Day +20: Day in the life of BMT – mealtime | Wrong about the bananas

Without an immune system, a food-borne illness is much easier to get, and much more dangerous for Nadia. So we have to be very careful regarding food and drink. This not only includes what she consumes and how, but also anything that comes in contact with anybody’s mouth. In this case, the germaphobes are right, and we have to try to think like them.

Anything that comes in contact with someone’s mouth has a 2 hr timer on it. So if Nadia drinks some water from a cup, the cup has 2 hrs before it has to leave the room, or at least go in the trash. This rule holds for anyone else in the room as well. In order to keep track of this we either write the time directly on the object using a permanent pen, or we write it on the white board in the room.

The kitchen prepares special meals for BMT patients. The food tray comes plastic wrapped, and individual items within are also wrapped. But, Nadia, being 2, does not really eat anything off the tray. So we bring in tetra packs of puree, individually wrapped cheeses, and yogurts (and on occasion chips when we want to be parents of the year). Each one of these items is wiped down before bringing into the room, and once opened, a 2hr timer starts.

Tara is able to make Nadia her favourite fruit smoothies though. We’ll save this complicated process for another post.

Only Nadia is allowed to eat in the isolation room, so mommy and daddy take turns eating in the parent’s lounge, where we swap stories with other parents, provide each other encouragement and hope, and sometimes a shoulder to cry on.

Oh, and we were wrong about the bananas! I don’t think all BMT centres are the same on this. A BMT manual from 2013 we purchased said no raw fruit, but our team here feels that fruit with skin on it is OK, as long as the skin is wiped down before it is brought into the room. Then the fruit has to be peeled before eating. So when a banana comes from the kitchen, it is wrapped in plastic, put on the tray, and then the tray is wrapped. Double protection. 😉

And sometimes we just let her eat chips in the crib.

And we write it all down. The nutritionist has a keen interest in keeping Nadia fed and will recommend a feeding tube if needed. At any time Nadia could end up developing sores in her mouth from the BMT process, at which point eating will become uncomfortable. It is important to get the feeding tube in before everything gets really sore and swollen. There is an option beyond feeding tube but I won’t go there.

Also, the nurses are very interested in the amount of fluids Nadia is taking in. They weigh every diaper, and weigh Nadia daily (down from twice daily) to make sure she is not retaining or loosing too much fluids. Either case could mean trouble.

Happily, Nadia is eating, drinking, and peeing/pooping like a champ. 😉

Nadia eating pudding using a large soup spoon. The kitchen keeps sending up the largest spoons they have for a toddler. Sigh. One would think a Children’s hospital would have an over-abundance of teaspoons for little mouths.