Congrats on surviving your heart surgery: Here's a burger and some tater tots (Page 2)

Because I'm feeling Pollyanna-ish this morning:

My mom was in Abbott in Mpls this summer (she's not any more and is doing better ). While she was there, my family and I spent a lot of time there. The cafeteria was shockingly good--REAL salad bar; several stands of different food; vegetarian options that didn't suck; and--check this--nutrition information posted on everything they served. There were also triple burgers with cheese and bacon, of course, but there were options.

Two sour notes in my praisefest: 1) they also had a Mc Donalds and it was always packed, day or night, and 2)the actual hospital food they sent up to her room was the usual nasty schlock. We ended up getting her food from the cafeteria--grilled chicken burgers on whole grain buns with spinach salad and berries/watermelon and like that.

I wasn't feeling up for a crusade, but even getting them to make the cafeteria supply the patient food would be a huge improvement.

These stories are just stunning.  Most especially the ones with the hospital.  The schools don't surprise me, because we all know that cost is the major factor there.  But a freaking cardiac ICU?????  

I really hope that we can introduce some form of personal responsibility into heathcare.  Costs are going to do nothing but explode if we can't align people's incentives to make good choices about both utilizing healthcare resources and keeping a healthy lifestyle.

One thing that can help with utilizing medical resources is Health Savings Accounts.  HSAs are tax-advantaged accounts which the person owns which takes the first x amount of health costs.  If you use more than that account, there is a high-deductible policy that covers you for large medical expenses.  For example, I pay the first $5000 of health costs per year from my HSA.  Routine checkups are free (covered in the high-deductible policy).  If my med costs go over $5K in a year, then insurance covers 100%.   If we don't spend the $5K, then the account rolls-over and grows with time.  You can treat it like an IRA.

You bet that we think twice about going to the doc for a little sniffle or whatever.   You are spending your own money.  You make sure you really need to do that.  You also ask your doc if whatever test they're ordering is really the best or is really needed.  

Personal responsibility.  Personal control.  Incentives aligned for most cost effective treatments.

I work in a hospital too (for another 10 days, not that I'm counting) and it's the same.

All new hires at my hospital start work on the first Monday of the month, and all have to attend the same orientation that day. After hours of training/cheerleading about how keeping people healthy is our job, what do they serve for lunch? White bread. Deli meats. Sliced American and provolone cheese (provolone only because we're in Philly). Chicken salad. Tuna salad. Potato salad. Macaroni salad. And cookies. 

Our cafeteria selections: Pizza. Something hot, often fried, always slathered in butter or a thick sauce or gravy. Side items kept in steam trays in a two-inch-deep bath of oil (this includes the steamed and grilled veggies). A grill/fry to order section that serves burgers, cheesesteaks, fries, tater tots, fried chicken, grilled chicken, and chicken fingers. A typical deli sandwich counter. And a surprisingly well-equipped salad bar... but I can't get past that I've now had two different friends find live bugs in their salads, so I can't really stomach it anymore. 

By my observation, the official lunch of doctors at my hospital is chicken fingers, fries or tots, and coffee or a large soda.

Our hospital cafeteria is so horrible I basically refuse to eat there.  It amazes me because the person who runs it is actualy a bonafide chef and can make excellent food.  I threw a fit (Ok a couple fits) because I typically have like 5 minutes to walk down there, try to find something 1/2 edible and scarf it down and they had NO healthy options in the surgeons lounge either. (donuts chips and poptarts)  I was told the "The team members (AKA hospital employees) do not want to pay more than 3-5$ for their meal so we have to make everything cheeply" yeah right. 

Bill - 2009-08-15 3:43 PM Yesterday afternoon I was asked to come up to the cardiac ICU to be on hand as they removed a patient from the ventilator. He was very difficult to intubate (put a breathing tube in the trachea) so in the event he needed to go back on the ventilator emergently they didn't want to be be calling around to find someone to do it.

This guy is in his 60's, over 350 pounds, maybe six feet tall, and he's just undergone bypass surgery a few days prior. So they get the tube out, he says a few words, breathing fine, oxygen levels are good.. no problem. I go on about my day and I call once to make sure he's good and I'm assured everything is fine. A few hours later I went up to put another patient on the ventilator and when I finished I went over to check on this guy. He's eating dinner:



Yes. That's a cheeseburger and tater tots, WITH vegetables (about 1/2 a carrot and 1/3 of a pickle). I thought it must be a mistake, in fact I was surprised he was even eating solid food. But the slip on the tray said "cardiac diet" and listed the items on the tray. No mistake. I walked around and saw every patient that could eat chowing down on tater tots and burgers.

