Happy RD Day!

Happy Registered Dietitian Day! Yes, this is an actual day, albeit one that it is not as popular as other calendar holidays. Nonetheless, it is important to recognize the role that dietitian's play in our nation's health and wellness. As you can see from the above graphic, RDs are advocates, something that was repeatedly reinforced to me during undergraduate courses and now I have seen in action during my time as a dietetic intern. That means that, while I'm not the one ultimately calling the shots for my clients/patients, I am responsible for presenting their wishes and opinions, as well as overall championing what is best for their nutritional health. To do this properly, I have to be well educated, base my recommendations in current, evidence-based research, and, most importantly, have spent time with the individual. I promise, RDs do more than it may seem at first glance!

Given that today is RD Day, and even though probably none of these individuals read my blog, I wanted to thank the many dietitians who have been part of my education and learning to this point. From job shadowing in high school to didactic learning in undergrad to now my supervised internship, I am incredibly grateful for all of the knowledgeable, friendly dietitians who have been willing to teach and mentor me in the dietetics profession. While I know that there is ever-more to learn, I do feel confident in my abilities in becoming a dietitian this summer, thanks to all these individuals.

And, as you are also probably unaware, March is National Nutrition Month (NNM)! Celebrated each year, the theme for 2013 (the 40th anniversary of NNM) is "Eat Right. Your Way. Every Day," focusing on the choices we all make each and every day in regards to our diets. There is not a set in stone diet that is appropriate for every individual, nor is every day going to be a model of optimum nutrition. Rather, it is about making healthier choices and, overall, consuming a balanced, varied diet.

NNM has been a switch for me this year. I've been accustomed to being a NNM champion during undergrad, organizing promotional materials, booths, activities, etc. This year, my only involvement has been assisting in planning a health fair for hospital staff, patients, and families with the other interns. Irregardless, it should be fun, and it is nice to have a bigger budget for materials and giveaways. :) The fair is today, which is appropriate given that it is also RD Day!

So, here's to nutrition, health, and dietitians! Next RD Day, I'll be able to celebrate for real!
 

A season of reflection

     Maybe it’s the weather. Maybe it’s because we are in the season of Lent. Maybe I’m just worn out from everything. Maybe my brain is overloaded from being in 7 different high-level care areas in 7 weeks. Maybe I’m overly anxious because I have no idea what my life holds after June 8^th. Maybe it’s because I’ve at long last reached my almost-breaking point. But, I’ve been in a funk for the past week or so, and have honestly felt alternately depressed, inadequate, down on myself for feeling these things, questioned my choice of careers, and then am once again back to normal. Nothing like roller coaster emotions! While I’m not sure what’s been going on, I know that having a low-key weekend has helped immensely, the snow and sunshine are lovely, and being outside truly makes Martha a much happier person.

     I don’t mention these things to be a downer, or to draw attention to myself, or to make you all start thinking something is terribly wrong with me. Because, quite simply, none of these things are true. Rather, as you all know, I’m an honest person and I also know that many people struggle with similar things on a regular basis. So, in sharing my struggles, I hope to encourage those of you who have been feeling the same way. We are normal, I promise! And, best part is, God is still in control, and loves us even though we truly are a mess (even at our finest moments).

     Enough of my philosophizing. Time for updates all around! Lots of rotations, per my usual. J

Pediatric ICU Once again, I LOVE peds! I enjoyed being able to complete assessments of older kiddos (versus the tiny neonates), observe a new diabetic education for a young child, do an obesity education on my own, and interact with the peds care teams. I was once again reminded of how important it is to build camaraderie with patients, considering myself successful when I cracked a smile out of a previously stone-faced teenaged male patient. And, as always, the RD’s in this area (as in every area I have been in) are absolutely amazing. I only hope to one day be as knowledgeable as they!

