Meals Are Now a Chore

Among the zillion things our bodies do that we normally take for granted is the ability to chew and swallow without difficulty – the physical act of how to ingest food is not something we generally need to think about. All of that goes out the window when you’re getting daily doses of radiation to the throat, creating a massive sunburn in the middle of your head, focused at the tonsils. This is super-sensitive tissue, which swells up badly with repeated irritation.

I’d been told that the difficult part of this process would start to ramp up between weeks two and three, and we’re there now. Up until this week it’s been uncomfortable but manageable, but the other day I woke up with a super sore throat that was painful even when doing nothing. Swallowing suddenly became a whole different ballgame. Even trying to gulp a mouthful of water can feel like trying to push a golf ball down a garden hose half its diameter. A feeling like crunching glass accompanies every gulp.

The sensation is very different for different kinds of foods. “Smooth” is the name of the game. The more slippery and smooth the food, the easier it is. Anything with any roughness has to be chewed to a puree before I let it hit the back of the throat (which is itself a challenge since I’m missing all molars now).

But what counts as “rough” food? We’re not talking about Grape Nuts and dry toast here – it’s things I’ve never thought of as “rough” before. Suddenly I’m aware that every bite of salad involves moving small pieces of rough-edged lettuce around in my mouth – never a problem before, but suddenly it’s like a grinding wheel. Likewise, a simple baked yam proved really hard to get down until I realized the problem was the skin – scoop the slippery stuff out of the middle and eat that, leave the skin behind. Someone made us a beautiful lasagna, which is mostly great, but the hamburger bits that had been baked in the oven felt like sand in the underwear – intolerable.

The dilemma is that my system is going “Hypermetabolic” as it tries to heal the rapidly incoming damage to soft tissues, and that requires more calories. So I need to consume more calories even as every bite starts to hurt. Meanwhile, my ability to taste food has diminished by ~70-80% now, so there’s no joy in eating at all – everything tastes like cardboard, and the act of eating feels like an exercise in forced maintenance. There is no such thing as an enjoyable meal right now – just things that are easier or harder to get down.

On top of it all, there’s the nausea aspect. The chemotherapy causes ongoing nausea which also makes eating harder. I get an anti-nausea drip every week which helps a lot, and have three different pills to take at different times to counter the effect. If I don’t get it right, we can pile “Sick to my stomach” on top of “Every bite hurts.”

For now, it’s all about finding ways to soften foods. Smoothies are great since I can puree the crap out of anything – I’ve never used the blender so much in my life. Rice is great if I douse it in chicken or beef stock and let it sit to soften, and add some butter or cream. I have permission to eat anything – the more calories the better. Cheese, whipped cream, smooth peanut butter, whole milk or cream, chicken or beef stock, all in plentiful supply and being added to everything.

One more piece here – I’ve always loved spicy foods, but those are completely off the table now. Suddenly there is zero tolerance for anything acidic or spicy in any way. Even a breath mint that would have seemed like nothing a few weeks ago now feels like fire in my throat.

For some patients, all of this gets to be too much to handle, and they end up on the bypass route – a feeding tube is installed in the stomach, and you squirt bottles of Ensure directly into the stomach, bypassing the throat entirely. I can’t say the thought hasn’t already become tempting, but it’s really not a road I want to go down.

I’m starting to make mental lists of all the things I’ll eat with gusto on the other end of this process, when eating is once again pleasurable.