The Salina Journal from Salina, Kansas on June 4, 1998 · Page 14
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The Salina Journal from Salina, Kansas · Page 14

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Salina, Kansas
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Thursday, June 4, 1998
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Page 14
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C2 THURSDAY, JUNE 4, 1998 HEALTH THE SALINA JOURNAL Cooking as caring Providing food for those who are ailing is expression of love By LEE SVITAK DEAN Minneapolis-St. Paul Slur Tribune s he wasn't hungry and that was the problem. For days she hadn't eaten much. "I have no appetite," she said with a shrug. } "Please take a bite," we pleaded. "To keep up your strength." At first she would oblige. A nibble here, a nibble there. Not enough calories to keep a bird alive, much less a 76-year-old woman, but any more food wouldn't stay down. Days dissolved into weeks as we scrambled for whatever might please her, in search of elusive flavors that would perk her flagging, erratic appetite. If a poached egg sounded pleasing one moment, the thought made her gag at the next. We were frantic. This graceful woman — mother, mother-in-law, grandmother, sister and friend to many, so full of gentle laughter, poems and songs — slipped into silence within weeks, her sparkling eyes dulled from medication. Months earlier, she had dined leisurely, savoring each forkful of holiday fare with pleasurable abandon. Now she, who for so many years gathered extended family around the table, could no longer tolerate the sight or smell of food. But we would not be thwarted. She had taught us well. As far back as we remembered, she had greeted us with the universal expression of love: "What would you like to eat?" Now it was our turn. We plied her with pudding and purees, gelatin and juice. "One more bite," we begged. Soon frail, she could no longer feed herself, so we sat at the edge of her bed, spooning soft foods into her mouth, one teaspoon at a time, just as she had done herself so many years before for four hungry infants. "Swallow," we whispered. "You have to swallow." By her bed we kept a journal, noting her nutrients and needs for the next family member in our care-giving schedule. "She prefers hot tea to coffee now," reads one entry. "She drank 20 ounces of liquid. Keep offering her sips. We're worried about dehydration," notes another. We hadn't expected to become caregivers so soon. Not now. Not while we were busy with our own families and the demands of the workplace, not with softball games and music lessons and church classes beckoning. But no one picks the time for care-giving. It picks them. "To some extent, every illness poses the question, 'Am I worth being taken care of?' " writes Laurel Robertson in "Laurel's Kitchen Caring." With each cup of tea or bowlful of soup served, we affirmed, "Yes!" Robertson notes, "We whose caring includes cooking have the chance to make these hard times a feast of love." And so we did as we gathered at her bedside. Few of us escape the role of caregiver, that tender moment when, regardless of our gender, a serious task transforms us into a mother. It does so as surely as it Photo illustration by Scripps Howard News Service Many people are caregivers to those who are very ill. It's important to find what the person needs to overcome depression, nausea and other problems. turns the noun into a verb — to mother is to nurture. When we care for someone who is ailing, we mother them. Webster's defines it the same way most care-givers would: to look after or care for as a mother does. We don't parent them. Or father them. Never mind politically -correct phrases. In times of illness, we all need to be mothered. In return we who give care feel the power of healing as surely as the one on the other end. Food takes on a crucial function in the healing process. "The foods a sick person eats play a tremendous role in how strongly he or she fights back against illness," writes Eileen Behan, a registered dietitian and author of the new "Cooking Well for the Unwell" (Hearst Books, 364 pages, $15), an indispensable guide for the caregiver. "At a minimum, food provides the energy for the battle; at a maximum, it may contain special nutrients research suggests may be key in fighting diseases such as cancer." But nutrition for someone who is seriously ill is unlikely to be the same as for a healthy individual, which can be confusing for the new caregiver. Calories take on critical significance when someone is chronically losing weight because of loss of appetite. Calories mean energy. Suddenly we counted calories each meal with new purpose and fervor: the more the better. Without enough calories, the body turns to stores of protein for energy, which results in muscles wasting away and generalized weakness. A protein deficiency affects the body's functions of tissue repair and immunity, Behan writes. Sufficient liquid becomes an issue for those who struggle with nausea, vomiting or diarrhea. For our caregiving, we calculated ounces of consumed liquid with a precision and intensity that had never been required of us when our own infants were sick. Potassium — important with certain medications and chemotherapy — became our passport to nutrition as we stacked bunches of bananas near the bedside. (We also could have chosen avocados, dried apricots, baked potatoes or more, but we didn't know about those then.) The role of care-giver varies by circumstance. Perhaps an illness is minor: a child or spouse sick with the flu who needs only some clear liquid and a soothing voice to ease recovery. Or it may be a diet that needs modification for health reasons, be it diabetes, allergies or high cholesterol. But it may be more: a friend home from the hospital and in need of meals during convalescence. Or a life-threatening illness that demands constant attention. With 76 million baby boomers in this country, most with aging parents, a whole lot of care-giving looms in the days to come. Add to those numbers