Nancy is still troubled by the process of getting pills down, food swallowed, and having it all proceed through as it is supposed to. The upper end of her digestive system seems to take issue with what most of us would consider food. However, she does fine with fortified liquid drinks, especially if chocolate infused. She has also reached accommodation with yogurt (orange cream) and various puddings, and last night with supper she was given puréed strawberries. These are high calorie items and can be fortified with protein, vitamins, and minerals and so, nutrition-wise, she is being adequately supplied.
Much of the issue with real food develops with the acts of chewing and swallowing, and, of course preference. A finely chopped egg or tuna mix (no bread) will suit her, but ham salad mix will present a problem if the ham had a rind on it that wasn’t taken off prior to grinding or chopping. She won’t deal with those pieces and in trying to separate them out much of the dish is trash. A ground beef–noodles–sauce dish is no better than one with an outer rind because of pieces of gristle. In this institutional setting there isn’t much hope for refinement.
With her physical abilities improving (slightly) each day we can look forward to the time when she is home and I can begin with better ingredients and take the time to improve them with selective cutting and discards.
She remains scheduled for a trip to the local hospital to have a “modified Barium swallow” study. It will be something like this: She will be given small amounts of a Barium preparation of varying consistencies from thin liquids to paste to a piece of coated cookie. As each of these is ingested the examiner(s) will observe images in real time on a screen and determine if and where there are problems. Nancy is scheduled for early afternoon this Friday and afterwards I will know more.