Monday, 16 December 2019

BEZOARS

Most bezoars cause no symptoms because they don’t completely block the digestive tract. Where symptoms do appear, these may include:
  • feeling full after eating very little food
  • a lack of appetite
  • nausea
  • vomiting
  • abdominal pain
  • weight loss

Your doctor may diagnose you with a bezoar by any of the following tests:
Bezoars are typically observed as a single mass, but they can comprise multiple masses. They may range in color from brown, green, yellow, or even black.
Doctors sometimes try to remove a piece of the bezoar during the endoscopy and examine it under a microscope to look for hair or plant material.


there are some pictures on various websites

Image result for bezoars symptoms

Wednesday, 20 November 2019

OPTIMAL NUTRITIONAL CARE FOR ALL

https://european-nutrition.org/

Optimal Nutritional Care for All




The Optimal Nutritional Care for All (ONCA) campaign is a multi-stakeholder initiative led by European Nutrition Health Alliance (ENHA) to facilitate improved screening for risk of disease-related malnutrition and to promote nutritional care implementation at national level across Europe.

At present there  are $ Campaign aims -

Measure te prevalence of economics of malnutrition
Educate medical and health care professionsl and students
Implements nutritional care in hospitals and  community
Infuence public awareness and policy making

So felt very inspired by a confenece and will try and do some public awareness on this

Monday, 18 November 2019

DIET AND THE HEART

Really good information in Heart Matters on diet https://mail.google.com/mail/ca/u/0/#inbox/FMfcgxwGBmsmGqPgGLMzGXWZNnPnBsGb

On exercise

Salt

Diabetes

getting your 5 a day

PLUS lots of other items  --worrth signing up for


Heart Matters banner

Saturday, 2 November 2019

DIABETES CONFERENCE






IDDT

Last Saturday I attended the IDDT annual meeting in Kettering. People came from all over the country and there were a number of workshops which were well attended. The day is a really good opportunity for peopel to talk about issues with ach other plus experts.

Really good information about the Freestyle Libre which had revolutionised control for many people.

The IDDT is a small charity which has no major sponsors  so is completeely independent. They produce excellent information on all sorts of topicas related to diabetes.



FreeStyle Libre

The IDDT has lots of useful infoprmation as well as advice to individuals. This year they have produced a helpful diary

IDDT's Diabetes Everyday Diary







Sunday, 6 October 2019

GOUT AND DIET

I seem to have had a spate of people asking me about gout and their diet. last week  I  saw an expert patient who described very fully how it had devestated his life .

Gout is a very painful form of arthritis which causes intense pain in joints. This pain can come on very suddently and causes the joint to be hot swollen and extremely painful.

It is due to uric acid crystals being deposited in a joint  and these are derived from purines which are in turn derived from various foods.



uric acid crystals magnified



As seen these crystals are almost like numerous needles!

General advice on diet is


  • Lose weight if overweight  --but do this gradually by following a balnced diet and increased exercise
  • Take plenty of water as it reduced the likelihood of crystals developing
  • Do not drink excessive alcohol --especially do not binge drink. have a couple of days alcohol free and do not take more than 14 units of alcohol per week.
  • Avoid offal like liver and kidney game like rabbit hare and pheasants, and meat and yeast extracts
  • Do not take excessive amounts of meat or poultry, dried peas and beans, mushrooms, vegetables like asparagus and caulifower, wholegrains like bran and oat bran and wholemeals bread
  • Dairy foods like milk, cheese and yoghurt are low in purines, as are eggs, breads, pasta and cerals except wholegrain ones, mots fruit and vegetables.
  • Some people are helped by a supplement of vitain C as this can reduce uric acid levels
  • Triggers somtimes occur for people where they can link eating a certain food with an attack

The UK Gout Society has helpful information on the website as does the NHS








Wednesday, 25 September 2019

HOSPITAL CATERERS ASSOCIATION -OXFORD BRANCH MEETING NEXT WEDNESDAY


IF THERE IS ANYONE INVOLVED IN CATERING FOR CARE GROUPS AND PATIENTS PLEAS LET ME KNOW AND I WILL SEND AN INVITE


Oxford Branch Meeting and training event 2nd  October 2019

Venue:  Hobart UK, Southgate Way, Orton Southgate, Peterborough PE2 6GN          
With thanks to Hobart for providing a venue and refreshments

To be joined by members of the East Anglian Branch

10am for introductions and welcome
10.30 Robert Beeston specialist volunteer on COPD at Kettering General Hospital.
  • Giving a wide raging overview of diet and COPD (Chronic Obstructive Pulmonary Disease –where nutrition and exercise are of prime importance)

11am Brian Northall expert patient.
  • Gout a very painful condition and how diet can help to control the symptoms of pain

11.30am Dr Mabel Blades consultant dietitian
  • Diabetes an interactive update on ideas on diet and general management

Hobart 12-2.00pm with Cooking presentation and hands on with Ware washing Equipment Innovation with thanks to David Grundy and Adrian Gregory of Hobart.

