Soft Food Diet after Oral Surgery

It has been three weeks since the Frog's oral surgery for full arch dental replacement or sometimes called all on four dental implants.   The surgery went well and he seems to be healing properly. 

One of the selling points of this procedure is that it is a one day procedure.  That seems to be essentially correct (albeit a VERY long day), but that statement is a bit misleading out of context.  Although it is a one day surgery and he now has teeth, he can not eat anything requiring chewing for at least four months.  In his case, he will require another implant in December which will presumably add another four months. 

That is the long way of saying we are three weeks into at least 32 weeks of a soft food diet.  We got very little direction from his oral surgeon on appropriate things to eat, other than the general suggestions of scrambled eggs, soft fish, or things that are pureed or could be mashed with a fork.  Definitely no pieces of meat, no lettuce.  Needless to say, I have been digging into this further and have discovered he needs a pureed diet or something on the very soft end of a mechanical soft diet.  Yes, I am eating the same thing (or at least for dinner) since it makes no sense to cook two different meals for two people.

Here are some of the highlights of what I know to date while I can still find everything.

Resources on Soft Food Diets.  By far the best resource I have found to date is a book by Sandra Woodruff and Leah Gilbert-Henderson entitled Soft Foods for Easier Eating Cookbook.  This book contains not only specific recipes but also has a tips on pureeing or grinding different types of foods in general, information on recommended equipment for the kitchen (blender, food processor, meat grinder, masher, potato ricer, etc.), descriptions and sources for various commercially available pureed foods such as Thick-It (which we have not used and likely will not) and nutritional supplements such as Ensure (the Frog has used Original Ensure or Ensure high protein for between meal snacks).

My go-to resource for preparing soft foods.

Other sources I have found helpful include:

• Easy-to-Swallow Easy-to-Chew Cookbook by Donna L. Weihofen.  This book has more "easy-to-chew" recipes than pureed recipes, but it is still useful.
• Essential Puree the A to Z Guidebook by Diane Wolff.  This book is by a gourmet cook.  The recipes likely taste better but are sometimes more complex, which is a negative.  My bigger complaint is the greater difficulty in using the book due to its layout and lack of index.  However, one of the big pluses is an accompanying website and blog (http://essentialpuree.com/blog/), which has all kinds of hints and suggestions from recipes to tips for how to fly on a commercial airline if you require a soft diet.  I have yet to make my way through all of the blog posts.
• Eating Guide for Pureed and Mechanical Soft Diets, from the memorial Sloan Kettering Cancer Center site, https://www.mskcc.org/cancer-care/patient-education/eating-guide-pureed-and-mechanical-soft-diets   This site has lots of practical information about the differences between a pureed and a mechanical soft diet, appropriate foods for each type of diet, what to look for at the supermarket, and specific recipes.
• Healthy Nutrition for ALS,   http://www.neurology2.ucsf.edu/brain/als/pdfs/healthy_nutrition_for_als.pdf  This site also has general info and some specific recipes. 

Equipment we find useful. 

• I am so thankful that we already had both a Vitamix high speed blender and a Cuisinart food processor.  We used these only occasionally in the past, but now use one or both of them nearly every day.  I don't know what we would have done without at least one of these.  I am very glad that we have both since they do slightly different things.  

Vitamix 5200 Blender and 7-Cup Cuisinart Food Processor

•  I also bought a potato ricer for "mashing" sweet potatoes and other veggies and to help when reheating polenta (https://www.cooksillustrated.com/how_tos/9036-reheating-soft-polenta), a good soft food when originally made but a bit of a challenge to reconstitue to porridge consistency. 
• I am using our 10 oz Pyrex custard cups to make single serve timbales (no, I did not know what a timbale was before this either!), but need to get more. 
• The cookbooks suggest numerous other kitchen gadgets, but we have not needed anything else special so far.

What works and what doesn't.

• Breakfast has been pretty straightforward.  Scrambled eggs work if eaten slowly.  Instead of English muffins or toast, which would not work, I fix hot cereal.  The cereal of choice so far is oat bran, which is much smoother than oatmeal.  Cream of wheat would likely also work, but I think oat bran has a lower glycemic index.  I add almond butter for taste and some fat.  It is topped off with pureed sliced peaches for the Frog and seasonal berries or a banana for me.
• Most of the cookbooks feature smoothies or blenderized soups for lunches.  We have had both, but they have not been especially popular.  Most of the lunches are now leftovers from dinner.  
• Before surgery our dinners were typically fish and a vegetable, a meat and a vegetable, or a meat/veggie stir-fry, with the occasional taco dinner or fajitas.  Fish fillets of soft fish like swai or salmon work well and we continue to have them, but unfortunately beef, chicken, or pork require much too much chewing nor do they blenderize well. They normally must be combined with something else for a better consistency.  This is still a work in progress, but things that have worked so far include chicken tetrazzini (http://www.neurology2.ucsf.edu/brain/als/pdfs/healthy_nutrition_for_als.pdf), chicken or ham timbales ( Soft Foods for Easier Eating Cookbook), and very smooth meat loaf (Easy-to-Swallow Easy-to-Chew Cookbook).  
• Anything that is a bit chunkier (salmon loaf, shrimp and mushroom souffle) has not worked well...not smooth enough; not easily mashable.
• Vegetables also need to be ground, but most of them are a mess even after being ground unless a thickener of some type is added.  We have had success with recipes that incorporate either potato or potato flakes as the thickener: zucchini-parmesan puree and savory carrot puree (both from Soft Foods for Easier Eating Cookbook) and puree of broccoli with garlic (https://www.mskcc.org/cancer-care/patient-education/eating-guide-pureed-and-mechanical-soft-diets ).  These result in something with the consistency of thin mashed potatoes.  Stouffer's frozen spinach souffle also works as a veggie with no modification.
• Vegetable baby food is easy to heat in the microwave, but has been unpopular primarily due to lack of taste.
• Macaroni and cheese works reasonably well, but needs to be blenderized with lots of extra milk. 
• Another starchy side that works well and tastes good is polenta parmesan (Soft Foods for Easier Eating Cookbook). 
• Sweet potatoes are supposed to work well, but I did not get them smooth enough in my one attempt.  I plan to give them another shot.
• Applesauce is a frequent addition to lunch or dinner.
• Ice cream is the dessert of choice.
• Between meal snacks include single serve pudding or Ensure.

This is a start. We are not starving, but there are more starches and carbohydrates than I would like and we need more choices to build in more variety.