Wednesday 3 September 2014

Eating People Is Wrong





Two stories running in parallel at the moment are about the quality of hospital food available and prescribing medication that adversely affects people with known allergies.

Hospital catering is mass catering.  But the "customers" do not go there to eat.  The eating is to enable them to survive and a vital part of the recovery or treatment process. The caterers, whether in house or out sourced have to deal with an ever and rapidly changing group of people.

There are some real problems here.  One is that food which is "healthy" may not be the food that many like.  But the food that the mass of people like may be bad for those who really do need "healthy" food.  This is before we begin to think about matters relating to ethnic or religious requirements.

Medications are not simple matters.  The trouble with this BBC story about allergy effects is that it may not be the substance critical to need that is the problem but one of the several or many packed into the pill or capsule or fluid to enable it to be taken easily and without taste issues.

One case known is a person who went into hospital but whose records were fully available.  This one was unlucky in having strong reactions to both gluten (wheat and some grains) and lactose (milk and dairy).  They soon developed bad digestive problems.

The dieticians supplying the food did their best but had very little food or options available to deal with this.  So there was a very limited diet of small portions.  But the digestive problems worsened and by discharge both food and liquid could not be taken.

On arrival home with the package of hospital medications then it was realised that two of the four clearly had lactose content.  Stopping them gave recovery within hours, although it then took days to obtain non-allergic substitutes, the problem being that they were not on the approved list for budgetary reasons.

Where the problem lay among the very busy, expert and good staff at the hospital was that although some knew of the issue the pharmacist did not since it was not the job of any to tell the pharmacist and the doctors did not take account of allergy.

Which raises the question of all those people apparently suffering serious dehydration or lack of food and who are in real trouble, some dying.  The management systems of the present completely lack the flexibility or the scope for individual inputs where reactions or allergy might be involved.

There is the ancillary problem that many who are reacting to gluten or lactose with digestive issues do not know that they are vulnerable because the family doctors have neither the time nor the brief to attempt any analysis into possible dietary complexities.

They just prescribe a pill or antibiotic that may make matters worse.

1 comment:

  1. Our son had a problem with a medication containing lactose. There was no substitute available and in the end he was better off without the medication.

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