Saturday, 7 September 2019

Kettering General Hospital


As a Governor at Kettering General Hospital I thought readers may like to see what is happening so am copying in the CEOs weekly message plus also the fabulous dance craze


A message from Chief Executive Simon Weldon

Hello everyone!

I’d like to start this week by telling you a little about the work I and the team have been doing in support of getting our Urgent Care Hub approved.

Last Friday, NHS Providers launched a campaign called Rebuild our NHS.  You can read about the campaign and what it is trying to achieve here:  https://nhsproviders.org/resource-library/rebuild-our-nhs.  We were asked to take part in the campaign, specifically to be filmed, to show some of the estate issues that are a day-to-day reality for staff and patients.  On Friday Channel 5 came in and filmed in our urgent care pathway.  It was a very supportive piece.  If you want to have a look at it please contact Dave Tomney and he will make the arrangements.  I’d like to thank everyone who helped support the filming.

Coincidentally, our local MP, Philip Hollobone had also secured a Westminster Hall debate in Parliament on Tuesday this week.  I went along to support him.  He did a great job in presenting and pressing our case and afterwards we met the Minister who is responsible to tell him about why we needed the hub.  I will be following up further with officials in DHSC.


Locally, we posted on Facebook about what was going on.  It obviously touched a nerve as since Friday it has reached 36,983 with 289 comments, 259 shares and 10,116 engagements supporting the concept of a hub at KGH.  Many comments are heart felt and based on people’s experiences and some are quite detailed.   This response is at a level way more than any other post we have ever made. Comments are very positive about staff but fully support our bid for an improved environment – with lots of real life examples.

It is of course very hard to secure capital in the current environment but it is also important that we keep raising the profile of KGH and what we need to serve our patients well and I want to assure you that I will absolutely keep at this no matter the difficulties.

Onto other issues: 

I couldn’t let this week go past without referring to the new dance craze certain people have initiated.  You can see for yourself here:


This was all in the context our EPR programme to digitise the hospital.   In October we will start to roll out the Vitals system across our Adult inpatient wards. This system will enable staff to electronically record and view patient observations using handheld devices that will be available in every ward. We’re making great progress to prepare for this having already set up 100% of the devices, completed some of the testing and now we’re getting ready to deliver training. Last week there was an open day in Foundation Wing where a number of people could come and have a play with the Vitals system.   And dance obviously.   You may have also seen that the EPR team now include a weekly update in the staff A-Z email. You’ll continue to hear more update through the various communication channels.

And finally, my shout out of the week goes to the IT Training Team. When new staff start at the trust it is really important that they are trained within the first few days to ensure they have the skills, knowledge and system access to be able to fulfil their job roles. In August, the IT Training Team had 512 attendances on various courses which is an all time record. This included delivering various training sessions to 120 new doctors. Well done to the team!

Have a good weekend and thanks for reading.

Simon

Simon Weldon – Chief Executive

Wednesday, 17 July 2019

INDEPENDENT DIABETES TRUST(IDDT) MEETING

Diabetes is one of those conditions where the more people know about the condition the easier it is for them to manage it. Talking to others also helps to empower them.

The IDDT has a meeting at Kettering Park Hotel on Saturday October 26th 2019 which may be helpful for people

Sorry not very good at scanning items !


