That Time I Became A Registered Dietitian: Part 2

This is part 2 of how I became a RD.  If you missed part 1 check that out here.  Continuing on…

Pediatrics:

I did a two week rotation at Children’s Medical Center in Dallas.  I was with two of the outpatient dietitians during this rotation. The first week I was in the GI clinic (the dietitian I was with worked specifically with kids with short bowel syndrome).  We did a lot of calculations because almost all of these kiddos were on enteral or parenteral nutrition support.  The second week I was in the metabolic clinic.  Now this was a really interesting week!  We saw mostly PKU (Phenylketonuria), MSUD (Maple Syrup Urine Disease) and Galactosemia kiddos. Most of this week was spent going over their lab values with them/their parents and adjusting and calculating formulas.  I also unfortunately saw what happens to these kids when they don’t follow their diets (these are inborn errors of metabolism and they are treated with diet). I REALLY enjoyed this rotation. When you work in pediatric nutrition you really get to specialize and I like the idea of that.  I only wish that I could have seen more inpatient stuff during this rotation! 

Long Term Care:

My long term care rotation was two weeks long and I was at Good Samaritan Society for this rotation.  I was honestly kind of dreading this rotation before I started it.  I thought it was going to be very sad and depressing but it wasn’t at all!  The facility that I was at was also a little retirement community with houses and apartments as well as a rehab facility.  I think that this really helped make this rotation enjoyable.  The people that reside at this facility are some of the most spunky and fun loving people.  They have all kinds of activities for them to participate in and they come and go in the dining room that is close to the dietitians office so I got to eavesdrop on lots of very interesting conversations!  These weren’t the people that I was assessing for nutrition related problems, but they really made the facility interesting and made the rotation kind of fun.  It also doesn’t hurt that I kind of love old people. I always say it’s because I was born an old person though. ;)   Anyway, I ended up really enjoying this rotation! 

Community Rotations:

We do several weeks of community rotations.  Everyone does a one week WIC rotation.  The others we get to choose where we go.  My other community rotations were at Cooper Clinic, Food and Fitness (private practice) and Davita Dialysis. 

WIC: I’m going to just be honest and say that this wasn’t my thing.  I don’t want to bash it because a few of my fellow interns absolutely loved it.  But it was my last rotation and the clinic was about 5 minutes from my house so I really can’t complain.  I did learn a few things that I didn’t already know and that’s the point of the internship rotations so I think we could call it a successful rotation!

Cooper Clinic: I was at Cooper Clinic for a one week rotation and I loved it! I had a few projects while I was there including writing this article that was published on their website and a really fun project at the grocery store down the street! I also got to sit in on a lot of nutrition counseling sessions with the dietitians in their medical clinic.  This was a really fun rotation and the campus is beautiful! 

I also spent a week at Food and Fitness. This was with a local private practice dietitian.  Interesting things in this rotation include giving a hydration lecture to a running group and learning how to put together a whole body strength workout.

My last community rotation was at Davita Dialysis and it was a 2 week rotation.  I drove all over creation for this rotation (2 hours one way!) but I enjoyed it! I learned a lot of in-depth information about renal nutrition that I will definitely be able to utilize during my career as a clinical dietitian. I also had a great preceptor so it was a fun rotation!

Enhancement Rotation:

In my program we get a one week rotation of our own choosing.  We can go anywhere we want for this rotation.  I chose Nutrition Support at Parkland Hospital for my enhancement rotation.  I spent the week with their ICU dietitians in a different ICU each day including the burn, surgical, neuro, cardiopulmonary and medical units.  I adored this rotation! This is a really cool/diverse hospital and I loved being here!  I’ve always thought that I wanted to end up working with trauma patients and this rotation definitely confirmed that for me!  I really love working with patients with wounds the most.  I I especially adored my time in the burn unit and could really see myself working with this type of patient.

