Пікірлер

• 
  @heba637417 сағат бұрын

  Can u please record other case ❤

• 
  @Anima7e17 күн бұрын

  Interesting, first time hearing about this feeding method

• 
  @Perry-qs6fx19 күн бұрын

  I have a question ! Recently diagnosed but instead of losing weight I blew up and need to start losing weight -the bloating is real! Any suggestions ?

• 
  @Nisha-kl8rl28 күн бұрын

  If you have liver disease, try Planet Ayurveda. Their treatment is the best, offering natural and comprehensive care.

• 
  @emhemmedkhsheba9080Ай бұрын

  Is there a comprehensive general guideline concerning Peripheral Parenteral Nutrition (PPN) with great Thanks.

• 
  @Bonitachulax3Ай бұрын

  I was going to get bariatric surgery in 2010 but I backed up and was already in the process of getting my surgery I wasn’t obese that’s why I backed up on my surgery day i was really young and I was this close to getting into the process I did the process of bariatric surgery like 3 times I even did the classes, the testing and etc, but till this day my dr still offers me bariatric surgery ‘ I did my research about bariatric surgery, gastric sleeve and gastric bypass for many years now 😌

• 
  @emhemmedkhsheba9080Ай бұрын

  Thanks once again the result is 885 mOsm / L, not 895 mOsm / L

• 
  @emhemmedkhsheba9080Ай бұрын

  Thank you so much. It's a very nice video. It has Informative information about PPN

• 
  @-Salmondo-2 ай бұрын

  Hi thank you for the video Can you please explain regarding the fluids. I don't think I fully understand why you chose the mL range for the patient.

• 
  @James-lh7eu2 ай бұрын

  Great video. I appreciate you showing sanitizing your hands and wearing gloves during an NFPE but don't forget the rest of your PPE, specifically masks (ideally an N95) to protect your patient and yourself especially while we are still in a pandemic with COVID still present and causing harm.

• 
  @goozfrabah5792 ай бұрын

  I drink plenty of water and im fine carnivore diet works for me and I have sbs I use lots of sea salt

• 
  @lisahenderson48243 ай бұрын

  Super helpful, thank you :-)

• 
  @lisahenderson48243 ай бұрын

  Really helpful, clear, simple info, thank you!

• 
  @ninadperiodon3 ай бұрын

  Just add Ox bile and treatment plan is complete. Thank me now.

• 
  @ninadperiodon3 ай бұрын

  bile sludge and gallstones .

• 
  @avadaly92963 ай бұрын

  Thank you Alyson! I always cross compare Z-scores/percentiles from the CDC growth charts in the EMR with Peditools and have noticed that in recent weeks they have been off slightly (ex. BMI Z-score of -1.26 vs. -1.32). I was wondering which you suggest using. I primarily work with adults but do see pediatric patients ages 2+ on occasion and appreciate your expertise!

• 
  @DietitiansinNutritionSupport2 ай бұрын

  You bring up an excellent point that is often discussed amongst many pediatric RDs! I recommend picking one and being consistent with the one you choose. Most often, I will use peditools as I know I am plotting the information in a consistent way every time. - Alyson

• 
  @user-rt3of5lc1u3 ай бұрын

  Thank you🙏

• 
  @user-jt3ho7zj6l4 ай бұрын

  You don't use the WHO Set 2 growth charts for 2-19 years old?

• 
  @DietitiansinNutritionSupport2 ай бұрын

  Thank you for your question. The WHO growth charts are recommended for use for 0-2 years of age and the CDC growth charts are recommended for those 2-20 years of age. While the WHO growth charts also have charts for 2-5 years of age, the CDC allows for better continuity of assessing growth trends for beyond 5 years. In addition, the methodology used to design both the CDC and the WHO 2-5 years of age are comparable, supporting the use of the CDC growth charts. - Alyson

• 
  @j5a6y4 ай бұрын

  The video is very infromative! Do you have related videos on what can be added/ cannot be added into PN (particularly some meds that are incompatible with PN)? Thank you.

• 
  @ericfitzgerald92144 ай бұрын

  @Stephanie what is your opinion on the Liquid I.V. Electrolyte drink mix? Im 41 with SBS, gastroschisis from birth, with colon intact. Ive recently quit smoking mj and suffered 10 lb weight loss. Im trying to get to 155 lbs and can barely stay at/above 130. I eat chicken and rice and steak and potatoes daily and can barely maintain weight. I stopped TPN @ age 7 and enteral nutrition at 17. I would rather die than have another stomach tube or live on machines again. Thank you for what you do.