Sunday, 16 June 2019

Blancmange


This is a really easy and nostalgic dessert --my granny was a cook in a stately home and this is her recipe

It is so easy but needs to be allowed to set and lovely then turned out into dishes as shown


BLANCMANGE
Ingredients
Serves: 6
·        700ml milk, divided
·        2 cinnamon sticks
·        4 tablespoons cornflour
·        100g caster sugar
·        1 teaspoon vanilla extract (optional)
·        75g shaved plain chocolate, for garnish
Method
Prep:10min  ›  Cook:15min  ›  Extra time:6hr chilling  ›  Ready in:6hr25min 
1.     Place 1/3 of the milk into a saucepan.  Bring milk to a simmer over medium heat.
2.     Meanwhile, in a small bowl, whisk together the cornflour and sugar. Whisk remaining milk into the cornflour mixture. When the milk in the pan begins to simmer, pour the cornflour mixture into the saucepan in a thin steady stream. Whisk vigorously and increase heat just a bit to bring the mixture to a gentle boil. Allow the mixture to boil for about 20 seconds while continuing to whisk, then remove from heat. Stir in vanilla.
3.     Pour into a dish or mould and refrigerate for at least 6 hours, or overnight. Garnish with shaved chocolate just before serving.

Easy to flavour it with cocoa powder of other flavours and colours using syrups or pureed fruit. Capuchino is a lovely modern twist

A blanmange rabbit on a bed of green jelly grass is very evocative of childhood parties





There are also packets of blanmange to buy




Friday, 14 June 2019

Message From Chief Executive at Kettering NHS Tust

I am a Governor for Kettering NHS Trust and a while ago someone asked me why I did not put messges fram teh Chief Executive on my blog so here it is


A Message from Chief Executive Simon Weldon

Hello everyone,

I hope you’ve all had a good week and not been too drenched by the seemingly never ending rain!  I thought I’d start this week by reflecting on my visit to Ashton yesterday, in my continuing exploration of the enhanced recovery pathway for orthopaedic elective patients.  I spent time with Anne and Linda watching them help patients mobilise post op.  As ever when I visit with a clinical service, I come away feeling inspired by what I’ve seen.  The skill and focus that both of them brought to bear on each patient was great to see.  I had the chance to speak to both patients and both of them were full of praise for the care they had received from the whole team.  Talking with Anne and Linda afterwards, they also pointed out they thought we could do more as a hospital to attract additional work – in short we didn’t make use of all of our available elective beds.  I think they are exactly right – we have acquired the reputation for not being as efficient or effective as the Woodlands just up the road.  Yet that reputation belies the reality – we provide better after care, our outcomes are as good, and we deal with more challenging patients.  I think we need to think further about how we promote the work and the services we provide – no one else will do this for us!

Yesterday evening I attended the Professional Excellence Awards.  These awards recognise the contribution of medical teachers, tutors, supervisors and students.  What I really like about the awards is that for each nominee statements supporting the nomination are read out.  These are heart-warming: they show how teachers of all types consistently go the extra mile to support the learning of their students; they also show how students are pushing themselves to really do the best they can.  This all happens on a daily basis and often out of view so it is so good to stand back and acknowledge those contributions.  And speaking of contributions it was entirely right that the evening paid a special tribute to our own Director of Medical Education, Dr Fayyazz Hussain.  He is stepping down from the DME role after 6 years and I think everyone would acknowledge he has transformed medical eduction during his tenure.  I thought his remarks at the start of evening were so to the point that I’m plagiarising them shamelessly here:  the world he said can be divided into people who see the world isn’t perfect and are overwhelmed by this and by those who see those imperfections and say that despite that, they will still try and make a difference.  And what a difference he has made to the medical education of generations of students.  We all owe him a great deal so it’s a pleasure to be able to thank him again for all he has done in this note.  I was also very struck by Mr Khairandish’s eloquent homily on those from whom we learn the most.  If you seem him in the corridor, ask him to tell you about it – it requires the element of performance for the full impact!

Also, yesterday – it turns out to have been a really busy Thursday – we had our Progress Review Meeting with NHSE/I.  Note especially the joint acronym there – we are now in a new regulatory regime where we have one regulatory conversation as opposed to two.  As I have said, this can only be for the good.  In straightforward terms, we only have one pot of money for Northamptonshire and that pot has to deliver both safe, high quality clinical services and do so within a fixed financial envelope.  In previous years, the money conversation has generally happened in one place and the quality conversation in another and that has led to some difficulties in reconciling those aims and being clear about the priorities.  So having one conversation has to be the right way forward.  Early days but hopeful signs is my view.

On a day that wasn’t Thursday – Tuesday in fact – we had our leadership brief hosted by Mark.  You can find the slides herehttp://kghintranet/Pages/Default.aspx .   We spent time talking about the health and well-being plan.  This included a memorable repackaging of the YMCA dance.  I’m reliably informed there is some video footage of this somewhere which I’m sure can be made available for the usual fee.  A personal highlight for me, was meeting Ernie, the Pets as Therapy dog, who won a CARE award.  Again, photos are available!