 

That’s a wrap!  Well I believe that’s all as far as my internship experience goes!  While I didn’t love every single rotation I tried to make sure to remember that it was a learning experience and that was what I was there for, not to have fun (though some of my rotations were a lot of fun!).  I also tried to be fair in my review of them because even though they may not have been my cup of tea, they are someone else’s career and passion so I would never want to put that down. 

Some of you who might be reading this may be thinking about becoming a registered dietitian or are in the process of applying for your dietetic internship.  I hope that this kind of gives you an idea of what an internship is like (remember that every internship program is slightly different).  If you have any questions about my internship experience or even about internships in general let me know!  My email is sarahsnacks@gmail.com I’d be happy to help the best I can!

Also, I know I said this was going to be a 2 part post, but I am going to extend it to a 3 part post because I also want to talk a bit about taking the RD exam.  So stay tuned for part 3!!

See you soon!

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That time I became a Registered Dietitian: Part 1

Well hello there!  It has been a VERY long time since I have blogged!  I decided to put it on the back burner while I went through my internship.  It was a very busy time and I really needed to focus just on that!  But guess what?!  I finished my internship.  I took my RD exam annnnndddddd… I PASSED!!!  I’m now officially a Registered Dietitian.

 

I’ve talked on here before about the path I have taken to get to my Dietetic Internship.  Like when I finished my second bachelor’s degree and got matched to my internship.  Well, here’s my catch up internship post!

 

So my internship was in total ~16 months. But really I don’t tend to count the first year of the internship since I was just taking graduate courses. I start count when my actual rotations started, so that was about 6 months.  So here is kind of a summary of my internship rotations… I’m going to split this into two parts so that it’s not quite so long of a read.

So this was my very first day of rotations.  Just look at the excitement on my face… so naive hahaha.

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Food Service Management:

I did a 6 week food service management rotation (mine was at Medical Center of McKinney) which involved some production and lots of management-y assignments like feasibility studies, business plans, a special catering event that I got to be in charge of (mine was a heart healthy black bean burger that was a HUGE hit!  p.s. I’ll post the recipe here soon!), inservice presentations, time and motion studies and plate waste studies just to name a few things.  I met some really great people during this rotation and I got to cook up a storm in a really big kitchen!

This was the first time I had to be there at 5am for production. Wearing a beautiful blue bonnet. With business casual attire.  Good times.

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Why did they let me have a knife at 5 am?

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I got to do a few newsletters for the department.  The best part was that I got to include my own recipes in them!

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And here’s my beautiful black bean burger from the 4th of July event that I was in charge of! I made every one of the black bean patties by hand!

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Clinical:

My clinical rotation was 11 weeks and I was at Baylor Regional Medical Center of Grapevine for this rotation.  This was by far my hardest rotation, but I LOVED it!  My preceptor was tough, but really amazing- I learned so much!  There were a lot of case studies and small assignments to do during this rotation but those were all done outside of my rotation hours.  During my rotation hours I basically got to be a clinical dietitian.  Every day I would get a certain amount of patients that I would go see.  I would assess them and make my nutrition  recommendations based on a variety of factors (disease state, lab values, etc).  I saw a lot of very interesting people during this rotation and oh how I wish I could tell those stories!!!  But ya know… HIPPA.  I saw a little bit of everything in this rotation including trauma/ICU, oncology, kidney disease, diabetes, wounds, cardiology, GI problems, tube feeding, parenteral nutrition, pulmonology and I even got to spend a little time in the NICU (oh how I loved those teeny tiny little NICU babies…. I was awed by their strength and how hard they fight).

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Prepping for my BIG case study presentation.  This patient that I had was quite interesting!  And I got to talk a lot about fecal transplants in this presentation. And if you know me but at all, you know I love talking about poo! (I know… there is something wrong with me)

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TPN calculations… and lots of em (especially when I was in Oncology and ICU)!

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Also, I love the heart health initiative that the Baylor system has.  The food in their cafe is actually healthy!  And they post nutrition information, so I knew that the baked mac and cheese that I loved so much only had 250 calories in it! (no but for real, this mac and cheese is to die for)

 

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Don’t forget the homework dates at starbucks with fellow interns!

