my client

we were fortunate enough that the doctors decided not to put the tube back in. we hust have to feed a lot smaller bites, feed her more often, and give her liquids by spoon instead of a straw. don't know how long to do this routine, if temporary. they say it's not going to be temporary. i've tried to feed myself on her schedule, it's hard. by the time you finish eating half a meal, you're too tired to eat anymore. since she now has to take liquids by mouth, we have to make sure she gets enough to eat. any suggestions on how to feed her 6 meals a day??

You might want to try Ensure products. It is liquid nutrition. Also check with pharmacies that stock items for A.D.L. - Activities for Daily Living, to see if they have a spoon with a deeper bowl to it. I am concerned why doctors think that her current condition is not temporary. Does this mean the swelling will not go down, or is it the difficulty in swallowing? This may be a time for consult with a registered dietician to outline a well-balanced diet that could be divided up into six small feedings. It is very important to keep her hydrated. Have you tried baby food? Or pureeing her food. It may not look appetizing and she may be dismayed at eating baby food or pureed food, but it will be the nutrition she needs to thrive.

today was not a successful day. she got her breakfast 30 min late. it took an additional 20 min to get her fed. lunch wasn't better. then i could only give her half the food and then wait an hour to feed her the rest. since we went a whole week without excercising, she's gotten week. so, we did only a 1/4 of the excercises we normally do. speech wasn't any better. she was up to speaking up 48 phrases, ranging from 3 words up to 8 words at a time. today, we only did simple sounds and single words. next time i go to walgreens, i'll see if they have that kind of spoon. her mom found her the atkinson chocolate shake. only thing was, she kept coughing it back up. that wasn't good. her output is a very dark orange color-both times. is that due to lack of hydration?? i think i did a decent job keeping her water intake up. we normally do 24 oz of water on top of her coffee, juice, and tea. she still gets her coffee, but the juice has been replaced with the choc stuff and she still has her tea. we've also added jello and taken away the activia. we don't know what has caused her espho to swell and drs won't make any statement of when it'll go down. i just know that at the beginning of the month, she could drink well with the straw. she would sometimes choke on food if she had too much. when she went to hospital, she was having trouble swallowing. she's already been on a pureed diet. but, we were getting to the point that it didn't need to be finely pureed. we've had to add broth to make it more smooth and soupy in order for her to swallow. she has a follow up with the primary dr next week, the gas dr the week after and the air dr the week after that. makes me kind of glad we're not going to houston for therapy the rest of this month. dang! it's past midnight, so i got to head to bed.