REAL Food for tubes - 02-19-2013 09:54 PM
I promised DonFoo that I would start a thread on putting real food down your feeding tube instead of the canned formula.
He calls it DIY. Most dieticians call it Blenderized Diet - BD
or Blenderized Tube Feed - BTF. I've researched it extensively and the forums helped so much in switching to a button instead of the dangling tube.
Basically it's common sense: the adjunctive forum and even the general forum always has questions about the latest greatest Anti cancer Diet and magical exotic foods. No body doubts that good nutriton is essential. Which is why I find it personally ironic that all the pegsters and pegophiles tout the nutrition aspect of downing 6 to 8 cans of high fructose corn syrup.
So far at least six dieticians have all assured me it's as good as real food, why because that's what they have told or taught.
NASA tried to have the astronauts use the canned forumulas but they all revolted and refused. The cans are perfect for space travel yet not one space station or one space faring nation uses them after trying them out. You can read the details on Wiki under Space Age Food.
What has happened is that a large group of concerned mothers whose children are entirely feeding tube dependent noticed that after a few years, their children did not thrive on the formula
Once they switched to BD or BTF, their kids perked up, put on weight, quit vomiting and improved in every way.
I'll do other links and info but have to go help Bev chop up real food for our dinner tonight. She will set out two plates as always, one for me and her, and I will smell mine, then dump it into the Vitamix, so I can put it down my tube. It's the best meal of the day.
But I'll leave behind a little history from a webpage of a guy I really liked but he died of cancer
[quote]Fairly quickly, these broken-down, synthesized formulas for enteral feeding became the norm; for a short while at least. It was quite an exciting time for the pioneers, who even went so far as to experiment with feeding patients into the jejunem during surgery. In 1949 polyethylene tubing was first used, and the first enteral feeding pump was developed. But problems of patient tolerance of these broken-down feeds seemed to be commonly arising. In an effort to address this, a sort of return to first principles took place: Hospital kitchens were asked to mimic a normal diet by finely pureeing and liquefying a blend of regular cooked foods, and naturally enough they were generally well-tolerated. The down sides in the hospital environments then though were cost � it was labour-intensive to prepare such foods, and (perhaps ironically) a hospital environment proved a difficult place to keep such foods free of contamination, as compared to sterile synthesized formulas.
In the 1960s, advances in the understanding of the role of amino acids led to further studies designed to see if new formulas could be devised to support patients without the side-effects those early attempts produced. This was supported hugely by the space program, with NASA getting very excited. They could see the great potential in an astronaut 'food' that was concentrated and gave a low fecal residue. These 'elemental diets' had many advantages for the nascent space flight program, in that they stored and transported well, had a very high nutrient density (so were very light), were very soluble so reconstituted easily, maintained an adequate nitrogen balance, and were easily tweaked and adjusted to meet an individual's specific metabolic needs better. But this stuff tasted so bad that the astronauts just refused to eat it. Even today, astronauts eat a largely natural diet, to the extent of taking fresh fruit and tasty baked brownies up with them. Tortillas make awesome edible, low-crumbing zero-gravity frisbees also.
Of course, patients taking their nutrition via tube do not really have a problem with how the solution tastes, and as more and more advances were made in materials for tubes, tube placement surgery and feeding formulas, the formulas derived from the NASA-led research became the standard go-to for tube feeding nutrition. But there was also a sort of medical research arms-race going on, with rapid advances in Parenteral Nutrition. For a while TPN (Total Parenteral Nutrition) was the one attracting all the attention, but quietly research continued in the roles of amino acids and other food constituents, in understanding digestion, absorption and gut physiology. Advances in the development of enteral feeding formulations, tube technology, and the demonstrated lower incidence of complications, lower cost and ease of access eventually moved enteral feeding to the forefront, where it remains the first choice option today.
Something else was going on in the 60's and 70's that related to tube feeding also � far fewer people were dying. Partly this was the result of a slow cultural change that had been gathering pace over the century � we seemed to become a lot less comfortable with allowing death to happen if it was at all avoidable, regardless of circumstances, in much of Western civilization � but a very large factor was technological. The miracles of antibiotics, amazing new drugs, advanced diagnostic and surgical techniques all combined to allow us to save lives that we never before would have been able to save. Serious accidents and injuries that once killed routinely no longer do. Life-limiting illnesses are still on the rise but with advances in treatment and diagnostics patients are tending to live longer. This modern phenomenon is especially pronounced at either end of the age spectrum, with the very young � the very prematurely born even � and the much older citizen.
Of course, saving all these lives means many more people living with serious impairments, a very common such impairment being the inability to eat. Since the last few decades of the 20th century, we've seen an explosion in the number of feeding tubes placed right across the world, most pronounced in countries like the USA. Actual numbers are hard to come by. According to an article published in 2005, there were around 344,000 people using a feeding tube at home in the USA, and the article quoted a 1995 study suggesting that 120,000 patients in long-term care were using feeding tubes also. One thing we do know is that tube placements have continued to grow faster than the population, so it would be reasonable to think there might be half a million to a million people using feeding tubes in the USA alone right now.
To go along with the boom in numbers of tube-fed patients, we now have commercially available enteral formulas in hundreds of different variations; many are very similar, just made by different manufacturers and to different calorie densities, but there are others designed with specific diseases and patient needs in mind. Most recently though, there has been an increasing uptake, driven in the main by parents and carers of tube-fed children and by adult patients themselves, in returning to a more natural food-based diet, often referred to as a blenderized, blended, or pureed-for-gastrostomy diet. It's almost as if we are somehow coming full circle.
