Tough to swallow

An inside look at some dietary, and indeed gastronomic issues of a Head & Neck cancer patient

My rehabilitation is going well at Hutt Hospital, with my various wound dressings decreasing in size, drains removed and this morning my neck sutures were taken out.

The one remaining hurdle for my escape from hospital is the ability to eat - in particular, swallowing.

As expected, I’m not yet able to swallow solid food, due to the surgical damage and inflammation in the areas. There’s also a complication from radiation and surgical damage from my 2009 treatment, meaning some material does not get swallowed; instead it hides in the bottom of my mouth before finding its way, if it can, to my airways and lungs, causing me to choke.

As seen on TV

The other day we did some X-ray videoing of the process, to see what was going on. Watched carefully by a team of specialists, I drank some liquid containing a “contrast dye” that allowed us to trace the journey of the fluids using a real-time X-ray video. In the example below, most of the liquid is eventually swallowed (after some effort!) but a small amount settles in the bottom of my mouth; a very small amount pools above my vocal chords; and a tiny, rebellious amount sneaks off down my airway. Generally, a simple cough can sort the problems out, as well as some well targeted clearing and swallowing techniques. There’s a lot of damage still healing from the surgery, so we are all expecting improvement. It helps to see what we’re starting with, and plan some techniques to cope.

So, we’ve been working on my swallowing skills by re-training the mouth and throat physiology to be able to get liquids and feed down. Each eating session is hard work. It takes a lot of energy and concentration to avoid choking - and due to the deliberate use of coughing and spluttering to mitigate the choking, it is often very, very messy! Stand clear.

Progress to Puree

My recovery plan is to begin with a fluid-only diet, and then building up a purée diet, then hopefully solids. This is a process that will take weeks and months, not days, so it is important to be patient, safe and persistent.

For those curious what a Hutt Hospital Purée Meal looks like, I have shown an example in the clip below.

So far, so good. On Sunday I went twelve rounds with a cream of chicken soup, and won. This morning, I consumed my first purée meal, with minimal collateral damage to the hospital sheets.

Small steps are fine. What we are after is progress, with maximum calories for the energy expended consuming them. I’m not wasting any time wishing for flashy meals; I’m after any form of fuel for getting me home. And that’s not too tough to swallow.

Putting my feet up in the Plastics Ward dayroom, having just gone 12 rounds with a cream of chicken soup.