Nutrition to the Rescue!

Yesterday was our second and final day with ServSafe. We took the test (wasn't too bad) and just waiting to hear back about the results from Chicago!
Lately I have been working on my project for our Lunch&Learn at St. E's that will take place the week before our Thanksgiving Break. I have decided  to do mine on wound VACS (vacuum assisted closure therapy).
It is a relatively new procedure that is used in many cases; the one that we see the most at St. E's is pressure ulcers. Many people used to die from these wounds they would get (which are essentially extremely bad and open wound bed sores) while they were staying in the hospital. This procedure actually uses vacuum technology to pull and consistently clean an open wound. The vacuum mechanism also pulls the wound edges back together allow it to not only heal when it normally wouldn't heal on its own; but it also heals the wound faster.  Nutrition is a very important aspect of wound healing as many people have come to realize. (CNN named dietitians #3 in jobs saving the world!!!) For example, today I saw an interesting case which is a prime example how protein contributes to wound healing.
I was doing research on a patient with the dietitian I was following and we noticed that the patient who had cirrhosis had a laparotomy (a large incision in the abdomen area) and the incision from this surgery would not heal. When we looked at the patients medications, she was taking Lactulose which is used primarily to neutralize ammonia levels in the body. The high ammonia levels are associated with the liver malfunctioning and can lead to disturbances in brain functioning (encephalopathy). Therefore, the patient had been on a protein restricting diet because protein contributes to ammonia levels in the brain.  Since her protein levels had been restricted, the wound would not heal because of the importance of protein in wound healing.
It always comes back to nutrition!

Is Diet Soda Bad for You?

I am doing this post in response to a conversation we had today with a patient who asked, "Is diet soda bad for me?"  In addition, I love diet sodas so it is a win win situation. This question has been debated for a long time, answers such as "It causes cancer" and "It can decrease fertility". Well as for the first one.. what doesn't cause cancer these days? and for the second one the reasons the "experts" say this is because SOME diet sodas contain caffeine which can, in extremely high, consistent doses, constrict blood vessels and and decrease blood flow to the uterus.  This does not mean that you will not be fertile. There also is this thing called diet, decaffeinated sodas if you are really concerned about that.

There is not credible study that shows that diet soda alone causes cancer. Now if you are washing down a Big Mac and large order of fries with a diet soda... it may lead to health consequences such as high cholesterol, diabetes, etc... however, I don't think that it is the diet soda causing any of these problems.  Another point that is misconstrued  is that "experts" claim that it increases your cravings for other sweet foods therefore causing people to gain weight.  Well if you do not eat these other "sweet foods" then you do not gain the weight! I can tell you that I drink diet soda everyday and I do not go around shoveling down everything sweet I can find. Its about self control; if you are choosing to drink diet soda, I would hope that you are trying to be conscious about other things you eat.  The diet soda ALONE is not going to cause a person to pack on the pounds. Its the actions that go along with the diet soda.  Saying that diet soda and regular soda are no different is an ignorant and misleading statement.  How we know this? LOOK at a soda can.

Here is what I see Diet Coke: No calories, 10 gms less of sodium, 0% carbs, NO sugars, NO high fructose corn syrup or sucrose.
If anyone can honestly read these labels and tell me there is no difference in Coke and Diet Coke, I would love to meet them.
In addition many diet soda companies also make diet soda fortified with vitamins and minerals... I think that has more nutrients than water.

 Now don't take that the wrong way.. of course our bodies need what but if you drink a coke plus instead of water every once in awhile you don't need to feel guilty about it.

Drinking diet soda doesn't make you fat... eating unhealthy foods such as ones high in saturated fat, trans fat, cholesterol, and sodium and have an inactive lifestyle does. Nutrition 101. 

So if you have the choice and want to make a healthier one.. choose diet over regular sodas, if you want to make an even healthier choice drink skim milk or a glass of water.

And that was me on my soap box. Thank you for reading... Have a great day =)

Week two coming to a close

Hello!