Behavioral Health Off to psychology! I chose this rotation because I’ve always been interested in eating disorders (EDO), and UIHC has both partial and in-patient programs for EDO. Substance abuse and in-patient psychology are also part of this area, but the primary focus was EDO. Even though I was not as involved in counseling and assessment (due to the nature of EDO treatment), I nonetheless learned so much about EDOs and this patient population. It was interesting to see how interviewing, presenting information, etc., have to be altered in this area, due to the many other diagnoses and issues experienced by these individuals. Truly, my heart was daily saddened at what I observed (especially with the young patients) and the hurts that were visible on these patients’ faces from past abuse, neglect. etc.  In the end, I’m thankful that individuals seek treatment from these disorders, and that dietitians are able to help them restore their bodies.

Medical ICU Shocking, I know, another ICU. J This ICU is an incredibly busy area, admitting patients with conditions such as diabetic ketoacidosis, lung conditions, substance abuse, etc. Always changing and ever challenging. Naively, I didn’t realize that lung disease was such a common issue, or overdoses either, for that matter, but this rotation opened my eyes to both. The MICU dietitian was a nurse before becoming an RD and thus is a great teacher for how to physically assess patients (examining hair for nutrient deficiencies, examining skin for edema severity, etc.). Also, given that she has a minor in biochemistry, she has immense physiological knowledge, which I thoroughly enjoyed. I just wish I could have soaked up more of her wisdom!

Surgical Cardiology My last clinical rotation before staff relief! Looking back, I wish I would have done more cardiology, but I honestly didn’t think I would enjoy it and thus didn’t pursue it at the time. However, I really enjoyed this area and am glad for the knowledge I was able to gain. The surgeries done at UIHC are intensive (left ventricular assist devices, coronary artery bypass grafts, heart transplants, ECMO, etc.) and dietary precautions with such patients follow suit. Many biochemical, medication-related, and lifestyle factors to consider, resulting in challenging and yet rewarding assessments.  I was also able to interact more with the diet techs and menu system, which made me feel like I was able to make more of a difference in these patients’ lives. Additionally, my RD previously worked in renal for many years, so I was glad to be able to gain even a little of expertise in this area. Oh, and, the other cardiology dietitian’s name is Martha. Enough said.

      As much as I enjoyed these rotations, in the last three I particularly noticed a common theme: Lack of hope. From my EDO patients who were struggling with so much, to my MICU patients who tried to overdose one or more times, to my cardiology patients who (often) had been making poor lifestyle choices and now have to deal with the consequences, I’ve been left daily pondering just how much these people need Christ. Don’t get me wrong, I’m not saying that I think we need to overtly evangelize while treating patients, or that medical treatment isn’t necessary (because it is). What I have realized is just how dark, dreary, and, at the cost of being repetitive, lacking in hope this world is without Him.

     So, friends, I encourage you to ponder just how much Christ has given us, even in the little things, and realize how completely lost and helpless we are without Him. That’s what Lent is for, reflecting on our absolute depravity and need for God’s grace. During this season, I charge you to reflect on these things, looking forward to the celebration of our Savior’s resurrection.

      Staff relief starts tomorrow! I’m blessed to have received my choices, which consist of two weeks in NICU and two weeks in in-patient peds. I know it will be intense, I will be doing lots of research at home, and I will be daily (and hourly, for that matter), challenged. However, I’m still excited for this opportunity to learn and gain more experience in these areas.

P.S. I ran a 4 mile race today, the Chili Chase in Davenport, IA, in a little under 34 minutes (not sure of the official results yet), which was under my goal time. This was probably due to training with someone who runs significantly faster than my usual speed. Yay for a running buddy! In the end, my time was good enough to be in the top 40 women finishers and receive a sweet new stainless steel travel mug to that effect. Perfect for use during my 7 AM mornings in the NICU. J

Rotations, Rotations, Rotations

1) I am in denial of the fact that I am already three weeks into this semester. Time flies!

2) As usual, I’m behind at updating on my rotations…which means I’m now restricting myself to one paragraph per rotation due to having five (yes, five) on which to report.

      To give you a better understanding of my life this semester, we change clinical rotations each week for seven weeks this semester, which is great due to giving lots of experiences and challenging due to switching areas every five days. I’ll start staff relief in February (so excited!), but more on that when it happens.