• 
  @DietitiansinNutritionSupport2 ай бұрын

  Hello! Thank you for reaching out. I recognize and empathize with your nutritional challenges managing this lifelong condition. You seem to be making very positive nutrition choices! While I cannot provide individualized nutrition information since I am not on your care team, here are my thoughts on Liquid IV. Risk of dehydration is very common in SBS, but so is the risk of kidney stones. Some versions of Liquid IV contain high amounts of Vitamin C (especially the immunity line), and high dose supplementation of Vitamin C increases the risk of calcium-oxalate kidney stones. While I think oral rehydration packets like Liquid IV can be great, especially when in a pinch, I would avoid consuming products with a significant amount of Vitamin C. It would be important to compare labels and choose the product that has a lower Vitamin C content-- but also consider what taste you like too! Also, creating a homemade oral rehydration solution can be a great way to be in control of what contents are in your beverages. - Stephanie

• 
  @ilknurebece87364 ай бұрын

  Thank you so much for this instructive case.What I don't understand is, is there a bag amount that varies depending on the hospital when switching to bolus feeding? On what basis did we base 237 ml? I think I missed that.

• 
  @DietitiansinNutritionSupport2 ай бұрын

  Thanks for your question! In this particular case, when Mr. X is preparing to transition to bolus feeding, he is also nearing discharge home on enteral nutrition support. In hospital settings, enteral nutrition formulas often come in large 1000 mL containers. However when discharged to go home, individuals will typically have access to their enteral formulas in 8 oz cans (237 mL). To make it easier for the patient, we will give guidance for the number of feeds per day in approximate full or half can measurements, although we can use the 237mL/can to help us calculate what the actual provisions will be. Hope this helps!

• 
  @kimberlysnotion4 ай бұрын

  Thank you SO much for putting this video together. I loved how you went step by step and explained the guidelines. I wish I had this when I was in my DI.

• 
  @renedecquir19314 ай бұрын

  Very informative

• 
  @khizrabanu8974 ай бұрын

  Free Palastine

• 
  @virginiainnes90424 ай бұрын

  My mom has complete liver failure and is on the transplant list. But she is not doing well at all and the wait has been very long. I have a question: should someone with liver failure (not due to alcohol) restrict their carbohydrates to reduced amounts and increase protein? What amount healthy fats? Thank you and God bless!

• 
  @DietitiansinNutritionSupport4 ай бұрын

  I’m sorry to hear that your mom is not doing very well. This question is difficult to answer without knowing more about your mom’s medical history. If the reason for her liver failure is non-alcoholic fatty liver disease (NAFLD), there may be some merit in limiting carbohydrate intake and, more specifically, carbohydrates coming from simple sugars, especially fructose. However, if her liver failure is from something else, such as a virus or autoimmune disorder, limiting carbohydrate isn’t necessarily recommended. For the most part, a balanced diet high in fruits, vegetables, and whole grains as the carbohydrate sources will work for most liver patients. Protein and healthy fats are also important parts of the diet. I would encourage you to reach out to a dietitian within the transplant clinic where your mom was evaluated for transplant, as they can offer more concise advice based on your mom’s individual case. Best of luck! - Beth

• 
  @onismochipato29805 ай бұрын

  Educative and comprehensive video. If you you could as well provide a video on management of electrolytes by a dietician

• 
  @laurenginipro17145 ай бұрын

  We don’t really see refeeding with IDPN. The dextrose content of our formulas are much less than your example.

• 
  @lillianraker64295 ай бұрын

  This video is so well done, thank you for providing clear and compassionate information!

• 
  @ghousiazaffar12476 ай бұрын

  thankyou for this amazing series , you make it really easy to understand . will there be a discussion on chloride ? or its already done , can you let me know this

• 
  @manaschaudhari59196 ай бұрын

  I think this is fake I don't believe in no anyone stay even 10 year

• 
  @bellcoolmountain66506 ай бұрын

  This women gives me hope

• 
  @shairagawad636 ай бұрын

  Why no activity factor for ballpark method?

• 
  @arthurtheartist6 ай бұрын

  excellent video. one of the best I've seen on this topic.

