CentraState - Healthy Directions

let's talk about your diet tumor, a strict dietary regimen became vital to maintaining her health. Her doctor referred her to CentraState Medical Center for an outpatient nutritional consultation and, according to Dorothy, the session was "a godsend." A After being put on a protein-restricted diet by her physician, Dorothy must closely monitor her protein and sodium intake. Too much protein can damage her remaining kidney—which is in a weakened condition—and too much sodium hikes up her blood pressure. Her consultation at CentraState led her down the right path. Dorothy met with Christina Mackesy, RD, clinical inpatient and outpatient registered dietitian at CentraState, to discuss her situation. Mackesy emphasized the importance of portion sizes, and explained to Dorothy how to monitor her sodium intake. "She woke me up to the fact that it's important to read food labels, and she taught me how to do it so I know the amounts of protein and sodium I eat," Dorothy says. "The consultation helped me understand what I need to do to stay healthy. It was so helpful—I wish I had done it years ago." Outpatient consultations with a registered dietitian are covered by most health insurance plans. In the sessions, the patient discusses his or her health history and nutrition and lifestyle habits, the dietitian talks about the connection between an improved diet and improved health, and the two collaborate on a customized nutrition and wellness plan. Depending on insurance coverage, patients can return for as many sessions as they like. fter 73-year-old Dorothy Shapiro of Freehold had one of her kidneys removed due to a cancerous vAluABle AdviCe Mackesy explains that a patient's path to a consultation begins with a visit to his or her doctor. "A physician decides that a patient needs special attention from a dietary perspective and refers the patient to us," Mackesy says. "Sometimes the doctor asks us to educate the patient about a specific type of diet to address a medical condition, and we work closely with the patient to overcome challenges or obstacles." A registered dietitian (RD) is the ideal source for nutritional guidance. In addition to having a bachelor's degree, RDs have met current minimum academic requirements as approved by the Accreditation Council for Education in Nutrition and Dietetics of the Academy of Nutrition and Dietetics, and completed a minimum of 900 supervised practice hours of preprofessional experience accredited/approved by the Commission on Accreditation/Approval for Dietetics Education of the Academy of Nutrition and Dietetics. All RDs must also obtain continuing education credits to retain their credentials. A PeRSonAl APPRoACh After a consultation—which typically lasts about an hour—the dietitian sends a letter to the referring physician detailing the advice and educational materials provided to the patient and diet and lifestyle modifications discussed. One CentraState physician who refers patients for nutritional consultations is Marc Feingold, MD, who is board certified in family medicine. Dr. Feingold says many of his patients welcome the focus on nutrition. "I'd love to sit down with all of my patients and discuss in depth what they eat, but I think that is done better by dietitians in the Nutrition Department because they're specialists in that area," Dr. Feingold says. "Many patients want an understanding of how their diet impacts their cholesterol and digestive system, how limiting salt intake can lower their blood pressure, and the impact nutrition has on their chronic medical conditions." Mackesy says that to have the greatest impact, she must address each patient's unique situation. "I don't just give them a diet and say, 'Go home and do this,'" Mackesy says. "I ask them about their situation to find out if they're working the night shift, putting in long hours as a student, or taking care of five kids at home. Everyone is different, so I take a personalized approach to how they can make modifications in their daily lifestyle to improve their health." For more information or to speak with a registered dietitian, call (732) 294-2766. To schedule an appointment with a registered dietitian, call Centralized Scheduling at (732) 294-2778. Physician referral is required. HD Christina Mackesy, RD, provides individualized nutrition guidelines to help patients ensure optimal health. www.centrastate.com March/April 2012 11

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