     So, here are my brief synopses on my rotations as of late:

Production/Catering 

This rotation was just as it sounds, with lots of hands-on work in the kitchen, primarily due to being there during the holiday season. We also were able to see cook-chill, a unique operation in which food is cooked, bagged, rapidly cooled in special equipment, being then able to be safely stored in refrigeration for a few weeks. My fellow intern and I were also able to assist with catering functions, work on cost analysis and new ideas for daycare menus, observe the receiving process of food items, and many other tasks (such as pre-plating holiday meals for 500+ people. No big deal). Additionally, five other interns and I planned, prepared, and hosted a holiday appreciation meal event for the Food and Nutrition Services workers. Our theme was Candy Land and it turned out splendidly. Even better, Child Life Services at the hospital are going to use all of our decorations for the pediatric patients!

Mother’s Milk Bank of Iowa
Each intern at UIHC has the opportunity to spend a week at the Mother’s Milk Bank of Iowa, a facility of UIHC in which donor breast milk from eligible nursing moms is procured, properly stored, pasteurized, and shipped to neonatal intensive care units and eligible infants across the Midwest. I was able to pasteurize milk, assist with packing milk for shipping, learn more about milk banks, and help “log” milk (a system for keeping record of how much milk is donated per donor, how much donor milk is on hand, etc.). Before this rotation, I didn’t realize that such operations were unique (only 11 in the United States) and governed by strict food safety protocol and contamination checks. Overall, however, I now understand how important milk banks are for infant health. The benefits of breast milk are numerous, and through MMB, premature infants (whose own mother’s milk may not have come in yet or who have inadequate milk expression for their baby’s needs) are still able to receive all of the benefits of breast milk.

Sidenote: Please “like” the MMB of Iowa on Facebook! Such establishments truly save lives and getting the word out that MMBs exist is important.

Outpatient Nutrition Clinic
My first rotation of 2013 was at the outpatient nutrition clinic, now housed at Iowa River Landing (the new outpatient clinic for the University of Iowa). Even though it was a slow week while I was there, I was still able to observe the two outpatient dietitians counsel a variety of patients. I also completed my first solo diabetic education, so I was pretty excited. J I really enjoyed seeing patients from so many different walks of life, and, as I have mentioned before, assist them in changing their lifestyles to healthier behaviors. Even though many individuals are referred to such clinics by their physician, I still feel that they are farther along in their readiness to change than someone who is recovering at the hospital, making the educations much more personal and in-depth (due to greater availability of time). Also, the outpatient dietitians are true educators, appreciated and valued by their clients. I was able to learn so much through observing and working with these R.D.s.

Trauma/Burn
Definitely a switch from outpatient, but interesting nonetheless. UIHC has a specific intensive care-style unit for burn patients, in which hydrotherapy (cleaning of the wounds), excision of the wounds, etc., are all performed. Due to my naiveté, I didn’t realize the prevalence of frostbite, with my week in this unit consisting of many assessments of individual’s with TMAs (transmetatarsal [toe] amputations) and leg amputations. Also saddening, I followed some pediatric patients, who sustained burns through freak accidents and common home happenings gone wrong. Definitely an intriguing patient population, one with heightened calorie and protein needs, which is great for an R.D.! I do enjoy helping people find more foods to eat instead of encouraging moderation and restriction.

Neonatal Intensive Care Unit (NICU)
I finish my NICU rotation tomorrow and truly am left in awe of what I have seen in this unit. Babies that are as young as 24 weeks gestation are admitted to this unit and treated until they are able to go home and continue normal growth and development. While most all of the infants are premature, some are also term babies who have genetic abnormalities, critical health conditions, etc. Nutrition is, obviously, a huge component of proper growth and development, making the two R.D.’s who work in this five bay, 76 bed unit an integral part of the care team. Truly, these women are absolutely phenomenal and I am beyond impressed with their clinical knowledge, judgment, and ability to assist in treating these babies. Not possessing previous exposure to premature infants, it had not occurred to me that they are unable to consume foods orally for some time (due to having immature sucking reflexes), thus necessitating enteral (into the gut, if it is medically appropriate) and/or parenteral (into the veins) nutrition support. The calculations for such recommendations are, shall we say, complicated, and so many factors must be considered that are not as critical in the world of adult nutrition. However, I have absolutely loved this rotation, probably due to its complexity and the necessity of a strong science background in order to properly assess and help treat these “kiddos” (what the patients are fondly called on the unit).