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All of my case studies and competencies from this rotation!

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And there was lots of this!  Did I mention that this internship was REALLY stressful!!!

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Those two rotations were my longest and most time consuming rotations.  And I think that’s where I’m going to leave you for part 1.  I don’t have as many pics from my other rotations, so I’ll sum up the rest of them in part 2!

See you soon!!

Rare Disease Day… living with a degenerative eye disease.

Rare Disease Day

 

Today is Rare Disease Day.  Let’s share to increase awareness!

Not everyone that is suffering from a disease looks like there is something wrong.  Eye diseases are one of these.  I don’t share my story often because I think people really don’t understand because it doesn’t look like there is anything wrong with me.  I find that more of a “yeah yeah yeah, I have bad vision too because I wear glasses/contacts” kind of thing happens.  But in honor of Rare Disease Day I thought that I would share my story just a bit.  And I’ve also been posting a bit more about it on Facebook because of the Olympics (Olympic Bobsled gold medalist Steve Holcomb has the same eye disease as I do).

 

I have Keratoconus, a degenerative eye disease.  I think it’s questionable if it is actually in the rare category (though the actual numbers would put it there) because many people have it that are undiagnosed.  Which is why it is so important to share and increase awareness!!  Also go see an ophthalmologist or a therapeutic optometrist NOT a regular optometrist (they will only check your vision not your eye health!  This is why so many people don’t know that they have KC!!)

 

What is Keratoconus?  It is a condition in which the normally round dome-shaped cornea progressively thins causing a cone-like bulge to develop. This results in significant visual impairment.  It’s also degenerative, meaning it will continue to progress and deteriorate over time.  The cause is still unknown.  Genetic? Maybe…  Environmental? Maybe…

 

Everyone with Karatoconus is different.  Some will stabilize a bit after 10-20 years and some will go blind (like Steve Holcomb).  Some with Karatoconus (KC) have it in only one eye, some in both.  Mine is much much worse in my left eye than my right.  

I also see shadows and halos in both eyes and have double vision in my left.  It also makes my eyes extremely sensitive.  To everything.  I have terrible eye allergies and being out in bright sunlight makes me nauseous.

It makes all of the simple things like driving, watching TV and reading extremely difficult.

 

This is a pretty good example of how I see:

 

Night is very difficult because of the halos.  It’s exhausting to drive at night because I have to concentrate so hard on just being able to see the road.  Brake lights and headlights in traffic don’t help.  I have to squint very hard which helps a little with the halos, but it is even more exhausting.

 

Treatment…  there’s not much that can be done that is non-invasive.  They try to fit you for hard (RGP) lenses at first.  There are a few new soft lenses out there (sclerals and hybrids).  I’ve tried them all.  None of them work for me.  My eyes are completely intolerant to contact lenses.  There are also intacts (implanted prescription inserts).  A lot of people have success with intacts (there is no cure for KC but they can help with your vision distortion) but the procedure is very expensive and not covered by many insurances.  Then there’s the corneal graft (AKA the corneal transplant).  That was the only option besides RGP lenses when I was diagnosed…. scary huh?  There’s a new procedure that is seeing great results at halting the progression of KC, but it’s CRAZY expensive (corneal crosslinking- CXL) and not yet approved by the FDA.  Lots of clinical trials going on right now with CXL.   

 

As for me… Right now I wear glasses and do the best that I can.  There is a clinical trial that I would really love to get involved with but right now is not the time unfortunately with my internship.  I had two really good visits with my eye doctor and haven’t had to go to the cornea specialist in a couple of years because of that.  However, you can be stable for a long time and a stressful or traumatic event can trigger progression all of the sudden.  I have definitely felt some changes to my eyes in the last month.  My internship is stressful to the point that I have to tell myself daily that I don’t have time for a nervous breakdown right now and that I just need to go into survival mode and keep it together.  I will definitely need to go back into the cornea specialist soon to investigate. 