Finally, also on Tuesday, we had EGM, my senior team meeting.  I talked about the upcoming work on estates.  There’s a lot to say about that in due course but one thing to highlight here.  I know we’ve got quite a few services which have ended up in places that are less than ideal, often on the basis of sorting out a short-term problem.  The TOPs service is probably one of the prime examples of this.  Just to say here I’ve asked for the list of those services to be pulled together across the hospital so we can start sorting them out.  Eileen is leading that work so let her know if you’ve any areas that you want to be considered.

Thanks for reading and have a good weekend.

Simon

Simon Weldon
Chief Executive

Tuesday, 11 June 2019

SIMPLE VEGETABLE SOUP

I make soup frequently and this is todays

2 bags roasting vegetables ready prepared
1 bag grated carrots
2 tablespoons split lentils
600 ml boiling water
tablespoon soya sauce
1 tablespoon tomato ketchup

serves 4

put the water and vegetables including lentils in a saucepan, add the water and bring to the boil. Simmer for an hour. Add the soya sauce plus tomato ketchup to taste

I made this soup and used vegetables reduced from the local supermarket all of which cost me 80p and the soya sauce was in the cupboard and the tomato ketchup was from washing out of the bottle.

So 4 or more substantial portions of soup for less than £1



Image result for free soup picture download

Saturday, 8 June 2019

COPD and nutrition

CHRONIC OBSTRUCTIVE PULMONARY DISEASE is a chronic disease causing breathing difficulties.

Nutrition is important in maximising health in this condition

Some key points

  • Excess Weight --if you are obese then it can be more difficult to carry the extra weight  and make you more breathless so gradual weight loss is a good idea
  • Under weight can cause you to feel tired and lack energv--this can be checked by looking at the MUST https://www.bapen.org.uk/screening-and-must/must-calculator
  • Adequate fluid is important so aim for 2 litres a day --all types of fluid are useful such as tea, coffee, herb and fruit teas, juices, low sugar soft drinks, milk and malted milks
  • Regular meals of breakfast, lunch and evening meals are important. To save energy it is useful to cook 2 portions of meals and then freeze the other portion for later. Items such as a slow cooker does save time in cooking.
  • Take 5 portions of fruit and vegetables each day
  • Ensure you take enough protein like meat, fish, eggs, cheese and pulses  
There is helpful information at https://www.blf.org.uk/support-for-you/breathe-easy

The BDA has useful information on nutrition in COPD and you can always ask  your dietitian about advice

This is me giving a talk at the local Airways Group

Tuesday, 21 May 2019

SNACKS

Snacks are so useful for those with small appetites to maximise nutrition. However some snacks become mini meals or I have seen little children being given large sausage rolls and large bags of sweets as a snack.

Some ideas

Fruit of all types including the mini fruit pots ideal to keep in the office or tool box
Pop corn
Lentil snacks
Carrot sticks or celery sticks and hummus, or cottage cheese or my favourite marmite 
Nuts of all kinds eg almonds
Small portions of dried fruits
Crispbreads or oat biscuits on their own or with a topping
Small sandwich
Small slice of toast
Small bagel 
Rice cakes

The BRITISH DIETETIC ASSOCIATION HAS A USEFUL  FACT SHEET ON SNACKS



Image result for picture of snacks food




Thursday, 16 May 2019

VITAFOODS--GENEVA


I have been to this for a number of years and it is so good to see items ahead of when they become available .

Really useful for any one involved with diet and health

Went on the first day
A Fantastic Start to Vitafoods Europe 2019

Vitafoods Europe 2019 has officially opened today, presented by KSM-66 in association with FrieslandCampina, and welcomed thousands of visitors from around the world to network and discover the latest products and ingredients to emerge in the Nutraceutical market.
It has been a successful day across the whole exhibition with all areas of nutraceuticals being prominent at the show through the following areas:
  • New Products Zone
  • New Ingredients Zone
  • Packaging Zone

  • Sustainability Square
  • Sports Nutrition Zone
  • Tasting Centre
Don't forget to visit these areas during the second day of the event to explore new sustainable products and ideas being introduced to the market.
Visit our NEW feature: Sustainability Square - K90
Visit the brand new Sustainability Square located at the heart of the show, to learn about insights within nutraceuticals, and our commitment for a more sustainable future. Discover the latest consumer trends through iPad presentations and take a short survey asking: "What does nutraceutical mean to you", to receive a reusable water bottle.