I now finished with week two. On Friday we went to Good Sam for our first "Intern Friday". We heard from multiple speakers.  The ODA's (Ohio Dietetic Association) president Cynthia Stegeman spoke with us about the ODA and the upcoming 91st Annual Conference, Empower U, which is actually being held in Cincinnati this year! She drew ten names to get into the conference for free and help out the ODA in setting up, giving out awards, taking pictures etc. and I was chosen! So I save money and I get some awesome networking contacts, sounds like a win win situation to me! The conference is May 17 and 18th at the Hyatt Regency downtown. Our other speaker was Thomas Imhoff a pharmacist at Good Sam. He was an excellent speaker who gave a seminar on Drug Nutrient interactions. He not only was able to tell us about drug nutrient interactions, but he also explained exactly how everything happened in the body. He should be a professor; I learned more in his 2 hour seminar than I learned in most of my classes.
I also got a lot done this week relating to my acute care rotation. I chose my subject for my lunch and learn that I will present in front of all of the dietitians at St. E's which is wound vacuum assisted closure therapy (VAC). I also chose my patient that I will use for my case study, which is a man that I saw who was only 27 and had diabetes type 1, testicular cancer, and a wound VAC. Very excited to have those two projects started.
This week I am back at St.E's Monday Wednesday, and Thursday on the wound and cardiac floors.  On Tuesday I will be attending ServSafe at the Greater Cincinnati Heath Council which is a two day class that focuses on Food Safety.
Should be an eventful week! I will keep you posted!

Taking over the Capitol

Helloo,
Just got home from an exhausting day trip to Columbus that started at 5:30am. To say the least I am tired! We spent the day at the Ohio Dietetic Association conference about public policy.  While we had an extremely difficult time finding out where to park and actually go, it was interesting to hear the speakers and meeting with different members of the House and Senate. We heard a speech from Representative John Carney about the importance of dietitians being advocates for public health to their members of the House and Senate in order to get issues addressed that may be overlooked by members of congress who may not be educated and aware of health issues. We also learned how a bill actually gets passes (very complicated and longgg process).  In addition, we heard from Representative Anne Gonzales who discussed a breakfast school program that she was advocating for to get passed. Children hunger, especially at school, is a very important issue that does need to be addressed. Her pilot program involves each child receiving cereal, milk, and fruit every morning at school.  While it does sound like a good idea on paper, it does seem like waste of the food and allergies to certain food products such as gluten could be areas of concern with this program.  We heard from a couple other speakers and then were able to walk over to the Capitol building and have a tour inside.

The Capitol Building had an amazing ceiling!!

Lindsay and I in front of the Capitol Building

All in all it was an interesting experience but definitely a long drive! I am ready to get back to St. E's tomorrow. On Monday and the next two weeks, I am on the wound care and cardiac floors. Monday was definitely very interesting; I was shown extremely large pressure ulcers and with my weak stomach I almost puked.  These wounds were at least 5 inches in width and 4-5 inches deep on patients' butts! This is why I didn't go into nursing; I thought I wouldn't have to see that kind of stuff! However, I do like the floors I am on and I feel as if I am getting more patient interaction which is what I wanted.  I still have not actually consulted on my own but hopefully I will be ready to do that by the end of this week. Will blog soon!

Have a great day... I am going to bed =)

One week down =)

Hello all,
      Week one was a success.  I am now done with oncology (thank god) and moving on to the behavioral unit! Oncology was a very big eye opener on how valuable your health is (so take care of it!).  I say people who were not ever 40 and had a medical record a mile long.  I feel very lucky that I have a healthy family.
      Super excited/ interested for these next two weeks. The agenda for this week is Monday/Wednesday/Thursday- St.E's. Tuesday I will be attending a conference in Columbus at 8 am (aka leaving at 6 am... wayy too early). Should be interesting though, not exactly sure what all we will do but I am sure it will be a productive day.  Friday is our first "intern Friday" with the Christ and Good Sam interns we will be hearing from a couple of speakers.
      It will be a busy week so I should have plenty to share with you! I better get off to a early sleep so I can be somewhat prepared for this week! 'sweetdreams'

Day 1 and 2 in the Real Deal Completed!

Hello all!
Sorry I didn't get to blog on my first day! All went excellent; however, it is very overwhelming! First this we did was have Epic training (semi complicated system) and then we broke off with our individual dietitians who we are going to be following till the end of the week. I am in oncology, urology, and neurology for this first week which is an eye opening experience. I am beginning to realize that dietitians play a very customized role in each patients situation, for example a cancer patient is going to be assessed and counseled completely different than a patient with diabetes, and you have to adjust your questions and concerns for each situation.  This is going to be very hard to do when we only have a week or two in each department.
I never realized how different real life experience is than actually working in the real setting.  I think I have learned more practical knowledge in the last two days than I had in all four years of college.  I definitely suggest for future dietetic students that UC offers them a chance to do a few rotations in a hospital throughout their college career to get them familiarized with the hospital setting and Epic before they start their internship.
All of  the dietitians at St. Elizabeths' are extremely nice and understanding.  The dietitians go slow and explain each step (which is very helpful with the doctors handwriting in the med recs and when putting information into Epic). They are also understanding when it comes to the fact that I have been there for two days and still do not know how to get to the cafeteria, when it is right next to the diet office. Hospitals are sooo confusing! All of my departments are on the same floor, but I still can't get from one to the next without getting lost. I am supposed to have 25% of the patient load by next week ah :-/ ! Not to mention that, of course, I have been sick for my first two days with a cold. Haven't been sick in over a year but go figures it happens now! Looking forward to the weekend for rest. Will write sooon!

