Hello friends,
Last week I was checked into hospital to have half my thyroid removed. Although this sounds less than ideal, in reality it was very lucky indeed. The pesky nodule that was spotted hiding in my gland was caught very early, the surgery was straightfoward and I'm now recovering safely at home. All in all, it was the best healthcare experience I've ever had, which I apparently repeated very enthusiastically to every member of staff in sight when coming round from the anaesthetic.
If you've been under general anaesthetic, you'll know the drill with pre-surgery fasting and limited fluid intake. The night before I tried to set myself up for the long haul with a big dinner and late night snack with a pint of water, but by the middle of the afternoon the next day my stomach was grumbling indignantly and my head was starting to throb. My body felt all over the place when I woke up in the ward. It had been about 24 hours since my snack, but it was about 36 hours in total when I finally ate.
I broke my fast with a bowl of hot, well-honeyed porridge and some apple juice. Perfectly hearty and soothing. Shortly afterwards, I was handed a strong cup of tea, and then another, and then a cheese sandwich and apple crumble with custard for lunch. It was brilliant. I felt like I was back at my Gran's house and all I had was a sore throat. The apple crumble in particular felt almost as good as the morphine I was happily swimming in (well, not quite). They know what they're doing in the NHS - they know the power of a hot dessert at lunchtime.
It got me wondering if feel-good food was actually a real tactic for recovery; if comfort food does make you feel better despite not necessarily being the ‘healthiest’. The NHS has national standards for food and drink in healthcare referring specifically to the idea of food as medicine. A quarter of patients in hospital, including a fifth of admitted children, are affected by malnutrition, which increases the risk of healthcare complications and the need for further interventions [1]. There are guidelines that state the energy and protein requirements of both nutritionally well and more vulnerable patients must be catered for and standards for the level of quality required; it's a clear priority that patients and staff have access to quality food.
Various studies have explored the beneficial elements of ‘comfort food', whether psychological, neurobiological or pharmcological. These palatable foods are generally higher in sugar, fats and carbohydrates - which is why they're so delicious - swaying from the usual idea of a balanced diet. When you're in good health you'd probably consider them to be occassional treats, but for those that aren't in the best of health or potentially reluctant to eat, they might be more of a lifeline. In fact, the UK Association of Dietations recommend nutritionally-dense food for malnourished patients with a poor appetite, with examples including cheese scones, rice pudding and - hooray! - custard [2].
Interestingly, a study has shown patients with chronic pain do engage in comfort-eating but it appeared to be through an indirect relationship with stress, meaning that patients were comfort-eating in repsonse to the stress caused by the pain, rather than the pain itself [3]. It makes sense: I know that custard doesn't actually line and directly soothe my freshly-cut throat akin to the Gaviscon firemen battling heartburn, but just clutching a warm bowl full of sugar that smelt like my childhood made me feel a whole lot calmer, even if the pain was still there. The idea of a ‘memory menu' has been successfully put into practice with Nottingham University Hospitals NHS Trust offering high-calorie comfort foods, chosen by the public, alongside healthier options to suit the needs of different patients.
From the perspective of someone recovering from surgery, if there is something you know will make you feel better and put a bit of colour in your cheeks, it's worth having. Getting better feels easier with a full tum and a big smile. My committed squad of carers have be happily bringing me ice cream, peppermint tea and painkillers (prunes were also discussed, opiods are no joke). Hopefully I'll soon be well enough to whip up my own crumble and crack open a tin of Ambrosia, pouring one out for my lost thyroid lobe. Until then it's feet up and gentle recline for me!
Yours in custard,
Deb
References
https://www.england.nhs.uk/long-read/national-standards-for-healthcare-food-and-drink/
https://www.bda.uk.com/resource/malnutrition.html
https://doi.org/10.1016/j.appet.2019.05.027
I like the more analytical style