Swallowing difficulty

[LoveMyKids]

Overnight it seems like my PALS is having a hard time eating because of gagging and having a hard time swallowing. My PALS does not want a peg and swallowing pills is becoming more difficult. If I can keep her calorie content high enough with smoothies, etc., is that enough?

 

[dalvin]

Max has been managing on smoothies since January or February I think

 

[cheerleader]

My husband has lived on boost plus for a year. Your pals should have a swallowing test, and they will tell you what type of foods she should be on. Do you go to an ALS clinic? That is part of the clinic day.

 

[Graybeard]

He should get the peg while he can. It will only get worse. The peg is not a bad thing, and is easily reversible. I lost weight until I went on the peg, and have gained back.

 

[lgelb]

LMK,
Smoothies, purees, Boost, whey, shakes...all good options. Your question was "are they enough"? Short answer is, yes, with a good nutritional mix and fiber, and hydration of course. Max's recipes have been posted. You can also add ThickIt, cornstarch, flour, whatever to thin liquids if those are a problem.

At some point your PALS may not be able to handle these options either, but today is today. I don't see the need for a swallowing test or a special clinic visit, but YMMV and I would definitely get started on whatever recipes you choose, to see what works best. It is not just texture and thickness that matter, but also flavors and the order of presentation, e.g. acidic food like tomato separate from dairy and all that. Also, watch spices as some can be irritating even if they weren't before.

Depending on the type of gagging, semisoft foods like cheese, tender meat, canned fruit/veg, etc. can still be options. I'd stay away from foods w/ kernels like corn, peas, berries w/ seeds, even in puree form.

Not sure what pills you have been giving, but many are available as orally disintegrating (though even these often have to be helped along) and most can be crushed/dissolved in VitaminWater. Shorter-term, you may be able to give in applesauce, pudding or similar food, crushed or uncrushed.

 

[Janie H]

I have had to switch to soft foods and I still get choked sometimes, someone mentioned smoothie recipes, if anyone has any idea, let me know. I do strawberrie banana mix and ensure with banana, I put ice in all so it's more like a shake.

Janie

 

[CGARS]

I take my pills twice a day with Boost pudding, easy and adds 600 calories.
For sure you can live on shakes/ensure alone, get creative.

 

[Schmidhogan]

One benefit to the PEG is economic. Ensure is very expensive. Formula for the tube, however, is covered by most insurance.

 

[LoveMyKids]

Thank you so much for all the help. She had a good dinner. I think we will take all of your suggestions & re-evaluate some of our food choices. I really appreciate all the responses!

 

[poppies]

Two of my husband's favourites are a smoothie made of 250ml full cream milk, a scoop of vanilla protein powder, a teaspoon of cinnamon and a frozen banana. Frozen bananas are excellent for smoothies as they make it nice and cold but especially because they thicken them to a good consistency for swallowing. I buy a bunch of bananas, peel them all and wrap each one individually in cling wrap, then put them in the freezer. They don't go brown, they are perfect to add to a smoothie at a moment's notice. I sometimes top the smoothie up with some blueberries or strawberries. The second favourite is half a cup of raw oats cooked with one and a half cups of water. I then add 1 scoop of protein powder, cinnamon, a mashed fresh banana and 125ml of milk. More milk can be added if you want to make this mixture drinkable, but I usually feed it to my husband with a spoon and it just slides down.

 

[MaxEidswick]

>Max has been managing on smoothies since January or February I think

yuck, but yup! 2.400 cal/day

 

[gooseberry]

I do 2 greek yogurts, for protein, half and half, frozen or fresh fruit. Whip it up. Gives lots of fiber,protein, and calories, You can leave half in the fridge in a thermal glass and drink it later and it doesnt seperate. I do this for Steve everyday. Sometimes we use icecream, nutella, peanut butter, cocoa,...basically whatever he is in the mood for. They are thicker so they are easy for him to get down. I dont use ice because these are thick on their own from the frozen fruit/ice cream etc. I always put in a frozen ingredient.

 

[Diane H]

I don't get it. Why have someone have to make the smoothies, feed them to the PALS, and repeat the process several times a day when a feeding tube and can of Jevity is all but effortless for the caregiver? We are all so concerned about the burden we put on our caregivers and a feeding tube would simplify things for them. Jevity is nutritionally balanced, has fiber as do the smoothies, and is available in three different calorie levels to meet the specific needs of the PALS. Cost if you buy it yourself is about $1.25 a can, probably equivalent to the ingredients of a smoothie. Smoothies, yogurt, ice cream, etc. can still be given for the taste (and taken straight as Ben and Jerry intended not converted to yuck by nutritional additives) but need not be forced down for the sake of basic nutrition.

 

[Graybeard]

I'm glad I don't have to depend on my family for nutrition. I pour a can of Boost + in the hanging bag, hook it up to my peg, and sit here at the keyboard six times a day.

 

[cheerleader]

Diane, think it has to do with the"idea" of still being able to eat! Guess it feels more normal! My hubby won't get the tube, so......