Another day with Rumpke

Vale,
Update on the exciting first week, we went to another Rumpke facility: Rumpke Recycling!  We went on this field trip with the Christ and Good Sam interns so I got to see my long lost friend, Laura =).  Again, a very interesting field trip.

 We were able to tour the recycling facility at Rumpke and see how they separate out all the recycled goods we throw away (some they can take, a lot they can't take).  It was actually a very interesting process and very well engineered. I found out that we are actually not supposed to put the lids of products such as 2 liters, milk jugs, etc. in the recycling. In addition, the numbers on the bottom of products pretty much do not mean anything. They cannot take anything that is a 1 or 2 as many have been told. They can only take plastics that are in jug or bottle shapes. So, no orange juice cartons or butter containers! In addition, no plastic bags, styrofoam, drinking glasses, and metal scraps. I did not know any of this going in, and we learned that many people employed are there to solely there to separate out the items we throw out in our recycling that they cannot accept. We heard an interesting story that some genius in Cincinnati decided to recycle a deer carcass.  What a smart person; it contaminated the plant and all the recyclables; in addition, they had to shut down for a few hours.  Thank you to the smart hillbillies that Cincinnati produces.
       Another interesting side of the tour was what they do with the recyclable products.
-Aluminum cans- sent to the Anheuser- Busch company were they are melted down and reused within a matter of days.
- Glass Bottles- sent to a company that uses them to make fiber glass
- Plastic- sent to a company that make underground plastic tubing
There are more, I just can't think of them right now.
      We also learned that you can take your caps from 2liters and milk jugs that Rumpke cannot accept to some Aveda Salons where they will use them for mascara cases and lipstick cases.
This was a very eye opening experience into what it means to go green.  There are so many uses for products that we can utilize so that our used products do not end up in a landfill.  I will admit I was not recycling before this tour of Rumpke but this experience has definitely changed my mind.

Porter loves recycling.

Excited to start my acute care rotation at St. Elizabeth's Monday! Still so much to do.
Salvete

Rumpke and Dietetics?

Vale All,

Back to the grind! First day of my fall internship... not in the hospital yet, but I will be Monday! All in all it was a very exciting day; I was kind of reluctant at first when I heard that we would be taking a tour of Rumpke dump. However, the tour was very interesting, and I never realized how much planning and engineering goes into the process of disposing of my garbage I throw out everyday. For example, a story out tour guide explained to us is that when the police came to Rumpke this past February to search for evidence in a murder case, the people at Rumpke were able to locate an exact 1 acre area where the trash was dumped on that particular day out of the hundreds of thousands of acres of garbage.

Another interesting sight that we saw on the tour was an area of Rumpke that actually takes the toxic gases that are given off, naturally, by garbage and breaks down the gases to methane which is then transferred directly into Duke Energy's gas lines to fuel close to 3,000 homes and business from trash.

Rumpke's area which they are currently dumping in is estimated to only last 13 more years; they are trying to expand their area, but I realized today how important it was the respect the three R's. This is the point where I  made the connection of Rumpke's process and waste disposal in with a dietitian's job; it is important to bring to the attention of the hospital or facility we are working at to be more mindful of their waste disposal and consolidating the garbage to help the environment.

On another note, we also reviewed tube feeding formulas and calculations (YAY!). While it is not the most thrilling part, it was good to have a review before being thrown into the hospital setting.  Tomorrow we will be counseling each other in order to gain practice on how to communicate with patients with different conditions/concerns.
I am glad to be back in the groove of work finally; I was getting a bit bored!

(Pretty picture of lake area at Rumpke)

More to come...
Salvete

Mission Completed.Mini Summer!!

    Vale,        
            Finally have our project for Wesley Meals on Wheels completed!! Menu is approved so the elderly can eat =).  I have realized through this project how difficult group projects can be; but in addition, how important it is to be able to work in groups in order to get a larger goal accomplished.  The tension was high and everyone was frustrated, but it was important to stay calm and stay professional and not lose your cool on anyone ;).
     
