Ms. Rajeswari. A Senior Clinical Dietitian,Head – Department of Dietetics at Apollo Cancer Center,18 years of Experience Apollo Hospitals.Co-author for Dietitians Pocket Books on “Basics of Clinical Nutrition for Adults, Pediatrics and Beyond the Basics: Transplant Nutrition.
In an exclusive conversation with Zotezo, she has spoken about Oncology.
Team Zotezo: What inspired you to become a dietitian, and why did you choose to work in the Oncology Department?
Dt.Rajeswari A : There is actually just like normal. I am just fond of the frame actually being frank and during my screen my higher secondary school. I wanted to have a pure science taken up and to go next to the college. What should be chosen up so normally the girls will be choosing either biology, geology or something like that, but I don’t make it a different field. so I have taken up nutrition during my college days and probably that time we never had this much exposure to go-to nutrition and dietetics. So later on, you know in the year 2002 and know we won’t have much exposure or focus on nutrition or something like that. so even you know, when people ask me what field you’re doing it available the same you did, you know it to cook thinking you’re doing it I said no it is not cooking things with something. It is different. I will probably so that is the thing that can come and I did my Master’s also nutrition dietetics and once I started by wanting to start my career in the field of nutrition, clinical nutrition and I just had values were searching for a job then I got a call from Apollo Hospitals. I had an internship over here. I didn’t do my college internship or six months in the meantime. I was being recruited as a clinical dietitian. I start working. If you’re handling any specialty. We need to have a multi-specialty focus and a multi-specialty knowledge is essential for a dietitian to have it because if you’re focused on any pediatric oncology or if it is going to be cardiology or if it is going to be obesity management or anything like.the base should be multi-specialty you need to have it.so this is how I being got trained up so the base almost say 7 years have multi-specialty experience and I moved on to oncology. My boss asked me what do you want to do in which field or specialty so I chose oncology. So I started intervening it is more than a job. It’s passionate and works doing it right now.
Team Zotezo: What are the nutrition guidelines during cancer treatment?
Dt.Rajeswari A: Guidelines are currently what we are following is the European Society for parenteral Clinical Nutrition. Then we have the Aspen guidelines table using it at the World Health Organization all three we are using it up because we need to have whenever we are applying a practice clinical basic guidelines or something like that. We need to have enough data supporting the practices also so we are following Aspen guidelines, Espen guidelines and World Health Organization guidelines.
Team Zotezo: What are some of the best ways to manage a healthy weight while getting essential nutrients?
Dt.Rajeswari A: It’s a healthy diet in a sense basically starting with a diet. I think the most common thing an individual should have is good sleep. So more of us are lacking up almost 8 hours of sleep has been reduced almost it is 5 hours it is 4 in half hours some of them are lesser than that.they are yogi recommending only 2 hours sleep is enough for a human body but I won’t feel like that because in our day-to-day life how much stretch we are coming across how much workers we need to focus it down. So the basic thing is it has to get attention and food enough hydration of water that is also essential for individuals who need to maintain their health. In spite of this, I am focusing on three majors. We can have five tesa in between two-mild snacks. You can have hydrate free hydration we need to have a because even water consumption is also been reduced in individuals undergoing therapy or in a normal version. Also, we can see so the water consumption level is being calmed down so that it can be entertained for an individual to go ahead to have at least group 2 liters of fluid may be. It can be plain water. It can be any form of juicers or buttermilk or something, which is healthier and then we’ll put in the carbonated beverages for some so find focus on natural foods, which is easily available that can be used as in nutrient for a healthy diet.
Team Zotezo: What role can dietary supplements play while a patient is undergoing therapy?