[/quote]
history of enteral feeding
He calls it DIY. Most dieticians call it Blenderized Diet - BD
or Blenderized Tube Feed - BTF. I've researched it extensively and the forums helped so much in switching to a button instead of the dangling tube.
Basically it's common sense: the adjunctive forum and even the general forum always has questions about the latest greatest Anti cancer Diet and magical exotic foods. No body doubts that good nutriton is essential. Which is why I find it personally ironic that all the pegsters and pegophiles tout the nutrition aspect of downing 6 to 8 cans of high fructose corn syrup.
So far at least six dieticians have all assured me it's as good as real food, why because that's what they have told or taught.
NASA tried to have the astronauts use the canned forumulas but they all revolted and refused. The cans are perfect for space travel yet not one space station or one space faring nation uses them after trying them out. You can read the details on Wiki under Space Age Food.
What has happened is that a large group of concerned mothers whose children are entirely feeding tube dependent noticed that after a few years, their children did not thrive on the formula
Once they switched to BD or BTF, their kids perked up, put on weight, quit vomiting and improved in every way.
I'll do other links and info but have to go help Bev chop up real food for our dinner tonight. She will set out two plates as always, one for me and her, and I will smell mine, then dump it into the Vitamix, so I can put it down my tube. It's the best meal of the day.
But I'll leave behind a little history from a webpage of a guy I really liked but he died of cancer
[quote]Fairly quickly, these broken-down, synthesized formulas for enteral feeding became the norm; for a short while at least. It was quite an exciting time for the pioneers, who even went so far as to experiment with feeding patients into the jejunem during surgery. In 1949 polyethylene tubing was first used, and the first enteral feeding pump was developed. But problems of patient tolerance of these broken-down feeds seemed to be commonly arising. In an effort to address this, a sort of return to first principles took place: Hospital kitchens were asked to mimic a normal diet by finely pureeing and liquefying a blend of regular cooked foods, and naturally enough they were generally well-tolerated. The down sides in the hospital environments then though were cost � it was labour-intensive to prepare such foods, and (perhaps ironically) a hospital environment proved a difficult place to keep such foods free of contamination, as compared to sterile synthesized formulas.
In the 1960s, advances in the understanding of the role of amino acids led to further studies designed to see if new formulas could be devised to support patients without the side-effects those early attempts produced. This was supported hugely by the space program, with NASA getting very excited. They could see the great potential in an astronaut 'food' that was concentrated and gave a low fecal residue. These 'elemental diets' had many advantages for the nascent space flight program, in that they stored and transported well, had a very high nutrient density (so were very light), were very soluble so reconstituted easily, maintained an adequate nitrogen balance, and were easily tweaked and adjusted to meet an individual's specific metabolic needs better. But this stuff tasted so bad that the astronauts just refused to eat it. Even today, astronauts eat a largely natural diet, to the extent of taking fresh fruit and tasty baked brownies up with them. Tortillas make awesome edible, low-crumbing zero-gravity frisbees also.
Of course, patients taking their nutrition via tube do not really have a problem with how the solution tastes, and as more and more advances were made in materials for tubes, tube placement surgery and feeding formulas, the formulas derived from the NASA-led research became the standard go-to for tube feeding nutrition. But there was also a sort of medical research arms-race going on, with rapid advances in Parenteral Nutrition. For a while TPN (Total Parenteral Nutrition) was the one attracting all the attention, but quietly research continued in the roles of amino acids and other food constituents, in understanding digestion, absorption and gut physiology. Advances in the development of enteral feeding formulations, tube technology, and the demonstrated lower incidence of complications, lower cost and ease of access eventually moved enteral feeding to the forefront, where it remains the first choice option today.
Something else was going on in the 60's and 70's that related to tube feeding also � far fewer people were dying. Partly this was the result of a slow cultural change that had been gathering pace over the century � we seemed to become a lot less comfortable with allowing death to happen if it was at all avoidable, regardless of circumstances, in much of Western civilization � but a very large factor was technological. The miracles of antibiotics, amazing new drugs, advanced diagnostic and surgical techniques all combined to allow us to save lives that we never before would have been able to save. Serious accidents and injuries that once killed routinely no longer do. Life-limiting illnesses are still on the rise but with advances in treatment and diagnostics patients are tending to live longer. This modern phenomenon is especially pronounced at either end of the age spectrum, with the very young � the very prematurely born even � and the much older citizen.
Of course, saving all these lives means many more people living with serious impairments, a very common such impairment being the inability to eat. Since the last few decades of the 20th century, we've seen an explosion in the number of feeding tubes placed right across the world, most pronounced in countries like the USA. Actual numbers are hard to come by. According to an article published in 2005, there were around 344,000 people using a feeding tube at home in the USA, and the article quoted a 1995 study suggesting that 120,000 patients in long-term care were using feeding tubes also. One thing we do know is that tube placements have continued to grow faster than the population, so it would be reasonable to think there might be half a million to a million people using feeding tubes in the USA alone right now.
To go along with the boom in numbers of tube-fed patients, we now have commercially available enteral formulas in hundreds of different variations; many are very similar, just made by different manufacturers and to different calorie densities, but there are others designed with specific diseases and patient needs in mind. Most recently though, there has been an increasing uptake, driven in the main by parents and carers of tube-fed children and by adult patients themselves, in returning to a more natural food-based diet, often referred to as a blenderized, blended, or pureed-for-gastrostomy diet. It's almost as if we are somehow coming full circle.
[/quote]
history of enteral feeding
Today I went out and got me a Blendtec and tried the receipe for the Jevity 1.5. The Blendtec did a great job and it was great to add real food through my feeding tube. It was great to have food go in and not get a upset stomach. Thank you for posting the receipe.