What does a dietitian do on first meeting?

[kikidee1994]

Hey guys well I'm off to see a deitition tomomorow and I don't really now what I'm going for ? Apart from I haven't been able to eat in nealy a year and been on forstip drinks :stinks:
I've tried every think in deit wise like low residue and ect
Should I have question to ask her or him
Someone help ,...!!!
Thanks guys x:kiss:

 

[hornby]

From personal experience with one, they will weigh you, take a hight measurement and work out your bmi. I was in your position and she put me on modulan. Its a high calorie liquid diet made by Nestlé!! Good luck

 

[nogutsnoglory]

Well if you haven't been able to tolerate food one question you can ask them is how you can begin to incorporate liquid or solid foods that may be more bearable for you.

In my experience with nutritionists they get a background story of your health condition, want to see recent blood work, and will tailor a plan to meet your nutritional needs.

 

[Kev]

OK, I've been to three different dieticians/nutrition counselors. 1st was just a general one who visited with me in hospital, pre-diagnosis. Her only advice was that I needed to masticate more (funny at the time, but in retrospect, pretty pathetic in context to my disease... but, again, this occured pre-diagnosis). 2nd was a booked appointment with a nutritionist who specialized in IBD. She reviewed my files, took a lot of info, did the weight N measurement thing, then began instructing me on how to read food labels, what foods to watch, avoid, etc.. And even tips on food prep, lunches, that sort of thing. I found it to be extremely worthwhile. I had kept a daily food diary, started it when I first found this site.. advice from another member. The nutritionist recommended it.. and I kept it up for quite some time... until I reached a point where I was confident enough in how well my LDN was working that I began experimenting with eating normally.
Recently, after my diabetes diagnosis, I again was sent to a specialized nutritionist, this time for diabetes. Again, pretty normal, pretty routine, and I learned a great deal. I see the opportunity to see such specialists as a veritable godsend. Helped me immensely. I don't see any downside IF the person you end up with knows their stuff... All the best.

 

[kikidee1994]

Hey guys well i went to the deitition and was told that beacuse of all my food problems she can't help only I might have to have a feeding tube put in so not looking forward to that=
I have to try and my fortisip drinks again and if I keep bringing them up I have to ring her and then go in to hospital

 

[nogutsnoglory]

That seems like an odd response is the nutritionist familiar with IBD? If possible it would be best to consult with one ego knows about the illness.

 

[kikidee1994]

She involved in the the other side of things to so because I've been on forstips for so long my body not actpeting it so she though the tube is the next step for me
I duno never uadmit dune before so I don't really no a lot of things about my illness as it is tbh

 

[Kev]

Yeah, that sounds pretty bizarre to me as well. Like, it comes across almost as if he/she didn't even phone it in.....

I mean... ANY nutritionist should be able to provide rudimentary training in areas such as basic nutritional content, which foods are high in fibre, residue, etc.. And info on which fibres are easier to tolerate.. my memory sucks but I think I recall info on long chain water soluable fibre from way back (I was on a high protein, low fibre, low fat, low residue, lactose free diet in the early days... ) Info on things like pulp, roughage, etc.. all of that should/could be germaine... Or info on supplements, vitamins... products like Ensure, Boost, etc.. There is just a gut load of info there a dietician/nutritionist should be able to provide... or at least query your knowledge level on. If you already know this stuff... that's one thing. But, if you don't know even the basics, that could have been a place to at least start.

 

[kikidee1994]

I've dune all of them deits and jUicing food I've tried everything I can to eat and keep it down but I'm struggling to keep water down now I've tried the low residue cave man diet gluten wheat and dairy free , paloe diet thing I've dune so much to try and helpnmynself and I told her that and she just gave me some forsisp to try again from there so I don't really now
What did your deittion do ?

 

[alex_chris]

I've dune all of them deits and jUicing food I've tried everything I can to eat and keep it down but I'm struggling to keep water down now I've tried the low residue cave man diet gluten wheat and dairy free , paloe diet thing I've dune so much to try and helpnmynself and I told her that and she just gave me some forsisp to try again from there so I don't really now
What did your deittion do ?

Hey kikidee, I know this is not the subject of the conversation, but how are you doing inflammation wise? The best diet won't help if your Crohn is just very active.

 

[kikidee1994]

At the moment I'm terrible , even the tramdol tablets I've took tonight sent helping I'm up and down walking around back and fort to the loo and I'm feel as sick as a dog , I've tried so many things and everything I'm trying to do its up in sick or coming straight out in my poo , but tbh my GI is not the best and I'm looking at getting a second option at a different hospital

 

[Kev]

Well, my nutritionist didn't put me on a diet... she taught me how to read food labels, and recommended the hi protein, low fat, low residue, low fibre, lactose free regimen. It really didn't "fix" anything, especially when I was flaring.. and I was flaring more often than not. Some say you can starve Crohns by following the SCD diet, but it supposed to take a lot of time to work, AND you have to stick to it religiously. I never could do it. Anyway, the idea behind what she recommended I eat and avoid eating was more to give my guts as much rest, as least bother, as possible. But it wouldn't stop the crohns.
I once went 7, almost 8 weeks drinking only 3 glasses of water a day, just to get my pills down... and drinking water felt more like I was eating the glass. A real nightmare.

