Nhs fortasip ensures

[Catatedog]

Anyone had nutritional supplements on the NHS?

I
had a private bowel resection after an injury. The dietician has advised fortasip compact protein along with food advice. My appetite is really poor and have lost weight. My GP practice is saying no need to prescribe

wondering if anything else can make myself or ways to argue i need from GP.

Anyone had nutritional supplements on the NHS?

I
had a private bowel resection after an injury. The dietician has advised fortasip compact protein along with food advice. My appetite is really poor and have lost weight. My GP practice is saying no need to prescribe

wondering if anything else can make myself or ways to argue i need from GP.

If you don’t meet the prescribing guidance it’s unlikely your gp will prescribe them. They are not bound by anyone’s advice. If a hcp wants you to have them then they need to prescribe them, if they can’t prescribe then they need to speak to their seniors re prescribing not the GP.

other healthcare staff are very quick to forget that the legal responsibility for a prescription lies with the signature NOT anyone else. Very hard to defend going outside the prescribing guidelines and ‘the dietician told me too’ is not a valid reason that would stand up if there were any side effects.

@uncharteredwatersmy reading of the local guidance is it is refer to dietetics for short bowel sindrome. Pressumably they also need to take responsibility for any consequences of not giving the prescriptions. I have not been signposted back to the dietitian or private consultant.

@slb09 I had my first surgery on the NHS. However, guidance was not followed afterwards. The two consultants discussed this after my private surgery, as it resulted in a more extensice surgery and they said it was a good thing I had insurance as I ran a high risk for a perferation

I have paid for blood thinnersning injections, drressings pain relief but dont feel i should have to cover things where had the nhs followed its own guidelines I likely wouldn’t have needed.

NHS dietitian/nutritionist. I've had her for years snd see her and a gastro every rhree months.
I still have a couple on my repeat prescription for when my tube fails.

The Op has said she remains overweight despite losing 7% (which is unlikely to be material if overweight)

but doesn’t seem keen to clarify how overweight so reasonable to presume fairly substantially overweight. In any event, even if just slightly overweight despite losing 7% it would be most odd to be prescribed this.

The GP is correct. You have a small appetite atm. So what you do eat, ensure it’s as nutrient rich as possible

@ketchupbroc there are a lot of assumptions in your post. What experience or qualifications do you have to know what is significant or concerning for weight loss?

I havent shared my exact BMI as don’t think its relevant. The dietician I saw and @hamiltonfan have said the degree of weight loss over a short period of time is not healthy. I think the concern is the loss of muscle mass and nutrients my body was also quite athletic, meaning that its more complex to assess both a healthy weight and weight loss.

do you have any advice about how to make small pausions of low fibre foods nutrient dense? Its not really that my appetite is small. Its virtually nonexistent. I am obviously forcing myself to try and eat the advised foods but eating say a yogurt feels like a lot of food.

@valentinesgranny Sorry to hear you have a tube. I had one inserted due to the bowel not working after surgery and it was not overly pleasant.

I will try to get a NHS dietitian referral. I an not sure these probs will go away particularly quickly.

@redphonecasedo you work at a GP’s? My GP has been sent advice from a dietitian when I was a private inpatient My NHS app says prescription request denied follow food first advice.

I am concerned that the request also related to colastiramine, which I can not just buy. I felt so unwell before being on this and was going to the toilet more than 15 times a day. This obviously meant fluids were really important and food took a bit of a back seat. Despite this I ended up hospitilised with dehydration.

Yes, I'm a GP.

Food first is better.
Hopefully you have a leaflet detailing low residue food - soup is your friend here as you can add milk/cream. Mash is good add cheese & cream.
Ice creams, white rice and pasta dishes with white/cheese sauces can be good..
Puddings - I use the individual sponge puddings and add cream or custard to increase calories.
Try all milk coffee to drink.
You could buy build up or complan in the pharmacy but really calorie for calories trying protein rich food is better and will be nicer. If your appetite is small concentrate on what calories can I eat.

If your surgeon/dietician really thinks you should have them, then a private script should be written post private surgery.

do you have any advice about how to make small pausions of low fibre foods nutrient dense?

Surely your dietician has given you extensive and tailored information about this already OP?

the dietitian advice involved a meal plan which included two fortasip a day. I am being told its easy to replace with food first so was looking for tips.

I am doing things like putting milk powder or pb2 in yogurt. Buying greek yogurt or protein desertts. Nut or seed butters, sardinese or cheese spread on toast. Propper carbinara made with egg and cheese but am still loosing weight.

Do you think it would be better then to ask for an appointment based on symptoms?

I am not coping overly well due to D&V and a abdoman that randomly gets distended with not eating seeming to be the best way to clear. sure there is a psychological component to it all. Its really hard to eat when its caused pain and there

Yes I would make an appointment re that and take the paperwork re supplements to also ask about.

I like soup and have one I love with butternutsquash peanut butter and coconut miljk. I can only normally eat really small amounts of this and figured could have it with a bit of chicken for protein.

the dietician said soups can sometimes fillup too much for there nutritienal value but presume this is why you add cream. Having it with cheese on toast or avacardo dependent on flavour would add to it as well.

I am going to make a cheese sauce to have on some potatoes or pasta.

i like icecream and yogurt but am otherwise not a big pudding person. Could do to have more easy savoury snacks. I may make some small fishcakes as could enjoy one dipped in a mayo based dip. I like risotto, perhaps aranchini balls would also work.

@Catatedog I'm sorry you are going through this. Hopefully you get sorted.

My mother had them. She preferred the milkshake variety.

You’re very focused on this.

because it would probably explain the Gp’s reluctance to give something for weight gain to someone who despite losing 7% of their body weight, remains overweight.

dont you think?

So it was a private dietician who recommended this?
Then they need to prescribe it as well. Or refer you back to your consultant for issue.

I’ve had a very similar type of nutritional drink prescribed by the NHS and my Must score was lower than three. So it is definitely possible. I’m sorry they’re not being more proactive in helping you.

On this basis hospitals wouldn’t feed overweight patients. Food is for weight gain!

I don’t think the GP knows my weight. However, my understanding is a lot of weight loss in a short period of time can be dangerous. The body goes into a starvation mode and looses muscle mass and coming out of the state can cause refeedding syndrome. I have had blood tests which have shown I have needed vitamines and other support to digest food e.g. urine tests showing +3 ketones.

Thanks was this recommended by a dietician or something the GP suggested.

struggling at the moment as have just brought back the chicken and potatoes I at 7. My system just doesn’t seem to want to move food through in a logical way.

Yes it was a private dietician while I was an inpatient. My insurance covers inatient meds but not out patient so will be paying the full cost of all prescriptions if privately issued. This doesn’t seem overly fair, as if the NHS had followed its own guidance the expectation is I would have not lost so much bowel in the surgery and therefore have less problems to mannage going forward.

I have not asked the NHS to cover the immediate things from surgery e.g. blood thinner injections, pain relief antisickness dressings etc.

Food is not “for weight gain”

Fortasip is ”for weight gain”

I am just trying to explain why a GP wouldn’t be happy prescribing fortasip to someone who was overweight pre surgery and remains overweight post surgery despite 7% weight loss