the more than 1.2 million people diagnosed with cancer each year, according to Donna L. Weihofen, who wrote "The Cancer Survival Cookbook." Nearly all will struggle with common eating-related problems. TOhe role of caregiver will not cease until we do. Sixteen chaotic weeks passed from the day our caregiving began until our feast of love, served bedside, drew to its inevitable close — too soon, yet at the right time. She was at peace. And, for the moment, so were we. Cooking for the ill Tips for people who are taking care of the ill by the Minneapolis-St. Paul Tribune: • Serve small amounts, preferably on an oversized plate (large amounts can overwhelm those with little appetite). Cut individual food into even smaller pieces, even with sandwiches. • Serve many small offerings of food throughout a day instead of only three square . meals. • Encourage eating by setting a clock for predetermined snack times (every two to four hours). • Serve foods rich in calories and nutrients to maintain or increase weight of patient. • Bland, colorless, odorless foods may help during times of nausea and vomiting. • Serve foods cold or at room temperature if nausea is a problem. • For nausea, sip liquids slowly through a straw from a covered container to mask scent. • Do not serve favorite foods during times of nausea and vomiting to prevent them from being associated with illness. • Page through cookbooks with the patient to see if particular foods sound pleasing. • For those who find that food doesn't taste the same, rinse mouth with fruit juice, wine, tea, ginger ale, club soda or salted water before eating to help clear taste buds. • If there is a metallic taste in mouth, try tart foods to mask it: Add citrus juices or vinegar to sauces, salad dressings, broths. • Use a straw if mouth or throat is sore. • As a caregiver, handle food safely. Botox / Not approved for wrinkles FROM PAGE C1 "It worked much better than I expected," said Griffin, 52, who said he got the injections to ease two deep frown lines on his forehead. And he said, a surprise side effect of the treatment is that his migraine and tension headaches eased. And patients say there's another bonus: Some have found after getting two injections, that the muscles are actually retrained not to tense, allowing the wrinkles to permanently disappear. So where's the down side? Well, for starters, the doctor could inject Botox in the wrong muscle. "That really is the biggest complication," said Susan Monteleone-Laird, director of training and development at Cosmetic Surgery Consultants. The Marietta business screens physicians on experience and education and offers a private referral service for patients for a fee. "If you get someone who is inexperienced, who either injects it in the wrong muscle or allows it to drift, you could end up with a droopy eye for a couple of months." To keep that from happening, patients are told not to rub the area that receives the injection. The Food and Drug Administration also is less than thrilled with the newest use of Botox. Although it has approved its use for such disorders as eye tics and cross- eye, called strabismus, the federal agency takes a dim view of its promotion for wrinkles. And in 1994, it singled out a doctor's Botox ad to state its position. "This promotion of an unapproved use is an egregious example of promoting a potentially toxic biologic for cosmetic purposes," it wrote in a Federal Registry notice. And because the drug is relatively new, there is no data on the potential risks of long -term use. The injections — which typical- ly offer a temporary fix for three to six months — are also fairly pricey. Usually, the first injection is between $300 and $400, with follow-up treatments sometimes costing less. And of course, the treatment is not covered by insurance. Market is massive Botox's advantages for those with wrinkles was an accidental discovery of Dr. Jean Carruthers, a Vancouver ophthalmologist. After completing her treatment of a patient with eye tics with Botox, the patient got upset with Carruthers because the patient's wrinkles returned. Carruthers discussed the incident with her husband, a dermatologist. And in the process, the couple discovered a new market for the toxin. Botox is marketed by Allergan, which originally did not buy the drug to appease vanity. The company, which focuses on eye prob- lems such as cataracts and glaucoma, merely added Botox to its battery of medications because its success with eye tics and crossed eyes. And yet, those treatments make up only a fraction of the $90 million in Botox sales the company made last year. The company will not disclose how much has been sold for cosmetic use. The market — especially as baby boomers seek ways to hold on to youth — is massive. And doctors see another advantage: Botox allows patients who are skittish about doing more invasive procedures get a taste of what they might look like with a more permanent solution, such as a facelift or laser resurfacing. Clft Smoky Hill ' River Festival 9 Watch for it in the June 7th Salina Journal Salina Journal 333 S. 4th • Salina, Kansas • 67401 Mississippi, Mississippi, FOUR* Mississippi *•_-' Reach a market that grows bigger by the second. Every eight secopds a boomer turns 50. The over 50 baby boomers are becoming the largest, most powerful demographic category in the country. Make sure your ad targets the population with purchasing power. Your ad can reach this market in the Salina Journal's Senior Lifestyles edition. This annual publication will feature stories on travel, health, volunteering and using the internet. To take advantage of this timely opportunity, contact your marketing consultant at 823-6363 or 1-800-827-6363. Deadline: Tuesday, June 9 Publishes: Sunday, June 21 the Salina Journal 333 S. 4th • Salina, Ks. '67401 It's an ^•^ w« • advertising offer you wont leve!!! Call your Salina Journal marketing consultant for the incredible details! the Salina Journal (785) 823-6363 • sjadv@saljournal. • www.saljournal.com 1-800-827-6363

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