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Friday, June 03, 2005

Hard Boiled

Coeliac disease is a common condition amongst Europeans. It's basically an allergy to gluten. Sufferers who ingest gluten will suffer from massive amounts of diarrhoea and eventually develop terrible inflammation and ulceration of the intestinal lining. It is imperative that a person with coeliac disease keep to a gluten-free diet, as damage to the intestinal lining not only causes great discomfort, but it also inhibits the absorptive properties of the gut and the person can become seriously malnourished.

Gluten is found in wheat and wheat products such as cereal, bread and pasta. It's easy to find 'gluten free' products in the UK, and most people with coeliac disease eventually become so used to avoiding gluten that they do not really think of it as a problem.

One such person was admitted to my ward and had forgotten to mention his special dietary requirements to the doctors and to the staff. The next morning, I came round to find him staring forlornly at his muesli and toast, looking very hungry.

"May I have boiled egg for breakfast instead?" he said, "I normally have two every morning."

"For sure!" I replied, "I'll let the staff know"

One hour later, I get a call from the nurses who said to me, "The cook is throwing a strop (tantrum) and says that he needs to be seen by a dietician first".

"Ridiculous!" I answered, "The dietician won't be around to see him until after Tuesday!" (It was a 3 day weekend)

"He says if the patient wants a special diet, he'll have to buy it himself from the canteen"

Another hour passes and the nursing sister, executive manager and site co-ordinator call me up and say that the catering services have refused to provide special diet for my patient and that I'll have to put a cannula in him and start up a drip because he won't get anything to eat over 3 days.


So I went up to the ward and wrote up a prescription on the fellow's drug chart:

'Boiled Egg, TT, OD, Mane' (Boiled Egg, Two doses, Once a Day, in the Morning)

We all looked at each other and grinned. The pharmacist arrived on the ward, gave me a wink, and headed off toward the catering department, the drug chart held before her like a shield.

Thirty minutes later, I went to check on my patient and he was sitting there looking forlornly at his two boiled eggs.

He looks up at me and says with a sigh, "I usually have them soft-boiled".



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