      As always, I’ve managed to bore you all to tears with my lengthy updates. ;) Now, onwards and upwards to the pediatric intensive care unit (PICU) next week! Oh, and, our grad classes start again this upcoming week, too. Busy times in the life of a UIHC intern. :)

My 2012

What is a blog if it doesn't have an end-of-the-year recap? This past year was undoubtedly one filled with more changes, challenges, opportunities, and decisions than I could ever have imagined. I am definitely blessed beyond measure, which, while sometimes making me feel guilty, makes me ever-grateful for my heavenly Father who has given me these things to enjoy. God is faithful. So, here's to 2012!

My 2012 Top 12 (in no particular order, I might add)

Graduation Four years of learning, friendships, memories, and being molded into who I am today. How am I old enough to have a bachelor of science degree?!?!

April 1^st, 2012 A day that will live in infamy. I was accepted to the dietetic internship at the University of Iowa Hospitals & Clinics!  (Go Hawks! J)

Moving to Iowa City Settling into my adult life by moving everything I own minus some books and my American Girl doll to my new city.

Joining One Ancient Hope Presbyterian Church. God has providentially, as always, placed me in a church that I can serve and grow. My faith in the body of Christ has been restored.

Enjoying existing friendships Self-explanatory, but I can’t be thankful enough for these people! You know who you are. ;)

Making new friends Moving to a new city is cool and all, but, if it wasn’t for the gracious people who have let me become a part of their lives, I’d be pretty lonely.

Being in my first wedding It was such an honor to be in the wedding of my dear friend, who was also my former roommate and lab partner. I’m just glad my decorating skills were (surprisingly!) up to par.

Running the Chicago Marathon A challenge I didn’t realize was really that great of one until after the fact. After running 26.2 miles, why do I now struggle with a 3 mile run?

My grandparents moving to Aledo What I’ve wanted to happen since I was little finally has come to pass! I’m excited to see more of them as this year progresses.

Scholar Week Celebrating four years of hard work with the best cohort and faculty anyone could every request. Being able to present my research was definitely an honor.

Road Trips Spring break in Arkansas, a post-graduation trip out West, senior ladies retreat in Michigan, weddings across the Midwest. Fun times!

Hy-Vee Career Day Not only a great experience, spent with one of my favorite coworkers, but also an opportunity to see where my education and talents can help serve other people.

I am anticipatory of where God will take me this year. We'll see if it's another 2012. "I know not where He leadeth me, but I know with Whom I go." With that behind me, how can I help but be excited? No room for worrying about RD exams, grad school, getting my first real job...right? Right.


 Wishing you all the best, my friends, as we enter this new year.

That’s why I say thanks, every day

Have I mentioned yet that fall is my favorite time of year? Well, it is. The colors, weather, flavors (yay pumpkin!), Thanksgiving, and everything else about it make me one happy person. Not that I try not to be happy on an everyday basis, but, you get the idea. J

And, two days ago, Thanksgiving was celebrated throughout the country and beyond. I like this day, one that calls us to remember just how blessed we are, even in the worst of times. However, every time I see a challenge to “remember one thing you are thankful for each day,” etc., I can’t help but be dumbfounded. Because, what do I have NOT to be thankful for? And I mean it! In every instance I can think of, there is always something to for which I can be thankful. Stressed because of work/interning/homework? Well, I’m thankful that I have a job (and one that I love), I’m able to learn from knowledgeable dietitians at a top hospital, and I’m able to learn how to better serve people. Annoyed because it’s raining when I have to walk to the hospital? Well, we need the rain, and it breaks up the scenery.  It just takes stepping back for a minute to see these things. I’m not saying it’s easy, but I am saying that I think it’s important to do so.