• 
  @BARF_FACE_90006 ай бұрын

  Thanks for more info. I just got a test result back that mine is quite low… I have struggled with issues of IBS and only now finally charting a path to recovery / treatment.. to be continued but- I guess knowledge is power and I’ll have to get some more enzymes somehow someway!

• 
  @christinavakas7 ай бұрын

  I have EPI. You really hit home with me. No one is following up on me. I probably call the gastroenterologist and set up an appt. Been taking Zenpep for 2 months. Cost is outrageous. Thanks again for a clear, concise presentation on EPI❤

• 
  @shairagawad637 ай бұрын

  how to determine fluid requirement for patient not on dialysis who just needs fluid restriction?

• 
  @user-kn2ov4fg8k7 ай бұрын

  thank u help a lot!!

• 
  @manaschaudhari59197 ай бұрын

  How many year survive on tpn

• 
  @louellaeischen67098 ай бұрын

  Thank you for the information.

• 
  @RDNamanda8 ай бұрын

  Would love to have more detail on his electrolytes prior to initiation of enteral nutrition, and if any electrolyte replacement was required before starting. Did he develop refeeding syndrome?Thanks for a great video.

• 
  @DietitiansinNutritionSupport7 ай бұрын

  Thank you for your question! Mr. X’s basic chemistry, phosphorus and magnesium lab levels were drawn daily since admission. The day his feeding tube was cleared for use his phosphorus was slightly low at 2.3 (reference range 2.5-4.3 mg/dL), potassium was within normal limits at 3.5 (reference range 3.3-5.1 mmol/L) and magnesium was within normal limits at 2.0 (reference range 1.6-2.6 mg/dL). Due to Mr. X’s mild hypophosphatemia, we recommended IV phosphorus supplementation. IV electrolyte supplementation should always be discussed with the primary team. It was decided Mr. X would receive a one-time dose of 30 mmol IV potassium phosphate. Per the ASPEN Refeeding Syndrome Consensus recommendations, we created a plan to monitor his basic chemistry, phosphorus and magnesium levels every 12 hours for 3 days while initiating his tube feeding. Given Mr. X’s phosphorus was only slightly low and he received IV supplementation, the dietitian felt it was appropriate to begin a slow initiation of tube feeding with Mr. X. Mr. X’s next set of labs 12 hours later revealed a phosphorus of 2.1, potassium of 3.2 and magnesium of 1.7. With the downtrend in electrolytes, Mr. X may have been experiencing mild refeeding syndrome. At that time the tube feeding was held at the current rate of 20 mL/hr and electrolytes were supplemented. If Mr. X had a dramatic decline in his electrolyte levels the ASPEN recommendations suggest decreasing the calories provided by 50% and advancing by 33% of the goal calories every 1 to 2 days. The next set of labs 12 hours later demonstrated Mr. X’s phosphorus had improved to 2.4, potassium to 3.4 and magnesium to 1.9. Given improvement in Mr. X’s labs his tube feeding advancement was resumed and his further labs draws were unremarkable. Reference: da Silva J, Seres D, Sabino K, et al. ASPEN Consensus Recommendations for Refeeding Syndrome. Nutr Clin Pract.2020;35(2):178-195.

• 
  @RyanMcGirr-bu4qr8 ай бұрын

  EPI tested twice well below normal range of 200-1000. All symptoms except flatulence. Five or more stools per day. If I eat fat they float. Before PERTs foul smelling sometimes. Have tested fat soluble vitamins levels and bone density. Dental health has declined greatly this last year. Was put on FODMAP diet and many lab test. Before EPI test my mental health was questioned and was drug tested. Still having issues.

• 
  @eliderobot6204 ай бұрын

  me too, I go like 6 times to the toilet, anything I eat immediately comes out, anything liquid triggers diarrhea, I have type 1 diabetes, osteoporosis, severely underweight

• 
  @sandymutert8495Ай бұрын

  I tested out at 58 per the test…out of 200.

• 
  @scarredwarrior36148 ай бұрын

  Are there any videos on calculating needs for anorexic patients?

