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Hip, Hip, Puree….

On a day to day basis speech therapy teams across the UK will suggest to patients and their families that a pureed diet and/or thickened drinks are advised to reduce the risk of them aspirating (which potentially leads to pneumonia) or simply choking to death on foodstuffs that prove challenging for them to swallow.  For some of these individuals it may be a short-term measure through recovery phase, for others it can be long term, in some cases that mean forever..

So our SLT team agreed it would be useful on both a personal level and to support EU swallowing awareness day, to undertake the challenge of a pureed diet for a 24 hour period.

If I’m completely honest, while I wasn’t looking forward to it, my reaction was fairly relaxed.  How hard could it be?  I like yoghurt, I love chocolate milkshake, I enjoy a bit of mash and it’s been known for me to optimistically attempt a celeriac puree after a decent episode of Masterchef professionals.

 

At risk of seeming to exaggerate, the reality was starkly different to my expectation – in short, my experience of a pureed diet was grim start to finish.  I am wary of painting too dark a picture but it is hard to flower the summary as there was little positive to report even from such a short stint as 1 day.

I expected the food to taste worse once blitzed, in some cases it did in others it didn’t.  The sweet potato puree was nice but the pea puree was awful!  The real difference was the lack of comfort I could take from the food I ate, seemingly all of the food that makes me feel satiated and happy is crunchy, chewy or crispy! I love hummus but only on a carrot stick or a crisp! I love mash but only next to a pastry crust pie!  It really brought it home that this dietary restriction takes the enjoyment from eating and ultimately, from food.   We found the food also gets worse in terms of taste as it cools – which should certainly be a consideration for relatives and care staff supporting patients. 

I also found the food made me bloated and I suffered heartburn from breakfast onwards.

Another issue which must be horribly frustrating for those following this type of eating plan is that I couldn’t quench my thirst – at all.  The easiest way I could describe it would be if you had done strenuous exercise and needed a drink you probably wouldn’t choose a thick milkshake and certainly not a thick soup! It just doesn’t hit the spot. 

The bleakest paradox is this: being on a pureed diet puts food on your mind, you have to put thought into what you will eat, when you will eat it, where you will get it from (who knew that loads of shops don’t sell milkshake!?) and how you will prepare it… so the nature of the recommendation puts food on the agenda, then the diet itself stops you feeling satisfied by the food you want and are being forced to think about.  It would also make you highly aware of any illness leading to this requirement; when I am poorly I reach to a biscuit tin, bag of midget gems and a bottle of Lucozade for comfort, in this circumstance all are off limits which for me would compound the feeling of being unwell and out of sorts.

On a mildly lighter note a thickened gin and tonic beats a thickened bottle of cider hands down!! But again the grim reality we realised is that a relaxing glass of wine is again off limits and a trip to the pub would be made much more challenging than normal.

Retrospectively it now seems glaringly obvious, of course a pureed diet with thickened drinks would have a major impact on your diet but much more than this it can really impact your life, potentially your activities and it should be considered that this could possibly go on to affect mood and morale and hydration.  This is a tough gig – 1 day was bleaker than anticipated and I feel I will be more sensitive and understanding to those who have to undertake this recommendation.

I am glad that we took the opportunity to sample this diet and I expected to be able to write a far more light-hearted and anecdotal review and blog.  The experience brought it to light that the restrictions of a pureed menu could easy push into all aspects of your life and have a far wider impact than simply a less enjoyable, worst tasting lunch and dinner.   For people whose treatment plan includes this strategy the huge positives are that these modifications can; dramatically and rapidly impact their ability to eat, reduce their likelihood of choking, immediately lessen their risk of developing painful and dangerous chest infections.  For some people, the positives on balance outweigh the drawbacks but since this challenge I feel I will have first-hand understanding and consideration of the challenges patients may face and I can now provide more support through this process. 

 

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