Healthcare Advocacy in D.C.

Well, I went to The Hill.
The Crohn’s and Colitis Foundation asked if I would, so I said, “OF COURSE!!!”

My professors were kind enough to let me get finals out of the way early so I could go make noise on Capitol Hill for a couple of bills:

1. The Medical Nutrition Equity Act H.R. 2501: Currently, health insurance in America will cover medical foods as long as they’re inserted through a nasogastric (NG) feeding tube, even if there’s no clinical indication for insertion of an NG tube. We need these medical foods covered orally! Medical foods are NOT groceries…that seems to be the consensus on The Hill, and I had to explain from the position as a future registered dietitian:
– Medical foods are broken down into single amino acids, digestible monosaccharides (single sugar components) and lipids, so the body can absorb them easier. These are especially important in patients who are malnourished.
-Medical foods are important, especially in pediatric patients, to prevent or prolong the need for more expensive/potent medications.

2. The Safe Step Act H.R. 2279: There are laws in 25 states currently that protect patients, but not in Oklahoma where I live. In Oklahoma and states like it in this respect, insurance requires patients to first fail a medication before they can then be prescribed a medication that would be helpful. However, there’s no burden of responsibility on the insurance companies to review the appeals process submitted by the doctor stating that the patient is failing a drug. This could mean up to 6 months time would pass before a patient finally receives permission from the insurance company to try a new drug. I experienced this firsthand in Oklahoma last year:
– My drug of 6 years, remicade, began failing me because my body developed antibodies to it since my doctor repeatedly forgot to write the order for it, delaying the time between infusions of remicade.
-I “failed” the drug, meaning I began to experience uncontrollable symptoms. I was told that it would take “several months” before insurance would approve another drug. I was missing work and knew I didn’t have “several months”. Literally, I was scared that I would die. I was violently losing blood 30 times daily, losing weight, and I couldn’t stay hydrated. I was hospitalized twice last year because of issues associated with failing remicade.
-I moved my care to Texas, which is a 6 hour round-trip ordeal for me to receive treatment. Because Texas has laws in place that protect patients, I was able to get my infusiong within 72 hours of finding my new GI doctor in Dallas. When insurance acknowledged that I was “failing” remicade, I was able to get on a new treatment within 48 hours of the doctor submitting an appeal to insurance.

The Safe Step Act would require insurance to make timely decisions so patients could receive the treatment they need as prescribed by their doctor, potentially avoiding missed time from work, loss of employment, surgery, hospitalizations, or even death (in extreme cases). The Safe Step Act saves healthcare dollars and lives!

A local GI doctor (George) and I spoke with the staffers for Senator Inhofe and Congresswoman Horn from Oklahoma, and then we met up with friends from New York and Kansas (Sarah and Tyler) to speak with Congresswoman Davids and Senator Roberts (side note: Kansans are truly some of the kindest people I have ever met). Our goal was to get co-sponsors for these bills so we can make them into laws, bettering the lives of IBD patients and beyond. Most, but not all, of the legislators were receptive and even supportive! Contrary to what we see/hear in the media, Republicans and Democrats CAN agree on some things, and since these bills are bi-partisan, that made this whole, “please support these bills” requests much easier.

I saw Congresswoman Alexandria Ocasio-Cortez from New York from afar- SO exciting to see women MY AGE in Congress! I also saw Senator Ted Cruz from Texas about 127 times.

Between our meetings, we grabbed lunch underground at a cafeteria and waltzed over to the U.S. Botanical Gardens for some peace and quiet from the hustle and bustle. Shout out to Sarah from NY for knowing D.C. like the back of her hand, because I felt like we had a tour-guide, and this was a gem:

Since the 20 days that have passed since meeting with legislators, we have gained 22 co-sponsors for The Safe Step act. I sent another follow-up email to some staffers today, and we are actively seeking more support.

If you’re interested in these bills above and want to make noise where you are, email your representative and ask them to co-sponsor the above bills. Tell your story, and let them know how these bills would help you. These bills are currently both on the House of Representatives side, but we will have Senate call to action soon!

I’m learning that advocacy is so, so important. If you’re affected poorly by the systems in place, we can make a change…but we need to tell our stories. Lawmakers need to know how we can change our world, and advocacy is the perfect space to not only let people in positions of power see how we need change, but also to offer a solution through these bi-partisan bills.

