Wednesday, January 27, 2010

Too much OJ leads to crisis and hospitalization

A friends father recently had a health scare due to OJ - yes, orange juice, that healthly bright beverage that Florida citrus growers push into trees and onto grocery shelves.   The problem comes when the OJ is fortified with vitamins and minerals - it can be too much for a body to handle, especially an elderly body that already contains medications and supplements. 

Here's what happened:  My friends father, age 84, had heart surgery about three months ago and, after a three of weeks in a rehab facility, was well enough to be home alone.  He was warned about eating right and getting enough vegetables so he thought some fruit or vegetable juice would be good for him;  he'd get fluids and the benefit of the fruit (fiber, vitamins, minerals, etc.).  He drank one 16 to 20 ounce glass of OJ a day.   After 5 weeks he had trouble breathing, was retaining fluid and his potassium levels were sky  high.   His orange juice of choice was fortified with calcium, multiple vitamins and minerals plus added sugar, preservatives and flavors.  With his existing prescriptions and supplements more than a few ounces of this OJ was the LAST thing he should have.  Eating the oranges would be fine with the natural benefits.  

After more than 5 days in the hospital, he was fine and back to normal.  To help him understand what and how to eat better, his daughter in law requested a meeting with a dietician to identify drug-food interactions and what might be helpful or beneficial for him.   The lesson learned are:
  • when it comes to supplements - in food or in pill form, we really need to be mindful of interactions
  • after surgery and before your loved one goes home, ask to speak with a dietician about drug interactions, special foods to avoid or add to a diet, be there when they talk with your loved one and try to get the doctor to join in too
  • Ask the dietician to WRITE IT ALL DOWN - this might be hard but tell them ahead of the appointment that your elder needs written instructions, copy these and send a copy to their regular physician
  • Create a food and prescription schedule for your loved one.  This doesn't have to be a minute by minute play by play of their day and you can include a variety of things they can or should have for each meal.   
  • Help your loved one shop and, if they select "banned" things, remind them of the interaction and possible consequences; if possible, get them to put it back.