Yesterday was the fourth dilation procedure and the results were positive. In this case positive is a good thing. This time around they were able to go from 10MM to 12MM. That results in a 44% increase in volume that the esophagus can open. It is definitely a move in the right direction. One difference this time around is that I did make an effort to try to swallow larger amounts of liquids or solids (mushy stuff) to the point of being uncomfortable or some slight pain. The thought here was use it or lose it. My throat is still healing from the treatments and will be for a few more months. That means strictures are still going to form and that is what is narrowing the esophagus. Prior to the procedure yesterday I told the GI doctor this and he said there was some validity to that. Going forward my intent is to continue this practice until my throat is healed. One technique that I have developed is to take a large sip of water and then do a "hard swallow" where I try to force it down as fast as possible. I do feel some momentary pain doing this but I feel that demonstrates that it is pushing the esophagus to its current limit and breaking any strictures that may have recently formed.
I did find a study that looked at the sizes of the esophagus in relationship to swallowing disorders. Anything below 18 MM was considered a problem for swallowing solids with 13 MM considered the minimum for any solids. Below 13 MM liquids start to be a problem. I can attest to those numbers at this point. Being at 12 MM makes a huge difference swallowing liquids compared to 10 MM. When I got home yesterday I was very hungry. Because the procedure is done under general anesthesia I can't "eat" for over 8 hours before the procedure. That generally puts it in the middle of the night so for me its over 12 hours without any feedings. The first thing I had when I got home was some Progresso tomato soup and I had no problem eating it this time around. It was easy enough to eat that I had two servings and was able to get 360 calories from it. This soup is pureed and has no solids in it but I did have a slice of bread with butter. If I ate the bread in very small bites with the soup and it was almost a normal meal and close to 500 calories.
At this point Operation Garbage Plate has almost fully liberated, I mean reclaimed, eating liquids. My next procedure will be in a few weeks and hopefully this will start to reclaim some ground in solid territory.
Friday, September 26, 2008
Wednesday, September 24, 2008
I Need To Move To France
No.. its not to pursue some experimental procedure or get freedom fries from the source. My desire to move to France is a bit more decadent. It's for pate and brie. I made an interesting discovery in the war on swallowing this week. On the weekend Sue picked up some port wine cheese. Always looking for things to test out in the mushy diet category I decided to try some. Also wanting to continue my quest to live life on the edge I decided to try it with a bit of a cracker that was also out on the counter. I discovered two things. First that that particular brand of port wine cheese wasn't all that good. Second that cracker brand was made with swallowing disorders in mind. (OK, maybe they had other things on their mind but I can dream can't I?) This particular cracker brand tended to crumble into nothingness and unlike other bread type products didn't reassemble into a mushy plug in your mouth but stayed separate. That is a key feature when your esophagus is narrowed like mine. By staying in particle form I was able to actually eat the cracker with something on it.
So what does this have to do with France? Two days later I was at a local grocery store checking out the various food buffet bars. I was near the cheese counter and took a look over there and saw that they had pate but in larger portions than I was comfortable buying for an experiment. The person at the counter asked if they could help and I said sure. I explained my situation and she offered a taste of the pate to see if I could eat it. Sure enough the pate went down without a problem. I could actually eat it like I normally would have and I didn't even have my water bottle with me. Of course this makes sense seeing as pate is essentially pureed chicken or duck livers with added flavoring. (Yes I know, surprising that someone who has named their swallowing recovery "Operation Garbage Plate" would also like Pate.) The person at the store cut the portion they had in the case in half and off I went. At home the pate with the cracker was the perfect in between tube feedings snack. It has the added bonus of having lots of fat and calories as well. (Did I mention I need to eat between 2,500-3,000 calories just to maintain my weight?) It took less than 24 hours for the Pate to disappear.
