Tuesday, March 17, 2015

Advance Diet As Tolerated

Allowing people to restart a diet after surgery is an interesting process.  Typically what happens after a surgery involving the bowels is the patient starts with clear liquids.  Clear liquids are to be distinguished from "full liquids".  To be clear, the liquid should be transparent (and without red food coloring).  You should be able to see through it.  Milk, orange juice, veggie smoothies, and motor oil are not clear liquids (although I guess vegetable oil would meet criteria, yuck).  Jello gelatin and popsicles are part of a clear liquid diet.  Once somebody tolerates clear liquids, they would move to full liquids (minus the motor oil).  I learned this morning from the nurse that cotton candy is considered a liquid, weird (gelatin and windows are also liquids, but in very viscous suspensions).  Milkshakes and pudding are also part of a full liquid diet.


After the liquids are tolerated, they move to a soft diet.  Things like yogurt, applesauce, oatmeal, mashed potatoes etc. are soft foods.  Chips, crackers, steak, nails, are not soft foods.  After the soft diet a regular diet is allowed with variations based on the overall health of the patient (low-sodium, weight management, high fiber, gluten free, etc).

That's a lot to manage and track from one diet to the next, and many people have surgery.  So the best order to receive is the target diet and an order that says "Advance Diet as Tolerated".  This is a crazy notion of letting the patient direct themselves.  Well, we finally have that order in place for J.  He had an Icee before the order was changed.  We're excited to see where this new freedom takes us.

He has already taken a walk this morning.  He's watching TV again.  Maybe he won't try to be interesting today.  Just keep it simple.

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