It’s so crazy to think that we are reaching the end of July. It literally feels like July 4th was just yesterday! With the end of the month, that also means my first two graduate classes are coming to a close as well. It has been a bumpy ride, especially this last month, but I’ve enjoyed it! I had the opportunity to take Nutrition Support (a class about feeding tubes) and Bariatric Nutrition (a class about weight loss surgery)- two things in which I am highly interested in.
I learned so much these past two months. If I had to choose a favorite class, I really don’t think I could. Bariatric nutrition provided me with a lot of opportunities to learn about weight loss surgeries, but much more in depth. Nutrition support, on the other hand, gave me the opportunity to create my own patient for our case study project. Now at first, I did not like that idea. I know that in practice, I will never get to make up my own patient, so I didn’t understand how this would help me at all. But, when I decided that my patient would be based off of me, it became a lot more fun.
My fake patient was a 22 year old female with cystic fibrosis who was admitted into the hospital for a CF tune-up, PICC line placement for IV antibiotics, and a gastrostomy tube due to her inability to gain weight. Granted, this patient is NOT me, I don’t have a feeding tube and I made her weigh less than I do! After talking about my patient’s decreased lung capacity, lack of appetite, and the nutritional significance of all of her medications, I dove into writing the order for her feeding tube. I will spare you the details of calculating out her calories, protein, fluid, and fat requirements. Just know it was a lot of math.
One thing that made this assignment even more fun is that I really had no idea what I was doing. In our undergraduate studies as nutrition students, we really do not talk a lot about how to help patients gain weight. CF is barely mentioned in classes because it isn’t as prevalent as obesity or diabetes. All I had to go on was what I knew. So, I used Google. A lot. I was thankful that I had access to the Nutrition Care Manual, where I was able to find a formula that is used to calculate calories for those with CF (again, that’s not something that is not taught). I finally got most of the information I needed, but I was still hesitant. So I gave my own Registered Dietitian a call in Fort Worth. God bless her.
Rachel is the sweetest person and deeply cares for her patients. When we first said hello, she immediately asked how grad school was going and how I was doing in general. When I asked if I could pick her brain about my case study, she was more than willing. We spent 20 minutes on the phone talking about pancreatic enzyme supplements and how to calculate how much a person needs based on their fat intake. She walked me through how to get answers that I wasn’t sure about and confirmed that I was doing my calculations correctly. It was such a blessing and I learned so much from her!
All of that to say, I emailed my case study to my professor Sunday night and I am hoping for a good grade on it!
But that wasn’t the point of my post; and to be honest, I was a little hesitant to write and share this particular post. If you remember my blog post about my last doctor appointment, it didn’t go well for me. I had lost weight yet again and I’ve been on a new antibiotic for a mold that’s growing in my lungs. My dietitian had talked to me about feeding tubes being a possible future step to take if I don’t gain weight, and I wasn’t ready for that.
But after doing so much research on feeding tubes for my fake CF patient, my mind has begun to think a little differently.
Testimonials that I have read from other CF patients with feeding tubes all show a positive outcome for those patients. They are happy, gaining weight, and they no longer have to worry about if they are eating enough calories because they get fed during the night while they sleep.
I can only imagine how it would feel to not stress over the number of calories I get each day. I think grad school, my teaching assistant position, and my internship are going to have enough stress all on their own. Of course, I know having a feeding tube has its own risks and complications. But could the benefits weigh more than the possible problems?
I go back to Fort Worth next week for my check up. I will have labs done every time I go to Fort Worth now due to the VFEND that I am taking (consistently I might add!). I’ve been weighing myself on our scale at home at least once a week. Sadly, (unless our scale is wrong) I have not gained back any of the weight I have been losing. What’s so frustrating about that is, I have been actively trying. I eat breakfast more often than not, I do more to add calories to my meals, and I’ve been taking my enzymes and fat soluble vitamins on a more regular basis.
So right now, I’d appreciate your prayers. I’m scared for what the future holds for me, but I know God has a plan. Pray that as I talk to my doctor and my dietitian that the Lord will show me what the best thing is for me. Pray for my support system as well. Most everyone that I have talked to about this is against it. It’s understandable. It’s something we aren’t used to. But please pray that we would all have an open mind about this, and that they will support me in any decision that I choose to make for myself.
As always, be looking for another blog post next week after my appointment!