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Tube feed formula vs smoothie/shakes

bonefamily's picture
bonefamily
Posts: 27
Joined: May 2012

Nelson has had his PEG for a few weeks now and we are using the prescribed formula - Osmolite 1.5. We are having a hard time meeting his calorie goal and he continues to lose weight. We are able to consistently get in 4.5-5 cans of the 7 that are goal.

Did anyone start on formula and switch to smoothies? Do you switch it up? I've seen the recipe section, just trying to find out what made the decision for or against the formula based diet when you were 100% PEG dependent. One major advantage to the formula is that our insurance covers 100% of the cost, but we are open to a switch for better weight management.

blackswampboy's picture
blackswampboy
Posts: 341
Joined: Jul 2012

I use Osmolite 1.5: 2 cans per meal, 3 times a day, religiously. so far I've gained 15 lbs. of my goal of 40.
5 cans is only 1755 calories--not enough for fast weight gain.

for a while my weight plateau'd and I started using 7 cans per day. oddly, didn't seem to make much difference. and since my supplier wouldn't increase shipment quantity without a new prescription--and the stuff isn't cheap--I dropped back to 6 per day. since going back to 6, I'm gaining weight again. go figure.

I tried supplementing osmolite with drinking smoothies, but ran into a lot of mouth pain and stopped. if I plateau again, I'll supplement with Ensure via tube. I've also supplemented with juice and gatorade in tube for more calories.

when I can start eating again, I plan to stay with Osmolite for a while. until I can get well over 2000 calories/day from eating by mouth.

best wishes to Nelson.

Tonsil Dad's picture
Tonsil Dad
Posts: 488
Joined: Dec 2011

I make shakes with Nestle Vhc (560 calories) in 8oz , I also add lots
of other thing such as brownies, peanut butter, milk, ice cream, anything
with lots of calories and in one 16oz drink you have an easy 1000 calories,
so two of them a day and the food I also eat I'm good to go. You can make
them healthier with nuts and flax and oil but they don't taste as good.

God bless
Tonsil dad,

Dan.

phrannie51's picture
phrannie51
Posts: 3721
Joined: Mar 2012

then I can't see any reason why not to suppliment his tube diet.....I don't know about pouring smoothies down a tube, tho...I'll leave that to the more experienced tube feeders...Hondo's wife makes real "food" for his tube, blends it all up to the right consistancy and they pour it down. Asking him how she decided on a consitancy etc is what I'd do before I put anything down my tube that wasn't made for it (keep in mind, my tube has always creeped me out, and I have had to use it only in the last 3 months of treatment....I have never put anything down it but Ensure and VHC and Coca Cola to clean it....so I'm not the bravest of the tube users here :).

p

Greend's picture
Greend
Posts: 679
Joined: Feb 2010

Version 2 from a sober typest:

For two years I followed the directions using the liquid nutritions through my G-peg but I never did put on a lot more weight and quite frankely I felt like crap most of the time with no energy and basically the blaahs. Now my wife had had been nagging me about blending up reqular food to shoot in the tube but for some reason I was reluctant to do that because 1) I didn't want to place more work on her and 2) liquids really are easier and take less effort to eat. Now being the persusive (sp) lady she Is I finally relented and let her cook me up some real food. I guess in her excitment she may have gone overboard on some foods that might tend to lend themselves to flatulence (farts for those of us down south). My first "real" meal consisted of collards, rutabagas, lima beans, hamburger and some carrots. We added water to get the consistency needed. Now the rest of the story I have told in the past so for you old timers just bear with me. To digress a bit you need to know about a game I played while sitting on the can trying to pass a softball for those times I did not include Miralax with my Ensure feeding. I have a 24 inch piece of rope that I flip beneath the door while moaning and groaning as my rectum attempts stretching exercises unknown to civilized man. When I move the piece of rope my 18lb solid black and loveable cat named Rufus plays tug of war with me and he will do this for hours. Usually I see two paws beneath the bathroom door tring to get the rope. Not a lot but it kept me entertained. Well on the day I ate my wife's concotion I was struck with one of the worst gas pains I had ever encountered. Unfoutunately for poor Rufus I exploded as he was in mid leap for the rope. That cat made moved I didn't think were possible. He did a 1/2 mid air flip, every hair on his body was sticking straight out, his eyes doubled in size and when he hit the ground he was in full stride running from the room. Two days later he finally showed himself again.
Now there is a reason for this story. I personally highly recommend blending food for 1) the psylogocial feeling, 2) the added nutrition, 3) the immediate increase in stamina and strength and 4) its a good way to get rid of strays if you have them. If you can overcome the need to tube feed "breakfast" foods at Breakfat time then it gets easier. Since I can't taste my food I usually put any leftovers from the families meals the day before, add whatever nutrients are needed to make it healthy and supplement with Ensure if I think I am missing any vitamins or minerals. Typical meal will be possibly sausage - blends up easy- a small can of peas and carrots, possibly a slice of pie, slices of mango, maybe sone canned fruit and gatorade (if needed for the liquid to keep it thin enough to go through the tube. I genetally stay away from meat with gristle and foods with crispy crusts because they are difficult at time to blend to a consistenct=y needed to tube feed and cause plus in the tube. Blened food with supplements as needed are the way to go if your stomach can handle the food.

