For patients at Northwest Indiana Nephrology, experiencing renal failure and having to take dialysis treatments complicates nearly every aspect of your life. Whether they’re on home dialysis or they visit one of the many dialysis centers across the region, their lives revolve around the treatments that they need to survive.
One of the many major aspects of the care that NWI Nephrology provides is related to diet and what foods patients put into their bodies. There to assist and guide dialysis patients through the incredibly important area of diet are dietitians who work to keep patients healthy, help them understand how what they consume affects the way they feel, and how eating better can help them feel better.
Tricia Fisk, a Dietitian with NWI Nephrology, has worked in the field for 16 years.
“Originally for me, I was in sports throughout high school. I played volleyball, softball and basketball, and I was interested in eating healthy and trying to be physically healthy. I read a lot about nutrition and it kind of stimulated me to pursue that,” Fisk said when describing what influenced her to become a dietitian.
Dietitian, Mindy McConnell, has worked in the field for 13 years, and in speaking about drew her to the industry, she said, “I guess my passion is teaching and I love cooking, and the science of nutrition. So, (the career) was that perfect combination of both of those.”
“Not to speak for all of us, but our favorite thing to do is getting to work one-on-one with the patients,’ McConnell said.
NWI Nephrology Dietitian, Linda Welch, is in her 12th year working in the profession after raising her children and then wanting to get back into the workforce. “I was looking to come back to work and knew someone working in the field so I contacted her, and then I just sort of stayed in the position!”
For dialysis patients, there are many restrictions that come with having to be on dialysis, and it’s the dietitians’ goal to work with them to eat healthy and, in turn, feel healthy. That’s not always easy considering what goes into our food now, with preservatives like phosphorous, as well as the immobility of patients, and the other health problems that they might be experiencing.
“Phosphorous, potassium, and sodium are in nearly every food that you eat, and the dialysis machine doesn’t really dialyze the phosphorous out as well as potassium,” said Fisk.
“It’s very challenging for them considering things like phosphorous, potassium, and that they have to restrict things like fluid,” Welch added.
“Many of our patients are diabetic as well so they’re following those restrictions also,” McConnell said.
Fisk, McConnell and Welch advise their patients by following up with them on a regular basis and viewing lab results to try and maintain or improve their diet and overall health. Working in renal care means that as a dietitian, they’re a much more prominent part of the overall team treating each patient.
“The nurses do a great job of including us as part of the healthcare team, and to help develop the rapport we have with the patient,” said McConnell. “We stress the importance of the team and that we’re working together with you to help you to feel better.”
In renal care, the role that a dietitian plays is seen as a larger part of the healthcare team because diet affects so much of what dialysis patients do and feel, how they’re doing on dialysis, and the outcomes as far as their lab values are concerned.
“You don’t necessarily see that in other areas of nutrition like, for example, the hospital,” McConnell added. “Yes, we’re there and we see patients, but the weight is greater with dialysis patients.”
“We are really an integral part of that team,” Welch echoed.
While it can be a challenge to make an impact and build relationships with some patients, it’s the goal of Fisk, McConnell and Welch to get to know their patients, improve their eating habits, and improved their quality of life.
“It can sometimes be a challenge to build a rapport with home dialysis patients when they’re not in the clinic three days a week,” said McConnell. “Because they’re our more independent patients, it can be a challenge. It takes a little bit more work to develop that relationship, but when you do it’s always going to be there.”
“That’s the big challenge with the home programs,” added Welch. “You’re lucky to get to see them once a month so you’re not able to build a better rapport with them as quickly. I think it (home dialysis) is great for the patients, but it can be more challenging in other ways. ”
Being part of a team that is working to help improve the lives of dialysis patients can be challenging, but it can also be very rewarding.
“My favorite part is when you have a patient whose labs aren’t great and you finally break through to them,” Fisk said. “Their labs get better, they get healthier, and they look and feel better. I like working with patients who are a bit more difficult. It can be frustrating but I like the challenge, and when they overcome everything it’s a good feeling for me, at least.”
Welch spoke about what she loves about the work in saying, “What I really like is that you really get the opportunity to know the person long-term. When you do see progress, whether it’s them getting a lab in control or feeling better, and them allowing you to make a change in their life is very rewarding.”
“I would agree and celebrating successes with the patients, and knowing that they’ve worked so hard to achieve that, is great,” added McConnell. “Focusing on the positive with the patient really makes a difference.”