Keep moving forward!

Not pictured: coffee shops, crab cakes with my friend Hope, riding bikes through a thunder storm, touristy monuments, and a cocktail reception with new friends

P.S. If YOU want to support medical research directly, please consider donating to my fundraiser here!


So…You Want to Be a Registered Dietitian Nutritionist?

So…You Want to Be a Registered Dietitian Nutritionist?

Happy National Nutrition Month! MARCH! Can it feel like Spring, already? To commence National Nutrition Month, I’m sharing some things about a profession I’m pretty stoked about: nutrition! Scroll down for more.

H O W

How to become a Registered Dietitian Nutritionists (RDN)? What is an RDN?

An RDN is a food and nutrition expert who has successfully completed:
– a bachelor’s degree
– prerequisite coursework for a DPD or CP
– 1200 hours of supervised practice (dietetic internship)
– a national credentialing exam

There are a number of routes to becoming an RDN, but here’s the route I took/ am currently taking:
bachelor’s degree: check! B.A. in Sociology- note: the bachelor’s does NOT have to be in the field of nutrition, because beginning in 2024, a master’s will be required to sit for the credentialing exam.
– I worked full-time and took the prerequisites simultaneously, because I could not afford to up and quit my job. I took biochemistry, organic chemistry, chemistry 2 with the lab component, and nutrition through the lifespan one.semester.at.a.time. It took 5-ever, but I am told that it will be worth it. Plus, I didn’t accumulate additional debt from paying on a course or two at a time. Bonus: If you work for a hospital, a lot of them will pay for the prerequisites!  Look into their tuition-reimbursement programs and see!
-I enrolled in a Didactic Program in Dietetics (DPD). A DPD is ONLY the coursework component to become a dietitian- not the internship. Think of the DPD as step 2 in the process after completion of prerequisites. I FULLY planned on working and going to school simultaneously like I had been doing, and then I was planning to apply for a dietetic internship (DI) later. Thankfully, I moved to a town with a Coordinated Program (CP) that combines the internship with the classwork.
-I’m currently completing the CP, and when it’s all done, I’ll have all my supervised practice AND some graduate degrees under my belt. Once I graduate, then I am eligible to sit for the CDR credentialing exam. Some states require additional licensure to be a licensed dietitian to practice (LD).

I wanted to be credentialed- that was important to me, because in order to work for the World Health Organization, hospitals, and community programs like WIC, even NASA…they require that RDN credential. Without the credential, the future seemed uncertain and volatile to me. If credentialing isn’t important, I suggest checking out programs in integrative nutrition. However, I don’t know if “nutritionist” will always be an option without pursuing the credential. Many people are advocating for the “nutritionist” title to be protected through the RDN credential, which can only be attained via the steps I listed at the top of this post. What I’m saying is, all dietitians are nutritionists, but not all nutritionists are dietitians…make sense?

What does an RDN do?
Where are they?

Glad you asked! They work anywhere and everywhere! In gyms, hospitals, schools, corporate wellness, for NFL, the NHL, MLB teams, the Olympics, collegiate sports teams, community programs, in education/academia, for the NIH, the WHO, for THEMSELVES in private practice, in the media, and beyond. RDNs provide individualized, evidence-based nutritional counseling and medical nutrition therapy (MNT). RDNs take a scientific approach to health maintenance and prevention. RDNs can even join practice groups (DPG) and gain field-specific knowledge in areas like pediatrics, diabetes, integrative and functional medicine, culinary arts, and environmental hunger. Dietitians can even become board certified in sports nutrition, pediatrics, clinical nutrition, oncology, diabetes, and more!

^Texas Medical Center in Houston

What excites me about the field of nutrition?

I think there’s room for entrepreneurship and growth in the nutrition field. People are more interested in nutrition and disease prevention than ever, and the job growth for this field is exciting. I like the idea of piece-mealing a career that’s rooted in science, helpful for others in areas like counseling and education, and practical. There’s constantly new research being published to keep up with, and the science nerd in me loves that. I like that the field doesn’t have to be rigidly structured and black and white- there’s room for flexibility in nutrition…and I’m excited to see what that looks like in my own life as a professional.