Diagnoses & Conditions Nutrition

We have digital and printed forms, either of which are required to be completed, with personal details, medical aid details, and accepting our terms and conditions and your agreement to pay the deposit in order to secure your online booking..

Only if you are treated in hospital and your medical aid provides authorisation. 
For consultations at the rooms and online, payment is required after each consultation. 
You are responsible to submit your claim to your medical aid.  

Contact our reception a minimum of 24 hours in advance to make alternative arrangements, we are happy to assist.

According to the POPIA ( Protection of Personal Information Act), I am bound by law to obtain your permission to investigate your nutrition status and health profile, obtain your medical records, blood results, histology reports, and communicate with your doctor (s) or health care practitioner (s) such as a psychologist, or speech therapist, if needed. 

My responsibility is to safeguard your medical and nutritional records and ensure these are locked and private at all times, for the duration required by the law.

I also require your consent to inform the practice secretary at least 24hours prior to the booked time of consultation, if changes or cancellation is required, and your consent to pay the bill (private rate), on the day of consultation, and to claim back from your medical aid, what portion may be covered by your medical plan, after payment was received by the practice

You may book a consultation with me at the rooms, prior to your admittance, for discussion and planning of your nutrition care whilst in hospital.

Alternatively, you may request a 10 – 30min consultation via email/WhatsApp, for me to assist you on the day of your admittance or surgery, or on any day during your hospital stay.

If your doctor did not refer you to me already, I will contact him/ her, obtain consent, as well as necessary information from your hospital file, to assist you, with the most appropriate nutrition care.

I will come to meet with you in the ward, at a suitable time, in between other procedures, and discuss and arrange the appropriate Nutrition Therapy, which may  include one or more of the following:

• pre or post-surgery Oral Nutritional Supplements,
• nasogastric / tube feeding
• PEG ( percutaneous endoscopic gastrostomy tube) feeding
• Intravenous nutrition ( TPN)
• Special meal requests presented to the Hospital Food Service

A daily check-in session will be done, usually, 10-30minutes, your nutrition care progress will be discussed with you, and the nutritional regime adjusted as needed.

In-hospital consultations are charged at Medical Aid rates and billed directly to your Medical Aid if your medical aid plan provides dietetic cover.

If not, you will be responsible for the payment of the bill.

During the consultation I ask you to give me information regarding any or all of the following which may be relevant:

• Your personal objectives, and what you would like to achieve with my assistance
• Your primary concerns, symptoms and/or diagnosed condition (s)
• Your intentions re losing/gaining weight
• Your height and weight may be measured if you wish, and measurements such as girth if needed
• The medication and/or supplements you take,
• Medical history ( including for eg Cholesterol/ Blood Pressure / Reflux Disorders / Colon conditions / Anemias / Kidney, liver or gallbladder disease/ Diabetes or Blood Glucose problems / Allergies /  Thyroid function  / Bone density results / Eating Disorders / Rheumatic Disease / previous surgeries involving abdominal organs / Gastro-Intestinal Tract) / Cancer diagnosis /  surgery or treatment(s) / Fertility treatment and / or pregnancy 
• Previous successful/unsuccessful efforts you had made to manage your nutrition
• Previous advice given which left you with Questions / Areas of confusion
• Family, cooking, cultural, social, religious, work or travel-related influences
• Emotional / comfort eating habits
• I ask very specific questions re your typical daily intake of foods snacks and drinks
• Also portions sizes and frequency of eating certain foods.
• Also exercise and weekend habits

I answer your most important questions, or if time allows, provide you with a few good meal options to choose from immediately.

After this consultation, I spend time obtaining more medical information, if needed, and prepare an individualized nutrition plan with explanatory notes for you.

This is usually discussed at the second consultation in detail, with the best food options,  portions sizes and quantities, meal and snacks for the day, supplementation, cooking advice, and suitable recipe examples.

Only if this is needed to give a clearer picture of your nutrition-related health status.

During the first consultation, it may be clear from your history that blood tests or a medical check with your doctor will be indicated.

For eg previously raised blood glucose or cholesterol, symptoms such as disturbed or recently changed colon function, sudden or extreme weight loss, chronic fatigue, hair loss, family history of thyroid function problems, etc.

If recent blood tests were done we will obtain these results with your permission, or provide you with the Lancet or Ampath form to do the indicated blood tests. These results will be discussed with you during the consultation and also with your doctor, with your permission, should this be needed.

The first consultation is always 60min. Should you feel you only need one consultation, you will be given as much feedback and assistance as possible, during the available time.

In most cases, the 2^nd consultation also requires 60 min.

Follow-up consultations may be 30, 45, or 60minutes.

The consultation fee is adjusted pro-rata.

Fee schedules are obtainable from the practice receptionist.

During the first consultation, a thorough assessment is made, followed by the preparation of a detailed individualized document and nutrition plan. At the second consultation, the individualized plan is discussed and explained, with the intention to help you feel well-informed and inspired to apply the advice and the plan.

You may need no further consultations. However in most cases, a follow-up consultation is recommended, after a period of implementation, which may be after 1 or 2 weeks, or 3 – 6months.                                                       

Also recommended, is a yearly consultation, to do nutrition status assessment, with repeat blood results observed, weight check, food diary, and clinical symptoms discussion.

Yes.

