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2009-08-17 1:44 PM
in reply to: #2350774

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Subject: RE: Congrats on surviving your heart surgery: Here's a burger and some tater tots

Bill, are they given a menu of sorts to select from? I'd be curious as to the the options were if there was one.

This is just so wrong on so many different levels.

I could see them letting a terminal ill (I guess that would be a hospice) patient having a comfort food diet like that.

If this were April 1st, I think you were pulling our leg.

Thanks for sharing.

 



2009-08-17 3:52 PM
in reply to: #2353688

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Subject: RE: Congrats on surviving your heart surgery: Here's a burger and some tater tots
crusevegas - 2009-08-17 1:44 PM

Bill, are they given a menu of sorts to select from? I'd be curious as to the the options were if there was one.

This is just so wrong on so many different levels.

I could see them letting a terminal ill (I guess that would be a hospice) patient having a comfort food diet like that.

If this were April 1st, I think you were pulling our leg.

Thanks for sharing.

 



They do have choices, but I believe because he hadn't been on solid food prior to that he wasn't given a menu from which to order. I don't know that he'd choose differently. I'd hope so, but who knows. The whole thing is so absurd I just couldn't believe what I was seeing.


After I asked the dietician about it she went back and discussed it with her supervisor, who is apparently mad that I questioned the situation. I'm sure it's something about my lack of professional expertise. I admit, I'm an amateur when it comes to clinical nutrition. But I'm pretty sure I can hold my own in a discussion about the merits or lack or merit of these foods in this setting.

As for whether or or not the physicians are aware, I don't know. They're on the unit all the time but I don't know that they look at what their patients are eating. I'm good friends with two of the cardiologists though (one of them is my daughter's soccer coach). Might be a good guy to ask about it.
2009-08-17 3:56 PM
in reply to: #2353640

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Subject: RE: Congrats on surviving your heart surgery: Here's a burger and some tater tots
DerekL - 2009-08-17 1:26 PM
Bill - 2009-08-17 1:09 PM FOLLOW UP:

So I went to speak to the hospital dieticians to get the lowdown  on how this could qualify as a "cardiac diet". I gave her the story and showed her the picture. She's a friend, and knowledgable about her job, so I was surprised to hear her say "Well those tater tots should be BAKED, not fried, and he shouldn't have cheese on there". I'm pretty sure tater tots are fried before they're put in the bag, but either way.

So I asked how this could happen and she bascially said (what most people already know) is that healthier options will go uneaten. She took it a step further though, and said when patients don't eat their meals, their "calorie count" gets too low and that generates a dietary consult ($$) and often the patient ends up on liquid nutrition supplements like Ensure ($$) or even IV feeding ($$$$). Essentially it's cheaper to feed them burgers and fries, because they'll eat them and it makes the numbers right.

Unreal.

So is the CT surgeon or cardiologist aware of this? I would raise royal hell if that were the cardiac diet given to my patient so that the hospital can save money.


I don't think that's the direct intent. Really I can't think of any other reasonable explaination though, so in a setting where all roads seem to lead to money, I have to wonder if that's not part of why no one does seems to be bothered by it.
2009-08-17 4:09 PM
in reply to: #2354092

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Subject: RE: Congrats on surviving your heart surgery: Here's a burger and some tater tots
Bill - 2009-08-17 4:56 PM
DerekL - 2009-08-17 1:26 PM
Bill - 2009-08-17 1:09 PM FOLLOW UP:

So I went to speak to the hospital dieticians to get the lowdown  on how this could qualify as a "cardiac diet". I gave her the story and showed her the picture. She's a friend, and knowledgable about her job, so I was surprised to hear her say "Well those tater tots should be BAKED, not fried, and he shouldn't have cheese on there". I'm pretty sure tater tots are fried before they're put in the bag, but either way.

So I asked how this could happen and she bascially said (what most people already know) is that healthier options will go uneaten. She took it a step further though, and said when patients don't eat their meals, their "calorie count" gets too low and that generates a dietary consult ($$) and often the patient ends up on liquid nutrition supplements like Ensure ($$) or even IV feeding ($$$$). Essentially it's cheaper to feed them burgers and fries, because they'll eat them and it makes the numbers right.

Unreal.

So is the CT surgeon or cardiologist aware of this? I would raise royal hell if that were the cardiac diet given to my patient so that the hospital can save money.


I don't think that's the direct intent. Really I can't think of any other reasonable explaination though, so in a setting where all roads seem to lead to money, I have to wonder if that's not part of why no one does seems to be bothered by it.


Don't worry - the hospital won't lose money.  They will charge the patient (insurance company) for the consult and the special feedings.  This issue isn't losing money - it's increasing the cost of health care.  The guy is recovering and needs to take in a certain amount of calories.  If he doesn't, it should automatically trigger reviews like those listed above. The algorhythms that determine this kind of stuff doesn't take into account the QUALITY of the calories, just the numbers. 

I would hope, however, that there is (a) a healthier set of options on the menu to choose from, and (b) a baseline consult with a nutritionist about healthy eating patterns for secondary prevention.
2009-08-17 4:41 PM
in reply to: #2354076

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Subject: RE: Congrats on surviving your heart surgery: Here's a burger and some tater tots
WOW! That's awesome that you followed-up on it.

You have every right to question what they are eating. Just like their family should question it.

Lowered calories = liquid nutrition = more $$$. Well from the sounds of it that patient could go a few days without too many calories.


Bill - 2009-08-17 3:52 PM

crusevegas - 2009-08-17 1:44 PM

Bill, are they given a menu of sorts to select from? I'd be curious as to the the options were if there was one.

This is just so wrong on so many different levels.

I could see them letting a terminal ill (I guess that would be a hospice) patient having a comfort food diet like that.

If this were April 1st, I think you were pulling our leg.

Thanks for sharing.

 



They do have choices, but I believe because he hadn't been on solid food prior to that he wasn't given a menu from which to order. I don't know that he'd choose differently. I'd hope so, but who knows. The whole thing is so absurd I just couldn't believe what I was seeing.


After I asked the dietician about it she went back and discussed it with her supervisor, who is apparently mad that I questioned the situation. I'm sure it's something about my lack of professional expertise. I admit, I'm an amateur when it comes to clinical nutrition. But I'm pretty sure I can hold my own in a discussion about the merits or lack or merit of these foods in this setting.

As for whether or or not the physicians are aware, I don't know. They're on the unit all the time but I don't know that they look at what their patients are eating. I'm good friends with two of the cardiologists though (one of them is my daughter's soccer coach). Might be a good guy to ask about it.
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