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Cath’s turn – The puree and thickened fluid challenge.

I’m just coming towards the end of my day’s challenge. I’m so glad I took part in this and although it’s been difficult at times I can honestly say I’ve enjoyed the experience. We take so many things for granted in our everyday lives, eating and drinking being two of them.

The planning, shopping, preparing and cooking for this challenge has required much more thought, time and effort than I imagined. Despite all of this though I didn’t find actually eating the food too bad, in fact I was pleasantly surprised! My meals tasted good and filled me. I find making the food look good on the plate helped.

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Lunch at work – minced beef, potatoes, mushy peas and carrots with sweet potatoes
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Xmas pud
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Stage 1 cider
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Stage 1 cappucino

 

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Breakfast – Ready Brek and puréed apple

Tonight I even ended up going through my kitchen cupboards to see what I could puree for my pudding! I found an individual Christmas pudding (still in date I might add!). I blended it with custard – it was yummy!

I struggled with the thickened fluids though, I found they didn’t satisfy my thirst and I craved for a normal drink of cold water all day. To celebrate the end of my challenge I thickened a cold cider. It had quite a head on it but it remained fizzy and tasted ok. I’ll not be having more than one though!

 

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Puree and Stage 1 Challenge – Jen’s turn!

Having completed the stage 1 and puree challenge on Tuesday, I’ve had some time to muse about the experience and discuss with friends and colleagues.

Enjoying cooking and food I had relished the thought of the challenge of making tasty puree options but I soon realised that a challenge it really was.  It’s made me reflect that this had been a choice for me but for many of our patients, diet and fluid modification is a necessity to ensure that swallowing isn’t difficult or dangerous,  and often lasts longer than a day!

My husband who is always up for a challenge also accompanied me on this puree challenge experience.  I soon realised the anxiety that this instilled in me, will he eat enough? What will he have? What snacks can we modify? Etc etc.  This really opened my eyes to some of the worries that having someone close to you on modified food and drink can elicit and reminded me of how emotive eating and drinking is.

I also must question how balanced what we ended up having was.  It felt very dairy heavy!  This stressed the importance in my mind of the involvement of our Dietitian colleagues with patients with swallowing difficulties.   Lastly it has given me a massive amount of respect for the catering department in our hospital for meeting the challenge of providing balanced modified diets every day for patients with swallowing difficulties.    

This is a summary of my experience…

Lots of preparation and use of Tupperware the night before! The dishwasher also got some serious use!

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Pureed porridge and morning stage 1 cup of tea

 

lunch
Thick parsnip soup, pureed tinned fruit and stage 1 squash

 

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Dish of the day – Cumin roasted veg and houmous

I’m really grateful for this experience and I found it very powerful to walk in my patient’s shoes for a day.  The insight it’s provided me with is invaluable; I had numerous ‘ah ha’ moments throughout the day.  I recommend any Speech and Language Therapist working with people that have swallowing problems to give this challenge a go.  

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First Forays into Puree…

First of all I should confess to have found the puree diet challenge more difficult than I imagined I would.

Part of this is probably due to the combination of the food plus drinking thickened fluids combo. We thought we’d go all the way and do both.

It has not so much been finding foods acceptable to eat in pureed form or their preparation, both of which have appealed to my inquisitive side and certainly provided food for thought (!)

What I hadn’t anticipated was the difference in th physical sensation of eating: I have felt a noticably ‘heavy’ feeling in my stomach throughout the day, accumulating with each newly ingested morsel. The closest parallel I can think of is drinking too much fluid quickly – that kind of ‘I’m a life bouy’ inflatable stomach feel. I think there’s a feeling of fullness from liquids that lacks the satisfaction I’d get from a range of solid textures. Not to mention a developing queasiness.

I actually haven’t consumed a wholly different diet to normal for me:

– 1L of Smoothie for breakfast

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Breakfasting in my car…no change to the daily commute there

 

– 1 cup of coffee

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– 1 hot chocolate

– 1L diluted squash

– Mushroom soup

– a greek yoghurt with fruit puree

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– Mashed potato, carrots, cauliflower and steak in gravy

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Winner winner pureed beef dinner

 

Actually, looking back at it like that makes me realise there are quite a few things different about it.

– I wouldn’t usually drink a smoothie instead of eating raw fruit. Why? Because I like crunch! I would miss that. I like that it takes me a while to eat it and feel full.

– I would drink many more hot drinks than this a day usually. (Note the absence of the cup of tea, one of the most prized of drinks for many folk and most lamented for those who are on thickened fluids.)

– I would snack a lot more during the course of the day – much more difficult to do when your options are strictly limited. Not many snack foods are puree (puree = preparation). Though I didn’t actually need to prepare much other than the drinks (one of which enthusiastically prepared by my colleague Jen!) and my main meal.

My other thoughts…

I’m pretty sure my coffee went cold quicker…was it all that whisking that did it, Jen? I also had a sweetener in my coffee where I wouldn’t normally.Possibly to make it more palatable? Dinner went cold too – a thin skin developed on microwaving.

My smoothie separated and required shaking to get it to the right consistency. Basically you need to have your wits and what not about you to keep shaking it.

But these are little details.

I like to think that like a lot of changes, adoption of a diet like this would be more manageable with time, preparation and psychological adjustment. After all, it’s but one day in my life so far.

But ultimately I think it’s going to depend on the person. You might not know how you’ll react or cope within a situation until it arrives. I certainly didn’t correctly predict my own feelings. Perhaps I’ve learned not to second guess or predict – myself or others.

Having said that, I do think I’ll enjoy a cup of tea in the morning.

Puree Diet Challenge

In pursuit of Puree

In celebration of EU Swallowing Awareness Day 2017 I, along with my esteemed colleagues in the speech and language therapy department at Chesterfield Royal Hospital, will be embarking upon a one week venture to experience eating and drinking differently; to purely eat pureed food and quench our thirsts’ with only thickened drinks, modifications which we regularly recommend to our patients to support them to swallow safely.

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Blenderrrrs ready!

A lot of my friends, family and colleagues would I’m sure admit themselves not to know much about how SLT’s assess and manage swallowing difficulties and less still about the measures for modifying diet and fluids. As the bread and butter of my work, I feel as though I can profess to know a good deal about this area.

And yet how much can we truly understand without experiencing for ourselves?

And so it is that we embark on the puree challenge. Wish us luck!