I have recently had the experience of being a hospital inpatient. This was for a planned orthopaedic procedure and took place at a prestigious NHS hospital. In the admissions lounge (which doubles up as follow-up clinic) there is a poster that says “Are you on the MEND” with MEND standing for Medications, Exercise, Nutrition and something I can’t quite remember right now with my painkiller addled brain! It gave me hope that maybe my food in hospital would be ok. … probably the thing I had worried about most, and certainly the concern that had most effected the amount of luggage I was now carrying. Obviously we in the UK are all aware of the stereotype of hospital food – much like that of 1980’s school dinners – but most of us also know, or presume at least that things have moved on. We just don’t know by how much.
So, aware I was going to be in hospital for around a week, unsure how much food a standard portion would be (I eat rather more than your average 90 year old having a hip replacement or in with the flu), on opiate painkillers after the op (which cause excessive constipation), and with no visitors to bring me grapes due to the ongoing Covid restrictions, I had armed myself with a huge number of high fibre foods, some kombucha and a decent amount of extra protein in the form of bags of nuts, and some actual beef collagen powder.
To be fair, the care at the hospital was exemplary: the ward staff helpful and kind; the surgeon, a good bedside manor; the anaesthetist fully understanding of all my worries about being put to sleep; the other patients in my bay a pleasure to be with. … but the food, and indeed some of the staff serving it, were well .. random. Some was actually very tasty, some seemed to be home cooked, but other meals were most definitely prepacked microwave, aeroplane type concoctions – on one day even served in their plastic tray rather than on a plate. One day I was allowed a cheese salad as a side to my main choice, the next I was told salad was a main meal and I couldn’t have 2 main meals. (To clarify here, the salad was not a main meal unless you were a 4 year old at a party – half a tomato sliced, approx 2 leaves shredded iceberg and 4 slices of cucumber, with a slice of ham / cheese / an egg or whatever other protein you’d asked for with it and the other main meal I wanted did not come with added vegetables – it was only bean stew and rice.) It gave me and my fellow bay-mates some good laughs albeit if with a tinge of frustration.
Nutritionally speaking, when recovering from trauma of any kind one has an increased calorific need. As well as this there is a need for certain specific micro-nutrients, that may be different depending on the surgery that has been done, and increased protein for all to aid healing. Bones obviously require increases in calcium and vitamin D, whilst and vitamin C and zinc support collagen repair (ligaments and tendons) and decrease inflammation. Omega 3 also helps reduce inflammation and it is also thought that green vegetables and brightly coloured berries can be particularly good at decreasing inflammation around orthopaedic sites due to their antioxidant effects.
So how did my hospital food fair when looking at those nutrients.
I believe I did get enough protein, particularly when I added in my home brought nuts. I also think that through my own considered choices I got enough calcium (yoghurts for breakfast – although some days I couldn’t eat them as they were so sweet – and cheese and crackers as pudding). A few days running I ate the offered salmon – so that ticks my omega 3 box. .. and certainly it was good that each day had the same, but varied menu. However I did not get anywhere near enough in the way of green vegetables and fruit. – meaning that my zinc, vitamin C and vitamin D levels were probably compromised and that my (and all my bay-mates) bowels were problematic.
I had taken with me a 1l carton of V8 juice; some beetroot, ginger and turmeric shots; kombucha; a packet of ground nuts and seeds (containing significant flax) for my breakfast yoghurts; nak’d bars (main ingredients cashew and date) and some dried fruit. These additions I think served me well – certainly I opened my bowels a full day or 2 sooner than my bay-mates – but I question whether they should be needed.
I am so grateful for everything we get on the NHS, and I am aware that fruit and veg, in our topsy-turvy world, cost more than docusate and senna (laxatives), but when a hospital wants to remain at the top, and get the best results for each patient, maybe the nutritional element of recovery should be factored in a little more to their food choices. Maybe we, as patients in the modern world where money is tight, will have to bring in our own extra food, but I do think that if that is the case we should at least be provided with a list of what might be helpful. It should not rely on the knowledge of the individual patient to affect the recovery experience they have.