Foods for the newly texture-averse / post-anesthesia food problems.
May 21, 2018 3:40 PM Subscribe
A relative of mine had general anesthesia for gastrointestinal problems and four weeks later still can't handle most food - not because of digestion, but because everything 'feels wrong' in her mouth. She is the sort of person who does all the cooking for holidays, is the office baker, etc., so this is a major psychological downer. Resources? Ideas? What's worked/not is beneath the fold (and a little more GI stuff).
So far, OK:
Greek yogurt, including fruit on the bottom and blended
Protein shakes. (she is super bored of shakes.)
Small amount of soft cheese like cream cheese
Pudding, ice-cream, jello
Generally 'cold and soft' or, to a lesser extent, 'warm and soft'.
Maybe
pastina soup, and
an egg-salad sandwich, although I think she got rid of the bread and just ate the innards.
Not OK:
Any meat. Ground meat, solid meat, pan-fried, boiled, grilled, chicken salad, tuna salad, all had gross textures.
'French' yogurt that someone brought
Canned fruits
Fresh fruits, mostly
Pastries
Bread
Also dismissed: My suggestion of medical marijuana, which she is eligible for in her state. (Also, I don't think they'll put her on mirtazapine nor do I think it would be beneficial for her given my prescriber-side experience with it.)
Not tried yet, but suggestions I've come up with:
Nuts (because they're discrete, small, and you don't commit to a whole sandwich.)
Avocado, either by itself or as mousse.
Small amounts with gradual acclimation.
Diets for people with oral surgery
There are no GI digestion problems or restrictions. (She can have seeds, nuts, etc.)
More medical detail:
Her GI issues - which are a super-late complication of a 1980s-era colitis surgery - did create vomiting for the week or so, and she wasn't able to eat and had a NG tube for about 15 days, NPO through almost all that - so no food, except for failed trials, for a bit over two weeks. Once she got put on TPN (IV nutrition) she pushed herself and could handle protein shakes so she wouldn't have to go on TPN at home (which she did back in the 1980s). Dysphagia was ruled out in the hospital.
So far, OK:
Greek yogurt, including fruit on the bottom and blended
Protein shakes. (she is super bored of shakes.)
Small amount of soft cheese like cream cheese
Pudding, ice-cream, jello
Generally 'cold and soft' or, to a lesser extent, 'warm and soft'.
Maybe
pastina soup, and
an egg-salad sandwich, although I think she got rid of the bread and just ate the innards.
Not OK:
Any meat. Ground meat, solid meat, pan-fried, boiled, grilled, chicken salad, tuna salad, all had gross textures.
'French' yogurt that someone brought
Canned fruits
Fresh fruits, mostly
Pastries
Bread
Also dismissed: My suggestion of medical marijuana, which she is eligible for in her state. (Also, I don't think they'll put her on mirtazapine nor do I think it would be beneficial for her given my prescriber-side experience with it.)
Not tried yet, but suggestions I've come up with:
Nuts (because they're discrete, small, and you don't commit to a whole sandwich.)
Avocado, either by itself or as mousse.
Small amounts with gradual acclimation.
Diets for people with oral surgery
There are no GI digestion problems or restrictions. (She can have seeds, nuts, etc.)
More medical detail:
Her GI issues - which are a super-late complication of a 1980s-era colitis surgery - did create vomiting for the week or so, and she wasn't able to eat and had a NG tube for about 15 days, NPO through almost all that - so no food, except for failed trials, for a bit over two weeks. Once she got put on TPN (IV nutrition) she pushed herself and could handle protein shakes so she wouldn't have to go on TPN at home (which she did back in the 1980s). Dysphagia was ruled out in the hospital.
What about rice puddings (sweet) or risottos (savory)? Easy to get a lot of calories in that way and you could gradually add in more parts or things she might want to warm up to.
posted by jessamyn at 4:02 PM on May 21, 2018 [2 favorites]
posted by jessamyn at 4:02 PM on May 21, 2018 [2 favorites]
My idea would be to introduce new textures in a gradual but consistent way. Maybe make a list of foods that rates them by how wrong the feel - from 0 to 100. So maybe a protein shake or yogurt are a 3, yogurt with fruit is 5. Soft canned fruit like peaches or pears might a 10, a hamburger might be an 80. Then at every meal, eat a something that is slightly uncomfortable but tolerable but plan on getting more of the nutrition from things that are OK. Then once a day try a little bit of something that it is a bit of a push. So if right now foods in 0-5 range are fine, have a little 6-8 at every meal and try to have 9-10 once a day. Hopefully, after a week or so, her mouth (and brain) will have adjusted to the point where the 6-7 are just fine, 8-10 are tolerable and 11-15 is the push range. There is probably no point in pushing herself to eat something way outside of her current range - aim for slow and steady.
