Kaunseling diet : Perkara yang selalu dilupakan?

Bismillahirrahmaanirrahiim..

Buat teman2 yang diingati selalu. Ramadhan hampir2 berlalu, sejauh mana telah kita manfaatkannya? Apakah kita akan bertemu lagi dengannya tahun hadapan? Ya Allah, kurniakanlah kami Taqwa ya Allah. Terimalah segala amalan kami ya Allah.. Dan berkahilah sisa masa Ramadhan kami ini ya Allah...

Kawan2, tajuk kita kali ini ialah : Pemakanan sihat (Balance, variety & moderation). Sebenarnya, Ayat sendiri (terus-terang) selalu ter'lupa' untuk ajak pt amalkan pemakanan yang seimbang. Dulu2, masa praktikal, terutama sekali masa ramai pt kat luar bilik kaunseling tu, selalu nak cepat2, terus 'attack' masalah pesakit. Terus prioritize utk advise pt ttg habit yang salah mengikut penyakit yg dihadapi.. Jarang-jarang utk advise pt amalkan pemakanan yg seimbang, cukup semua kumpulan makanan..


Kat Normah ni, Ayat dipertemukan seorang Nutritionist Ming yang sangat cekal & belajar 'clinical' nya through the hard ways selama setahun (b4 i came) sebab... selama setahun Normah carik Dietitian, tak jumpe2.. Sangat mengkagumi die...

Mungkin sbb latar belakangnya sbg Nutritionist, so, mmg sangat tekankan healthy eating nih. Lepas tu baru kaitkan dengan penyakit (diet-disease relationship).. Diet-disease relationship pun satu education tool yg sgt penting utk kita kuasai.. Takde gune advise pt macam2 tapi diorang tak nampak 'kenapa' kena jaga makanan.

Berbalik kpd tajuk asal, biasanya lepas ambik diet recall + kira requirement pt (utk determine portion size each food group utk pt), kitorang akan mulakan dgn introducing the pt to all the food group. (cereals, fruits, veggie, milk products & meat groups)... lepas tu, pt terus nampak lah ape "food group" dia yang hilang. After cakap kepentingan setiap food group (general) barulah spesifikkan kpd kenapa certain food group penting utk kawal penyakitnya & food group mana yang kena jaga2.. inilah, education material yang selalu digunakan.. (My colleague was trained in Australia)

Lepas tu, bagi nasihat kat pt kena individualized. Betul2 prescribe menu according to their requirements. Dulu my colleague Ming used to give menu as similar as pt's diet recall. Basically, the idea of giving the menu is to guide pt regarding their portion size. I had once face a pt whom complained to me (during follow up visit) that she is tired of eating the same food. Erk.. adoi, rupe2nya die tak faham, yang the sample menu is just to guide her on the portion size, not to follow it blindly every day!!.. kesian pulak.. sebenarnya, biasanya 1st counseling session, mmg tak sempat nak explain CHO counting (diabetic diet). Usually, we only explained on CHO counting during the next follow up. 1st counseling session cuma bagi portion size utk makanan penting cthnya nasi & roti or ape2 CHO-contained foods yg pt ambik..

2nd follow up, then only i give the CHO distribution & explain thoroughly about CHO counting. Kalau sempat, ajar food label reading terus. Bila hadapi masalah macam ni.. (lebih-lebih lagi Cik Hazirah Jaafar dah pesan yg guideline MNT baru = CHO counting kene ajar awal2- info from the conference), tetibe saye teringat sample diet sheet yg di'hadiah'kan oleh Cik Mazuin Kamarul Zaman yg diambik dari dietitian di tempat praktikalnya dahulu kala.. Alaa.. yg CHO exchange list tu... So i developed my own.. ta daa..

Lepas tu, timbul masalah lain pulak, ada sesetengah pt yang tak dapat imagine, cup tu besar mana, kotak mancis tu cane gayanya? so, diet sheet di atas pun berevolusi seperti di bawah...



Diet sheet yang baru ni, lipat suku (bukan separuh).. faham ke? maksudnye, bhgn cereals + tubers tu lipat ke dlm, tapi table utk exchange list distribution tu appear kat hdpn/luar.. (adoi, betapa tak retinya nak terangkan)..

Later on, i realized that this exchange list is not only useful for Diabetic diet, but also to the rest. Wt loss, renal disease.. utk pt post surgery pon penting, sbb kadang2 kita prescribe high protein diet kat pt, n pt baru nampak other sources of protein yang diorang boleh ambik selain ikan, ayam & lembu... Hmm.. jadi, inilah diet sheet yang kerap kali difotostat kami..

I tried to email all these to all of you, but the size is very big. tak muat gmail tuh.. so, takpatlah.. takpelah, share kat sinilah. Im sure u can do a lot more prettier than mine.. hehe..

Sampai di sini dahulu.. sbnrnya banyak lagi yg ayat belajar kat sini. Alhamdulillah.. Ada kesempatan Ayat kongsi lagi.. (i want to learn the swallowing assessment!!.. kat sini ader swallowing assessment nurse- Saadah remind me of this issue)

Salam sayang buat semua.

Jom buru malam Al-Qadr.

Ada rezeki jumpa kat Convo nanti, kalau saye dapat cuti lah.. (sedang menanti result transcript yg tak kunjung tiba)

wslm