It’s no secret I have my share of demons, but I’ve always shared them publicly, (whether you wanted to know or not; if you don’t, go start your own blog and stop reading mine).
Some people have been sober for 10 years.
Some are straight out of the detox ward upstairs.
I’m somewhere in between.
But I value this community of lawyers, doctors, vets – both the military and animal kind – financial planners and people who just got lost along the way.
When Bill Leiss asked me to write a second edition of my first book, Mad Cows and Mothers Milk, I quoted a Neil Young line: “Heart of Gold put me in the middle of the road. Traveling there soon became a bore so I headed for the ditch.”
The ditch trilogy stands up strong 45 years later, and was featured during Neil’s solo show in Omemee, Ontario (that’s in Canada) a few weeks ago.
To add insult to injury, his next studio recording was the harrowing “Tonight’s The Night”, though with a perversity that was becoming typical of him the latter wasn’t released until after the subsequently-cut “On The Beach”. Both albums stand up strongly to this day. Both use the rock format as a means of redemption and rejuvenation, the very act of recording (no overdubs) serving as therapy. “Tonight’s The Night” and “On The Beach” were pretty free records,” Young pondered, lighting another unfiltered Pall Mall.
“I was pretty down I guess at the time, but I just did what I wanted to do, at that time. I think if everybody looks back at their own lives they’ll realise that they went through something like that. There’s periods of depression, periods of elation, optimism and scepticism, the whole thing is…. it just keeps coming in waves.
You go down to the beach and watch the same thing, just imagine every wave is a different set of emotions coming in. Just keep coming. As long as you don’t ignore it, it’ll still be there. If you start shutting yourself off and not letting yourself live through the things that are coming through you, I think that’s when people start getting old really fast, that’s when they really age.
‘Cause they decide that, they’re happy to be what they were at a certain time in their lives when they were the happiest, and they say ‘that’s where I’m gonna be for the rest of my life’. From that minute on they’re dead, y’know, just walking around. I try to avoid that.”
I can’t swim, but the quote above encapsulates why I like being near the beach.
No change, though the hospital is serving an immunocompromised population.
As Ellen W. Evans, junior research fellow, Cardiff Metropolitan University, writes in The Conversation, chemotherapy treatment can reduce immune function and the body’s ability to defend against opportunistic pathogens. It is well documented that people undergoing chemotherapy are at an increased risk of infection, including those transmitted via food.
This is not just about suffering through a tummy bug. People who are already undergoing the gruelling side effects of chemotherapy can be made seriously ill simply because the food they are eating isn’t being handled properly at home. Added to that is the fact that foodborne infection could cause delays in treatment, and potentially increase patient mortality.
But the problem is not down to patients’ laziness. In our newly published research, we have found that they are not being given consistent information, nor do they recognise the serious risks that food can pose.
In our study, we investigated the availability and adequacy of food safety information available to UK cancer patients. We looked at online food-related resources, and conducted in-depth interviews with patients and their families on their food experiences during chemotherapy treatment.
Although some food safety information exists for chemotherapy patients, their access to it is limited. In total, we found just 45 resources online that related to food safety. These included 35 from the 154 NHS chemotherapy providers in England, Scotland and Wales, the Department of Health, and three from 184 identified UK cancer charities.
Looking at the content, 67% of the food-related information resources we identified included food safety advice – for example, “ensure eggs are thoroughly cooked”. Guidance on hand decontamination routines, such as hand washing, was most frequently included (49%). But information on how to reduce the risk of listeriosis, or safe alternatives to particular foods – such as unpasteurised dairy products, and raw or under-cooked meat – were lacking.
Most worryingly, we found that some of the online advice actually promoted potentially unsafe practices. For example, some suggested eating lukewarm food, when this temperature range can encourage bacteria growth.
The most comprehensive food safety resources that we found were tailored to the needs of neutropenic patients – those that have very low levels of white blood cells – but these are unlikely to be given to, or accessed by, all people undergoing chemotherapy.
An assessment of food safety information provision for UK chemotherapy patients to reduce the risk od foodborne infection
Public Health, December 2017, vol. 153, pg 25-35, E.W. Evans, E.C. Redmond, DOI: http://dx.doi.org/10.1016/j.puhe.2017.06.017
Given the increased risk of foodborne infection to cancer patients receiving chemotherapy treatment, and the risk of listeriosis reportedly five-times greater to this immunocompromised patient group, there is a need to ensure the implementation of domestic food safety practices among chemotherapy patients and their family caregivers. However, information regarding the adequacy of resources to inform and enable patients to implement domestic food safety practices to reduce the risk of foodborne infection is limited. Consequently, this study aimed to evaluate the provision of food safety information available to UK chemotherapy patients.
In-depth semi-structured interviews and content analysis of online patient information resources.
Interviews with patients and family caregivers (n = 15) were conducted to explore food-related experiences during chemotherapy treatment. Online food-related information resources for chemotherapy patients (n = 45) were obtained from 35 of 154 National Health Service chemotherapy providers in England, Scotland, and Wales, the Department of Health (DoH) and three of 184 identified UK cancer charities. Identified food-related information resources were reviewed using a content-analysis approach to assess the inclusion of food safety information for chemotherapy patients.
In-depth interviews established that many patients indicated awareness of immunosuppression during treatment. Although patients reported practicing caution to reduce the risk of communicable diseases by avoiding crowded spaces/public transport, food safety was reported to be of minimal concern during treatment and the risk of foodborne infection was often underestimated. The review of online food-related patient information resources established that many resources failed to highlight the increased risk of foodborne infection and emphasize the importance of food safety for patients during chemotherapy treatment. Considerable information gaps exist, particularly in relation to listeriosis prevention practices. Cumulatively, information was inconsistent, insufficient, and varied between resources.
The study has identified the need for an effective, standardized food safety resource specifically targeting chemotherapy patients and family caregivers. Such intervention is essential to assist efforts in reducing the risks associated with foodborne infection among chemotherapy patients.