Cooking for the chemo patient: Tips given and welcomed here

[fishnfla]

I touch upon this in another thread, with suprising and unintended results, which has renewed my energies and faith in mankind. You foodies, always giving of yourselves, aint y'all?

Our family friend& neighbor is starting her chemotherapy for the pink ribbon one. Sunshine, I'll call her for her bright and colorful personality. Her of all people, a former critical care nurse, now in quality control, which is bigger her smile or her heart?, family of 3 beautiful girls. Why?

She will beat it, she has a large support group. My wife has been asked to be her caregiver assistant, good choice, she is a cancer survivor (thyroid), her father passed from lung cancer some 7 years past, shortly thereafter her mother relapsed with breast cancer and lived with us during the acute and chronic phases of the disease, she fought and fought and taught us alot (you'll see), 2 years ago my best friend and older brother was afflicted with rare and aggresive form of sinus cancer, he only lived a year. Shirley and Bob died within 6 months of each other. They were great foodies, both had cooking mentioned in their obits. I learned alot about cooking for chemo from them

So, unfortunatly, one thing we have found is that everybody has a cancer story. Regretably we all know someone who will go thru it and chemo. This thread is for them.
I wish it was not needed.

These are some things I've learned:
1. Sunshine is in the stage of: 'the word feel is a 4 letter word'. Dont ask a cancer patient how do they feel. They get sick of being asked that, even if you mean well. talk about anything else

2. Cancer treatments are better and better all the time. They are personalized to the individual and the type of cancer, with different goals and results. Some folks have different and new side effects. People are living longer and surviving. NUTRITION IS HUGELY IMPORTANT. The point of this thread really. Be prepared to customize the menu for the patient, while at the same time preparing stuff for the family.
For example, Shirley chose quality of life over length of life treatments. She was on experimental drugs that affected her appetite in various ways, cravings for one thing and then absolute disgust for the same thing. She could not stand the idea of large portions, evrything had to be small, the plate, the fork, the portions. She was one of those 'dont want to be a burden' types. We struggled with that at first, 'til we said "stop being a pain and just tell us what ya want" It worked better after that.
For example 2, Bob had aggresive therapy. Surgery and radiation and chemo. Radiation of the neck killed all his taste buds and he had no saliva. They had to remove most of his teeth and could not chew. He became obsessed with eating steak ( to him the sign of a normal life), but it was a lot of soups for him. I got buttloads of soup recipes now. it was never enough, he was big fella so he had to take nutritional supplements, ensure and etc. towards the latter parts we got him some self-prescribed medical marijuana. He grw up in the 70's, no big deal. It helped more with his pain than appetite though.

as a general rule:
--avoid spicy foods, also things that are visually unappealling. I mean lasagna is my favorite, but ya got to admit, it kinda looks gross..grilled food had that effect on our mom too
--find the comfort food, its the easiest. ice cream for shirley ( wendys frosty) Bob claimed that pickles were something he could faintly taste. Steamed hamburgers, like krystal or white castle worked. He could eat those with his kids
--during the throwing up phases of chemo nothing works. stick with bland things, broth, toast, tapioca, etc. Cook for the family then, but dont make overly aromatic dishes for the household, the odor can trigger sickness.
--be vigilent about hygiene. chemo patienst are immune suppressed. dont cook or visit when sick. Avoid risky foods like seafood, rare meats, and raw veggies. Clean fruit well and cut it up when you can. wash your hands
--the doctors, of course, will specify and help with certain diets, but some patienst balk at "special" diets. They want to be normal as possible.
--be prepared for cravings, like a preganat woman, but dont overdo it. The person may desire something at one time, then evryone brings that one thing 'til they are sick of it and stuck with it. Go small, go slow

So now I am getting ready to help out with Sunshine. Her family is easy: her kids&hubby eat what our kids&this hubby eat.Blue collar family fare--I am assigning stuff to some of the supporters. She herself likes "appetizer" stuff and finger foods, and seafood. To start am going to make a batch of chinese dumplings and some shrimp bisque(that is the safest seafood dish I can think of). She is going to have 3 months of chemo overall. She has a favorite restaurant, upscale trendy tavern fare ( actually she likes the strong drinks the bar makes ;) so i am going to be taking out from there or copying stuff from their menu. Any input is certainly welcome.

