Transcription:
Keeping a Healthy Diet After Injury

Scott Webb (Host): Welcome to Picking Our Brain with Shepherd Center. I'm Scott Webb. And nutrition is an essential part of staying healthy for all of us. It also plays a vital role during and after recovery from injury. In this episode, Jill Newsome, Clinical Nutrition Manager at Shepherd Center and Allison Motter, Dietician at Shepherd Center, join us to discuss what maintaining a healthy diet means during recovery. First off, I want to thank you both for being here and give you both a chance to tell listeners about yourself. So Jill, I'll start with you. What's your role at Shepherd Center?

Jill Newsome (Guest): I am currently the Clinical Nutrition Manager at Shepherd Center. And I've been here a little over 10 years, going on my 11th year. I'm responsible for our three full-time dieticians and two pair in dieticians. In addition, I cover inpatient teams, so inpatient brain injury and spinal cord injury teams. We also are responsible for covering outpatient. So, we see our patients that return in an outpatient setting to provide education as needed. Along with the patient care, I am responsible for our department's computer systems. So, our electronic medical record and our dietary management system.

Host: Well, it certainly sounds like you have your hands full. And we have one of those dietitians here today. So Allison, tell us about yourself. What's your role at Shepherd Center?

Allison Motter (Guest): I'm one of the inpatient dieticians here at Shepherd Center. I've been here just over five years. I cover one of the inpatient brain injury units, as well as 10 spinal cord injury patients. As dieticians, we work with patients to supply the nutrition they need for their rehab and their recovery while they're here at Shepherd Center. Sometimes this means working with patients who are dependent on enteral nutrition, which is when they must be fed through a tube in their stomach. And this can entail calculating total calories, total protein, their hydration needs and adjusting the feeding prescription week to week based on how their weight's trending, how their labs are looking, medication changes and other factors.

Some of these patients can progress to the point where they start an oral diet. And we then work with the patient and their speech therapist to supplement their nutrition through their feeding tube if their oral intake falls below what they need. And as they continue to get stronger and tolerate more by mouth, we work with them to wean them off the enteral nutrition altogether.

We also work with patients who come to us already on a full oral diet. And these patients often require a lot of education on their quality of nutrition and how it impacts their overall health, especially throughout their rehab and recovery.

Host: Yeah, I'm sure education is key and I'm looking forward to some free education here today, myself. So, Jill, back to you, what role does nutrition services play in rehabilitation and recovery?

Jill: Well, a lot of what I'm going to say, kind of echoes what Allison just touched on about the services we provide at Shepherd for our inpatients, as far as enteral nutrition needs and then transitioning to oral diets from enteral nutrition, educating throughout the stay on weight loss, weight gain. But really nutrition plays an integral role in everyone's health from day one and especially at an acute care hospital when somebody comes in and has a traumatic injury, the initiation of nutrition, whether it's tube feeding or an oral diet is very important at the acute care hospital, which then helps us. It's a better base when they come to us at Shepherd Center, so a lot of times after a traumatic injury patients have lost a significant amount of weight.

So, when they arrive at Shepherd Center, we're working on weight gain or a lot of time skin healing, if they have wounds coming in. We're working on healing the wounds as well. So, it really starts from day one of their recovery journey with initiation of nutrition.

Host: Yeah, I can really picture what you're saying. That sort of day one, you and your team, you know, you're on the job and working with folks and Allison, I want to have you discuss the importance that nutrition plays in our overall health, of course, but especially after injuries.

Allison: Nutrition is definitely the building blocks of our health. Many of our patient population has had a traumatic injury happen to them and it's completely disrupted their nutritional foundation by the time they get to us. We see firsthand how important it is to have adequate nutrition for recovery.

When our patients arrive, they're often getting much more intensive therapy. They are a lot more active than they were at the previous hospital, meaning they're going to require a higher calorie and higher protein needs. So, we provide that education to patients and recommend oral supplements or supplement through the feeding tube as needed to help them regain that strength or any weight they've lost, like Jill mentioned, help those wounds feel up. On the flip side, many of our stroke patients ended up in their situation because of their diet and lifestyle. And we're very lucky in this setting where we work with patients for a much longer period of time than the acute care settings often have. So, we can really take time to develop a rapport with these patients and families and provide that long-term education.

