CASE STUDIES - Always read the label…
Paul McArdle
Clinical Lead Dietitian, Birmingham East and North PCT
I meet patients about twice a week, usually connected with my specialism - diabetes. As well as meeting patients on heir own, I also meet them in partnership with a senior diabetes nurse. Patients might be newly diagnosed or their condition may not be controlled for one reason or another. My aims are always to inform people about their condition and enable them to take control of it by managing the types of things they eat and drink along with their activity level.
When I see a newly diagnosed type 2 diabetes patient, I'll give them advice as part of a wider education they'll receive. This is aimed at self-management of the disease. Often aimed at weight reduction – 80% of type 2 diabetes patients are overweight. I'll talk to them about the importance of regular meals and eating something 'starchy' - like potatoes, rice, pasta and chapatti. They should include at least five portions of fruit and vegetables each day, and 'oily' fish such as salmon, mackerel, sardines or trout once or twice a week to protect from heart disease and stroke. We don't recommend 'diabetic' foods, we focus on healthy eating - a diet low in fat, sugar and salt, but not necessarily fat-free nor sugar-free.
The diabetes community team is much bigger than the dietetics team. In the full team there is a diabetes nurse consultant, a diabetes specialist nurse, a diabetologist, a link worker and a podiatrist, as well as myself.
As dietitians, we're often called upon to assist doctors in the diagnosis of suspected food allergies and intolerance. As self diagnosing of a food allergy or intolerance can put patients at risk of nutrient deficiencies, it's important this is done properly and supervised by a registered dietitian. Through helping patients to manipulate their diet, they can avoid foods which may cause them problems, whilst still obtaining the right amounts of nutrients.
Siobhan Oldham
Chief Dietitian, Gloucestershire Hospitals NHS Foundation Trust
While training, I did clinical placement at Hammersmith Hospitals NHS Trust in London and was very lucky to work there for 20 months gaining wonderful experience. From there, I worked at the Frenchy Hospital in Bristol for three months and then landed a great job at Princess Margaret Hospital in Swindon covering intensive care, gastroenterology and home enteral feeding. This means feeding a patient through a tube, leading into their stomach. I thoroughly enjoy the specialist area of home enteral feeding and have been in my current post for six years. I especially enjoy working with our nutrition nurses and helping develop the team and service.
One of my best days was going to see a newly discharged little boy. He had been through a lot and his parents were struggling to deal with his feeding and equipment at home. I was able to give them further training on how to use the equipment and advice on how to make feeding easier. I also brought along a backpack for the feeding pump, so he could go out on the rest of the family’s trips. The little boy beamed from ear to ear at the thought of a trip to the park with his brother and sister. Mum and Dad started to cry as they hadn’t seen him smile like that for months.