             Anyways, today was my last day of the summer session so I am on a mini vacay again!!! Boy O boy do I need it.  I will definitely have plenty to do though, I will be doing a project for my three professors at UC, Dr. Sarah Couch PhD, RD, Elise Cowie MEd, RD, LD, and Rebecca Smith RD, LD in which I will be reseaching and compiling information about job projection and salary for other employment options for students in our program at the University of Cincinnati.  In addition to this task, I have also dedicated a few days to babysitting nephew, Jakob, so we can have some godmother/aunt and godson/nephew bonding time!! :-)

Pretty excited for that!

Well its gorgeous out, so I am going to get off here and go out for a nice long walk!!

Salvete

Mission: Complete MOW (Meals on Wheels) NOW

Vale All,
Finished up out Meals on Wheels Menu Project today (sort of)!  We have to get it approved tomorrow = \ .  Nervous to sit in on that because if the board does not approve our menu we will be working hard for the next week to get it ready! Hopefully it does get approved because we did spend a lot of time an effort on this project.

    Today,  I also attended my first Teleseminar at the Greater Cincinnati Health Council on Omega 3 Fatty Acids which was a very interesting experience.  We sat at a round table and listened over a radio with other dietitians to a seminar that was being given in another state.  We then discussed what we heard and our personal experiences with Omega 3 supplements and patients. Very interesting to hear how much of an effect omega 3's can have in oncology patients in reducing tumor size (important to remember if I ever am counseling oncology patients in the future). 

   Just a week and half more to get through and then I have at least a mini break, which will be much needed!

Salvete!

Life as I am Knowing it

Vale,
            Ah Sunday, what a day. Sundays are the best day; the day of rest and relaxation.  However, Monday's unfortunately follow Sundays and Mondays in my book are dreadful.
           Wesley's menu planning is going well.  I feel as if we are very much on schedule with our menu planning.  What we are doing just seems very repetitive and it is frustrating when you are constantly working to modify a diet to fit government regulations but end up giving someone similar foods for every meal because no other food works@#!%. Then, you have to wonder since we are only providing these seniors with one meal are they following this diet we are prescribing them for the other meals they eat throughout the day?... I hope so. :-/ This is the frustrating part of being a dietitian.. you can only do so much to change a person's diet... they have to want to change their eating habits or their health status won't change.  However, after hearing from the head of the program and how passionate he was about the Meals on Wheels program it made me realize how much he valued out time and effort we were putting into this project and made me feel like a valued asset to his company.  His outlook of how much he wanted to expand and build the Meals on Wheels program was very inspiring and motivating to want to do the best I could for the clients of the staff of Meals on Wheels.  I am very excited to complete this project and move onto to my clinical rotations at St. E's!!
            This weekend was a much needed, relaxing one that I wish would never end, but I am ready to get back to the grind and get this menu completed for Wesley.  Better get cracking!
Enjoy this beautiful day!
Salvete =)

Why 4:30am, Why?

Vale,
     Well that is a time of day I definitely would prefer not to see more often.  I think that the whole world should be sleeping at 4:30am in happy unison, although I will say I did get to see a gorgeous view of sleepy Cincinnati with the moon still out that I do not think I will ever see again.
     Today, we started out menu cycle planning at Wesley Community Services which provides a meals on wheels service in the Cincinnati area.  We will be planning a 28 day menu cycle for fall and winter within a group of seven.  I feel that we got a lot accomplished today with a lot of sticky notes (I think we are going to put post-it notes stock through the roof so everyone should invest now)! Our group is meshing extremely well and we have the starches and entrees out of the way, but still SO much to do before next Thursday!
       At Wesley today, we also got a chance to meet with their head production manager, Stacy, who showed us around the facility and we were able to see the production line which was very interesting.  The facility was very nice and large; plenty of space for production of food for the Meals on Wheels and after talking with the workers, I see how meaningful and important Meals on Wheels is to not only the recipients of the meals, but also those who produce and deliver the foods.  The program seems very well staffed and ran and hopefully Wesley can expand to reach more disable and elderly adults in order to assist those who cannot provide themselves with adequate nutrition at home.
      I also found out over the weekend where my placement is for my first acute care, clinical rotation starting in September: St. Elizabeth's in Northern Kentucky! I am extremely excited about this not because of the proximity of the location, but also because of the focus of bariactrics and the reputation of St. E's. I feel like this will be a great place to start out and that I will be able to meet other successful, educated dietitians who I can learn from.
      Soo much to do today, tonight, this week, so I need to get going! I also need to see Rebecca tonight because she is leaving me to go to New York this week =(. I will miss you soo much girl! This summer has been so much fun; I hope you have a blast!
Salvete
Anna

