Dietician?

[Depressed_Boy_Skelly]

I had a dietician a year or two ago, but she went on maternity leave. She is the only one in the diabetes clinic who has knowledge of my bowel condition. There is no other one around that has that knowledge of it as it’s a rare condition.

I need a dietician, at least until she comes back in September. I’ve tried medication for the bowel condition, which doesn’t work so I stopped treating with it. I rely heavily on Imodium and codeine, it’s my only way of living what’s left of my life.

I wanted to try a low fibre diet. Just to see if it works.
How do I go about getting a new dietician? My next appointment in the clinic is October this year. I am getting my pump on the 7th July but I don’t think I can ask about it there as I’m not going for a dietician and/or about my bowel condition.

Anyone got any advice?

 

[Lucyr]

You can ask for a referal to the dietician in any appointment but it would be best to call the clinic and ask for a referral. You should have a phone number you can ring if you have any questions, or there may be a phone number on your appointment letter?

 

[Proud to be erratic]

Firstly, you absolutely should ask about this at your June appointment because that clinic will know (or can find out) what dietectic resources exist in that hospital. But I would send an email to that clinic consultant as soon as possible, via his/her secretary explaining that you have the appointment and in need of dietectic assistance, for the reasons you've explained. I have followed this sort of path more than once in the last 2+ yrs and on every occasion been thanked for giving advance warning.

From my very limited experience, dieticians in the Hospital where I had my surgery were scarce resources (not so surprisingly) and, which I found a bit unusual, there were 8 altogether. Each worked directly for the head of their department, only one in each department and there was no overall co-ordination of dietectic support; each of the 8 knew of the other 7, they had no remit to periodically confer together nor to look out for best practice ideas.

After I was discharged, I had the support of a dietician from my previous Diabetes clinic and, while she knew a lot more than I did about things like carbs and correction ratios, at no stage was she able to help with my bowel problems after a total pancreatectomy. Indeed, even though I frequently said I felt sure I was malabsorbing and so carb counting was of limited use, that aspect was outside of her experience and ability to help with.

I happened to still be under the follow up supervision of Macmillan, from when I'd had chemotherapy and their dietician was excellent; she listened tried different treatments (advising my GP to provide prescriptions for these) and clearly did further research. She concluded that my problem could be a bacterial overgrowth and got me referred to a Gastronterologist. Unfortunately this whole process took nearly 2 years to bring to a good conclusion, which meant my carb ratios were always suspect for those 2 years.

The Gastro consultant was very thorough, checking all possibilities with different tests, mainly from blood. Quite early on after I came under him he confirmed that bacterial overgrowth was a possibility but in his experience very tricky to verify; it seems that the theoretical tests show up false positives and negatives, so he didn't bother to ask for faecal tests. Eventually he prescribed an antibiotic which needed unique authorisation and that seems to have resolved matters.

Your GP might know where else you could get dietectic support, that depends slightly if your local hospital is also a teaching hospital. Otherwise press for a gastro consult. A dietician within a diabetes clinic may not have the expertise for managing bowel problems that aren't routinely associated with diabetes. It transpires dietectics is a very specialised and parochial business!

 

[everydayupsanddowns]

Do you have contact details for a DSN? They may be more accessible, and be able to offer advice about the dietetics service in your hospital and how to get a referral?