Fruit Explosion blew up on me!

Ok, this morning I was STARVING. The calories and carbs and lack of satiating fibre etc. must be having it's impact on me. I gave in to my craving and went to Tim Horton's in the hospital lobby (after all, I see my patients there all the time). I chose a fruit explosion muffin. Seemed reasonable, no fibre, I saw blueberries in it, must be low K and at least sort-of low phosphate. I was actually a bit embarrassed walking through the lobby with my paper bag. Everyone surely must know there was a muffin in there...something I would normally not indulge in - all that fat and sugar! Sitting in my office afterwards, I am informed by my Arti that the muffins at Tim's have phosphate additives in them. In fact, pretty much everything at Tim's has phosphate additives - even the cream for the coffee!  There is only one food at Tim Horton's that Arti says I could have had - a plain bagel with cream cheese. My coffee was ok because I used just a bit of milk in it - no additives in that.
Good grief! This is one of the easiest, most accessible places for our patients to grab a snack or meal pre or post dialysis.
I have learned so much this week about how much I value my freedom to choose my food based on my likes and wants - and not based on what I am being told is a must-do because I have an illness that requires it. If nothing else, I am more empathetic. And more concerned for the patients - and more aware of how their dietary restrictions must burden them on top of the burden of coming to dialysis 3 times a week. Will it change my bedside practices? Maybe. Maybe I will be more accepting and understanding of the values that I see on routine blood reviews that are done in the unit. Given the fact that there is no solid evidence as to what phosphate value we should be targeting in our hemodialysis patients, we really don't know if 1.5 is better than 1.7. Maybe quality of life - achieved through a slightly more liberal dietary intake - is more important to patients. And that is something that I learned to appreciate this week. Arti, thanks for jumping on my weak suggestion that we should do this and actually ensuring that we did. Ann, Carol, Roshina, Julie Ann, and Jeff, thanks for joining in the fun.
I for one am really looking forward to my weekend of liberation!

Alison