Some ideas that might be OK or at least tolerable:
Brie (without the skin)
Peanut butter
Soft canned fruit like peaches - maybe pureed for a few seconds first
Creamy soup
Canned soup with soft chunks (potato, rice, overcooked carrots)
Risotto (a creamier form of rice)
Well cooked pasta
Oatmeal
posted by metahawk at 4:07 PM on May 21, 2018 [2 favorites]
Some ideas that might be OK or at least tolerable:
Brie (without the skin)
Peanut butter
Soft canned fruit like peaches - maybe pureed for a few seconds first
Creamy soup
Canned soup with soft chunks (potato, rice, overcooked carrots)
Risotto (a creamier form of rice)
Well cooked pasta
Oatmeal
posted by metahawk at 4:07 PM on May 21, 2018 [2 favorites]
Best answer: Thinking about the egg salad, there's a lot of bean or vegetable salads that can be reduced to a similar texture. Also very very soft beans/veg: refried beans, broccoli or cauliflower or carrots steamed/nuked to nearly mush, and if she doesn't like it hot you can let it cool to lukewarm, or maybe even try making a tiny quiche/omelet/scrambled eggs and eating cool or room temp.
Cream Of soups? The Campbell's ones could even be strained to get out the tiny bits of solids in it so it's just soup-liquid.
Potato/sweet potato, with toppings of choice. Hash browns. Vegetable fritters.
Fruit baked to mush and cooled.
No-go on meat, but have you tried fish? A very mild white fish, not tilapa and maybe not salmon or tuna to start, gently poached or steamed.
Is she averse to strong flavors as well? Everything you list, except egg salad, barely has a smell or flavor. If she does show interest in something flavor heavy but texture-bland, there's tofu (if you're not familiar, the internet has plenty of tips for making it nice and flavorful). When my grandfather had chemo-induced reduction of taste and smell plus dysphagia we mashed a lot of food he liked and then seasoned the shit out of it so he could vaguely taste it, so see if she'd be interested in trying mushed-up lasagna (veg, to start with) or another casserole type dish or stew or soup she'd been fond of before.
Nobody wants a sandwich when they're struggling with food issues, anyway. Just offer tiny servings of whatever might go over well so there's no real pressure, keep the rest put away, and then go get more if she wants more. Too overwhelming, bites before meals. Stock up on zip-locs and deli containers.
I know you don't want to wear her out with constant discussions of "this? this? what about this?" but you might try doing a very basic exercise where you name flavor groups (alliums, greens, tomatoes, salty, sweet, spicy) and textures (crunchy, creamy, dry, soft, oily, cold, hot) and just have her rate them 1-3 on interest/appeal. It's possible the reason you have so many mushy food responses is because she's specifically only wanted that or was afraid to venture beyond it, but it's worth asking how she feels about a potato chip or fried cheese or a cookie.
You might also check with a nutritionist or dentist; there must be some effect on the literal inside of your mouth and tongue to go without eating for so long, and in the emphasis on keeping her fed at all there might be oral care you haven't heard about because it was low priority, or some Weird Tricks you might get from that kind of specialist that her surgeon's office isn't going to know.
posted by Lyn Never at 4:54 PM on May 21, 2018 [1 favorite]
Cream Of soups? The Campbell's ones could even be strained to get out the tiny bits of solids in it so it's just soup-liquid.
Potato/sweet potato, with toppings of choice. Hash browns. Vegetable fritters.
Fruit baked to mush and cooled.
No-go on meat, but have you tried fish? A very mild white fish, not tilapa and maybe not salmon or tuna to start, gently poached or steamed.
Is she averse to strong flavors as well? Everything you list, except egg salad, barely has a smell or flavor. If she does show interest in something flavor heavy but texture-bland, there's tofu (if you're not familiar, the internet has plenty of tips for making it nice and flavorful). When my grandfather had chemo-induced reduction of taste and smell plus dysphagia we mashed a lot of food he liked and then seasoned the shit out of it so he could vaguely taste it, so see if she'd be interested in trying mushed-up lasagna (veg, to start with) or another casserole type dish or stew or soup she'd been fond of before.
Nobody wants a sandwich when they're struggling with food issues, anyway. Just offer tiny servings of whatever might go over well so there's no real pressure, keep the rest put away, and then go get more if she wants more. Too overwhelming, bites before meals. Stock up on zip-locs and deli containers.
I know you don't want to wear her out with constant discussions of "this? this? what about this?" but you might try doing a very basic exercise where you name flavor groups (alliums, greens, tomatoes, salty, sweet, spicy) and textures (crunchy, creamy, dry, soft, oily, cold, hot) and just have her rate them 1-3 on interest/appeal. It's possible the reason you have so many mushy food responses is because she's specifically only wanted that or was afraid to venture beyond it, but it's worth asking how she feels about a potato chip or fried cheese or a cookie.