Mystery Shopper Week

Vale,

Traveled to Indiana today! What a lonngggg trip, and we saw farming equipment driving down the back roads that looked like a transformer.  I think they are building some suspicious items out there. But anyways, the food was not very impressive unfortunately.  All in all it was about three hours of driving, I am exhausted! My migraines this week are not helping anything- switching over migraine medicines is not a fun time; I feel like I sleep and eat more than anything else and still do not feel all that great.  Unfortunately, I did not get to stop by and see my daddy at work today for his birthday, but Happy Birthday Daddy, I love you! I have so many surveys to type up from these hospitals; I am slacking in that department.  Next week we will be doing cycle menu planning at Wesley Community Services so that will be a nice change! However, I am not looking forward to having those menus demolished by our professors and having to redo them a million times =(. 

Visiting 9 hospitals in 1 week is a bit overwhelming and I am now sick of hospital cafeteria food.

Salvete!

Mystery Shopper Intro !

Vale!

Sorry I have not posted in awhile I have been rather busy, in addition last week, was pretty much a repeat every dayyy. But alas, today we met out at Cincinnati Health Council and discussed our new project, the Mystery Shopper Project.  I have done this project in the past; it is where we go around and eat at a variety of cafeterias (some around here others not so much...) and rate them so the boards can make their customers happy and improve in areas they may have overlooked! Very good program, in my opinion =). So upon leaving, I figured lets grab the bull by the horns and hit up Good Sam, Christ, and Children's, since I was in the area. Needless to say I was stuffed! You would think I might save some money on groceries but somehow I feel as if that will not happening (sorry mom I am already feeling hungry again!). Many more to go to with in a span of five day; Miamisburg and Oxford tomorrow and two in Indiana Wednesday. Hello, high gas prices!  However, all for a good cause in the end, I hope all the hospitals use our information in a positive way to improve their hospitals for the betterment of their patients and staff.  Just found out about another class we have to take in October that is another $155 =(.  The bank account is going to get thinner by the months this better pay off in the end because I know my student loans won't be paying off themselves!  Health industry seems like the best place to be right now so I can't think of a better place I could be right now.

Have a great day!

Salvete

Day 2: Diabetic Carb Counting and Code of Ethics

Vale,
Day two, not so bad.. worked on some carb counting for diabetic patients. It is nice to have a intern director leading the program that is very straight forward about what we need to know and does not make us memorize/ spend countless hours doing extra work that is not practical for our field like so many other professors have done in the past. (Thank you Elise!) We also learned how important it is to have integrity especially when it comes to patients and doing the best thing for them and not just cutting corners to keep costs down in this crazy economy.  
The code of ethics has finally been updated and is actually interesting to read (need to always know how to protect your butt in the medical field!).  Still lots to read and catch up on and many more tutorials to do online which is difficult to do with a Pretty Little Liars Marathon on. I cannot wait to get this book stuff out of the way and get down to business, so excited to be hands on.  I am starting to feel more and more prepared with each passing day so hopefully by my first day in a hospital I won't fatally injure anyone... having a dream that I gave someone the wrong enteral nutrition formula and causing there feeding tube to explode and kill them was not exactly the best dream to start the week out to =/ .  Need to get off this blog/ facebook and done to some serious reading!


Salvete!

Day 1 of Orientation and I survived.

Salvete

I have never blogged before, but I figure this would be a good year to begin doing so in order to document my journey to become a registered dietitian.
            I am a Coordinated Program Dietetic Intern at the University of Cincinnati.  I will go to a variety of hospitals/ organizations that will provide the experience I will need to sit for my final exam in June of 2012 to become a registered dietitian (if all goes according to plan ::crossing my fingers::) 
            I will be going to several different preceptor sites which I will know at the end of the week.  I will also be doing an extended 7 week intensive program at Children's Hospital which I am extremely excited about.
My goal is to become a clinical dietitian within the pediatric bariatric surgery department. 
            Today we got a rather large packet on the Ohio Food Safety Code and watched a video of a restaurant in New Orleans that violated just about every code (I hope none of you who went there for the Sugar Bowl ate at Oceana's).  However, Gordon Ramsey did whip them into shape and turn there restaurant around with alot of cussing and some hard work.
           This blog may be boring to some, but I hope some will find my adventures interesting! Come back for more this first week is getting a few techinal things out of the way concerning fun stuff like HIPPA and blood borne pathogen training. But more fun and interesting things are to come!
Vale