Introducing Meredith, Your IBD RD

meredithMy name is Meredith and two of my greatest interests are IBD and nutrition. Here's why: My IBD journey began in August 2010 in a Five Guys in Connecticut. My parents and I were on our way from Massachusetts to the University of Delaware for me to start my junior year as a dietetics major. Little did I know when I first stopped in the bathroom and saw that blood in the toilet, that it was the beginning of the most painful and the most rewarding time in my life.

After a few months of pretending I didn’t have a problem, I finally got a colonoscopy in December 2010 and was diagnosed with ulcerative proctitis. I remained in remission for most of my spring semester, but by the time I came home to Massachusetts for the summer, the bleeding, frequency and urgency were back with a vengeance.

I remember lying in the fetal position in the backseat of my mom’s Volkswagen Beetle on the way to my GI’s office, desperately trying to minimize my pain and maintain continence of my bowels. I went into that appointment convinced that he would give me some magic pill to tame this flare and put me back to normal, but instead, I got prednisone. The next few weeks consisted mainly of lying on the couch, crying at Grey’s Anatomy reruns, and meticulously keeping track of my intake and output in a vain attempt to find some food I could tolerate. This was the first time in my life I was ever unexcited about eating and I hated that feeling. I hated that the food that once gave me nourishment now only caused me pain. I hated that I felt nervous every time I ate for fear I would regret it. I hated how my mom and boyfriend would silently enjoy their meals, feeling guilty for the fact that I could not do the same. I was already on my way to becoming a dietitian at this point in my life, but it wasn’t until then that I truly knew how I wanted to help people. I knew then that I wanted to prevent others from feeling the way I did that summer. I knew I had to get better so that maybe someday, I could help someone else do the same.

In early July 2011, my doctor finally insisted I go the hospital to have my labs checked out, get re-hydrated, and maybe come up with another plan to get this flare under control. What I naively thought would be a 2-3 day affair turned into a 2 and a half week stay at my local hospital followed by a transfer into Boston where I remained for another week. In a total of about 6 months, I had gone from 140 lb to 108 lb, a 22.8% unintentional weight loss. I now know as a clinical dietitian that this combined with my decreased intake and obvious fat and muscle wasting meant I met the ASPEN (American Society of Parenteral and Enteral Nutrition) criteria for severe protein calorie malnutrition. And yet I was seen by a dietitian once throughout this whole ordeal, only to offer me Ensure on my meal trays. I could easily get into a rant about the lack of focus on nutrition in the hospital, especially for IBD patients but that sounds like a good discussion for another blog post.

Anyway, a repeat colonoscopy revealed that my ulcerative proctitis had spread into full-blown pancolitis and the doctors told me what I already knew: that I had one very sick colon and it needed to go. And so on August 2, 2011, my best friend’s 21st birthday, I celebrated another birthday: that of Stella the stoma.

I consider myself extremely lucky regarding my ileostomy experience for several reasons:

  1. I am in the healthcare field and I find all aspects of the human body (even the gross ones) pretty interesting.
  2. I had an unbelievably supportive boyfriend throughout this whole ordeal. He thought the noises my bag made were hilarious and found it fascinating that you could see what I had eaten 8 hours later.
  3. I shared an apartment with 3 other girls but I had my own bedroom and my own bathroom.

 

And it is for all of these reasons that most of my memories surrounding my ileostomy are pretty positive. Oh, except for the fact that I couldn’t pee on my own until after my ileostomy reversal. Yeah, I was using disposable catheters to pee for 4 months because I was never able to void after my first surgery. So that was fun.

But who cares because I got to finally eat again! I cannot even begin to tell you how excited I was to eat some Laughing Cow cheese. I had seen so many damn commercials in the hospital and that was the one thing I knew I wanted when I got home. However, in trying to get back to what I felt was a healthy weight for myself, I also ate a lot of crap. I took this opportunity to eat whatever the hell I wanted (except fiber. I was mistakenly terrified of fiber) and so I did. Unfortunately, I gained back more than I ever lost and my boyfriend ended up about 15 lbs heavier too. In studying nutrition, there is a lot of focus on helping people to lose weight and not so much on how to gain weight in a healthy way. This is something I definitely wish I had known more about back then and something that I educate people on in the hospital more often than weight loss if you can believe it. But once again, that’s a topic for another time.

After my ileostomy takedown, I gradually eased into my new life with a J-pouch and I’m happy to say that I’m almost back to who I was before I was diagnosed. I say almost not because I’m lacking something, but because I’ve changed for the better. I am a stronger, more confident and more empathetic person for having gone through what I did, and I think a lot of other IBDers and ostomates can say the same. That is what makes this community wonderful and why I am thrilled to be a part of it.

I am even more thrilled to start my new role as the of resident nutrition expert for the Girls with Guts community. Even with the ileostomy, I graduated from the University of Delaware on time, got my Bachelors of Science in Dietetics in 2012 and completed my dietetic internship in May 2014. During my internship, I got the opportunity to work alongside the clinical dietitians at 900+ bed hospital and it was there that I got to do my first nutrition education for a new ostomate. The patient was a middle aged man who had just had a partial colectomy due to colon cancer and was so overwhelmed by this change in his life. I have never felt a greater sense of pride and accomplishment than when I walked out of that room after offering what I knew, not just about nutrition, but my own ostomy experience.

I have been a registered dietitian (RD) since July 2014 and have worked part time in a few different local hospitals. Today, I work full time as a clinical dietitian for a very small community hospital on the north shore of Massachusetts.

I can’t wait to share what I already know and what I discover in the world of IBD and nutrition, and I can’t wait to learn from all of you!