Monday, June 29, 2009

Blenderized Diet . . . Fractured Jaw Diet . . . No Chewing Allowed

(See below at bottom fourth of the article, I have a number of links to reliable websites for those needing to temporarily follow a blenderized diet.)

For some reason a former patient popped into my mind a while ago. I was working at the pre-op clinic when this slender young teen was about to commence her summer vacation by undergoing corrective jaw surgery that would require her to follow a blenderized, or fractured jaw, diet for at least 4 weeks.

Her mother was concerned about keeping weight on the young lady's size-zero frame during the recovery phase. The purpose of our pre-op teaching and health-history-gathering was to deal with specific issues and concerns such as these. The dietitian was unable to join our meeting, but we did put in a consult for her expert advice for the period in which the patient was to be in the hospital. However, advance planning was also in order.

Our hospital's hand-out on blenderized diets was woefully disappointing to the mother. This many-times-over photocopied, one-page handout was meant to help a patient determine how they would take oral sustenance for 6 weeks . . . The mom was right, our information sheet lacked so much that it was embarrassing. The good news is, better resources are available online.

Fractured Jaw or Jaw Surgery

We rest a broken jaw in order for the bones to knit, just as we rest a fractured arm or leg. Stressing the healing bones with chewing is painful and interferes with healing. Often during the recovery phase, the jaw is wired closed for a period of weeks. Some hospitals are better than others at providing good information about the importance of continuing oral care as well as providing specific suggestions for promoting optimal nutrition when a liquid diet is required during convalescence.

Advanced preparation--more than purchasing a blender

Before I was a nurse, my husband had jaw surgery. Advance preparation for the procedure included purchasing a blender. We were given a very simple handout from the surgeon's office with a few suggestions. There was no Internet to go to for advice, so my husband's blenderized diet was boring, repetitive and did not provide him with the level of calories and protein he needed. He lost a LOT of weight during the recovery phase--and he didn't have any extra weight to spare . . .

What am I going to feed [my kid, myself, my spouse, etc.] on a blenderized diet?

I want to begin by stressing the absolute necessity of consulting with a dietitian at the hospital if you or your loved one has special, underlying nutritional issues such as the need to also follow other diet restrictions including gluten-free, diabetic, vegetarian, bariatric,  etc.

The American Association of Oral and Maxillofacial Surgeons (AAOMS) addresses post-operative nutritional concerns on their website. They specifically caution about the importance of taking in adequate amounts of free water and calories. The AAOMS recommends keeping a journal to record fluid volumes taken in and calories consumed to ensure these needs are being properly met. They also suggest planning blenderized meals in advance. It's hard to "wing it" unless you have all sorts of options available in your kitchen to make the blenderized meal appealing.

When restricted to a blenderized died, it's important to understand that liquids are digested more quickly than solids. In order to maintain energy and keep up with the body's metabolism during recuperation, blenderized meals should be given more frequently than a standard diet. (It may be necessary to take a blenderized meal from 4 to 6 times daily). Protein shakes are recommended for all blenderized diets. (I have some links to follow below for specific recipes.)

For the lactose intolerant, the milk-based tendency for blenderized diets may seem a bit disconcerting at first glance, but there are lactose-free options in the form of soy milk, and nutritional supplements such as Ensure, Boost, or Osmolite.

Web pages with blenderized diet information

I recommend looking at every one of these. They all offer good advice, but you will find some great suggestions that are unique to each specific site.
  1. Dartmough-Hitchcock Medical Center fractured jaw diet
  2. Dartmough-Hitchcock Medical Center blenderized diet information
  3. Aspirus-Wausau Hospital Diet for Jaw Surgery (Blenderized Diet)
  4. Ohio State University Medical Center Blenderized Diet for Jaw Wiring
  5. Kaiser-Permanente, "No Chewing Required," Blenderized Diet
Interesting products

I have no commercial interest in any medical products and don't receive or seek any income or favors from anything I've written on my blog. In looking for my fractured-jaw, blenderized diet information, I learned about commercial products that assist the wired-jaw patient take nutrition without sucking through a straw.  Actually the products do have straws, but the liquid-filled bag or bottle is squeezed with the hand to force the contents up through the straw and into the mouth.  These products can be used to clean and rinse the mouth as well as to easily take in fluids. This product looks like it would be very useful, particularly in the first few post-operative days.  Check out a variety of nutrition squeeze pouches and squeeze bottles at Craino Rehab.com (their NutriSqueeze bottles look good) and Dinner Through a Straw.net

Do you have suggestions?

Please let me know of other good tips and sources of information for people on blenderized diets. I'll be happy to post your suggestions or links here. I'd particularly like to know about blenderized diet recommendations and resources for individuals on special diets like gluten-free and diabetic diets.
Please click on the comments section to read Shirley Taylor's comments and suggestion. Thank you, Shirley!


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4 comments:

greenthumb said...

Carolyn,
My son was in a work accident on Tuesday. He was very lucky to escape with a broken jaw, a few broken teeth and a gash under his chin. A crane holding a 5600 lb concrete block hit my son in the chest and face. He is very lucky to be alive. He is very weak and panics since swallowing is hard for him at this time. He does find comfort in the use of the mouth suction unit. (Dentists use them) We had to purchase one for when he is released from the hospital. He has always had sinus issues (mostly in the morning) and is lactose intolerant. You have given me alot of information that I hadn't received from the hospital. He is to be released in the morning and looking forward to his recovery.
Regards,
Shirley Taylor
Vancouver, British Columbia

Carolyn Cooper, MPH, RN said...

Shirley, I wrote you a fairly long reply that is lost in cyberspace. I want to thank you for your comments and extend my hopes that your son is enjoying a good recovery at this time.

I really appreciate your suggestion regarding the mouth suction unit! Good idea--as it's useful and it helps with the loss of control one feels when faced with a wired jaw.

Carolyn

Protein Drinks said...

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Benjaminnewmexico said...

If you're like me and not one for sweets, having my jaw wired shut really inhibits your appetite at a time when your nutrition is at it's peak importance in aiding the healing process. I have found that the Cambell's Chunky series of soups, when cooked first most importantly, are excellent. The brocolli potato and cheddar bacon are my favorites, as well as the creamy chicken and dumpling. The beef stew types are good too, there is an amazing selection. Just cook as directed then liquify in a blender. Avoid ones with celery as it doesn't blend down well and you'll spend the rest of your night picking string from your hardware. Get well soon everyone!!