My personal opinion.. and I'm no doctor, no training in that field at all.. is that you HAVE to get your Crohns settled down... and once settled, stick with a safe/sensible diet. It isn't much help, I'm afraid. And, as to how to get it settled down, that's the $64 question

 

[kikidee1994]

She asked me about food labels and I now how to read them been doing it for ages but like this past year it took me 6 months to see a Gi speaclist , but I haven't had a meal since last year July I just feel stuck

 

[hugh]

I've dune all of them deits and jUicing food I've tried everything I can to eat and keep it down but I'm struggling to keep water down now I've tried the low residue cave man diet gluten wheat and dairy free , paloe diet thing

Did you have any benefit from diets?
There are often one or two things that are overlooked or mistakenly presumed to be ok when people try the diet.
If you feel that you've covered diet well enough then great, but if you want to revisit diet we're here to help

 

[kikidee1994]

Every think I tried in the different diets in was throwing it up , I did each one but had no good results

 

[UnXmas]

.
I once went 7, almost 8 weeks drinking only 3 glasses of water a day, just to get my pills down... and drinking water felt more like I was eating the glass. A real nightmare.

Kev - do you mean you went almost 8 weeks with no food? What did you live off?

Kikidee - Although I've never got to the point you are at, I've always been able to keep food down, I have never found diet to help me much. If I avoid too much fibre, I feel a bit better, but even with that I can still be really really sick. The benefits I can achieve through diet are minimal.

I had seen dieticians and nutritionists before - I never found them helpful, they all gave me wrong advice. They have certain guidelines about what will help people with digestive problems. However, if your symptoms and reactions to food don't conform to the norm, following dieticians' advice is obviously not going to help.

For example, something that applies to quite a lot of people with digestive problems is that they will feel better giving up dairy. But if dairy is no problem to you, then you're not going to feel better cutting it out. There's no way to know which pieces of advice apply to you without trying them. But then why would you need a dietician? You can go online or ask on this forum and find all the commonly given pieces of information - eat little and often, don't eat too much fibre, avoid overly rich foods, drink plenty of fluids, etc. etc. etc.

This kind of generalised information provides ideas about things to try that might help, but never guarantees it will. It sounds like you've experimented with diet enough to know all these things for yourself already.

The only reason I can see that someone might benefit from seeing a dietician is if they have trouble sticking to a diet and find having someone to be accountable to and to encourage them helpful to have.

It sounds like your disease is way past the point where diet could make any kind of significant improvements. It actually sounds to me like the dietician was quite sensible to admit that she can't help you. I know that hearing you need more extreme treatments was not what you wanted to hear, but I do think it's better than if she had claimed she could help you and sent you off with some useless meal plan which would only mean you got sicker. Tube feeding may at least keep you healthy and nourished while your doctors try to get your disease under control.

 

[Kev]

UnXmas.. The answer is body mass.. I went from 245 lbs to less than 170 in 3 months.

I agree that dieticians/nutritionists can screw up.. or give bad advice.. or poor advice. I think that Crohns is problematic for medical professionals of all ilks. Giving anyone a custom tailored diet/nutritional plan isn't something I'd consider feasible, practical, even logical. Why? Well, what exact damage has the disease done to a patients GI tract? My guess is that even with the best diagnostic imaging, scopes, etc., what one person can tolerate, absorb, benefit from.. is going to be vastly different than the next patient. I think that is why keeping a food diary is so vital. A nutritionist may tell you that this or that is good food... but, if your food diary indicates it isn't a good idea for 'you', then avoid it. I discovered I was extremely intolerant of lactose back then, and I avoided it in dairy products. But I was still having issues. Nutritionist taught me how to 'read' food labels... and I discovered lactose was in lots of stuff.. like margarine.. or vitamins.. I never would have guessed. And recently, with the diabetes... before seeing a diabetic nutrition counselor, I had eliminate sugars.. But she taught me about carbohydrates. At my 3 month labs, thanks to controlling diet, my sugar levels are about 6.3, near normal.

If you know all there is to know about diet, nutrition, etc., then don't waste your time. But, if you don't, seeing someone who specializes in that field, especially if applicable to your specific disease.. it seems like there is a lot of potential benefit to be had for you.

 

[kikidee1994]

It sounds like your disease is way past the point where diet could make any kind of significant improvements. It actually sounds to me like the dietician was quite sensible to admit that she can't help you. I know that hearing you need more extreme treatments was not what you wanted to hear, but I do think it's better than if she had claimed she could help you and sent you off with some useless meal plan which would only mean you got sicker. Tube feeding may at least keep you healthy and nourished while your doctors try to get your disease under control.[/QUOTE]


I was sent some food from the hospital like liquid form and I tried some as was throwing up
I do not now if there any think elase I can try I feel stuck and in want to eat as I don't want to be in hospital

 

[UnXmas]

It may be possible for you to have tube feeding at home. My doctors have suggested I might need a feeding tube, and apparently patients can be taught to administer their own tube feedings at home.

Also what kind of anti-nausea meds have you tried? I used to take domperidone. It didn't work all that well but it did help me a bit. But once when I was in hospital and had just come round from surgery the nurses gave me an injection of some anti-nausea med into my stomach. I really wish I could remember what medication this was! What I do know is that it worked amazingly and very quickly.

I'm so sorry I can't remember the name of this medication - but perhaps if you ask your doctors about anti-nausea treatments they'll be able to find something to help you. On the Wikipedia page for antiemetics (anti-nausea meds), http://en.wikipedia.org/wiki/Antiemetic in the "types of antiemetics" section it lists a number of treatments that can be given by injection, which are stronger than the types you get orally. There must be something that can help you!

 

[kikidee1994]

I would prefer to be at home I take domperdone and buccastem 15 mg but that one u put under your gum and it gets in to the blood stream quicker
Thanks for all your help x