Strawberry planting day at the ranch. Instead of black plastic, we use plastic flowerpots with the bottoms cut off. These go into the soil, with about two inches clear above the soil line. They are filled with soil to that two inch mark, and the strawberries go in. As they grow, we will train them over the rim. This will keep various insect type critters from going after the berries as easily as they would were the berries growing directly on the soil. It also helps with soil rot damage to the berries from the rain/watering then drying cycles we go through.

While Mom handled those, yours truly did another weeding run. When I am well, I can spend hours weeding if the gardens call for it (and right now they do) but at this moment, I pull enough weeds to fill one yard waste bag (basically, just a trash bag, but thinner), as that’s about as much as I can manage. Today I went after thistles that came up to my hip, with tons of puffball seeds just waiting to break loose and bury themselves in other areas of the garden. The simplest way to deal with seeding thistle: gently bend the stem with the puffballs – very, very gently, so as to not knock the puffballs yourself – and then use pruners to snip the stem about six inches or so under the puffballs. If the stem has already branched, snip six inches or so under the branch. Once snipped, gently – very gently – shove the clipped stem puffball first into a bag. Repeat as necessary. Once the puffballs are gone, snip the plant into manageable pieces and bag those, then pull the remainder of the plant up by the root.

In one area where I was pulling thistle, I encountered some stinging nettle. I reached for it before I realized what I was going for, and luckily, I did not grab a whole handful of it. The only stings I got were on my left index finger and the pad of my right hand. Yes, I weed bare-handed. I find that I just can’t grasp the weeds and pull them entirely, with their roots, out of the soil. For nettle, though, I made an exception, got my gloves, and pulled the giant thing out. Nettle spreads by rhizomes it sends out, so the actual root area can take some work to get to, as you have to work through the outer areas of the thing before you can pull the rest of it out and get the root. While stinging nettle does have some medicinal use, we do not grow it intentionally here, just as we do not grow purslane, which was the weed of the year when we first put in the gardens. This time around, the weeds of the year appear to be thistle and hawkweed, neither of which we want hanging around. There are masses of them, and I’m considering hiring some day labor to get all the weeding done, as there is no way I’ll be able to get it all done so my  plants can be put out.

Switching gears: those of you who stumbled across this here blog because of searches for oral cancer and/or tube feeding and/or medical things: welcome! A tip for those feeding via PEG, if you’re like me and have to do it slowly: when feeding the rather thick usual formula using the gravity drip method by  syringe, once you’ve poured some formula in, pour in some water as well. The water will help dilute the formula and prevent the formula from gumming up the tube opening (and the syringe opening).

(My dog Einstein grabbing a nap in the background.)

Once that run completes, pour about 20 ml or so of water down the tube as a mild flush to get any formula residue out of the tube opening. That way, the next round in about 10-15 minutes won’t encounter any blockages when you pour it down. This also helps keep your fluid uptake up, which will be better for you and keep the doctors happy. I run formula at a rate of 20-30 ml plus water every 15 minutes. One can of the formula I use is 237 ml, so it takes about two hours to complete a feed session with formula for me. In good sessions when I don’t feel like I’m going to burst or throw up (dry heaves, really), I can press that interval down to about five minutes or so.When the feeding session is complete, flush the tube with more water.

Another tip for those stuck with a PEG who have, or had oral cancer, and have to undergo radiation to the head and neck: keep eating and drinking by mouth if at all possible – even if it takes pain meds to do it – and do exercises to keep your mouth opening as wide as possible. Eating and drinking keeps the muscles working and helps deal with the inevitable scar tissue buildup, and also helps keep your gallbladder happy, by giving it something to do.  Since I didn’t, when I went back to eating by mouth after nine months on the tube, my gallbladder had basically turned into a bag of stones, and the pain from it trying to do anything was excruciating, ultimately resulting in another surgery to have it removed. The mouth opening exercises are as simple as continuing to open your mouth as wide as you can and holding it for ten seconds, doing five to ten reps of that, four or five times a day. Trismus is a horrible consequence of radiation therapy, and you don’t want to wind up with a seriously limited opening like I have, at about 13 mm. If you’re already past all the treatment, and you are dealing with trismus, do stretching exercises every day. In both cases, working with multiple sets every day instead of one set once a day seems to be better, based on the various papers I’ve read. Most utility treatment recommendations involve tongue depressors, but I have used a Therabite previously. Unfortunately, I have not been diligent in using it over the years. Since my unexpected hospital stay, however, I’m getting myself in order on that, and I’m now using it while I feed. I am aiming for five sessions a day, with ten reps per session, holding my mouth open for seven seconds each time. It can be painful, but the benefits far outweigh something that can be dealt with  by taking Advil/Tylenol or pain meds. There are other things you can do to make an effort to prevent trismus or help with it if you have developed it. A tip for Therabite use: once the pads are on the mouthpiece, I slip a sandwich bag over them when using it. That way, I avoid the necessity of changing the pads often due to slobber/drool/mucous all over them. Teeth in or teeth out? That’s up to you. Since my opening is so limited, I have to use it with teeth out, as I can’t fit it in my mouth when wearing them.

Time for another feed. Be well, peeps, and I’ll catch you next time.