Dt.Rajeswari A: First foremost generally we won’t recommend a patient initially during the First therapy whenever they come in it has been diagnosed in the diagnosis patients to go for a commercial supplemental something. I did not initially. There’s work essentially where a patient is able to take a normal diet. Probably we can encourage them to have a normal diet which is naturally available the protein whatever carbs which we are getting it up we are making to have it and utilize those things naturally.if not sure or they are not able to take properly we can go for the second being the commercial fields. We can recommend commercial formulas, which are readily available so that they can compensate in nutrition laws for the dictatorial in for the nutrition depression can be prevented in such individuals. So probably during the therapy problem when you see normally. We assess a patient screening will be done in the nutritional assessment will be carried out. So when the dietitian fees is a patient needs there is already undernourished then we need to focus on the furthermore treatment will furthermore Detroit in the health status of individuals, in that case, is probably oral nutrition supplement will help a lot so we can start one of them serving for an individual and then we can go ahead with a normal diet, along with two servants with the oral nutrition supplement it helps to overcome the nutritional depression also.so that is how we are practices is doing it up.
Team Zotezo: What practices would you suggest for patients after their treatment?
Dt.Rajeswari A: Basically what we recommend is doing therapy for almost a year. They will be coming to the hospital for therapy or a combination of carob gates. So doing the therapy generally we recommend them certain do and don’ts during therapy so that they prevent them you know, the infection from infection is point of seeing you all so we have to think about it. So normally we recommend not to be continued to be on a certain diet not to have outside foods or to be in a crowded area or something like that so that their energy level is already low. So they shouldn’t get any infection or cross-contamination consuming foods so we can recommend not to have any outside Foods or something. That’s responsible for day and then loss of go for the crowded areas to prevent further infection. So these steps will ask them to continue for another or six, four months so further recurrence can be preventable in such individuals. So gently these what we recommend is for this particular the one year of therapy won’t see us doing do’s and don’ts they can continue on the six, four months to in order to prevent a recurrence zone. So yearly ones for the maintenance very big for health checking can be done to bring technical analysis for months or one year or two. They can be a really simple process to provide that occurs. during the treatment course, whatever you are doing with dos and don’ts we can do in for another one more month or one year they can continue with it.
Team Zotezo: What is the role of a dietitian on the cancer therapy team?
Dt.Rajeswari A: Normally, we have a major role in cancer treatment, it can be chemotherapy or radiation or it can be surgical, so probably we intervene in the screening will be done. Adjustment will be carried out. It will find out whether the patient is malist properly before surgery. So we need to give clearance to the nutritional status of whether they are fit for the surgery or not. When they go chemotherapy or something or they might have, the therapist has the latest complications. They might be having it up that they might have nausea vomiting. To overcome those complications. We need to give some input to overcome such because people will have too many views on their perspective. They have their own perspective to might be some friends or the relative who gives you the latest information may be much worried about it whether they have the hair falls with that they have vomiting after completing the therapy. So we do the first counseling having the major role play in the therapy. We make them understand how far we can overcome this complication and how frequently we can have a diet plan. These things will help them. proactive thinking about the radiation and the complication helps them to overcome. So radiation during the second to the first or second week normally daily planning for four weeks or six to eight weeks will be planning it up. In those cases the second week of radiation will be a crucial period where they will have discomfort during the therapy toxicity will be more and their intake will be reduced.so proactive thinking helps a lot to a dietitian to play a major role generally we recommend is oral nutritional prior to therapy to overcome these complications.so we need to maintain the weight so it plays the major role for dietitians.
Team Zotezo: Can you share the most important thing you do for people with cancer on a regular basis?
Dt.Rajeswari A: Yes, we do for all patients who are stepping in the hospital.so within 24 hours of the admission we do screening we do an assessment and we find out whether the patient nourished or malnourished, so if the patient is malnourished with the patient’s we have a regular follow-up of the intake during the hospital stay will be done. So the calorie count has been maintained to read monotheist the intake if it is not up to the mark. Probably we can intervene on the oral nutritionist supplement. We can encourage them to have some supplements. As we can encourage them if they are comfortable with the oral diet. We can go ahead with the oral nutrition again. And if not sure they have any difficulty in swallowing or something like that. Probably we can recommend the input the actual nutrition like anthro nutrition or theatrical nutrition we can recommend.so these decisions all are taken on a daily basis does who are stepping into the hospital.so it is a day to day we are doing it up.