I couldn't believe it. I mean really, WTF? Why not just give them a gun and one bullet? Or why even operate on them if we're going to feed them garbage while they're recovering?

I had the same feeling I get whenever I'm in the grocery store and I check out everyone else's cart. I can't help it, I look at everything they have in there. And then I look at the people in the store, 75% of whom (in my area, about 60% nationwide) are at least 20 pounds overweight. I just bums me out. I feel like our country is eating itself to death. We talk about the healthcare situation and people get fired up about what the government is going to do (or not do) to take care of them. But people don't take care of themselves. And they're not put off in the least when they're served tater tots and burgers in the cardiac ICU after heart surgery.

I don't get it. I'm not just ranting. I'm embarking on career #3, going back to school to get a masters in exercise and nutrition so I can work with people who need that sort of help as opposed to taking care of "end stage" patients like I do now. I wonder though if you can help people who don't even realize there's a problem.

Don't most businesses want repeat customers?

Speaking from experience, cardiac post-op depression is a very significant issue.  I had to go through a manditory session with a hospital psychologist prior to my surgery.  I had no idea ahead of time that it was going to be a problem and was thankful to have a better understanding of what was going on, although at times the depression would still overcome me.  It was absolutely deabilitating at times. It also had a big impact on my family and relationships.  Some of my family were unconditionally supportive, while others either couldn't or didn't want to deal with it.

I eventually got through the worst of it and I came out with a distinctly more low-key, more mellow personality (I think in part due to my increased sense of my own mortality).  But even eight years post-op I still occasionally get "the blues", often with no obvious trigger or reason.

Eating is often a release - it certainly is with me, as is alcohol at times.  Even though you know some foods are bad for you, the immediate gratification from food & drink is a powerful force. 

Exercise also helps me to manage things - one of the reasons I'm here at BT.

When I was in the cardic recovery ward, there was another guy who was my age, 47.  He had undergone a quadruple by-pass, and was complaining about the dietary and lifestyle guidelines his cardiologist had given him.  Turns out that he smoked, didn't exercise,  had a couple of martini's every evening before dinner, and ate red meat at most meals.  He told me there was no way he was going to change his lifestyle - he was comfortable with it and that was it... 

Mark

I used to work in Cardiac Rehab at a hospital and was shocked by some of the meals served to the post-surgery patients.  As Bill said, the saddest part was the food was so terrible, many patients had family members sneak in fast food to clog their new arteries.
I think the worst case was when I went to take a post-bypass patient for a walk in the halls and as I entered the room his nurse came in with a full-sugar soda and candy bar for him - I just stared in disbelief.  And it was my job to educate this man on heart-healthy eating *sigh*
So now I work with bariatric patients to try to prevent the need for heart surgery.  I'd like to think I'm helping them change their ways, but it's so discouraging to see people consistently making unhealthy choices.  I think all the crap in most food is killing people's brain cells.

That is just sad! I mean I do not eat 100% healthy all the time but I try. My wife and I spend 30 bucks a week on fresh veggies, fruit and other such things (all bought from our local produce shop). We spend a lesser or equal amount at the grocery store getting some basics such as flour, cereal (love PB Puffins), non fat milk, cheese (usually a nice sharp chedder), butter etc...We try and make as many of our own meals as we can including making and then refrigerating fresh pasta or homemade pot pies etc...Seeing what others have in their carts always amazes me!

As for the person who posted the high school lunch menu...weirdly enough my high school (back around 2000) switched to whole wheat buns and most kids liked it just fine. They also have a salad cart thingy that was so popular they had to add a second cart in so they did not run out all the time. Granted these are not the healthiest salads of all times but they usually had plenty of fresh veggies, only a limited amount of dressing, croutons, and cheese and usually with a good source of protein like grilled chicken, tuna, or egg. I just checked their website though and they do not have that salad cart listed 

I was in the hospital during the NFL season and we had a Monday Night Football party in my room with the night staff to watch the Tampa Bay Bucs play.  The nurses and aides ordered a bunch of pizzas and soft drinks and we had a good old time.  I was wired afterwards and one of the nurses finally gave me something to make me sleep at about 3AM - only to get woken up at 4AM so they could draw some blood.

Mark   

Have a 7.5mm french on hand with a miller blade (skip macintosh), stylette and of course some lidocaine spray.  God I love the smell of Intubation in the morning CCU!