The practicalities of cooking and preparing food; some useful tips

Carrying on from my post on healthy eating and some useful tips about food shopping, today's post is about ways to manage cooking and preparing food for people with a chronic illness or even an injury and sometimes pregnancy. Unfortunately for many people with a chronic illness this can be elusive or very limited and many sufferers require help, whether that be to assist them or to prepare and cook meals for them. Personally, I do not have to prepare or cook any meals as I live with my parents. That of course is not an excuse not too, it's because I find it very tiring and also have difficulty standing for periods of time. It is one of the reasons why I had to move back to my parents and I am forever grateful for their help, even if at times I dislike asking for it. On good days I can pour myself a cold drink and get things out of the cupboards but on bad days I need help with that and may also need help to cut up my food and use a straw in my drink, because I cannot lift up the cup. On some occasions I have also had to be fed. Non of which is very nice.

What can cause problems is the fact that my meal times can vary and be different from that of my parents. This is because my days have no set pattern and when I eat very much depends on when I am awake. Neither of which is particularly good or healthy. When I end up eating at different meal times I can sometimes feel like a burden and will often ask for something very easy and quick to make. There is only so many times that you can eat toast though! If my Mum is making a stew or some sort of sauce etc then she tends to make a big pans worth and then freeze several portions and give them to my Nanna, who is 87. Lately she has been setting some by for me too, sorry Nanna. Therefore they only need to be heated up in the microwave then. Microwaves are a great invention.

Many people find cooking or baking to be very therapeutic and find that they enjoy the creativeness and relaxation of cooking and baking. In which case they may want to use some of their spoons (see spoon theory post) on cooking and baking. It all depends on the person. Some people like to be more hands on and creative with their recipies if they also suffer from a lot of food intolerances, which can also affect many people with M.E. There are a lot of great blogs about M.E that have some nice recipies for gluten free diets etc. A year ago I used to do quite a lot of baking and used to enjoy the relaxation and creativity of it, as well as the eating of course! I used to enjoy the arm work out of not using a mixer but after some post exertional malaise I started to use a blender and also to try and sit down as much as I could rather than stand up. Unfortunately I haven't been able to do any baking lately.

The following links have some great tips to help people with a chronic illness or injury cook and prepare food. It has been compiled by chefs, occupational therapists, authors on disabled living and accessible kitchenand bathroom designers and give a range of tips for sufferers and carers.

http://www.thekitchn.com/cooking-with-a-physical-disability-171416

http://www.cookingmanager.com/tipscooking-disability-injury/

I thought it would be better for me to give the links rather than me re-hashing, especially when there's some really good tips. So be sure to take a look. I have included a few others below, some of which I learnt at clinic. Remember all the tips don't apply to everyone and may be suited to each sufferer at different times during their illness. Knowing that there are ways though that you can help yourself and help others is great and allows us to pick and choose what we need in order to keep us as healthy as possible.

* Is there someone that is available to cook meals for you. Perhaps if they are cooking in bulk they can give you some portions to freeze.

* Can someone help you to prepare meals? Or to cook them?

* See my post on shopping for food for links on companies that deliver frozen foods that just require you to defrost and heat up.

* See your GP about what is available in your area to help you. Or to refer you to an occupational therapist.

* Seek advice from an occupational therapist who can advise you on different techniques that put less strain on the muscles as well as any equipment that would be of use to you to help make preparing and cooking food easier

* Visit a specialised disabilty equipment shop to see what is available and to also get advise.

* Do not be ashamed or put off by microwave meals. They are easy to prepare, thus saving energy. Have a look out for good quality ones that have less saturated fats and not processed to make it a more healthy option and you can always add extra vegtables or a salad too it. The dietitian from the clinic gave us this tip.

* Use pre cut vegtables, either fresh or frozen. Always annoys me how they are more expensive though

* Do the dishes another time if you do them manually. If you do have a microwave meal then save on dishes by not putting it onto a plate aswell.

* Sit down as much as possible to put less stress on your legs.

* If there is  a gadget to help you do things easier, use it. For example with the mixer. You may also benefit from an electric can opener.

* Store the things that you use most in easy to reach cupboards. Cereals and bowls for example.

