Capt. Lindzi Howder, 455th Expeditionary Medical Support Squadron nutritional medicine officer in charge, checks a patient's feeding equipment at the Craig Joint Theater Hospital on Bagram Airfield, Afghanistan, March 5, 2013. Howder is responsible for all facets of patient and staff feeding at the CJTH. (U.S. Air Force photo/Staff Sgt. David Dobrydney)
Capt. Lindzi Howder, 455th Expeditionary Medical Support Squadron nutritional medicine officer in charge, receives a packet of parenteral nourishment from Maj. Fernando Santana, 455th EMDSS pharmacy flight chief, March 5, 2013, at the Craig Joint Theater Hospital on Bagram Airfield, Afghanistan. Parenteral nourishment is administered directly into a patient?s bloodstream. (U.S. Air Force photo/Staff Sgt. David Dobrydney)
Tech. Sgt. Liezel Huynh, 455th Expeditionary Medical Support Squadron nutritional medicine flight chief (left), and Staff Sgt. Nicole Kilson, 455th EMDSS diet therapy technician, prepare for the lunch rush at the Craig Joint Theater Hospital cafeteria on Bagram Airfield, Afghanistan, March 5, 2013. The nutritional medicine flight serves more than 8,000 meals a month. (U.S. Air Force photo/Staff Sgt. David Dobrydney)
by Staff Sgt. David Dobrydney
455th Air Expeditionary Wing Public Affairs
3/6/2013 - BAGRAM AIRFIELD, Afghanistan -- Man cannot live on airpower alone, and at the Craig Joint Theater Hospital here, the 455th Expeditionary Medical Support Squadron Nutritional Medicine flight works tirelessly to keep their charges fed.
"We are the only nutritional medicine flight in Afghanistan," said Capt. Lindzi Howder, flight officer in charge. "We feed a lot of people."
The flight serves more than 8,000 meals a month, including regular meals for hospital staff in the cafeteria, MREs for use during contingencies and liquid diets for patients that cannot feed themselves.
Howder noted that allowances have to be made for local customs.
"A lot of the foods we serve are halal, because we have more local nationals. Americans come in and out very quickly in the inpatient ward, but our long-term patients are Afghan ," Howder said.
The liquid diets they serve can come in two forms: enteral, which is fed into the patient's stomach, and parenteral, which is administered directly into the patient's bloodstream. While Howder is responsible for recommending a patient receive parenteral nourishment, the actual supplies are maintained at the pharmacy.
"It's very tightly regulated because being in the blood there's a high infection [risk]," Howder said.
The parenteral nourishment is made up of simple dextrose and amino acids, while Howder likened the enteral to baby food.
"It is a medication, but we keep it in-house because it doesn't need to be refrigerated," Howder said.
Howder is one of just 45 dieticians in the Air Force, and the only one deployed to Afghanistan.
"I had to work very hard to get here, because this is the only deployment billet for the Air Force," she said.
"I'm also the only dietician ... for the Army Weight Control Program. Any time an Army member falls outside of those weight guidelines, they have to be seen by a registered dietician."
In addition to her duties at the hospital for the joint force, Howder also goes on Freedom Radio twice a month to answer questions about nutrition.
"I'll tailor the radio show to what people are asking. For example, a common misconception is there's 3,000 calories in one MRE and there's not, it's 1,300."
Howder noted that this job is much different her normal duties at the Health & Wellness Center on Ramstein Air Base, Germany.
"A dietician is usually an inpatient dietician, an outpatient dietician or a food service dietician," she said. "Here I have to do all three."
Howder continued that at her homestation she mainly dealt with children or people playing sports.
"[At Ramstein] you're dealing more with healthy people than here you're dealing with chronically malnourished people who get blown up. It's a different side of nutrition."