• 
  @mahayousaf8708 ай бұрын

  Can you make a video on patients having Hyponatremia and Hypertension at the same time and how to deal with it. Eg.. Formula, fulid etc

• 
  @martham71989 ай бұрын

  Thank you! Curious if you think there would be a risk of giving too much protein in a short term PEG for patient with previously resected ilium (79 centimeters) after recent surgery with total duodenum resection and partial jejunum resection (100centimeters) patient is underweight and protein deficient. Thanks

• 
  @DietitiansinNutritionSupport6 ай бұрын

  Great question! If this patient recently underwent surgery and is baseline underweight and malnourished, I would definitely recommend providing protein on the higher end of the range. I would aim for at least 1.5 g/kg and up to 2 g/kg for protein recommendations. Important parameters to monitor would include: hydration status (ensuring adequate hydration) and renal function. If you have the capability to complete a nitrogen balance study, this may provide additional information relating to protein status. Thanks! - Stephanie

• 
  @jenniferkern15029 ай бұрын

  The detailed nutrition details are so helpful....thank you! I have SBS and am very motivated to learn as much as possible to help myself. This was a great resource. Thanks again!

• 
  @reardontapia9 ай бұрын

  Very thoroughly explained. Thank you.

• 
  @happyandhealthy8889 ай бұрын

  2 in 1 medical solutions

• 
  @BevLeeChannel10 ай бұрын

  How does alcohol or a liquid diet lead to malnutrition?

• 
  @DietitiansinNutritionSupport8 ай бұрын

  Thanks for your question! Alcohol itself doesn’t necessarily lead to malnutrition, but alcoholic cirrhosis certainly can for multiple reasons, including: 1) Decreased energy and protein intake (drinking alcohol instead of eating a balanced diet) 2) Systemic inflammatory state leading to hypermetabolism 3) Altered nutrient metabolism (the liver plays a significant role in nutrient metabolism, so when it doesn’t work properly…) 4) Malabsorption

• 
  @p.burrowes866010 ай бұрын

  Thanks for this video! A few questions... How often is adjusted body weight being used for these calculations? When would you suggest using it? Since Harris-Benedict was used for so long, has there been any evidence that the activity or stress factors we are used to adding need to be adjusted to prevent under or overfeeding since it is now known that we were using an equation that overestimated RMR to begin with? Thank you!

• 
  @DietitiansinNutritionSupport8 ай бұрын

  Thank you for your questions! This is how the Academy's Evidence Analysis Library (EAL) describes the usage of adjusted body weight: "Many of the resting metabolic rate, or RMR, equations that are used today by registered dietitian nutritionists are based on actual body weight. Research evaluating the use of adjusted body weight, or ABW, has been shown to underestimate or overestimate RMR depending on the patient's weight status. Reasoning behind using an ABW with individuals who weigh less than 95% or more than 115% of a standard body weight was based on the assumption that adipose tissue is inert; however, research to justify this assumption lacks evidence. If RMR cannot be measured by indirect calorimetry, actual body weight and the Mifflin-St. Jeor equation are recommended when estimating energy needs in non-critically ill patients. The Mifflin-St. Jeor equation demonstrated the most reliability in predicting resting energy expenditure, regardless of weight status, according to the Academy's Evidence Analysis Library Adult Weight Management Guideline. Alternative equations may need to be considered, as is the case with critical illness, mechanical ventilation, ascites, edema and other conditions. Although limited research exists, ABW and ideal body weight (IBW) have been used when assessing energy and protein needs in critically ill patients who have an elevated body mass index and require a hypocaloric and/or high-protein feeding. Estimations of IBW have also been used for people with amputations and spinal cord injuries. Dosing of prescription medications by pharmacists also may warrant use of an adjusted IBW; otherwise, in most other circumstances, RDNs will utilize actual body weight when assessing energy, protein and fluid needs." In regards to your question about the Harris-Benedict equation: From my literature searching, it seems fairly consistent that there are improvements needed for the Harris-Benedict equation to be more accurate for certain populations. While I did not find a consensus statement as to adjustments for activity or stress factors which were validated, I did see some interesting articles about some common populations and limitations using this equation for their needs predictions. If the RMR portion (unadjusted) of the equation were overestimating at baseline, there's potential that the entire equation may need revision as opposed to just overcorrecting the RMR overestimates with activity or stress factors. www.sciencedirect.com/science/article/pii/S0261561420306166 www.sciencedirect.com/science/article/abs/pii/S0271531707000383

• 
  @kimberlysimpson876610 ай бұрын

  Can land you on hospice also like it did me.. no food by mouth In one year & two months