* If you find it difficult to sit in a chair to eat your dinner because you need to keep your feet up try a tray that has a cushion on the bottom of it for more comfort and stability.

* Try to find lighter weight knives and forks if you suffer from pain in your hands or wrists. If  you eat out or at a family members or friends then take them with you too.

* Others may benefit from wider knives and forks, because your hands are less clenched and therefore put less strain on the muscles and joints. Again if you eat out take them with you for comfort.

* If you struggle to hold a cup or fear that you may spill a hot drink then use a straw instead.

* Keep snacks in easy to reach places so that if possible you can get them yourself.

* If you can handle the weight of a jug try keeping one close by so that you can easily top yourself up with water when you need it without going back and too to a tap. Best to try one with a lid.

* If you can cook for yourself, consider making bigger portions and freezing them for future dates when you aren't feeling up to it.

* Break the process into sections. For example prepare the food, then have a short break before cooking it.

Again my best advice is to seek help where you need it and to know your limits so that you don't make yourself more unwell. Whilst at clinic we were told of a sufferer that was making herself suffer even more because her family expected her to prepare, cook and then clean the dishes and put them away afterwards as she had done for many years before she became ill. However because she was suffering from a lot of post exertional malaise doing this, she decided to take drastic action. She decided to get a lock on one f her kitchen cupboards where she kept enough crockery, cutlery and pans to make her own dinner. Then each meal time she would simply cook or prepare a meal for herself and wash up her own dishes. After the dirty dishes started mounting and her family weren't being fed by her they soon realised that they needed to help out and the extent of the illness. This may seem drastic but they found a way to help themselves and however much we may hate it sometimes we need to be selfish in order to not exasberate our symptoms.

I hope that you have found these tips and those on the links useful. If you have any further tips then please leave a comment. It would be great to hear them.

Things I learnt at clinic: Healthy eating

Before I begin this post let me just be boring and say that all the inforamtion that I use in this post was gleaned from a registered dietitian at ME clinic and from the NHS's website. I am in no way telling you how to diet. This post isn't about losing weight it's about trying to eat healthily. If you have any issues with your weight or diet then I recommend that you discuss them with your GP or a registered dietitian, who can help you make the right choices for you. Okay, resuming business.

Eating healthily is big business nowadays and please note that I say eating healthily and not dieting. Although the dieting industry is absolutely huge (forgive that awful pun). Of course some diets do not abide by the rules of healthy eating and can sometimes do more damage than good to your body. Or cause you to gain weight as soon as you start to eat normally again, which actually is worse for us as what we gain back is more fat and not the muscle mass that we have lost by dieting. So unless you need to be on a specific medical diet for some health reason or for weight loss surgury the answer lies in healthy eating. Of course there is excersise too, which is really important but that just doesn't come into some of our radars with a chronic illness.

Of course eating as healthily as possible is something that we are all aware of and know that we should do, whether we adhere to it or not. To use that old similie that is because food to a human being is like pertol to a car. Therefore the better quality the food that we put into our systems, the better performance we will get from our engines. So you can see straight away how this can have an affect on someone with ME. Because we constantly feel like we are running on empty it is important that we utilise food to help us get through the day and to help our bodily systems. Our calorie intake should be determined by our level of activity. Therefore the more we do the more calories we need to support this. Take cyclists who ride the Tour de France for example, they eat between 6000 and 9000 calories a day to allow them to complete the race. Just one stage (day) can burn 4500 calories as well as the 1500- 2000 calories that a body needs to function properly. This is according to www.bicycling.com. Again think about a car if you only have enough petrol/ diesel for 30 miles but you try and do 50 then it is going to break down. Obviously for people with chronic illnesses the amount of activity that we do can be very little but we still need to take on enough calories to support all our bodily systems and give us a boost on our low stamina levels.

