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Saturday, May 5, 2012

Nutritional Information We Can Actually Use!

Since Alyn started radiation, he has been having a terrible time keeping down food.  I cannot think of anything scarier than to watch the person you love eat and throw up everything day after day.  I feel like we have tried everything.  Yesterday, out of desperation, we met with a nutritionist.  To date, nutritionists have not been very helpful.  This time was different.



I have been keeping a log of Alyn's eating habits to find a pattern.  Here is what we have discovered.
First and most important positive... liquids are going down easily and staying down.  Dehydration is always a concern.   My understanding is that if the patient is urinating regularly (just like counting a baby's wet diapers the first couple weeks of life), dehydration is less of a concern.  Here is a trick that I used during both of my pregnancies which is working for Alyn now.  Alyn is filling up and drinking water out of a 32 ounce insulated mug at least twice a day. Throwing in slices of lemon or orange increases electrolytes.  Another way is to drink a Gatorade or two a day.  Be careful of the sugar in Gatorade.  Both Gatorade and PowerAde have a low calorie alternative.

Second, depending on what time of day, Alyn's response to food is different.  He is taking medication to increase his appetite.  We are changing the time of day he takes this medication so that his appetite corresponds with dinner. 

Third, asking Alyn what he wants to eat is self-defeating.  If someone has no appetite or thinks they will throw up if they eat, then why would you ask them to choose which poison?  To get Alyn to eat, I have three strategies.  #1  I know what Alyn likes to eat, so when it is meal time I present him with two alternatives, so he has a choice.  #2  If I think he is not in a place to choose, I tell him what I am making.  #3  If he refuses, I go to our fall back meal.  What is a fall back meal?  It is a meal that he will eat no matter what.  That is unless he is physically unable to eat.  Some people call it comfort food.  What is your favorite food?  What makes you least sick?  What food makes you think of curling up in bed while mom strokes you and holds you until you feel better?  Chicken noodle soup?  Peanut butter and jelly?  Chocolate donuts?  Ice cream?  Pudding?  Jello?  Grilled cheese?  Mac 'n cheese.  Name your antidote.  For Alyn, it is Super Pretzels (frozen soft pretzels), melted American cheese and an apple.

OK.  So what were the nutritionist's magic ideas?  Our goal is to pack on the calories to stop weight loss and increase the protein to encourage healing and strength.  Body builders used to eat/drink raw eggs.  Can't do that anymore, not even in a milk shake.  Don't want to give our patient food poising.  Substitute? 
•There is a product called "Just Whites."  According to the nutritionist, you can add Just Whites to everything because it does not have taste, just adds protein.  Alyn is not sick of Jell-O, yet.  I can make Jell-O with Just Whites, and Jell-O becomes a source of protein. 
•Twice or double milk is another way to get protein into his body.  When following the directions to make non-fat powdered milk instead of making it with water, make it with milk.  This way you can make every recipe that calls for milk with twice or double milk and double the protein.  Add Just Whites, and triple the protein.
•Greek yogurt is a high source of protein.  I bought some vanilla Greek yogurt and blended it with vanilla ice cream, powdered almonds and a dash of honey for an amazingly yummy milk shake with approx. 30 grams of protein.
•Use Quinoa instead of rice.  1 cup = 8g protein
•Throw legumes into all kinds of dishes (for example spaghetti).  1 cup = 12 - 19g protein.
•Peanut butter has 10g protein for every 2 tbsp.
•Edamame tastes great and 1/2 cup = 11g protein
•Eat many small meals a day.  If you can only eat a few bites, eat every hour.  If you are making a milk shake, make extra and freeze a couple ounces in a Dixie cup for easy access to a tired patient that feels they can only stomach a couple bites.

Now put all this information together.  Alyn is having an easier time eating softer foods.  What are his favorite softer foods?  Milkshakes, sweet potatoes, ice cream, soup (especially matzo ball soup), bananas, Jell-O, pudding, etc. 
Do you have ideas for foods?  Please comment.
I am having a ball making milk shakes and plan to share my recipes here.

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