On that note (and now that you’ve all labeled me as officially an incurable optimist), here are a few specific things that my age is allowing me to see just how thankful I am for them, many of which I never realized were so special until now:

My parents-Not anything out of the ordinary, I know, but I realize more and more each and every day just how thankful I am for my God-fearing parents, who have and continue to sacrifice so much for me. I’ve never doubted that I am loved, full of worth, supported in my decisions, and created for a purpose. My parents raised me to be confident, responsible, to serve others, and, most importantly, to love God. What more could I ask for?

My family-Sorry, fam, but I thought the parents deserved a special spot. ;) But, I am still immensely blessed to have such amazing brothers, sisters, grandparents, aunts, uncles, and cousins. From having someone to play hotel with me in the tree cave to being able to read them stories to being able to share everyday life, I’m thankful for my siblings and wouldn’t trade them for anything. And, I am ever-thankful for the love shown to me by my extended family, who visit me, send me cards (and pictures!), and have always been an encouragement and integral part of my life.

Friends-New and old, I’m thankful for you! For being with me through thick and thin, to Arkansas, Narnia, Idaho, and back again, surviving 5 semesters of chemistry, for inviting me into your home(s), letting me be my nerdy, organized self, and putting up with my sometimes food and nutrition-obsessed talking points, I thank you. I’m glad we’re on this journey together.

Professors-For those who have and continue to invest in me, I am thankful. I wouldn’t be who I am today without them!

Iowa City-Even though I’ve only lived here for a few months, I absolutely love this town! The people, landscape, location, everything. I’m excited to become more involved in this community.

Peanut butter-I know, a little less serious, BUT, I am glad that someone was inspired to grind up peanuts and eat them! My diet would be drastically changed if there were ever a peanut butter shortage.

Masterpiece Theater-I probably wouldn’t watch TV-ever-if it wasn’t for Masterpiece on PBS. Downton Abbey, Foyle’s War, Call the Midwife, you name it; I’ve probably seen it and enjoyed it.

People-I love nothing more than talking to, spending time with, and getting to know people. I’m thankful that my work allows me to do these things each and every day.

Redeeming grace-Where would I be without this? And, I’m even more thankful for the fact that I have absolutely nothing to do with it, but it is a free gift.

I could go on for a really long time, but I think you all get the idea. Be thankful. Always. And don’t forget it!

P.S. Did anyone catch the Veggie Tales reference? Madame Blueberry, anyone? J

Back to where it all began

You know those times in life when everything falls into place all at once and you’re left being decently confident of what you’re meant to do in life? Well, I’m pretty sure that has just happened to me in the past week. Now that I have you all curious, I’ll proceed to my story. J

For the past ~3 weeks, I have been in outpatient bariatrics and have absolutely loved it. I like inpatient, I really do, but my passion for preventative healthcare has been revived this fall. Even though OP Bari is comprised of a lot of rules and more “black and white” nutrition recommendations, I really enjoyed the experience. Being able to counsel and educate individuals who are pondering and/or in the midst of making lifestyle changes is encouraging and it was great to see how some patients’ lives are completely changed through weight loss. I am able to see much more clearly just how multi-faceted the “obesity epidemic” is in our society and how debilitating this disease can be to an individual’s health and well being. I’m thankful to have had the opportunity to work alongside my preceptor to help change lives. Side note: I was also able to observe surgery (a roux-en-y gastric bypass) during this rotation. Yes, I was in the OR. In scrubs. Awesome, I know.

So, aside from being able to be involved with patients on a less acute, more personal level, I have also been pondering my path for next year, as I know that June will be here before I know it. Recent classes, conversations, etc., have all confirmed to me that my skill set, personality, talents fit best in a community nutrition setting, which is ironically where this 5+ year journey began in the spring of my junior year of high school. I left the two-day Iowa Academy of Nutrition & Dietetics (IAND) conference today revived and excited for the future of my profession, particularly as our society as a whole combats health crises and complicated food systems. Programs promoting community gardening for kids and encouraging greater vegetable consumption are current areas being implemented and are areas in which I can see myself flourishing. Additionally, pursuing a master’s in public health (MPH) has also been in the back of my mind for some time, especially given that I am currently connected to the University of Iowa College of Public Health through my internship at UIHC. And, every day at work confirms that I love HyVee and want to stay there.  Oh, and, last but certainly not least, I am incredibly blessed to have found a church that is passionate about serving the local community, one through which I am able to be encouraged, find community, and also serve others. All these factors combine to make me desire very much to stay in Iowa City.

