“Miss, why can’t my dad (patient) eat anything?”
Often when we hear of someone we know or a family member falling ill and admitted to the hospital, our instinct is to visit and check on the patient as often as we can.
And it has also become a habit and a norm to bring gifts as a gesture of goodwill and wish for a speedy recovery. The culture of bringing gifts is also something that is encouraged in Islam through the customs of visiting patients as well as being one of the Malaysian culture. However, several guidelines should be observed on what we should bring for patients especially where food is involved.
Get a doctor’s approval
Before we bring any gifts, we should ask for the opinion and confirmation from the doctor treating the patient. This is because we want to ensure that the gifts (whether food or other items) will not affect the condition of the patient in making it worse. For example, the patient may be allergic to certain foods, pollen, infections brought in from outside as well as anything that will affect the physical and mental health of the patient and disrupt the current treatment. Any advice and prohibition from the doctor are based on his or her knowledge and experience in caring for a patient’s health and recovery.
Patients who are fasting
Some patients who are admitted to the ward may undergo a phase of fasting or what we would refer to as “nil by mouth” (NBM). NBM is not a process similar to fasting in Ramadhan. NBM refers to restriction in giving food or drinks through the mouth (oral), nose (nasal) and through the stomach (gastro). It is meant to:
- Empty the stomach
- Prevent aspiration (food or drinks entering the lungs)
- Rest gastrointestinal activity
- Prevent contraindication and treatment complications
- Pre- and post-surgery
For NBM cases, patients are absolutely restricted from taking any food or drinks, even in small amounts, unless with the permission of the doctor, nurse, or dietitian. Numerous complications can arise if the NBM phase is neglected. Unfortunately, there are several ‘experts’ out there who sneakily feed patients out of pity. These people do not know that if food particles are to enter the lungs, the effect will be very bad and the patient may require intubation and a mechanical breathing machine. Do not worry, NBM is only done following a certain time frame. After the NBM phase, patients will be allowed food and drink intake based on their health conditions.
Consumption limit
There are several cases that require patients to be given food and drinks at a limited rate. This is usually known as restriction of fluid (ROF) and often done in patients with heart and breathing problems as well as obese patients. This is to control body weight and body water content so it does not affect the normal body system functions. Every excretion and intake of water (and food) by the patient will be noted and recorded in detail. For example, patients with heart failure problems needs to limit their fluid intake to reduce the burden on their hearts to pump blood throughout the body.
Suitable diet type
Some patients require diet plans suitable with their health conditions. For example, patients with diabetes cannot take sweets and sugary food (unless in hypo conditions), patients with high blood pressure cannot have a high sodium diet, gout patients cannot have a seafood diet and so on. This is to ensure the patient’s diet will not affect their health and recovery in the short and long term. Therefore, get a doctor’s advice before feeding patients outside food .
External supplements
In this modern age, there are so many types of supplements that claim to optimize a patient’s health. Some claim to cure heart diseases, kidney failure, diabetes, stroke and more. However, behind the ‘miracles’ of these products, most of it are produced without close monitoring, uses prohibited and dangerous substances, contains dubious mixtures, and does not have guarantee and confirmation from the Ministry of Health Malaysia. Most of these products promise a cure with a dozen harmful side effects. For this reason, we insist that patients do not consume any supplements without the knowledge of a doctor, especially if you or someone you know is undergoing treatment at a health institution. This is because supplements taken may have a high possibility of disrupting the body system, affecting the ongoing treatment as well as causing side effects that cannot be handled. Therefore, never mix different types of supplements into your diet. This is akin to mixing poisons and toxic into your body.
Taboo and food that are encouraged
Taboo and traditions that have been passed down for generations have long been synonym to our lifestyle as Malaysians. However, there are many practices and restrictions that are unfounded and its effectiveness medically unproven. The hospital will only encourage practices that have been identified its medical efficacy for the patient’s health benefit. For example, drinking 100 Plus and papaya shoot juices are encouraged for dengue patients. 100 Plus increases the electrolytes in the blood and papaya shoot juices increases the platelet count. This is not a 100% guarantee however it has properties that may boost the effectiveness of ongoing treatments.
As well as cases of high protein diet (for example, eggs) for patients with wounds (surgical or trauma). Scientifically, protein helps in healing wounds and wounded cell recovery. However, some people may believe that food like eggs will cause the wound to itch. Therefore, health specialists will suggest other high protein food like meat and fish.
Taboo and traditions are not wrong; it is encouraged to be practiced only after the patient has recovered and allowed to return home.
Anwari Hamzah is a trained nurse based at a hospital in Kuala Lumpur. This article is translated from the original at https://www.mmgazette.com/panduan-makanan-pesakit-di-wad-anwari-hamzah/by Nur Nadhirah.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]