So how can we eat healthily? Or what is considered a healthy diet? It's something that we hear all the time but the only thing that we commonly associate with healthy eating is salad. According the NHS's eatwell plate http://www.nhs.uk/Livewell/Goodfood/Pages/eatwell-plate.aspx our diet's should consist of one third starchy foods, such as potatoes, pasta and rice. Starchy foods or carbohydrates are energy giving foods, that also provide fibre and vitamins. Many people consider carbohydrates bad but they don't have much fat content and for an even more healthy choice there are many wholegrain options. Carbohydrates with low GI (glyceamic index) numbers can be beneficial for people with ME, as they release energy slowly and therefore are better for stamina than foods that have a quick burst of energy that could leave you feeling more tired. These include porridge, sweet potatoes and wholemeal or granary bread.

Another third of your diet should be made up of fruit and vegetables. Remember the 5 a day rule. Remember though this can include juices and soups, just make sure that you check it is not concentrated or flavoured to ensure that you are getting those nutrients down your neck. Fruit and vegetables are a good source of energy, vitamins, fibre and good sugars. Many fruit and vegetables are also good sources of anti-oxidants and can be good for boosting our immune systems, which can be useful for us ME sufferers, with us tending to pick up any bug making its rounds. What I will say though is that I know many people with ME can also suffer with IBS (post to come shortly) which can be aggravated by acidic fruits so if this is the case for you try to look more to non acidic fruits such as bananas, which are also a great source of energy. Also be careful of vegetables such as peppers and brocolli, which can also cause irritation. So for a good energy boost why not try a slow release carbohydrate such as porridge or a non sugary cereal with fruit to start the day off and improve that early morning dip in blood sugar and energy levels.

The last third of our diets should consist of protein, dairy and a small percentage of fats. Proteins include meat, fish, egg and beans and can be a valuable source of energy and provide lots of vtamins and minerals. When eating meat it is best to choose as much non processed meat as possibe and of course be aware of the amount of saturated fat content that the meat has. The leaner the meat the better. White meat is generally considered best for our health but red meat is also a valuable source of protein, providing us with iron and vitamin b12, which are good for helping combat fatigue which of course can be important to a person with ME. How often do you crave red meat when you are feeling exhausted or ladies on that oh so wonderful (spare me) time of the month?  So do not shy away from red meat, unless of course you are a vegetarian, you can avoid some cholestrol problems by eating quality meat and of course by cooking it in a more healthy way, such as grilling. Fish of course is well known as a healthy option, especially oily fish, such as mackeral, salmon or tuna (although tinned tuna contains much less omega 3). Oily fish is a good source of omega 3 fatty acids that are good for the heart and for energy levels. On average people should aim to have 2 portions of fish a week, one of which being an oily fish. Please see this link for more information on oily fish guidelines http://www.nhs.uk/Livewell/Goodfood/Pages/fish-shellfish.aspx Other sources of protein include eggs and beans. Eggs are a good food for those of us with ME, as they are quick to make and also have lots of vitamins such as vitamin A. There's no limit on the amount of eggs that you can eat a week but be aware that they contain cholestrol so take caution if you already have high cholestrol.

As for beans and pulses, they are very often forgotten about, other than the trusty baked bean of course, a can of which also counts as one of your five fruit and veg a day. Whoopee (cushion ;-)) Baked beans yet again are good for those of us with ME as again they are quick to prepare as well as nutritious of course. Try and combine them with wholgrain or granary bread, to maximise the nutrients because you are having a slow relase carbohydrate, protein and one of your 5 portions of fruit and veg a day. As for other beans and pulses they can be dried, which you have to soak over night, which could be bothersome but you can also get many in a tin. These include peas, chickpeas, kidney beans and butter beans. Try adding them into soups or stews or into sauces as an extra source of protein. Pulses are great for vegetarians as it gives them their source of protein. They are also a great source of iron and fibre.

Dairy is also an important source of protein and of course calcium, to help bone strengh and growth. Dairy products can vary in fat content, but there are plenty of low fat options to help you get the vitamins and calcium needed but in a more healthy way. Finally a small percentage of our diet should be made up of fats and sugary foods. Again the less saturated fat that we consume the better but some fats in moderation are needed by our bodies. Fat can help our bodies to absorb nutrients but also is a source of energy. Obviously if you are looking to lose weight then this is the first area that someone should look to cut down on, especially those saturated fats.