Still, what does this have to do with France? Well in the interest of science, and my being able to taste something other than Ensure, I decided yesterday to give brie a chance. Now that I had a snack transportation vehicle that worked, the cracker, I decided to try a mushy cheese and what better one than brie. (Really, I do have diverse taste. Or put another way I will eat almost anything.) The brie also went down OK with the pate. Not quite as easy but still not a problem.
Once again... what does this have to do with France? The French Connection part comes back from my college days when I spent some time back packing around Europe. One of the things we would often do for an inexpensive lunch was get a loaf of bread (of the french variety of course) some pate and brie, find a park bench and that would be lunch. You could get that stuff at almost any market and they would have a wide variety of types at different prices. Here these items are treated more as high end gourmet foods and are priced appropriately. Also the selection, at least locally, for pate is very limited. While these foods are great for me to have at home they don't do much to increase my food mobility in this country. However if I lived in France....
Of course now I can find a use for the time spent watching the Food Porn, I mean Food Network, Channel. Today I am going to try to make my own Pate with a recipe from Emeril. At around $14 a pound for store bought vs. around 2$ in ingredients to make at home I figured it was worth a try. The brie on the other hand I am going to leave to the professionals, for now at least. :-)
So score another small victory for Operation Garbage Plate. (Hmmm... maybe a pate garbage plate would work.) Today brie and pate tomorrow Stilton Blue Cheese. Viva la France! :-)
So what does this have to do with France? Two days later I was at a local grocery store checking out the various food buffet bars. I was near the cheese counter and took a look over there and saw that they had pate but in larger portions than I was comfortable buying for an experiment. The person at the counter asked if they could help and I said sure. I explained my situation and she offered a taste of the pate to see if I could eat it. Sure enough the pate went down without a problem. I could actually eat it like I normally would have and I didn't even have my water bottle with me. Of course this makes sense seeing as pate is essentially pureed chicken or duck livers with added flavoring. (Yes I know, surprising that someone who has named their swallowing recovery "Operation Garbage Plate" would also like Pate.) The person at the store cut the portion they had in the case in half and off I went. At home the pate with the cracker was the perfect in between tube feedings snack. It has the added bonus of having lots of fat and calories as well. (Did I mention I need to eat between 2,500-3,000 calories just to maintain my weight?) It took less than 24 hours for the Pate to disappear.
Still, what does this have to do with France? Well in the interest of science, and my being able to taste something other than Ensure, I decided yesterday to give brie a chance. Now that I had a snack transportation vehicle that worked, the cracker, I decided to try a mushy cheese and what better one than brie. (Really, I do have diverse taste. Or put another way I will eat almost anything.) The brie also went down OK with the pate. Not quite as easy but still not a problem.
Once again... what does this have to do with France? The French Connection part comes back from my college days when I spent some time back packing around Europe. One of the things we would often do for an inexpensive lunch was get a loaf of bread (of the french variety of course) some pate and brie, find a park bench and that would be lunch. You could get that stuff at almost any market and they would have a wide variety of types at different prices. Here these items are treated more as high end gourmet foods and are priced appropriately. Also the selection, at least locally, for pate is very limited. While these foods are great for me to have at home they don't do much to increase my food mobility in this country. However if I lived in France....
Of course now I can find a use for the time spent watching the Food Porn, I mean Food Network, Channel. Today I am going to try to make my own Pate with a recipe from Emeril. At around $14 a pound for store bought vs. around 2$ in ingredients to make at home I figured it was worth a try. The brie on the other hand I am going to leave to the professionals, for now at least. :-)
So score another small victory for Operation Garbage Plate. (Hmmm... maybe a pate garbage plate would work.) Today brie and pate tomorrow Stilton Blue Cheese. Viva la France! :-)
Sunday, September 21, 2008
Operation Garbage Plate: New Mission This Week
Another dilation mission, I mean procedure, is on for this week. This one will be two weeks and two days after the last one and hopefully my esophagus won't have closed up again. To help avoid giving back any ground that was gained I have developed a new strategy regarding eating. My first strategy was to try to get back to eating some of the foods that I normally would have eaten before starting treatments for cancer. I tried, without much success, things like bits of a cheeseburger, clam chowder soup and such. Foods that I though would be obvious success's but didn't work out so well.
