Leukemia and Bone Marrow Transplants

I was hoping to see a bone marrow transplant today, but none are scheduled for the day. The RD said she can arrange for me to see one next week, which I think will be pretty exciting. I have absolutely loved working with the Heme/Onc dietitian this week. We have a high volume of patients (20-30/day), and spend most of the day addressing nutrition-related issues caused by various treatments and medications. The vast majority of our patients experience nausea and vomiting on a regular basis as well as constipation, diarrhea, taste changes, and xerostoma/mucositis. I did a diet education on a Low Tyramine diet yesterday because one of my patients was on Zyvox (a medication that should not be consumed with foods containing tyramine). I have also spent a lot of time discussing the Neutropenic and the Oncology Select (basically foods that produce minimal odors to reduce nausea) diets.

Two particular challenges about this rotation: medications/chemo and the patients. First, there are such a large number of medications, chemotherapy and radiation therapies that create nutrition-impact symptoms. It is nearly impossible to memorize them all in a week, but I have learned a lot -- Noxafil, Zyvox, Sando, etc. I feel like we spend half of our time addressing issues caused by the patient's therapies. Secondly, I find the patient load difficult because so many patients are young. I think it hits home when you seen a 20 year old dying of a disease they were just diagnosed with a month ago. As a dietitian, you maintain a sense of professionalism to minimize the emotional attachment to patients. However, all of these patients are people, and I never want to become desensitized to their situations. I guess it is a balance.

Overall, I have learned a lot this week. Looking forward to renal next week.

Rachael