Apparently, yesterday, there were an unusual number of new patients. For most patients in the ICU and IMCU, Gayathiri prescribed the same diet as yesterday because their conditions had not changed. She only lists out detailed diet orders for new patients or for patients whose condition has changed significantly. The main thing she changed today was the amount of food. Most of the patients in the ICU are on an enteral feed and an IV, so over the course of their hospital stay, the IV fluids are decreased and the tube feeding volumes are increased. Today, several patients progressed toward a more normal diet, either from clear liquids to regular liquids or regular liquids to a soft diet. One patient improved drastically from yesterday. He is a farmer and had insecticide poisoning. He was on a tube feeding because his GI tract was too upset for solid food. Today, he had progressed to a soft food diet. The alcohol withdrawal patient from yesterday was on the same diet, and I found out that he was on a low fat diet to help preserve his liver. I got to see more food being administered through the tubes today, and there is some kind of a difference between patients. For some patients, the food is poured into their tube. For others, the food is sucked into a needle and pushed into the tube. The difference may simply be that the equipment is not uniform, but I am not sure if some patients need one type versus the other. Another thing I learned is that patients with lung infections are not given cold foods. Whether oral or enteral, cold foods can upset the respiratory system, so only hot foods are given to patients who are on some form of oxygen or respirator.
One of the new cases was very sad. The patient was admitted because of a cardiovascular incident involving his brain. He kept shouting nonsensical things and did not know what was going on. I believe it was his daughter and son-in-law who came to visit him. She started bawling uncontrollably and had to leave. I think she was so sad because it seemed he did not recognize her. He was on a tube feeding because he did not have the coordination to eat, so I am sure his condition had deteriorated rapidly from the time she was with him yesterday. This must have been very difficult.
The patient from yesterday with Dengue fever had a mosquito net around his bed today. I wondered what the use of a mosquito net was if he already had this illness, and the staff explained to me that on the off-chance a mosquito was able to make its way into the IMCU, it would be hugely detrimental if the mosquito bit him because it could spread it to everyone else. This makes total sense, but I did not connect these dots.
I got to see how huge this branch of Kauvery is today. To get to another part of the hospital, we went underground to the basement floor and snaked our way through the halls to surface in an entirely different building. On the third floor is the CCU, which stands for the Critical Care Unit. This unit is for cardiac patients only. Every patient in this room is on a low-fat diet. Many also have to avoid vitamin K because this vitamin is responsible for blood clotting. They were all also on a liquid diet if tube feeding was required or a soft diet if it was not. I am still unsure of the reason on this, but no cardiac patient was given a normal diet. Additionally, fluid balance is very important for these patients, and the amount of fluid intake depends on the severity of their heart failure.
We ate with our hands today at lunch, and I am getting used to it. BHC did not pack a lunch for me again today because the chef was notified too late, so I ate at the hospital. The dietitian told me not to buy lunch because the other three dietitians and she would all share with me. It is common here to share food. All four dietitians took out their food canisters from home and spread it out across the desk. We all took what we pleased, which allowed me to try many new foods. I was able to try snake gourd and brinjal. Brinjal is Tamil for eggplant, but there are many more varieties here. The type we ate today was much smaller and greener than the eggplant we are used to in the US. The influence of the Indian food definitely showed today. We were eating some spicy curry, and one of the dietitians started sweating and had to go to get water because it was too hot for her. I am proud to report that I was able to handle the spiciness better than someone who eats these foods everyday! I do not think I would have been able to when we first landed. The hospital staff also brought up a tray with several different food samples for me to try. They do this everyday for the main dietitian to try so that she can make adjustments if needed. She showed me the difference between the foods for the patients and staff. The food for the staff was much spicier than that for the patients because the patients' conditions make any stomach upset very difficult to manage.