That being said, the past week has provided me with many networking opportunities, covering grad school options, possible TA/GA opportunities (which would mean my grad school would be paid for or substantially reduced in price. And, I would get to teach again!), career opportunities once I complete my internship, etc. Encouraging times, to be sure. God has truly answered my prayers for direction and I am excited for what the future holds.  I’m thankful for what God has placed in my path and for the peace I feel in making these decisions. Nothing is for certain, and I know that doors could be closed. However, at least I know where to direct my efforts. At least for now.

My production/catering rotation begins on Monday! I’m excited to be reunited with my former kitchen worker self.  I’ll be sure to provide an update… once I remember how to find my way down to the kitchen. J

calm

As many of you know, I did something crazy, difficult, and altogether worth it two weeks ago. On October 7th, I, along with 40,000 other people, ran the Chicago Marathon. The experience was better than any I could have hoped. The weather was great, the course varied and well designed, I ran the entire way, and I finished in my goal time (4:20:07). I was only sore for two days afterwards and I think it is only now that the fact is sinking in that I ran a marathon. 26.2 miles. I never doubted that I could do it, but I never really thought about it being, shall we say, a big deal to actually complete the race until now. I was honored to be able to run the race with ONU friends, with the combined fundraising efforts of Team World Vision being enough to provide clean water for 64,000 Africans! God is so good!

As I already mentioned, the social aspect of being back in Chicago was great. Thanks to the hospitality of my dear college roommate, I was able to stay in the city and visit with other college friends. We were even able to have lunch with my newly-moved-to-Chicago brother. Score! Before and after the race, it was great to catch up with even more friends who are currently students at Olivet. A good weekend, for sure. And, the two tests that I had right after arriving back in Iowa City went just fine, in spite of my worries given the busy weekend devoid of studying.

Because I love pictures, here are a few for you to peruse. I know you want to see me in all my athletic-ness. :)

 

 Science major honors kids rock marathons :)

 

 

 In April, I convinced this girl to run the marathon with me. And we did it!

 

 

Sightseeing at Loyola with dear friends

 

So now, two weeks post-marathon, I find myself in the midst of trying to rediscover Martha. Now, don't go thinking I'm depressed or something of that sort, because I am not. I'm still the perky person you all know and (hopefully!) love. However, whenever I have finally completed a season of extreme busyness and stress due to homework, projects, rotations, marathon training, work, lack of sleep, etc., I have to step back and get used to normal life again. And it's always just a little bit weird. I have to remind myself that it is okay to sleep, a schedule of priorities is not needed at all times during the day, and I don't have to be actively doing something every waking second. Don't get me wrong, I still have plenty to do and keep me busy, but in comparison to previously, this seems like a lot less. I'm thankful for these times, even though they are almost more difficult for me than the crazy busy ones, because they remind me that I am very much a Martha, which can be a weakness even while it is a strength. My worth is not based on how much I get done and how busy I am. I am not being lesser of a Christian or person for actually having unplanned- and unspoken for free time. Quiet is good. After all, God rested on the 7th day. And Martha can, too.

 

In internship news, I finished my neuro rotation on Friday, which was a great experience. Due to circumstances at the hospital, it worked out that I was able to cover the floors by myself for about half of my rotation. My preceptor was still available for questions, etc., but I was flying solo for 4-5 days of my 9 day rotation. I've found that I tend to learn better by doing things on my own, so this worked perfectly. My next rotation is outpatient bariatrics, in which I'll get to watch surgery and be involved with more individual counseling. I'm excited!

 

There are other musings and thoughts going on in the mind of Martha right now, but more on those later. Maybe once something comes out of them. We shall see...

 

Have a fabulous Monday, my friends!