We get the opportunity to provide in-depth diet and lifestyle education, and work with them to apply it in their diet choices here, and then how to continue making those educated choices after they leave. We get to see some of our patients reach their weight loss goals, come off various medications because of their nutrition improving and just overall feel better because they've made these kinds of changes to their diets.

Host: Yeah, I'm sure they do feel better. And, and interesting, just sort of thinking about what you're saying that a lot of folks end up there because of perhaps poor nutrition. So Jill, let's think about that. Let's frame this a little bit. So, many people have been at home during COVID-19, working from home now. So, what advice do you have for listeners as we all try to stay healthy at home so that we don't end up necessarily there with your team?

Jill: I would recommend first, staying active for your physical and mental health while working from home. And then focusing more on a plant forward diet. Making sure you're getting in your fruits and your vegetables and your whole grains, staying hydrated. Really limiting alcohol, sugary beverages, high fat foods, high salt foods.

Host: Yeah. And Allison, I'm sure you have some thoughts on this as well. You know, we don't necessarily want to think about this in terms of weightloss but just sort of overall health, mental health, physical health, and I'm sure you have some suggestions for all of us, you know, because, at least me in particular, I know that I've treated myself to way too much comfort food. I made brownies last night at like 10 at night. I didn't need brownies. I just wanted them. So, maybe you can give us some suggestions as well.

Allison: Yeah, piggy back off some of the stuff Jill said, you know, nutrition to make all the difference in our overall health. It's so important to maintain a healthy diet and lifestyle. Like Jill said, I also encourage a plant-based diet, trying to limit animal foods and processed foods, especially ones with added sugars. So, only a few times a week and doing your best to keep an active lifestyle. The reality is we see the difference that patients who come here who followed a healthy lifestyle prior to their injury, versus those who less so did, but it's never too late to make those changes. We see patients who do make healthy changes here tend to have better overall outcomes. And just overall, I think it's so important to, you know, prioritize your own nutrition and your own health and never underestimate the value of fruits and vegetables.

Host: So then no to the brownies, is that what you're saying?

Allison: Everything's okay in moderation.

Host: Everything in moderation. Absolutely. That's how I feel about the fruits and vegetables, but, you know, we don't have to agree on everything here. Jill, this has been really educational, you know, just thinking about nutrition and framing it in the terms of rehabilitation, recovery, you know, how to address nutrition after injuries or how we can, you know, best avoid seeing you there at Shepherd Center by eating healthier plant-based fruits, vegetables and so on while we're at home. So, I want to give you an opportunity, you know, final thoughts here, on the services at Shepherd Center and how you and your team can help listeners.

Jill: Services provided at Shepard. We do provide patients with the opportunity to have outpatient visits with us and these can be in-person or now that COVID has hit, we do phone visits for our patients. For overall nutrition, it's really just making small changes that eventually add up to bigger changes, because if you change too many items in your diet, it's harder to continue to follow the changes.

So, maybe changing one item in your diet per week and then progressing from there. And it's the same thing with staying active that jumping into a full going to the gym, taking multiple classes is a lot for some individuals. So, slowly adding in a physical activity with the changes in your diet.

Host: Yeah, I think that's such great advice. You know, if you decide you're going to be healthier, you're going to eat healthier. You're going to be more physically active. Don't run a marathon tomorrow, right? Let's, let's, let's follow those baby steps, follow Jill's advice, pick some things. Start slowly. And work your way up, whether it's endurance for working out or a longer dietary nutrition plan and so on. So, great advice. And I'll give you the final word here, Allison, on a services at Shepherd Center, how you can help folks and just maybe reasons for optimism that we can all start slowly, and reach our goals and have a positive outcomes.

Allison: Shepherd Center's definitely an incredible resource for many populations who often don't have any other options. And it's a place that can change the course of someone's life after a significant injury and nutrition is one of those major factors that can make all that difference. It's so important, not only throughout the course of their recovery, but prior to the injury, as well as after they have left Shepherd. We like to think we play a big role here in their rehab and recovery process.

Host: Yeah. And I'm certain that you do, and this has been really educational to sort of understand, you know, the role that nutrition plays in rehabilitation, recovery, especially after injury and just all this great advice, how we can all be healthier mentally, physically. Great to know that you're doing Telemedicine. So, really awesome today. Thank you both. And you both stay well.

Allison: Thanks Scott.

Jill: Thank you, you too.

Host: And you can learn more about Shepherd Center at shepherd.org. This is Picking Our Brain with Shepherd Center. I'm Scott Webb. Stay well.