Cooking food in advance for an immunosuppressed person

August 22, 2014 2:32 PM

I am organizing (and cooking) meals for my boss and his wife. He was just diagnosed with cancer and has started chemo. I need ideas for the kind of meals I and others can prepare for a person with a compromised immune system.

I'm distributing this PDF as a set of general guidelines.

I don't know why this is intimidating (well, yes I do -- I don't want to kill my boss), but I need some ideas for foods or recipes that meet the following criteria:

• Can be made in advance.
• Can be reheated to a safe temperature (boiling for soups, 140 for other foods, per the PDF above) without getting soggy or curdled or otherwise gross.
• Freezable is preferable, but again see the point above regarding reheating.
• No raw foods whatsoever. (Not in the PDF, but an edict from the boss's wife.)
• All vegetables must be well cooked.
• Must be healthy, and not too pasta-heavy. (Trying to avoid a surplus of baked pasta dishes.)
• Easy on the stomach (nothing too spicy, cream-laden, etc.).
• Easily transportable and no assembly required once delivered.

I'd appreciate any suggestions about food, or any other suggestions about organizing meals/feeding a cancer patient.

We've already set up a community on Lotsa Helping Hands, so the basic logistics of sign-ups are worked out.

posted by mudpuppie to Health & Fitness (9 answers total)

That guideline document is great, but it's really detailed.* I'm immunosuppressed and I couldn't even make my way through it without losing focus! ;) To that end, I think this list distills the most important points, and you might want to put this in the email that you send out along with the PDF so that people have an easy "cheat sheet" for what they can and can't do.

Please do not include meals that contain any of the following:
- Non-pasteurized dairy products
- Soft or moldy cheeses
- Deli cold cuts/meats
- Miso or tempeh-based foods
- Smoked or raw fish
- Raw honey
- Raw eggs

These are all kind of surprising for people (except the raw eggs and unpasteurized dairy probably), so I think it's helpful to highlight them.

So, here are some good recommendations:

• Turkey meatloaf - I substitute sunflower seeds for the pine nuts for financial reasons. This can be made in a disposable meatloaf pan and freezes super well. It's super moist and reheats so nicely. I love this meatloaf.
• Hearty beef stew - Again, this recipe freezes nicely. If you don't want to use wine, beef or chicken broth from a can is fine.
• Creamy red pepper soup - Serve without the mascarpone cheese; it's still good. Again, sub in chicken broth for the white wine if you'd like.
• Calzones can be prepared and frozen and baked right from the freezer. So can lasagna etc.
• Chicken pot pies, too!

Thanks for doing this. It's a huge help for your boss and his wife, and you're very kind and thoughtful to do this in such a thorough and helpful way.

*It's also really unrealistic long-term, like, if I actually followed those guidelines I would never be allowed to eat at a restaurant again, basically, since I'm immunosuppressed for life. But it can be followed short-term or even in the medium-term, I imagine.
posted by sockermom at 2:57 PM on August 22, 2014

Having gone through this recently (making meals, I mean, not as the patient) -- the most critical thing will likely be what is he willing to eat. I'm sure experiences vary, but "must be high calorie" will probably trump "must be healthy." My friend was extremely grateful for McDonald's, which he repeatedly found appealing, easily digestible, and nourishing, when nothing else appealed.

The type of chemo is important; there are differing side effects. My friend ended up with a lot of nerve damage and couldn't have anything that was cold, certainly nothing frozen. But my friend's friend, who at the same time had a different cancer and different chemo, went through a lot of Wendy's Frostys. Really, the criteria for a great meal for both of them for a long time was just "I am able to put this in my mouth and swallow it and have at least most of it stay down," and the most important thing was satisfying the craving of the moment for the best odds there. There are a lot of cookbooks purporting to offer chemo-friendly cooking with nice healthy fare and...not useful. Chemo is a good time for dinner to be chocolate mousse.

I would ask him about his preferred comfort foods -- what did he eat as a kid, etc? -- and go from there. What sorts of things has he eaten through colds and flus, or even hangovers? Use disposable containers, and err on the small side for portions. One can always nuke up seconds but too much food in front of one can be off-putting. Also, drinks: if there are higher-calorie beverages he likes, load up on them. Gift cards to places with take-away he likes will probably be appreciated.

Not very helpful as far as recipes; sorry! Do cook for his wife, who will probably not have a lot of time for feeding herself but whose appetite will be more reliable.
posted by kmennie at 3:00 PM on August 22, 2014

Chili. Vegetarian or otherwise. I suggest not making it spicy at all, but including some hot sauce he and his wife can add _before reheating_ so that it can be seasoned to their individual taste. Can be frozen, is nutritionally dense, also tastes good.
posted by amtho at 3:27 PM on August 22, 2014

When my dad went through chemo, my mother often made him milk shakes or slushies with real fruit and the like. On good days, he got a healthy milkshake for lunch and some kind of light dinner. On bad days, she mad frozen fruit slushies with fruit and fruit juice and ice and he got it for both lunch and dinner on days when he could keep nothing solid down.

I am immunocompromised. I like meat thin cut and extra well done.

I am also a big fan of stir fry foods which tend to reheat well in part because all the stuff is small. The other reason I like stir fry is because it provides cooked veggies which have not had all the nutrients simply boiled out of the them. I loathe overcooked, mushy veggies. I just hate the taste and texture. But I also think they just don't really offer anything of real value.

When I am very ill, I become a big fan of real fruit pies and cheesecake. It is high calorie, I tolerate them well, and I feel they have some redeeming. (When I am very ill, I cannot eat raw fruits and veggies but I like cooked fruits, like peach or apple pie.)
posted by Michele in California at 3:51 PM on August 22, 2014

My sister cooked for me from The Cancer-Fighting Kitchen by Rebecca Katz when I was going through cancer treatment. I went for a lot of blaaaaaand white foods during that time, but the soups especially from this book successfully piqued my appetite and nourished me.

I don't know if the Katz's recipes meet all your requirements, but maybe some of the information will help your task seem less intimidating.
posted by strivesc at 4:26 PM on August 22, 2014

If you can make it in a crock pot, you can guarantee that the vegetables are well-cooked and the food will survive the reheating process. The crock pot is your best friend.

Honestly though you might just want to do a drive to drop off a shit ton shelf-stable staples for the patient, such as high calorie Boost/Ensure nutritional supplements and those 1L tetra pack boxes of high quality broths and soups. Have people provide regular food for his wife. This is much easier to manage than trying to QA food from a group of random people.
posted by crazycanuck at 5:03 PM on August 22, 2014

I really like this recipe for Turkey Chipotle Chili. I usually double the beans and bell pepper. I also usually quadruple the canned chipotle, and even then it's not usually very spicy, so I think that if you make it with the given amounts of the spicy(ish) peppers, it should be not-at-all-spicy.
posted by jaguar at 5:43 PM on August 22, 2014

I recently had a polenta lasagna that was wonderful (at a restaurant, so no recipe), and Google is indicating such a thing would freeze well. If that's not violating the spirit of the "no pasta" rule, it might be something to add to the list.
posted by jaguar at 6:07 PM on August 22, 2014

A Facebook page I follow just linked to this site, Once a Month Meals, which is all about meals that freeze and reheat well. Might be worth looking through.
posted by jaguar at 6:32 PM on August 22, 2014