The Process


Blending meals for use by g-tube dependent persons isn’t really hard.  Here are some pics of my process.  I cook the meat in two pans while the various vegetables are soaking in a water/vinegar bath. Then I set up my assembly line and blend one batch after another.

Setting up the assembly line

 

Blender and meat

 

 

 

 

 

 

 

 

 

 

End Result

 

 

 

 

 

 

 

 

 

I find it is much faster to make several batches of food if I get the meat mostly cooked, get all the vegetables, etc. prepared and then blend one batch after another.

You’ll notice some of the batches are the usual green (thanks to spinach) and some have a reddish-brownish tint.  That is because of adding beets.  More in my next post!

No Guilt Allowed


Life is hard, no?  Looking at the news footage of recent events in the USA, tornadoes, earthquakes, hurricanes, it reminds me that we each get hit with storms – the storms of life.  Some of us live in a perpetual storm, of sorts.   Living with chronic, complex care needs is a storm, imho. If you are not currently feeding via blended meals, but hovering on the periphery considering it, please DO NOT FEEL GUILTY!  In my emails, my signature includes a quote from Lori Borgman.  I don’t know Lori but I like what she says:

“I even wonder how you endure schmaltzy pieces like this one — saluting you, painting you as hero and saint, when you know you’re ordinary. You snap, you bark, you bite. You didn’t volunteer for this. You didn’t jump up and down in the motherhood line yelling, “Choose me, God! Choose me! I’ve got what it takes.” You’re a woman who doesn’t have time to step back and put things in perspective, so, please, let me do it for you. From where I sit, you’re way ahead of the pack. You’ve developed the strength of a draft horse while holding onto the delicacy of a daffodil. You have a heart that melts like chocolate in a glove box in July, carefully counter-balanced against the stubbornness of an Ozark mule.”

So as you sit there wondering “if” you can do this blended meals thing, “if” you want to even undertake such a task, give yourself a break.  Your energy might be maxed out with what you are already doing.  Each of us can only do so much. If you need to, wait.  Or decline altogether.  And please, don’t feel guilty.  Please. There are storms enough, without giving ourselves a guilt storm.

“This man beside us also has a hard fight with an unfavouring world, with strong temptations, with doubts and fears, with wounds of the past which have skinned over, but which smart when they are touched. It is a fact, however surprising. And when this occurs to us we are moved to deal kindly with him, to bid him be of good cheer, to let him understand that we are also fighting a battle; we are bound not to irritate him, nor press hardly upon him nor help his lower self.” Rev. John Watson aka Ian McLaren.

Also quoted as:  “Let us be kind, one to another, for most of us are fighting a hard battle.

Recipe


Making blended meals to feed via g-tube is not really complex.  I am convinced that anyone can do it!  Putting effort into the nutritional value of blended meals is just like putting effort into the nutritional value of our own meals. I strive to feed my family meals containing lots of fresh vegetables, fruits, grains, nuts and good proteins.  Very often I can take the leftovers of a family meal and blend them up into a meal for my 13 year old daughter, who is tube fed.  I’ll add more leafy greens or whatever I feel is needed to balance out the leftovers.

Today I am experimenting with escarole and quinoa.

Escarole

Endive

Endive is the cousin of endive.  They have very similar (identical?) nutritional profiles.

All leafy greens contain anti-oxidants which are thought to be important for best health and cancer prevention.

Escarole and endive also contain calcium, Vitamins C, A, Calcium, Phosphorus and Iron, Thiamine, and Niacin.

Escarole and endive have a slightly bitter taste to them and I don’t normally like that kind of taste, so I haven’t served these greens to my family in the past. Well, Natalie is my guinea pig! Of course, she will not actually taste it, but her blended meals will familiarize me with escarole and then putting it in a salad is just one step away!

Today’s recipe also includes broccoli.  I have advised against broccoli in the past because it is a cruciferous vegetable. These vegetables tend to produce varying amounts of gas in people. I have blanched the broccoli, enough to break down the crunch-factor a bit, hoping to reduce the gas production. It seems that ingestion of digestive aids, like pineapple, papaya, and perhaps lemon juice or vinegar can help the body in the processing of these vegetables.  I have not found any studies that support this, however.

Back to the recipe: I’ve mentioned quinoa before and I really like this “grain”.  It is actually a protein AND a relative of leafy greens!

Recipe:

1 cup cooked quinoa

1 c. cooked broccoli

1 c. liquid used to cook broccoli, or more as needed for consistency

1 c. water

2 c. escarole

1 tomato

½ c. walnuts

1 c. fresh pineapple (or canned in its own juice)

Blend and refrigerate.  Feed as you usually do for any other blended meal.

