After a few years on the job, it takes a special case to surprise many health-care workers. For Raffaele DiMatteo, RDN, CDN, a clinical dietitian at New York’s Bellevue Hospital, that surprise came in 2014 when his hospital admitted one of America’s rare Ebola cases. Beyond its deadly reputation, Ebola is unusual in its effects on patients, DiMatteo says. “It presents the practitioner with a multitude of challenges, from difficulty swallowing or loss of appetite to excess fluid or protein and electrolyte losses.
This patient required daily follow-up to ensure adequate intake of the prescribed diet.” Despite the potential for personal risk, DiMatteo was eager to begin treating the patient. “I knew we would be providing a valuable service,” he says. “Knowing how challenging Ebola is to treat and cure, [it’s most rewarding to see] a patient’s condition improve.”
What was your reaction to learning you'd be working with this one? Did you fear for your personal safety?
When I learned that we had our first confirmed Ebola case, I was actually quite eager to see the patient and start working with the team. Knowing how important fluid and electrolyte management is in Ebola infections, I knew that we would be providing a valuable service. I was not concerned for my own safety since the hospital established strict guidelines. This all came after the healthcare worker in Dallas was infected, so we were aware of the needed precautions when working with Ebola.
How was working with an Ebola patient different from your work with patients who have other infectious diseases?
When a patient is admitted with Ebola, it presents the practitioner with a multitude of challenges, from difficulty swallowing or loss of appetite to excess fluid, protein and electrolyte losses. Unlike other infectious diseases, this patient required daily follow-up to ensure adequate intake of the prescribed diet. Although electrolytes can be quickly repleted with IV fluids, the goal from a nutrition perspective was to provide foods rich in needed nutrients and electrolytes and provide isotonic fluids that would not exacerbate GI losses, hence making fluid management easier for the medical team.
What did you find most rewarding about treating this patient?
Following a patient’s labs and symptoms and looking for positive trends and improvements is rewarding. But, in the end, knowing how challenging Ebola is to treat and cure, seeing a patient’s condition improve is most rewarding.
What about food, diet, nutrition or health drew you to this field?
Whether someone uses food to help manage a medical condition or to improve his or her own health, the science of food has always been a fascinating topic to me. New research about phytochemicals or effects of vitamins and minerals on human health continues to draw me into learning as much as I can to improve the health and wellbeing of my family, friends and patients.