I will leave you with 3 things.
1. shirley taught us, that she was always the same person, its just that she was the same person living with cancer. your friend or family is the same person, so be yourself
2. when things got bad, she said she was not afraid of death, it was dying that she was afraid of, getting there was the hardest part
3. You foodies are always giving. We dont have to cook only when things are bad. Share when things are good too. Life's too short

[Lucinda]

1. You've covered just about everything. Really well said! One thing I'll add

is to nudge them be VERY proactive about anti-nausea meds. A lot of people don't want to deal with the meds but it can make an enormous difference.

[fishnfla]

5. they get tired of meds, i think

also, if you are suffering from nausea and vomiting, you have to take the phenergan as a suppository

[Lucinda]

8. That's why I am a HUGE advocate for proactive nausea meds.

Take em before you need em.
In my experience, you just cant stop that loop once you get it started. So its better not to let it start.

[Tangerine LaBamba]

2. Something to remember,

your remarkable post. This should be printed up and posted in every nursing and medical school in the world, as well as handed out to every family of everyone diagnosed with any kind of cancer. What you wrote here is what I think of as a Public Service.

It also reminded me of the great almost-final words of Warren Zevon, when asked by David Letterman on what would be his last TV appearance, who said, "Enjoy every sandwich." That's also the title of the tribute disc put out by Warren's friends after he died.

Enjoy every sandwich. Three powerful words.

And then I think of Art Buchwald, who said, as he was leaving us, something about all the times he passed up extravagant desserts out of an abundance of caution, because they weren't "healthy," because he was watching his weight, because, because, because. He counseled the reader to eat all the desserts possible.

Our trip on this blue marble is oh so short. Your words made it just a bit more crystalline, a bit more precise, a bit more careful, a lot more illuminated.

Good luck, thank you, and I'll be glad to help in any pale way I can.

[fishnfla]

6. not to sound trite

but oh so true. my bro had alot of enjoy life while you can moments--little things, packer games, hunting with his sons, hanging with his buddies in the garage. making the little things big instead of trying to make big deals about extravagance

[NMDemDist2]

3. sometimes drinking aloe vera juice helps with the nausea

it really does

it's a sad thread but a needed one, especially since we just lost a very dear DUer last week :cry:

[Lucinda]

4. I'll remember that! I never tried aloe.

I learned QUCIKLY to stay ahead of the nausea by being proactive with the meds. That changed everything for me.

I'll remember the aloe.

[fishnfla]

7. thats a new one on me-aloe vera juice

I'll give it a try next hangover ;)

part of the nausea/vomiting thing is mental, I think its part of why chemo patienst hate the " how are you feeling?" question. They may be OK at the present but fear the onset of puking at any time. I had to stop fishing offshore from suffering seasickness, it got to be a nagging worry whether it happened or not. Mind over matter

[Lucinda]

9. Mine wasn't mental. It was the toxins my body was subjected to.

[NMDemDist2]

11. IIRC the treatments cause the stomach lining to be irritated

the aloe helps with that

[Warpy]

10. Most chemo patients I cared for in the hospital

could usually manage to drink when food was disgusting to them. In extreme cases when any flavor or smell bothered them, we used unflavored tube feeding, 5-6 cans a day. These were people on ultra high dose chemo protocols when everything else had failed. People managed at home can probably manage on vanilla Ensure or any of the other clones.

Another point to make is that oral hygiene needs to be meticulous. One thing chemo does is suppress the immune system, and nothing will make a chemo patient sicker than getting an overgrowth of oral yeast. That means tooth brushing after every meal along with a good antibacterial mouthwash. It doesn't hurt to give the tongue a quick brush, too.

Still another is pain control. Chemo attacks bone marrow, meaning every big bone in the body is going to hurt. Taking that pain medicine before the pain gets severe means you can often take a bit less of it along with feeling life is a little more worth living.

Lastly, they would rather you tell them a joke than be solicitous. They already feel like the disease from their treatments. They need you to help them feel like people.

[fishnfla]

14. very good points all

I cant imagine people being able to eat hospital food ( I work in nursing homes, it seems the residents are content with the tube feeding versus the pile of brown mush, green mush and white mush)

The oral hygiene thing is important too, I had forgotten.

And the pain meds may also curb some folks appetite.

as for humour, see my reply to Tab below

[Arkansas Granny]

12. My mother didn't undergo chemo, but she took meds that often caused nausea.

We found a simple egg custard (eggs, milk, sugar, vanilla) to be a good choice when even the sight of most foods could trigger the nausea. It was bland, smooth and easy to eat and provided some nutrition.

