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marma Offline OP
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Hi All,

I helped my FIL in India, where choices are quite different when it comes to eating. We came up with a few solutions I haven't seen before and/or which aren't always practiced in many cases, that I think might be underused in the USA.

Here are a few tips I have

1. Healthy oils were added to supplement missing calories. My FIL didn't much care for ensure drinks, so we added oil to his food. We primarly used canola and mustard seed oils. For lunch, in order to catch up on his caloric intake, there were often times when we would add 4-5 tablespoons of oil to his lunch, for example. This not only gave him needed calories, it also made the food a lot easier to swallow. I know this level of oil consumption is unusual, especially in the USA, but it was critical for him.

2. A pressure cooker does wonders. This is a device that basically kills the fibers in a food (if you cook it long enough!) that makes it harder to chew or swallow. And it does it far more quickly than regular stovetop cooking. Many protein rich foods can be consumed this way, including beans, lentils, chana dal, and quinoa. Grains like rice and oatmeal can also be softened into total mush using a pressure cooker. All of these can be found in the USA. In the pressure cooker we were able to make a combination of rice and lentils that we'd then add several spoons of oil to. It was easy to make a 1000 calorie, protein and fiber dense meal in this way. I especially suggest sonsidering quinoa for this purpose due to its being a complete protein source, but it was not available in India. Get it at whole foods by the pound. Be careful that you get enough protein.

Pressure cookers are not nearly as scary or difficult to use as they seem. I use one most days even now; as do most Indian housewives. Without it we'd be cooking all day.

3. Track calories. It's pretty imperative that you do it regularly. There is no way to be sure you are getting enough calories unless you track them. If you don't do this, odds are you will not get enough, lose weight, and severely interfere with your body's attempts to heal. I used a website called thedailyplate.com to very quickly track calories and set up custom foods and menus.


4. The other foods he consumed regularly were eggs, milk, and fresh pomegranate juice (since it is low acid).


My FIL lost no weight during his treatment, despite a complete lack of taste and moderate difficulty swallowing for a few months.


Hope these suggestions help.


FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
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Those sound like very good ideas. You have obviously done your homework. Glad to hear your father-in-law is doing well.


Caregiver to husband Dx. Stage 4 SCC of gingiva with 3 nodes pos. Partial mandiblectomy with bone graft from iliac crest Dec. 2006. IMRT x30, Cisplatin x3. Completed Tx. March 15, 2007. Osteonecrosis & removal of graft & plate Oct. 2007. Recurrence of SCC Dec. 2007. Deceased Jan. 17, 2008.
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Marma,
Since pressure cooking something like rice and beans is not a typical american fare, why don't you post a couple of recipes with quantities and cooking times to get people started.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
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marma Offline OP
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Eileen,


First of all, there are many types of pressure cookers and they start at about 30 dollars new. But these suggestions are for any pressure cooker since we aren't being precise here; the goal is to liquify. Always leave the pressure cooker at least 30%-40% empty in order for food to expand and prevent leaks.

Starting with your food, water, and usually some salt, you toss it all into the pressure cooker and use a medium to low heat.

The amount of water to add should be at least double in volume to whatever is being cooked if it's in a dry state. In addition, plenty of salt (but not too much to over-season) should be added either during soaking or before sealing the pressure cooker. This will help to speed up the softening process.

It is ideal to soak foods with a lot of fiber such as beans at least overnight, but it's not required.

I will list some dry foods and their MINIMUM time to cook in order to be liquified if they haven't been soaked yet at all.

I'm going to list some common types of dal, whcih is the Indian word for LENTIL, which are usually found in Indian stores and are often in large grocery stores also.

Masoor dal, moong dal, and split peas are soft within 30 minutes. These aforementioned dals have a fragrance that some might take getting used to for some; in this case additional suggestions are made below.

Chana dal and whole urad dal: 2 hours.

White rice and quinoa: 45 minutes (longer for brown).

Most kinds of beans, including kidney beans and garbonzo beans will be softened in 2-2.5 hours.

You can combine any of the above to create your own flavors and recipes.

Nutritionally, QUinoa and chana dal pack the most punch per swallow.

I do highly recommend you wash these foods off before soaking or cooking them in a water and baking soda mix and rinsing thoroughly.


Here are some things below for flavoring for an eater who is sensitive to acidity. These are just my suggestions based on experience and should be used in moderation and experimented with carefully at first. I could be slightly wrong, so do use your own caution.


Coriander powder
onion
Turmeric
Cumin
Paprika
Nutmeg
Garlic
Ginger
Finely ground nuts like cashews and peanuts and almonds
Coconut Milk (don't overcook)

I usually add some or all of the above in plenty of oil and cook until medium brown, then add it to the cooked food before serving and mix it in well. However, each browns at a different rate, so I listed the above items in order of how quickly they cook, from slowest to fastest

A meal prepared from above should usually have enough oil so that it's at least 30% fat, or even much more, unless the person eating is fairly overweight. If the meal's too thick, add more oil or water, but keeping the oil content high is the best way to make sure it delivers enough calories.

If anyone is interested in me translating these into the more authentic Indian or other ethnic dishes they usually start out as, I'll be happy to type of a more specific recipe.

But I think that's enough for one post!

Marma

Last edited by marma; 09-16-2009 12:06 PM.

FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
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Thanks. That should be enough info to get someone started.

I have a question on the spices. Aren't tumeric, cumin and coriander on the hot spicy side. People who have had radiation usually can't tolerate anything that is hot spicy.

I'm also going to email this to my SIL who is a vegetarian. I'm certain she will find the pressure cooker method very interesting. Thanks again for the post.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
Joined: Sep 2006
Posts: 8,311
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Eileen,

I can tolerate hot stuff just as well as before but I don't use it as much now bc I want to taste what I'm eating.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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marma Offline OP
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Hi Eileen,

Good questions.
Tumeric, cumin and coriander are NOT on the hot spicy side. However, like I said, do exercize caution because each is strong in flavor and potentially irritating. Cumin is particularly gentle, however. The other two should be tried in moderation and you need to remember their potency also gets diluted in the food. I'd suggest starting with no more than a small pinch in one serving of any of the spices, especially paprika since some varieties are in fact spicy while others are quite mild.



FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
Joined: Jul 2008
Posts: 101
marma Offline OP
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I would also like to mention of spices that they are usually fried in oil for a few seconds up to a few minutes, depending on how quickly their flavor is released.

This tends to both take the edge off a spice and make it more pervasive in a dish.

Feel free to ask me about specific cook times of each spice. WHat we usually do is heat the oil to barely sputtering (medium heat) and then add the spices one at a time and stir. This mixture is then added to the dal, beans, quinoa, etc.


FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
Joined: Jul 2008
Posts: 101
marma Offline OP
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David,

You will probably not want to tase certain kinds of dal, should you ever eat them. They are VERY nutritious boring, even a little sulphuric sometimes:-)

I find that paprika powder is the best way to enhance a food without overpowering it. But it does have a little acidity so people who are sensitive should be moderate.


FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
Joined: May 2002
Posts: 2,152
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So what spice is it in curry powder and curries that make them so hot? The hungarian papricka Iget is not hot at all.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
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