The axiom that a battle plan is only good up until the time a battle is joined rings true in this case. As I have mentioned before there are several physical aspects to swallowing one of which is the ability of the esophagus to open up enough to swallow solids. This time around I decided that the primary goal in eating was just that, eating. Anything that I could get down even if it wasn't pleasant or something I would usually eat is what I planned on trying. That along with drinking large sips of water. While I have a nifty thermos bottle with a straw that I carry around with me at home the goal was large gulps of water from a glass. That is a much more efficient means of drinking large amounts of water. The goal with all of this was to keep using the esophagus, hopefully up to its current maximum size, so that it couldn't start to seal back up. On Thursday we will know if this works or not.
The idea for this approach came to me when I started the exercises to increase the opening of my mouth. The morning is the time when my mouth opens the least. I think this is because it has had all night to start to go back to where it was and give up some ground. To counteract this I have to do exercises multiple times a day. Then it came to me (Que revelation music now) that this may be what is happening to my throat. It is still healing from the treatments and if it isn't being used then it will close back up.
The primary foods that I am eating are deviled eggs with the egg whites, Jello Instant Pudding Cheesecake, waffles cut into minuscule pieces with lots of maple syrup, home made candied peanuts (I would have never bet that would work but it does, sort of.) and pureed soups. I picked up a small food processor with a big motor to puree soups like split pea. So far it is working out well. A larger food processor would not do as good of a job. Thanks to the Mega Industrial Food Appliance Complex (M.I.F.A.C. for short. :)) for providing an endless set of kitchen gadgets.
I plan to keep up the eating attempts to keep the esophagus open and hopefully this week we will find out that has worked. Hopefully we can keep to the same schedule and have the next two procedures also scheduled only 2 weeks apart. Then I could get in 2-3 more procedures before Thanksgiving.
The axiom that a battle plan is only good up until the time a battle is joined rings true in this case. As I have mentioned before there are several physical aspects to swallowing one of which is the ability of the esophagus to open up enough to swallow solids. This time around I decided that the primary goal in eating was just that, eating. Anything that I could get down even if it wasn't pleasant or something I would usually eat is what I planned on trying. That along with drinking large sips of water. While I have a nifty thermos bottle with a straw that I carry around with me at home the goal was large gulps of water from a glass. That is a much more efficient means of drinking large amounts of water. The goal with all of this was to keep using the esophagus, hopefully up to its current maximum size, so that it couldn't start to seal back up. On Thursday we will know if this works or not.
The idea for this approach came to me when I started the exercises to increase the opening of my mouth. The morning is the time when my mouth opens the least. I think this is because it has had all night to start to go back to where it was and give up some ground. To counteract this I have to do exercises multiple times a day. Then it came to me (Que revelation music now) that this may be what is happening to my throat. It is still healing from the treatments and if it isn't being used then it will close back up.
The primary foods that I am eating are deviled eggs with the egg whites, Jello Instant Pudding Cheesecake, waffles cut into minuscule pieces with lots of maple syrup, home made candied peanuts (I would have never bet that would work but it does, sort of.) and pureed soups. I picked up a small food processor with a big motor to puree soups like split pea. So far it is working out well. A larger food processor would not do as good of a job. Thanks to the Mega Industrial Food Appliance Complex (M.I.F.A.C. for short. :)) for providing an endless set of kitchen gadgets.
I plan to keep up the eating attempts to keep the esophagus open and hopefully this week we will find out that has worked. Hopefully we can keep to the same schedule and have the next two procedures also scheduled only 2 weeks apart. Then I could get in 2-3 more procedures before Thanksgiving.
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