This editorial is by Nora Saul, M.S., R.D., C.D.E., Manager of Nutritional Services at Joslin.
You have been recently diagnosed with diabetes and your physician has recommended you see the dietitian. He hands you the dietitian’s name and telephone number and says that he would like you to make an appointment.
While you nod your head in agreement, your mind screams, “There is no way I want to do this. I’ll just hear that I have to stop eating Philly cheese steaks and consume yogurt and soy beans. Please, I rather schedule that appointment for the root canal I’ve been putting off.”
It’s true; in some peoples’ minds visiting the dietitian is right up there with a dental visit.. I would like to think that we have gotten a bad rap, just like ours teeth loving colleagues.
So, I thought I would give you a better understanding of what to expect when you expecting to see the registered dietitian (RD) for diabetes education.
The first time you see the RD plan to spend about an hour. Ninety percent of the appointment involves talking and during the first half you are going to be doing most of it. The other 10 percent is spent weighing you and reviewing your blood glucose and food records. Already things are looking up: no unpleasant procedures, no vile tasting medications.
After the introductory pleasantries, you should hear some rendition of “what brings you to my office today?” This is an important question. The information in the medical chart doesn’t necessarily tell what you want out of the visit. And that is a vital piece of information. Because in the end, if your needs aren’t addressed, your never going to follow the recommendations anyway.
The answer to this question should be the largest part of your pre-visit homework. If you are capable of answering it, the likelihood your appointment will be nirvana (ok—at least pleasant and helpful) increases many fold.
But back to our imaginary visit.
You will be asked questions about your medical condition, food allergies, the medications and supplements you take, who does the cooking and shopping, what type of work you do (that gives some indication of how active you are at work), what type and amount of exercise (if any) you participate in.
Then there will be questions related to your diabetes: your control through the years, if and how often you check your blood glucose, if and when you have highs and lows, how you treat highs and lows.
If weight is an issue, you’ll be asked about your weight history, weight loss programs you have tried trigger foods, and weight goals. You will probably be weighed at this point.
Finally, you will provide a picture of your eating habits—what, how much and when? The how much and when are always important, but especially so with diabetes. Some diabetes medications require you eat consistently and on a schedule.
If you bring food records this part will go quicker and you’ll be able to give a more complete sense of your current diet.
After you give all this information, it’s time for the dietitian to do a bit of the talking.
After explaining the basic dietary recommendations for diabetes, you’ll, together, come up with a way to implement the recommendations in your specific situation, the challenge being to collaboratively develop a meal plan you can live with and actually enjoy that will help you bring your blood glucose into better control. And along the way you’ll formulate goals to achieve before the next visit.
And all through this part of the exchange you’ll be asked to demonstrate your understanding of the material covered.
When you leave you should have written materials to help support what you discussed as well as a way to get in touch for additional questions.
Not so bad after all, right?
Preparing for your appointment
- Think about why you are going and what you want to know
- Write a list of questions. Nerves make it difficult to remember all the things you wanted to ask. Having questions already prepared will help guide the conversation and help the dietitian understand your perspective.
- Bring you meter and or blood glucose records
- Bring 3-4 days of detailed food records. This will help you and the dietitian to look for trends and see the effect of different foods on your numbers.
- If you aren’t involved in food preparation, bring along the person who is. And even if you do everything, having an additional person can help you remember more of what was said.
What if you really don’t want to go?
Of course, I am biased, but I think you should give it at least one shot.
And if you are really have no interest, then say that up-front to your physician. Let someone else who wants the appointment take it. You can always change your mind later.