Q: Tell us about your career so far?
A: I studied archaeology and anthropology at university and only discovered dietetics a few years later when I realised I could combine my love of food and interest in healthcare into a job! I qualified as a dietitian working with adults 20 years ago, then specialised in paediatrics 15 years ago, and have been working with children and teenagers undergoing cancer treatment at Bristol Children’s Hospital for the past seven years.
Over that time, I’ve discovered that while the energy and passion of many paediatric oncology dietitians to support patients and families is there in abundance (both in the UK and internationally), there’s a need for highquality research to guide us in many aspects of nutritional care. I wanted to contribute to this research, so applied to the National Institute for Health and Care Research (NIHR) internship programme for the opportunity to improve my research knowledge and explore how we support nutrition for those undergoing treatment.
Q: Tell us about your role in supporting young people and their families?
A: As the lead oncology dietitian at Bristol, I help manage nutritional supportive care of young people having treatment under the haematology, oncology and bone marrow transplant teams. This involves getting to know many young people (and their caregivers) and their unique dietary preferences, requirements and experiences, and responding to the different nutritional challenges the cancer and treatment might pose.
A day’s work may include discussing food hygiene and safety practices with a new patient or how to optimise the nutrient quality and dietary patterns of a toddler who’s recently started steroids, working out a nasogastric tube feeding plan to support someone experiencing mucositis, or advising on the best initial foods to try for gut graft versus host disease. We might also be contributing to a parenteral nutrition prescription for someone whose gut is temporarily unable to digest food or discussing ways to wean a young child back onto an oral diet after they’ve been completely dependent on tube feeds over treatment.
One important thing I’ve learned in my time on the job is that nutrition needs never stay the same over treatment and it’s essential to plan with the young person and their family to anticipate how they may change and how we can respond to this in a way that’s effective and acceptable for them.
Q: What does your job mean to you?
A: I’m proud of feeling a useful part of a team of expert colleagues. Being able to contribute positively to care is really important to me.
Q: Tell us about your NIHR research?
A: I’d like to find out how to best support young people’s nutrition while having treatment for osteosarcoma. Due to intensive chemotherapy that affects taste, appetite and the ability to digest nutrients, many children lose weight and strength. We know this can be linked to their risk of catching infections and impairs their quality of life and the ability to tolerate the chemotherapy itself.
Nutrition can be supported differently for this condition across the UK, and I’d like to explore what effect different approaches might have on patients’ psychological and physical health, and their experience of treatment. I firstly need to review what evidence is out there already and then I hope to survey both healthcare professionals and those with direct experience of osteosarcoma, on their
thoughts around what we currently do and how it might be done better.
Eventually, I’d like to be able to support the development of guidelines on nutritional care for this diagnosis.
Q: How can patients support your research?
A: If you’ve gone through or are going through osteosarcoma treatment and are interested in telling me about your experiences around nutrition and what you think of my project plan, please do get in touch by emailing laura.sealy@uhbw.nhs.uk.
From Contact magazine issue 101 - Winter 2023