There is not much to report from SSNH. The only thing to mention is that the difference between SSNH and KMC was even more stark today. Dr. Siva again mentioned that he asks no patient history because he knows it all already. He has known some of these patients for 35 years and does not need to ask their names when they enter. Some of the patients brought gifts for him today. Again, the staff swarmed me just to speak with me. They are very friendly. I expressed interest in trying jackfruit, so Gopal, the chief accountant, walked with me to a fruit stand and bought some for me to try. Like I said, they are very friendly and easy-going, especially compared to the impersonal and professional staff at KMC. KMC has security officers everywhere, none of which speak any English. Today as I was walking to the BHC car picking me up to drive me back to the hostel, I could actually see the car as a security officer asked why I was in the parking lot and proceeded to shuttle me back inside the hospital. I told him that I was a trainee of Kauvery Academy and that I was leaving for the day. He did not understand this, so we went to the front desk, then down to Kauvery Academy, then to a different wing of Kauvery Academy where finally Swarna (my supervisor) explained the situation to the man. He then took me back to the parking lot where the car had moved by then (this process took 15 minutes). We searched some more and eventually found the car. Security is strict, especially for the parking lot and ICU/IMCU/CCU. This is unlike SSNH where I can just walk in directly to the doctor's office.
One of the new cases was very sad. The patient was admitted because of a cardiovascular incident involving his brain. He kept shouting nonsensical things and did not know what was going on. I believe it was his daughter and son-in-law who came to visit him. She started bawling uncontrollably and had to leave. I think she was so sad because it seemed he did not recognize her. He was on a tube feeding because he did not have the coordination to eat, so I am sure his condition had deteriorated rapidly from the time she was with him yesterday. This must have been very difficult.
The patient from yesterday with Dengue fever had a mosquito net around his bed today. I wondered what the use of a mosquito net was if he already had this illness, and the staff explained to me that on the off-chance a mosquito was able to make its way into the IMCU, it would be hugely detrimental if the mosquito bit him because it could spread it to everyone else. This makes total sense, but I did not connect these dots.
I got to see how huge this branch of Kauvery is today. To get to another part of the hospital, we went underground to the basement floor and snaked our way through the halls to surface in an entirely different building. On the third floor is the CCU, which stands for the Critical Care Unit. This unit is for cardiac patients only. Every patient in this room is on a low-fat diet. Many also have to avoid vitamin K because this vitamin is responsible for blood clotting. They were all also on a liquid diet if tube feeding was required or a soft diet if it was not. I am still unsure of the reason on this, but no cardiac patient was given a normal diet. Additionally, fluid balance is very important for these patients, and the amount of fluid intake depends on the severity of their heart failure.
We ate with our hands today at lunch, and I am getting used to it. BHC did not pack a lunch for me again today because the chef was notified too late, so I ate at the hospital. The dietitian told me not to buy lunch because the other three dietitians and she would all share with me. It is common here to share food. All four dietitians took out their food canisters from home and spread it out across the desk. We all took what we pleased, which allowed me to try many new foods. I was able to try snake gourd and brinjal. Brinjal is Tamil for eggplant, but there are many more varieties here. The type we ate today was much smaller and greener than the eggplant we are used to in the US. The influence of the Indian food definitely showed today. We were eating some spicy curry, and one of the dietitians started sweating and had to go to get water because it was too hot for her. I am proud to report that I was able to handle the spiciness better than someone who eats these foods everyday! I do not think I would have been able to when we first landed. The hospital staff also brought up a tray with several different food samples for me to try. They do this everyday for the main dietitian to try so that she can make adjustments if needed. She showed me the difference between the foods for the patients and staff. The food for the staff was much spicier than that for the patients because the patients' conditions make any stomach upset very difficult to manage.
Below is a tasting tray for the dietitian to try and adjust the foods on the hospital's menu. The water is used to rinse the spoon because the spices in each are very different.
This is Kaji Flower, a dessert from a local bakery called Arasan. I have started going there every day because their coffee and tea is amazing, and it is hard to pass up coffee/tea plus dessert for less than $1. Everything is cheap here, but food is especially cheap. To eat lunch at the hospital everyday while I am here, I would spend $7 total.
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