Download Nutrition and your bone marrow transplant - NSSG

The Patient Advice and Liaison
Service (PALS)
PALS will provide advice and support to patients, their families
and carers. It also provides help to sort out any problems or
concerns you may have. You can contact PALS free on
0800 052 6088.
Making a comment, suggestion or
complaint
We would like to know what you think of the services we
provide to you. We like to know when we are doing well and
when things go wrong, so that we can put them right. Contact
us on 01865 336786.
Translations and Braille
This leaflet can be provided in alternative formats on request.
These include other languages, large print, Braille, Easy
Read, audio-cassette, computer disc or PDF.
NHS Direct
NHS Direct offers health advice 24 hours a day, 365 days a
year and can be contacted on 0845 4647 and online at
www.nhsdirect.nhs.uk
Produced by Registered Dietitians
Community Health Oxfordshire
Version 1, May 2010
Nutrition and your
bone marrow
transplant
What should you eat to help your recovery?
This leaflet has been designed to help you to eat as well
as possible throughout your transplant. It includes
information on:
v Foods available in the hospital
v Foods suitable for relatives and friends to bring in for
you
v What to eat if your appetite is poor
Eating well can help to:
Nasogastric feeding
Some patients need to be fed using a nasogastric (NG) tube.
This is a very thin tube, which as the name suggests, is
passed up your nose and down into your stomach. It is a very
simple procedure performed by the ward nurses, and most
patients find the tube relatively comfortable. Special
nourishing liquids can then be slowly fed into your stomach
through the tube. You can still eat at this time if you wish.
Patients likely to be recommended to have NG feeding
include those who:
v Are underweight or have lost a significant amount of
weight before admission
v Decrease your risk of infection
v Are aged 60 or over
v Prevent loss of muscle
v Keep you feeling well
v Have another illness that can increase their risk of
infection
v Are having a type of transplant that will make their
mouth and throat extremely sore
Dietitian
The Dietitian will visit you during your admission for
transplant. If you feel you need to see the Dietitian in the near
future, please tell your Nurse.
You can also contact the Dietitian when you are not on the
ward by telephoning 01865 235421
1
v Have not eaten well for more than three days
The Dietitian, Nurse or Medical team will discuss this with you
if they feel you would benefit from this.
6
Suggestions for suitable foods to bring in
ü Full fat yoghurts (not probiotic, live or Bio *)
ü Shop bought desserts such as mousses, trifles, rice
puddings, custard, jellies
ü Shop bought milkshakes
ü High energy drinks e.g. glucose energy drinks
ü Cheese and biscuits (not blue or some soft cheeses *)
ü Wrapped biscuits, cakes, cereal bars (keep in an
airtight container once opened)
ü Scones, croissants, scotch pancakes
ü Wrapped sweets and chocolates
ü Snack pots e.g. Pot noodle
ü Sandwiches with suitable fillings, e.g. cheese and
pickle, cold meat (vacuum wrapped), tuna, sardine,
well-cooked egg (no salad or pepper *)
ü Fresh fruit (peeled *)
ü Any tinned foods
ü Fruit juice (long life or pasteurised*), squash, fizzy
drinks
ü Chilled ready meals (must be kept chilled at all times
and reheated as per instructions until piping hot)
*- when you are neutropenic (See “Neutropenic Diet” leaflet
for details)
Important
v Make sure any perishable foods are kept cool on the
way to the hospital and are stored in the fridge
v Check the fridge regularly and remove any out of date
foods
v The fridges are not suitable for frozen foods
5
Nutritional problems that can occur during this time
You might find that you have a poor appetite during your
stay, and many people experience taste changes. There
could also be times when nausea, vomiting, diarrhoea, dry or
sore mouth may decrease your wish to eat. If you do
experience these problems, they are unlikely to last
throughout your admission, and there is a great deal that we
can do to help with medications and advice on suitable foods.
It is quite normal for patients to eat less for two or three days
at some stage. Try not to worry if this happens to you.
However, you will probably feel better if you can eat some
food or nourishing drinks at this time.
Foods available in the hospital for you
v Cereal, porridge and toast are available for breakfast.
v You will be given a daily menu to choose your lunch
and supper from. The house keeper can also provide
soft moist, neutropenic, Halal or vegan menus as
required.
v Biscuits, cake or fruit are provided between meals
when drinks are served.
v “Snack boxes”, which include a sandwich and other
snack items, and “Lite Bites” which are hot snacks, are
available at any time via the housekeeper or nurse
Friends or family are welcome to buy a takeaway meal or
snack for you from the hospital restaurant, but if you are
neutropenic we advise that this happens when meal service
starts.
2
Extra foods available on the Haematology ward
The day room has facilities for making drinks and simple
snacks. There is a microwave, milk dispenser and ice
machine. Fresh bread, spreads, cereals, porridge and a
variety of tinned foods, including baked beans, soups,
custard, rice pudding and fruit are available there. This food is
for the patients, so help yourself, or ask one of your visitors,
the Housekeeper, the Dietetic Assistant or your Nurse to help.
Neutropenic diet
This is extremely important to minimise the risk of you getting
an infection from your food. You should be given a leaflet
entitled “Dietary advice for patients with neutropenia”. Ask the
Nurse or Dietitian for one if not.
Once you are neutropenic with a neutrophil count less than
0.5, you can still choose from the normal menu, but need to
avoid the following:
v Salad
v Any sandwich containing salad
v Uncooked pepper – don’t use the pepper sachet
Ways to increase your intake of nourishing foods
v Make the most of times when you are feeling well
v Choose options marked ED from the menus as these
provide more energy
v Eat small frequent meals and snacks, if you are not
able to eat normal sized meals. This is also useful to
help prevent sickness.
v If you can’t manage a main course, try Build up soup
and a pudding, cheese and biscuits, or cereal
v Have nourishing drinks such as ward cocktails or milk.
If you are not able to eat normally, nourishing drinks
can be a good solution, especially if your mouth is
sore. Ask the Housekeeper, Dietetic Assistant or
Nurse to make you a cocktail to try. If taken regularly,
these can help you to recover quicker. Try to eat a little
at meal times, but take cocktails between meals.
Ready made supplement drinks are also available.
How can relatives and friends help?
v Egg mayonnaise sandwich (contains pepper)
v Timing visits with mealtimes can make eating more
enjoyable, especially if you eat together
v Fresh fruit unless you peel it
v Ask them to get alternative meals from the restaurant,
or snacks from the dayroom for you, if preferred.
As this limits your choices, there is also a neutropenic menu.
You may choose from either the normal menu or neutropenic
menu.
3
v They could bring in foods that you are familiar with and
enjoy
v Bring in suitable snacks or ready meals. See next
page for ideas.
4