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Sue avoids surgery with dietetic support

Frankston Hospital, eyeConnect, World first, specialists , ophthalmic

Left: Zhoe Wharrington and right a diagram showing how a feeding tube works. 

The following blog is written by Zhoe Wharrington, a clinical dietitian at Peninsula Health.  

The role of clinical dietitians isn’t well known in the wider community. We work closely with the doctors to determine the best way to meet our patients’ nutritional needs and optimise their health. This week (12-18th February) is the Dietitians Association of Australia Smart Eating Week, which is encouraging individuals to seek an Accredited Practising Dietitian for individualised nutrition advice.

Sue, a highly regarded local resident who spends most of her days volunteering for the local community unfortunately found herself in the Frankston Hospital Emergency Department with worsening chronic abdominal pain and unable to eat and drink.

Sue was seen by the dietitian on admission and was diagnosed with severe malnutrition weighing only 38kg. She was initially commenced on Total Parenteral Nutrition (TPN) via a central line while her gastrointestinal tract wasn’t functional and until the tests were completed.

After days of tests that were inconclusive, it was thought that Sue might have a rare condition called SMA syndrome which caused her small intestine to be compressed, causing her pain and a reduced ability to tolerate food or fluid. 

The surgeons gave Sue two options. She could either have an operation to remove the compressed section of her bowel or have a nasojejunal feeding tube inserted (past the compressed bowel) to meet her nutritional needs and assist in weight gain.

Sue chose the feeding tube and worked closely with the dietitian to learn how to manage a feeding tube at home. The dietitian calculated how much enteral feed was required to meet Sue’s goal of weight gain and decided with Sue to run the feeds overnight to allow Sue to be able to do her normal daily activities and not be connected to a pump 24hours a day.

She was followed up with home visits with our Community Rehab Dietitian Thea Moloney. Sue managed to put on 5kg in 6 weeks and was able to be weaned off the nasojejunal feeds and have the tube removed. She now is able to meet her nutritional requirements with small amounts of soft food in combination with oral nutrition supplements. So far Sue has avoided surgery and is enjoying getting back to her daily activities without a tube in her nose.

This smart eating week, maybe take a mental note to think about finding the foods that fit you and in Sue’s case her ‘smart eating’ was seeking professional help until she could safely eat and drink again.