Many people now claim to have an intolerance or be allergic to some foods but statistics show that actually they are not as common as believed. What may be happening is that some people might be intolerant to the way some products are processed and not the whole food group. So for example with dairy products, many people may have a bad reaction to drinking milk a few times and then cut out all dairy products from their diets, which can be detrimental to their health. They may in fact be intolerant to the way that the milk is processed or even a certain brand. I have this problem with milk and have learnt that I can tolerate it in small quantities such as in tea but not in larger quantities. Therefore I get my calcium intake by having soya milk. As for other dairy products I don't have any problems with. Well apart from ice cream but that seems to have improved as of late. Oh it has been such hard work trailing that! I do sometimes find though that I am better with cheaper brands than more expensive ones, so again it could be an issue with the way it is made. Cutting out a food group entirely can really affect your body and if you have any suspicions about allergies or intolerances a doctor and/ or dietitian should always be consulted to monitor your health and responses. I know a few people with ME and Fibromyalgia try gluten free diets with varying responses in improved energy levels but again always check with a doctor and make sure you are monitored throughout. Most doctors and dietitians will also be able to guide you on starting to reintroduce certain foods from that food group to be able pinpoint where exactly the intolerance stems from. This way you can avoid the foods that make you ill but still get the health and dietary needs from eating that food group. Not sure where ice cream places there.

A good 'diet' should provide all the vitamins and nutrients that our bodies need and should always be the first port of call if you discover that you have a deficiency in any vitamins and minerals. However sometimes supplements may be needed to help boost our levels and support our immune systems. What I will say is to do this through your doctor or dietitian who have a clearer picture of your overall health and any medications that you are taking that could be affected by taking supplements. Or vice- versa depending on what ingredients your medication contains. For example many gastro resistant or antacid tablets can affect the absorbsion of other medications because they contain magnesium and therefore need to be taken at seperate times. Also taking on too many nutrients can also be detrimental to our health, so it is really important that your doctor can monitor your levels regularly and that you declare any supplements that you are taking to your doctor.

As I mentioned earlier foods that have high levels of anti-oxidants can be good for supporting our immune systems and help keep nasty bugs or infections away. Because let's face it having something else do deal with is never great and can lead to flares or even worsen our health for some time. Yes I'm talking about you nasty chest infection! According to www.bbcgoodfood.com the top ten immune system boosting foods are blueberries, carrots, lettuce and salad greens, beetroot, Brazil nuts, grapefruit, garlic, cranberries and ginger. So you may want to regularly include them in your diet.

Other tips that I learnt for trying to boost energy and stamina levels as much as possible include to always eat breakfast. How many sayings are there about the value of eating breakfast? And it's true. Think about it, supposedly you have been sleeping all night, (you can see why I say supposedly) therefore when we wake up our blood sugars are at a low and we are in need of sustenance to be able to get through the day. Again if you can combine a slow release carbohydrate here with fruit or a protein then you are giving yourself some good nutrients to maintain good energy levels. So for example, porridge with blueberries or wholegrain toast and an egg or beans. As well as food, being aware of what we drink is also really important because dehydration is detrimental to fatigue levels. So make sure that you are drinking plenty of water. Be wary of fizzy drinks because the sugar content can again give you a rush of energy that can lead to more fatigue and may also contain caffine. Caffine intake should be avoided after around 4pm to help you to fall asleep. Many people with ME have problems drinking alcohol and tend to avoid it but be aware that it is often a hidden source of calories and can actually cause the body to become more dehydrated, causing fatigue. Lastly make sure that you eat regularly to maintain energy levels. The dietitian at clinic recommended eating every 4 hours as this coincided with the bodies natural dips in energy, apart from over night of course.

So I have talked about what we need to be eating in order to keep as healthy as possible. However I do realise that when you have a chronic illness that eating healthily can sometimes be difficult. If you are a  sleepy bunny like myself then eating three meals a day can prove difficult, let alone every 4 hours. Then of course there are the practicalities, such as having the energy to shop for and prepare food. But that is all for another post, where I'll discuss more about these practicalities. If you have any tips that you think will be helpful for how to make life easier with the practicalites of shopping and preparing food then please post a comment. Hope you have found this post helpful.