Calories:

Quinoa has 250 calories in 1 cooked cup.

Pineapple has 149 when including the juice

½ c walnuts has 91 calories

The broccoli has 50 calories, tomato probably only 10 – 20, escarole only about 20. So we are getting a total of approximately 600 calories for 7 – 7.5 cups when the air is slowly blended out.  That means it is only 10 calories/ounce.  By adding ¼ c. olive oil to the recipe, we add only  4 ounces, but 480 calories, bringing it up to … let’s see 1080 divided by 64 = 16.875 calories/ounce.  Still a bit on the lean side, but very healthy.  Olive oil is a good fat, and no offense, but your brain is about ⅔ fat, and needs fat in order to, believe it or not, maintain the correct electrical conductivity of the cells! Olive oil’s main component is monosaturated oleic acid.  Oleic acid is one of the most common fatty acids in myelin: the proective sheath the covers communicating neurons in the brain.    Drink up!     ;D

Perhaps this recipe is a once-a-day recipe, as opposed to a three-times-a-day recipe. Finding protein sources (like quinoa) other than meat has been established as a very smart health practice. I will be working on more quinoa recipes in the days to come. One of them is for me – I found a recipe for a quinoa, salad greens, strawberries, blueberries, watermelon salad. Sounds great, doesn’t it?!  Come on over for lunch!

Communicating With Doctors


Here are some previous posts about communicating with doctors and other medical personnel.  This is one of our most important AND challenging jobs as parents/managers of chronic, complex care needs.

Keep Asking Questions

Doctors and Communication: You Don’t Have to Get Angry  

Managing Fear in Medical Emergencies

In All Honesty

Need a different button?


I recently received a helpful comment from one of my readers! YAY!!! For those of us managing a chronic medical condition that requires g-tube feeding, there are few resources better than other people in the same situation.

An old post of mine on G-Tube Care and Maintenance, here, prompted this comment:

“I know this is an old thread but I just wanted to leave a comment. We had the same problem with the mickey and was told by the GI doc this was a “standard” looking stoma: leaky, mucus, bleeding, uncomfortable. We switch to the corflo cubby and it dried up and granulation tissue went away. We are having trouble now because we think he needs a new size but it is sooo much better than a micky. That shouldn’t be the standard.”

Here is what their website says:

The CORFLO cuBBy® is a skin level gastrostomy device that utilizes either a right angle feeding set or a bolus feeding set to feed. It is made from medical grade silicone, and has a unique petal design, which offers comfort and reduces stoma irritation (emphasis mine).

If you are dealing with a difficult g-tube site, it sounds like the CORFLO cuBBy would be worth checking into!

Tubies and Vitamins


When feeding a person via g-tube for medical reasons, formula is one option.  Blended meals are another option.  I have been feeding my daughter (who is nearly 13 years old) blended meals via g-tube for several years.

There are several issues to take into account when feeding blended meals. We can inadvertently cause things like hypothyroidism due to a lack of iodine in our Tubie’s diet.  Most of us don’t have to worry about iodine deficiency because it is contained in lots of foods, in small amounts.  It is also often contained in processed foods because of iodized salt.

Sea salt and kosher salt, however are not iodized.  The USA used to require that all table salt be iodized in order to decrease iodine deficiency leading to hypothyroidism. (Hypothyroidism can produce many results including (but not limited to) fatigue, sluggishness, increased sensitivity to cold, dry skin, pale and puffy face, hoarse voice,  yellow skin, brittle hair and nails, sleepiness, frequent choking, constipation, poor muscle tone, delayed puberty, poor mental development, high cholesterol, goiter.) Hypothyroidism produces different effects at different ages.

The thyroid gland produces hormones that are critical to bodily functions. Iodine helps the thyroid gland produce the necessary hormones.  Keep in mind that it is possible to have an excess of iodine as well.

What to do?!?!?!?!

  • When I make blended meals for Natalie, I include meat.  When I cook the meat, I salt it with iodized salt.  Not heavily – just like I would if I were serving it to myself or the rest of the family.
  • I give Natalie a vitamin that (as most do) includes iodine.
  • I have her blood tested once a year for the amount of hormones produced by her thyroid and pituitary glands.

According to the Mayo Clinic, everyone needs about 150 micrograms of iodine a day, which is especially important for infants, children, pregnant and lactating women. Seafood and seaweed contain iodine and foods grown near the coast as well.