Denny and Rufus send warm regards

phrannie51's picture
phrannie51
Posts: 3721
Joined: Mar 2012

with lessons on how and what can be blended to make a good nutricious meal to go down the tube....

....but I gotta tell ya I have never laughed so hard on this site....not only could I relate to you pain and suffering on the pot, but the mental vision of the cat in mid air is still keeping a smile on my face (and I LIKE cats)....

Thanks for the great chuckle tonight.

p

Pam M's picture
Pam M
Posts: 2194
Joined: Nov 2009

If he can get a smoothie down, lots of us were able to whip up high calorie smoothies (my go-to was yogurt, protein powder, banana, peanut butter) - wow, just realized I forgot the calorie count - no way.

I was interested in tubing "real" food to get away from the corn syrup and "fake" food in my formula. I didn't do it, because I was concerned I wouldn't be able to match the formula's other nutrients, and, to be honest, I just didn't feel up to the challenge.

what you can and can't tube may vary, depending on the french (diameter) of the tube.

bonefamily's picture
bonefamily
Posts: 27
Joined: May 2012

Denny, that story made my week! Tears (the good kind!) were rolling!

He cannot swallow anything but water right now, so we are totally tube dependent for nutrition. From what I hear most people saying, stick to formula until he he can swallow, then go to real food smoothies to drink? I am worried about clogging the tube with real food and also getting the right nutrient balance.

We go see the nutritionist today and are going to check into getting a pump for nighttime feeding. He just struggles to get to goal and passive feeding about 1/3 of his nutrition may get him over the hump. He sleeps fairly upright anyway, so aspirating should not be a problem.

Barbara B
Posts: 40
Joined: Sep 2012

My husband's nutritionist suggested we use the pump and it did make life a lot easier.

As far as the formula, we added protein powder to his Ensure plus and vitamins (crushed of course) baby food and prune juice. Chemo does run havoc with the digestive track! Thanks Denny for that reminder =)

My husband also slept in a recliner for a few weeks so we did not have a problem with aspirating.

davkel's picture
davkel
Posts: 20
Joined: Apr 2012

Yep I had that same problem. The osmolite and ensure and carnation...all that artificial stuff gave me nausea and made me vomit. I bought a vitamix mixer (very heavy duty) and my wife started blending all my food. We can make anything and put it in the blender. Depending on what it is you may have to add liquid. We added beef or chicken broth and we could also add olive oil. (very high calorie) that got rid of the nausea and vomiting and stopped the weight loss. It, for me at least, is wonderful becuase we can use non-artificial foods and the smells are fantastic.

George_Baltimore's picture
George_Baltimore
Posts: 303
Joined: Jun 2009

Somehow you need to get the prescribed number of cans in him. When I first went on complete tube feeding, being hardheaded, I insisted on going on Ensure. I ended up with a stay in the hospital due to being rundown. Supplements do not give all the nutrients your body needs to survive plus there are not enough calories to gain weight back. You can see that just by reading the labels as you have done. I use Isosource, six cans a day. I'm thinking about going back down to five since my pants are starting to get a little tighter (can't blame it on the dry cleaner shrinking things since they are wash and wear). I was 220 pounds when I started treatment back in 2004. At my lowest, I was 129. Up until my surgery last year, I maintained 145 pounds eating by mouth. Now that I am back completely on the tube, I am at 150.

nick770's picture
nick770
Posts: 195
Joined: May 2012

I was 100% tube fed for a few months and the canned stuff made me sick so my wife made meals for me using a food processor and a blender. We got lots of recipes from lucysrealfood.com my weight only flutuated by a few pounds. With the blender my wife was able to add vitamin supplements as needed i used gravity bags for my feedings filled them up then hung them and let the food flow , it usally
took about 45 minutes to flow about 500 ml but i was able to rest or be on the computer.

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