or were actually fighting against the tube feeding...it would be extremely difficult. So, I hope this information helps you, but your mileage may vary.
And, please do understand that I am not a doctor or any type of medical professional. My views are my own and represent only my own knowledge and beliefs, distilled from a good bit of research. Take what you like and leave the rest.
PUBLIC SERVICE ANNOUNCEMENT
Did you know that Human PapillomaVirus (HPV) is the leading cause of head and neck cancer in men? What this means is that men from ages 9-26 (at least in the US) can be vaccinated against HPV and their risk of contracting the disease that caused me to write this post can be greatly reduced. See this link for news about the linkage and also the Centers for Disease Control website for more detail. Please share this information widely. If we can prevent just one case of this horrible disease through the spread of information, my work here will be done. :)
SECOND PUBLIC SERVICE ANNOUNCEMENT (or, SERMON)*
Did you know that cancer eats sugar? Cancer LOOOOOOVES sugar. If you were doubting that, just think about how a PET scan works (this is the type of test used to determine whether and where cancer is present in a body.) Check this out from PetScanInfo.com:
Before a PET/CT scan, the patient receives an intravenous injection of radioactive glucose. Many cancer cells are highly metabolic and rapidly synthesize the radioactive glucose. Information regarding the location of abnormal levels of radioactive glucose obtained from the whole-body PET/CT scan helps physicians effectively pinpoint the source of cancer and detect whether cancer is isolated to one specific area or has spread to other organs.
So, the procedure is that the patient gets an injection of radioactive glucose. They sit very still and quiet under a warm blanket for about an hour, then they are put into the scanning machine. The waiting period allows all the glucose to go to the area of inflammation in the body: the cancer. (Moving around during that time would cause it to go to muscles, etc.)
Here is a picture of three different kinds of scans on the same person. The PET is on the right:
See all that beautiful rainbow of colors? That's where the cancer is, going "nom nom nom" on the nice sugar that was just provided to it.
So it seems to me (and someone will correct me if I am not correct here) that: Cancer patients should avoid sugar.
And formulas? Are made of sugar, with vitamins and other nutrients added. Seems like a great reason to stay away from them - to me. (STEPPING OFF OF SOAPBOX)....
SO: BLENDERIZED RECIPES AND FEEDING
- The essential thing to remember is that anything you can eat by mouth, you can blenderize in a machine like a VitaMix or a BlendTec. (I don't care which one you use; I have a VitaMix and it works great, but I've heard good things bout the other, too. Do your own research there.)
- I’ve found with my VitaMix that I get best results at liquefying things if I:
1) Add a sufficient amount of liquid…enough to cover or just slightly “float” the other items in the blender carafe usually works, at least to start with
2) Warm the ingredients before blending. Ken preferred blends at approximately room temperature, so that’s what I was going for…but just-cooked food works fine, it will cool off or you can drop an ice cube in it. What you don’t want is to blend cold ingredients. Yucky.
3) Add items in stages, with the big / tough ones on the bottom…like chunks of meat. Get them mostly blended before adding other things.
4) Increase blend speed slowly from 1 to 10, holding onto the top of the carafe if it’s jumpy. Then flip to 1½ minutes on High speed; that should be enough to liquefy everything well enough for tube feeds.
5) Oh, don’t leave a spoon in the carafe when you turn power on. You will have to buy a new carafe. (Sad Face.)
OTHER GENERAL COMMENTS
- I prefer stock to broth if buying it at the store. Better nutrition. And I used A LOT of stock this year…so most weeks’ shopping included a couple big fat rotisserie chickens from Sam’s Club, which I ate and included in blends, and the carcasses of which I used to make stock (add a little apple cider vinegar to help soften the bones and bring out minerals).
- For feeding with syringes (using the plunger): Regular bolus syringeswith the big rubber stopper (see photo at right) are intended for ONE use only and will get harder and harder to use as you wash them. My often-sore hands were miserable trying to force the plunger in for feeds, and we had several messy accidents. Two words: Squirrel Syringes! These are great syringes with O-rings instead of the wide rubber plunger, and they work GREAT and last forever. After a while you may need to oil the O-ring and the bottom inside of the barrel the first time it’s used after a wash. They are called Squirrel Syringes because you buy them from a place that sells supplies for feeding orphaned birds and squirrels. The one I used was The Squirrel Store http://www.squirrelstore.com/ and they are available under “Rehab Supplies.”
Below is the O-ring syringe from Squirrel Store. So nice. It IS food-grade plastic...someone from the Blenderized Diet discussion list worked with the Squirrel Store folks to determine that.
