Tuesday, March 10, 2009

Before You Give Medical Advice...Look At The Patient....or Atleast Their File!

I saw a patient who told us that she had been drinking as much V8 as she could because her dietitian suggested it as a good source of nutrients and electrolytes. Now, it's true, V8 is a great source of vitamins and minerals. I mean vegetables are good for you and V8 is just a can of liquefied vegetables more or less, but that doesn't mean it's harmless.

The dietitian, who suggested that our patient double fist V8 because she was eating less and needed to keep her nutrient levels up, apparently thought it wasn't necessary to ask about the patient's primary illnesses. Even though it would take two minutes to ask and then see that the patient had tremendous peripheral edema and her legs had swollen up to 3x their normal size.. Oh, and why read a patient's file if you're suggesting a simple over the counter drink. Not even medication! Just a drink! Sure the file says the patient is on a diuretic...but who cares?!

Well, V8 is loaded with salt...if you've ever had it, you know it tastes like it was made with ocean water...salt, or sodium to be more precise, is an element the body uses to retain water. Peripheral edema is swelling that is due to an accumulation of water. A diuretic is a pill that helps the body get rid of water. The dietitian basically increased the severity of the edema and undid the work the diuretic pill by ordering the patient to ingest so much salt. This all happened because looking at a patient or reading her file wasn't apparently worth the dietitian's time...

Keep in mind there are plenty of dietitians out there that do a great job. The one that this patient saw is definitely not one of them.