For the past couple of days, Paul has managed to get a reasonable number of calories with very limited gastrointestinal distress. His total calorie intake – around 2000 – is a little less than the nutritionist recommended he have, but, at his current activity level, seems sufficient to keep his weight stable. What seems to work best is a little bit of lots of things: Odwalla juices, Carnation instant breakfast, Boost, Osmolite (as the name suggests, the low osmolality formula) and the occasional Coke or ginger ale. It occurred to me that we could bump up the calories on the instant breakfast by using some condensed milk; half condensed and half regular is working well. Add half a cup of coffee and you have the “instant breakfast mocha;” the little bit of caffeine makes Paul happy.

Using the pump to get in a few hundred calories overnight has helped. Spacefood can be tolerated overnight, at a very slow rate, although Paul finds that, if he wakes up in the night, there’s a lot of belly gurgling going on. There’s was apparently a little gurgling last night with the Boost, too, so he has decided to forego the pump for tonight.

Now that calories are getting easier, it’s time for a nutritional assessment of the foods on the safe list, to verify that he’s getting all the nutrients and micronutrients that he needs, and add supplements if needed.

And the big eating news: this evening, Paul ate half an English muffin, toasted, with a little butter and peanut butter on it. Did you get that? Paul ate – as in, put in mouth, chewed, and swallowed – something larger than a Cheerio! And there was no choking, and (as far as he can tell) no aspiration. There was, however, rejoicing in our little corner of the land. While that was only a small fraction of the amount he’d need to eat each day in order to get rid of the tube, it’s a step in the right direction. And I know that sitting with me, and eating something while I ate my dinner, was really satisfying for Paul. It felt pretty damn good to me, too.