[fishnfla]

15. and dishes as such would include

pudding, tapioca, jello, etc

[Tab]

13. As someone going through this myself, I'll say...

First, I'm done with the initial chemo and radiation, and will do surgery in two weeks (it actually would have been yesterday, but got postponed).

Chemos are much better than they used to be, you are right. There are two forms - the kind where you go to the hospital and get a full load, and then are incredibly sick afterwards. This maybe preferred for certain kinds of cancer, I believe breast cancer works this way. There is also what is called a continuous chemo infusion, where you get a "port" surgically installed in your chest (you don't have to, but the alternative is a lot of needles) and then you get a pump and chemo meds that feed you continuously 24 hours a day, although usually it starts on Monday, ends Friday, and you get the weekend to recover very slightly. This is what I had - I have colon cancer, and I did this for six weeks (and may need more post-surgery, don't know yet), coupled with radiation.

I don't know the criteria why continuous infusion is recommended for some cancers and not for others. The nausea effect is less, though. It also depends on the degree of cancer. I have Stage III. If you hit Stage IV, where it has metastasized (basically, it hopped the bus and is riding the bloodstream to other organs/areas) then I think you get the heavier hitting dosage, because it's exponentially more dangerous at that point.

My chemo finished mid-December, so in terms of food I'm much more normal at this point than I was. During it, though, I often wasn't really feeling like eating. If I was feeling like eating, I just wanted to eat what I wanted to eat, regardless of any special diet, as you note.

During it, I found it nearly impossible to consume a meal at once. This may be specific to my kind of cancer, I don't know, but I was only able to eat in small quantities. More often, perhaps, but I just couldn't sit down and eat a hamburger, for instance. More than once we went to restaurants, and I had three bites of my order, and took the rest home.

I also found (and still find, although I'm better than I was) unable to eat red meats, or anything overly fatty. I needed "light" food. Your mileage may vary.

I also didn't feel like cooking. I didn't cook for nearly two to three months. I'm not overly looking forward to it now, but I do cook about twice a week. In part it's the food aroma, in part just an exercise in energy, and in part just that if I'm not hungry myself, I'm less inclined to want to cook. Between all three, though, however, it was months before I cooked again.

But, for me, at least, it was mainly very small servings, and almost no red meat - nothing particularly fatty - and even now I find them hard to deal with. Fish and white meats were much easier, yet many a dinner went uneaten.

I will also comment that you mentioned the "pink ribbon" kind of cancer meaning, of course, breast cancer. The American Cancer Society had a selection of ribbons at the place where I went for radiation, with ribbons for nearly every kind of cancer. I will note that the ribbon for colon cancer was brown. Someone has a sick sense of humor.

[fishnfla]

16. Dont feel like cooking, had not even thought about that

Sunshine cooks for her family, usually. Even if she does not feel like eating, I think it would be a comfort for her to know that her kids are being fed. Will talk to the brigade about this,her may not wanna cook for some time after chemo, thanks.

And much luck& well wishes to you, I guess you know their are cancer forums out there. Cancer Compass was one that helped us.

Speaking of sense of humour, a funny prank my bro used to pull. Without any sense of taste at all,( no taste buds from radiation, not bad taste in a prank), my brother would pull a fast one on unsuspecting and well meaning well wishers who brought food over to his house.

"You know I cant taste anything', he'd tell them, 'but that may change with this dish!' he'd take a big portion and make a big show of taking a bite and acting like it might be the one that he could taste while the butt of the joke waited in the pregnant pause. (He was a real ham, my bro) Then he'd act all disappointed and say, 'nope, cant taste a thing' and hand the huge portion he took back to the person, turn and walk out of the room. The joke was to see the look of confusion of the poor butt of the joke, 'and what am i supposed to do now?' look as they stared at the food. Then all of us who were in on the prank would bust out laughing.

The dish giver would get over it and we'd all snatch up his food, and we'd all wait for the next victim to come in the door. Invaraiably the butt of the joke would be happy, in the end, to bring laughter and be eager to be part of the next rube who got tricked

[no_hypocrisy]

17. You never know . . .

My BFF's mother was dying of Stage IV lung sarcoma. Food, the sight and smell, made her gag.

Until I baked a peach pie. Nothing glamerous, only fresh sweet Virginia peaches at their peak and a homemade butter crust. It was the only thing she craved and ate. And then returned to aversion to food. It cheered her up immeasurably and was a fond memory as her disease progressed.