You might also check with a nutritionist or dentist; there must be some effect on the literal inside of your mouth and tongue to go without eating for so long, and in the emphasis on keeping her fed at all there might be oral care you haven't heard about because it was low priority, or some Weird Tricks you might get from that kind of specialist that her surgeon's office isn't going to know.
posted by Lyn Never at 4:54 PM on May 21, 2018 [1 favorite]
What about eggs? Scrambled or otherwise? For dental reasons i’ve been on a soft-food diet for the last couple weeks that sounds very similar, and scrambled eggs have been a life saver — soft and full of protein.
Also, baked (or microwaved) potatoes. Regular or sweet. I just microwave them then mix in some butter and cheese before eating the insides but not the skin.
I’ve also been eating a ton of over cooked pasta. Mac and cheese mostly, but any smooth sauce would do. The chunky meat sauce i tried with ravioli was not a good idea, regrettably.
posted by cgg at 4:58 PM on May 21, 2018
Also, baked (or microwaved) potatoes. Regular or sweet. I just microwave them then mix in some butter and cheese before eating the insides but not the skin.
I’ve also been eating a ton of over cooked pasta. Mac and cheese mostly, but any smooth sauce would do. The chunky meat sauce i tried with ravioli was not a good idea, regrettably.
posted by cgg at 4:58 PM on May 21, 2018
What about frozen banana "ice cream"? At least solves the "cold and soft" part.
It's definitely not healthy, but I find the instant mac & cheese (the microwavable "Easy Mac" style) to be softer and mushier in texture than even the regular boxed kind. I find most canned pastas (SpaghettiOs/etc.) to be pretty gross, but texture-wise, they may be OK (but yes, any overcooked pasta may work here).
If egg salad was OK, I think other kinds of eggs may work. I don't know how much I'd eat scrambled eggs cold, but room temperature scrambled eggs are generally OK (and you can mix in cheese if getting enough calories is an issue).
What about applesauce (homemade or otherwise)?
I also agree with trying mashed potatoes (white or sweet).
You don't mention beans but what about something like canned baked beans? Those can be decent at room temperature.
Also not super healthy, but I still enjoy some canned green beans every so often.
posted by darksong at 6:27 PM on May 21, 2018
It's definitely not healthy, but I find the instant mac & cheese (the microwavable "Easy Mac" style) to be softer and mushier in texture than even the regular boxed kind. I find most canned pastas (SpaghettiOs/etc.) to be pretty gross, but texture-wise, they may be OK (but yes, any overcooked pasta may work here).
If egg salad was OK, I think other kinds of eggs may work. I don't know how much I'd eat scrambled eggs cold, but room temperature scrambled eggs are generally OK (and you can mix in cheese if getting enough calories is an issue).
What about applesauce (homemade or otherwise)?
I also agree with trying mashed potatoes (white or sweet).
You don't mention beans but what about something like canned baked beans? Those can be decent at room temperature.
Also not super healthy, but I still enjoy some canned green beans every so often.
posted by darksong at 6:27 PM on May 21, 2018
Well, I'm an incipient geezer, so let's talk about fiber. After anesthesia and GI surgery, her gut may still be in an uproar, and her gut bacteria may be out of whack. Oatmeal, even the quick variety that doesn't seem to be fibrous but is. Apricots or other dried fruit, as a cooked compote if that works. As soon as she can tolerate anything fermented, like sauerkraut or kimchi, it's good for re-populating the gut.
I agree that risotto would be lovely. I don't eat dairy, so I make it with lots of sauteed-til-quite-limp-and-golden onions, white wine, chicken broth, maybe asparagus or mushrooms, but no cheese.
Quiche, scrambled eggs, soft-boiled egg.
Stuffing. I know, it's bread, but it's a savory bread pudding. Or bread pudding - it's easy to make and very tasty.
Polenta is a very specific sift texture; I like it, esp. with plenty of olive oil.
In the last couple years of my Mom's life, she wouldn't feel hungry, so I'd put a piece of cinnamon toast next to her, or a small plate of something tasty, maybe a scrambled egg or cheese and crackers, and she'd end up eating it because it was there and it was something she liked. Small portions, and take it away if it doesn't work. Cinnamon is soothing and a tempting aroma.
I love reduced chicken broth, ideally homemade, and noodles. Maybe throw in some carrots and let them get quite soft.
Would using a straw help the mouth-feel?
posted by theora55 at 7:08 PM on May 21, 2018 [2 favorites]
I agree that risotto would be lovely. I don't eat dairy, so I make it with lots of sauteed-til-quite-limp-and-golden onions, white wine, chicken broth, maybe asparagus or mushrooms, but no cheese.