- Toward the end of tube feeding, Ken determined that gravity feeding was more comfortable for him than using the syringe with the plunger. I needed to make blends thinner for that. This can be accomplished with more broth, water, etc.
- If a blend doesn’t have much fat in it you may want to add some cold-pressed flaxseed oil or coconut oil. Both are good for health and weight gain and the fat helps the blend to flow.
- As Ken started to feel better (at least paying attention) I made sure that all the blend combinations “made sense” so that he could taste a tiny bit of it. I was trying to get him to connect what he was getting for nutrition with the tastes. In general, you can blend anything and it doesn’t matter what you put together because, as we said when we were kids,
“it’s all the same once it gets to your stomach.” But if a mouth eater were to get juice, meat, and milk in one blend it might not taste great. It was a good theory; HOWEVER, what we didn’t know at the time was that radiation had caused a stricture in the esophagus and it was only about 2 mm wide. So he couldn’t really swallow anything, anyway. (Now that he’s had a dilation that’s getting better.)
- If the blend is foamy after blending, adding a little bit of water and a quick stir usually helps. Foamy blends = gassy eaters. Not good.
- It didn’t usually work to keep blended food more than 1-2 days in the fridge. I did freeze a lot of 2-cup Glad containers of food and that helped, especially when things would get crazy and I didn’t have time to make up a blend before I left for work.
- We went to Galveston with friends while he was still tube feeding and I pre-made and froze all his food for the week. It worked out fine.
- I always steamed veggies besides things most people would eat raw, like lettuce and tomatoes. Raw veggies upset his stomach.
WHAT TO BLEND
- My basic formula was to try to create a meal’s worth of nutrition in each blend. Getting that to include enough calories in the amount of food that the eater can tolerate is tough. I found that protein was hugely important there. Quinoa is a great source as are wild-caught fish & other meats.
- Here are some combinations I have used with good success. Quantities, I had to eyeball it. I learned pretty quickly. I could usually get enough for two feedings from one blender carafe. (Ken could only tolerate about 2 cups of food at a time…part of the reason his weight gain has been so hard.)
- Salmon, Quinoa, Spinach, Stock
- Pork Roast, Brown Rice, Collard Greens, Stock
- Blackeyed peas, quinoa, green beans, corn, stock
- Roast chicken, peas, romaine lettuce, tomatoes, stock
- Banana, berries, protein powder, V8 Vegetable Fruit Juice
- Lactaid Milk, protein powder, berries, spinach or kale
- Yakult is a probiotic that comes in 5-packs of little bottles. It’s by the yogurt in the dairy case. I added it about every other day to the breakfast blend. It helps keep or get the gut flora to the right place…we had a lot of trouble with thrush due to chemo.
RECIPE SOURCES
- I also made a lot of recipes from www.DrinkYourMeals.com but added flax or other oil to most of them as they are Zone Diet balanced. I needed my eater to gain weight, not lose or maintain it. You can get a free account on there as a tube feeder, and it includes advice from a dietician. They also have a Facebook group with the same name.
- A great resource is the blog at http://youstartwithatube.blogspot.com/ There is a Facebook group for them called Blenderized Food for Tubies.
- Great Q&A help at the Yahoo! group called Blenderized-Diet. You need to join the group to participate, but I found it very helpful.
- The People's Pharmacy book called Recipes and Remedies. Good information, too.
- Several library books I got from my local branch library. I had them working overtime getting me books on cancer caregiving, cancer nutrition, etc.
WHAT DIDN’T WORK FOR US/CHALLENGES
- Any kind of commercial formulas . I hope this is not true for you. I think an all-formula diet is not good, but if your eater needs to gain weight, they are a big help.
- Blending scrambled eggs. Too foamy.
- When Ken was in the hospital for a week in early December, I really had to work with the staff about his food coming from home, from me. They wanted us to try a formula, and given the difficulty we'd had with getting weight on him, I was willing. Sure enough, he got nauseated after a few hours.
Their main problem seemed to be, not whether he was getting sufficient nutrition, but where I could store the food. Early on I was told there was nowhere I could put it in a fridge or freezer. REALLY? I finally threw a little fit and after some bickering among the staff, they found a place for it.
The hospital was 3 blocks from our house, so I could go home and make more food, BUT that always seemed to mean I missed a doctor visit. Not good. One time I even went at 4 am to ensure I didn't miss a doctor...and I still didn't get back in time. :)