Your medical aid claim is prepared for you on the day of consultation and payment, emailed to you, and/or provided in hard copy.

As per required practice standards, this includes your ICD10 code(s), your referring doctor if applicable, his / her practice number, my practice number, consultation date (s), treatment codes, and fees paid.

Depending on how unhealthy your previous dietary habits were, you may lose 1-2kg of weight during the first week or 2. The safe, more sustainable pace of weight loss is 500-700g / week, therefore, 40weeks to lose 20kg.

The journey of nutrition care and weight control lasts a lifetime.

It is important to accept that this is not a ‘quick fix”, but an intelligent approach to understanding applying and enjoying good nutrition choices every day.  It is about learning a set of skills that you use for a lifetime.

Your nutrition plan will contain sufficient nutrients to support metabolism ( such as colon function ), mood and concentration, energy to exercise and maintain lean muscle mass, and not reduce resting energy expenditure.

You will feel a difference in your body within 48 – 72hours.

Your abdominal comfort is usually the first tell-tale sign.

Soon, within a week or 2 of consistent application, you will be seeing and feeling the difference.

No.  

Hunger is an intelligent natural signal and guide, to encourage eating.

If hunger is satisfied with a complement of nutritious foods, you will feel nourished, comfortably satisfied, and energized, until it is time for the next good meal / healthy snack.

Physiologically, cravings are important messages from the body that those important nutrients are required.

Your nutrition plan will be structured to fulfill your nutrient requirements appropriately.

Eating enough good nutrients every day is the most powerful way to eliminate physiological cravings.

Cravings related to emotional factors, should be identified and understood with empathy. You may need the help of a therapist/psychologist.

I will assist you during the consultation to understand the difference.

Emotional challenges are much easier to deal with when your body is nutritionally fulfilled and nourished.

What you choose to eat, can:

• assist your body’s metabolism significantly, reducing the need for medication. 

Examples: Blood pressure, cholesterol, a diabetes medication.

• slow down the progression of the disease.

Example: maintaining the current level of kidney or pancreas function, avoiding premature deterioration and need for dialysis or Insulin therapy.

• restore and regenerate healthy organ function.

Example: improve liver function and decrease liver enzymes.

• minimize Gastro Intestinal symptoms and improve the sense of well-being significantly. 

Examples: reduce esophageal reflux, stimulate comfortable stool production, alleviate bloatedness.

• maintain strength, mobility, and independence in later years

Example: maintain bone and muscle density, slow the progression of osteoporosis

Absolutely yes.

In fact, it is one of the most important stages of your life to optimize your diet.

Understanding which foods to eat, to meet the increased nutrient requirements of your body and the growing fetus ( or twins/triplets / etc ),

WITHOUT an unnecessary increase in kCalorie intake, is essential.

Examples:

Your dietary habits during pregnancy reduce

• reflux and constipation risk,
• hypoglycemic episodes,
• risk of hypertension, pre-eclampsia, gestational diabetes,
• premature delivery, postnatal depression,
• unnecessary weight and body fat % increase, 

It prepares your nutritional stores for successful breastfeeding and protects the unborn fetus from cardiovascular disease, obesity, and diabetes risk in adult life

The most beneficial thing to do is to establish good dietary habits and ideal weight prior to conception.

Your diet dictates your glucose and insulin levels, which influences both male and female reproductive health significantly.   

Therefore, the nutritional health of both parents – to – be should be optimized. 

Seeking help as a couple, to get your nutritional status optimized is under your own control,  to enhance your chances of spontaneous conception .

Practical steps can be taken,  such as:

• drawing up a healthy shopping list for the week,
• delegating to a helper to pre-prepare vegetables, cut up a fruit salad, prepare lunch boxes

Certain nutrients ( such as folic acid, iodine ) are essential for optimal fetal brain development during the first few weeks of pregnancy.  

It is wise to prepare your body for this special time, as you may only realize you are pregnant at about 6 weeks.

I do not recommend appetite suppressants. See the FAQ and my answer regarding this above.

Gastric bypass surgery may be an option in some cases.

However, it is associated with significant medical, and / or psychological risks immediately post – surgery, as well as long term nutritional deficiency risks.

IGB placement is usually recommended for 6-12 months and does not require permanent or surgical changes to the gastro intestinal structures. It is associated with much less risk factors, but still needs to be managed, to ensure nutrient intake is sufficient during these months.

Before making the final decision, I recommend consideration of the following list of “Nutrition- for -My- Lifetime” Truths:

1. This game is never over.   Even if you choose surgery / IGB placement, you still need to eat every day.

   With the right assistance, could you still find a better way of eating, a happier and healthier nutrition lifestyle, to play this game safely for life?

2.  There is always a place where “healthy” and what you consider as “nice” overlap.

     Maybe you could succeed in selecting these foods and building a daily enjoyable successful eating pattern by combining them!

3. Which are the ‘weak links’ in my chain? How did these hamper my success in the past?

     With the right guidance, you may be able to identify these ( lack of planning, emotional factors, cultural, family, or work influence, etc )  and find intelligent sustainable solutions.

4. Healthy enjoyable meals and snacks must be available every day at the moments of hunger.

     Have you done enough in the past to arrange your nutrition successfully with this intention?

Come and have a chat with me whilst you are considering your options, or before making a final decision.

I look forward to support and assist you, to achieve your goals, whichever decision you make!