Quiche, scrambled eggs, soft-boiled egg.
Stuffing. I know, it's bread, but it's a savory bread pudding. Or bread pudding - it's easy to make and very tasty.
Polenta is a very specific sift texture; I like it, esp. with plenty of olive oil.
In the last couple years of my Mom's life, she wouldn't feel hungry, so I'd put a piece of cinnamon toast next to her, or a small plate of something tasty, maybe a scrambled egg or cheese and crackers, and she'd end up eating it because it was there and it was something she liked. Small portions, and take it away if it doesn't work. Cinnamon is soothing and a tempting aroma.
I love reduced chicken broth, ideally homemade, and noodles. Maybe throw in some carrots and let them get quite soft.
Would using a straw help the mouth-feel?
posted by theora55 at 7:08 PM on May 21, 2018 [2 favorites]
Try shopping at the Asian grocery:
Dessert tofu
Congee
Ramen, udon, and other soft noodle soups in this family. Add boiled egg topping for protein.
Something with a heavy coconut milk based broth - maybe a tofu green curry on rice
Red bean paste based desserts (I know you said no pastries, but a red bean bun has a lot of filling to change the texture)
Miso soup, miso dressing on noodles (maybe soba noodles)
Omelet, you could try a sweet Japanese omelet as she seems to be doing well with sweet textures
posted by crazycanuck at 8:12 PM on May 21, 2018
posted by crazycanuck at 8:12 PM on May 21, 2018
Best answer: Approaching your question from the perspective of "how to make eating fun again" and setting aside the question of getting calories/nutrition -- and absolutely acknowledging that this is just one person's experience and may be totally unrelated to what's going on here -- I had very little appetite for about six months after my own GI surgeries and protracted hospitalization. I'm a big enjoyer of food and inveterate plate cleaner and it disturbed and upset everyone around me. It... didn't really bother me that much. I stayed active and got back into my normal life in every other way. I do enjoy cooking and I kept cooking for other people as well as enjoying a bite here and there, and around the six month mark it was like a lightbulb switched on and I gained five lb in a month. Things have been normal (in that regard) for me ever since.
All of this is to say that if your relative is disturbed that food feels weird, by all means it's great to explore creative ways to help her, but in my experience, this was far more disturbing to my family than it was to me. Is it possible she's going along with this quest for appetizing foods in the hopes that it will make you feel better?
posted by telegraph at 6:55 AM on May 22, 2018 [3 favorites]
All of this is to say that if your relative is disturbed that food feels weird, by all means it's great to explore creative ways to help her, but in my experience, this was far more disturbing to my family than it was to me. Is it possible she's going along with this quest for appetizing foods in the hopes that it will make you feel better?
posted by telegraph at 6:55 AM on May 22, 2018 [3 favorites]
Best answer: This sounds like a type of PTSD to me, and her guts are probably feeling bruised and tired like you or I would after an ordeal.
She should not consider this the new reality but a part of the recovery. These things take time.
posted by Lesser Shrew at 12:45 PM on May 23, 2018
She should not consider this the new reality but a part of the recovery. These things take time.
posted by Lesser Shrew at 12:45 PM on May 23, 2018
Response by poster: The psychological aspect was a huge one, and still is. One of the things we learned is that we had to pull back on, at least for now, approaching food as a familial celebratory thing. That created a lot of pressure on her.
She got a little more interested and realized vinegar was a new go-to, via, I think, olives and Mediterranean tapas-type things because they're pick-at style foods. Unexpectedly it turned into a spicy food craving and that overwhelmed the texture issues enough to get back into some foods. So slow and steady and purposefully small and occasional weird flavors seem to be the way to go.
Thank you, folks.
posted by cobaltnine at 8:50 PM on June 22, 2018 [2 favorites]
She got a little more interested and realized vinegar was a new go-to, via, I think, olives and Mediterranean tapas-type things because they're pick-at style foods. Unexpectedly it turned into a spicy food craving and that overwhelmed the texture issues enough to get back into some foods. So slow and steady and purposefully small and occasional weird flavors seem to be the way to go.
Thank you, folks.
posted by cobaltnine at 8:50 PM on June 22, 2018 [2 favorites]
Response by poster: Late final update: it got better.
The final answer turned out to be EMDR for hospital/icu PTSD. Worked in a handful of sessions apparently.
posted by cobaltnine at 7:16 PM on October 12, 2018 [3 favorites]
The final answer turned out to be EMDR for hospital/icu PTSD. Worked in a handful of sessions apparently.
posted by cobaltnine at 7:16 PM on October 12, 2018 [3 favorites]
This thread is closed to new comments.
posted by genmonster at 4:00 PM on May 21, 2018 [1 favorite]