When I am having an extremely bad eye day I tend to feel sorry for myself and have been known to throw the occasional pity party.  But most of the time I’ve really just learned to live with it and make adjustments to compensate for my vision problems.

I feel hopeful with all of the research going on right now (and the disease being brought to light for the general public by Steve Holcomb) that an actual treatment (or dare I say CURE) will be accessible for the normal folks one day.

 

Well, that’s my story.  I didn’t mean to ramble about it, but since I don’t talk about it much I apparently had lots to say!

California Lavash Giveaway winner!

Hey everyone, I apologize for my tardiness in posting the winner, but we’re headed into finals here and it is a majorly crazy/stressful time!

I had www.random.org choose a winner for me from the entries in the comment section and congratulations to Renata for winning the giveaway!!!

Renata, I just sent you an email.  You have 24 hours to get back to me or I will have to pick another winner.  Congratulations again!

 

Sarah

Triumphant return and a giveaway

Let’s pretend this is my triumphant return to blogging, okay??  Unfortunately a stack of books is pretty much my life right now.  But I absolutely had to take the time for this post!  Mostly because I have a giveaway for you!!!

So if you know me at all or have read this little mess of a blog you know I LOVE Lavash wraps!!  And there’s a certain company of Lavash wraps of which I always sing their praises.  So when they contacted me out of the blue and offered me some samples and a sample pack for me to give away I said ABSOLUTELY!!!  I don’t usually take free products on the blog to review.  Mostly because I feel like a lot of bloggers have turned their blogs into one giant advertisement.  But when a company I love with an outstanding product that is so SUPER healthy asks if I want to give away some of their products to one of my friends on the blog of course I’m going to say yes!

California Lavash is my absolute favorite brand of lavash wraps.  They’ve recently gone through a rebranding.  They are now officially certified non-GMO and they also repackaged their products to make them easier to store without getting squished. 

So here’s what they sent me (and whoever wins the giveaway will get the exact same thing):

 

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I got a tote bag (which I’ve already taken grocery shopping with me- it looks small but it really holds a lot!). 

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I also got four of their amazing lavash flatbreads.  I got the garlic olive oil, traditional, spinach and whole wheat.

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You can do an almost endless amount of things with these nifty little wraps.  But here are a few of my favorites (in no particular order)…

 

The hummus wrap!  Spread flatbread with hummus, sprinkle with cheese, a few dashes of Frank’s hot sauce, place into a hot skillet and brown up on each side.

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I served mine up with a cup of tomato soup.

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I also made some super tasty crackers.  Just cut them up into cracker sized squares.  Then I spritzed them with a little cooking spray and sprinkled on some of this deliciousness from a  Trader Joes sugar, chocolate and coffee bean grinder.  A cinnamon/sugar combo would also be delicious.  Or you could go savory with some salt and pepper or a little parmesan and Italian seasoning. 

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I also made another nice little wrap with one.  I slathered on some hummus, some hickory smoked tofurkey slices and then piled on the veggies.

 

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Then I played around with the garlic and olive oil one.  This was one variety that I hadn’t tried yet.  I loved this one because it’s thick, fluffy and a little bready.  And it was PERFECT for a panini style sandwich!!  My panini had hummus, sharp cheddar, sautéed kale, onion and mushrooms.  It. was. amazing!

 

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And last but certainly not least, the flatbread pizza! mmmm….

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So now here’s the part where you win some free stuff!!!  The winner will get everything that I got- the tote, and the 4 different kinds of flatbreads.

 

Who wants some?  Come and get it!!!

To enter simply leave me a comment in the comment section below!  For one extra entry tweet or facebook about this giveaway (use the share the love buttons below!) and leave me a separate comment letting me know that you did!!   The giveaway will end 11/20/2013 at 8:00 pm central time.  At that time a winner will be randomly drawn and will be announced the next day!  Good luck!