So, I didn't get into a dietetic internship program. And I can sit here and list all the things I shoulda coulda woulda done better. I can sit here and sulk deep into the muddy pits of rejection and voluntarily dig deeper...but for the same reason I've learned not to touch a boiling pot of water, I will not go there.
Sounds like
...really hot oil the moment you add in raw meat.
Looks like
...wrinkled Idaho potatoes.
Smells like
...hard-boiled eggs that have been in the fridge for over a week.
Tastes like
...orange juice after eating a piece of chocolate.
Feels like
...sunburn...enough said.
I wrote that during my lunch break at work today. Locked myself up in the lunchroom like a recluse and hid beneath the heavy aroma of day-old bread donations from Panera. It was raining then. Cold, Chicago rain. Watched the world wash my troubles away. I wrote that while I was developing Nutrition Assessment Questions in English and Spanish. I couldn't help it. I found out about this rejection a week ago, and for whatever reason, it's hit me harder and harder as the days go by.
Everyday, I give my supervisor and coworker a ride to the train station. Everyday, we talk about our lives outside of work, and bond. Other than the fact that the two ladies happen to be 40 years my major, I see a part of me in both of them. I learn a lot from them. I confide in them. Maybe it has something to do with the fact that I'm a huge fan of emotional catharses while on the road. Or maybe, just maybe, they're supposed to change my lives, I just don't know it yet. Maybe they already have, and it's just one of those things that take awhile for me to really know it.
"Move on," the Supervisor exclaimed after I told her I didn't match for an internship, "Take that supervisory position and move on." Two words were all it took. MOVE...ON. It's pretty simple. I can say that "it's harder than it sounds" but I'm thinking, maybe if I do just that, I won't waste time thinking about how hard it's actually going to be.
So, I've decided, I'm moving on. I'm taking the world by storm. I'm not going to let anyone or anything make me feel inferior. Only I, can ever let myself feel like that. I've always wanted to learn the hard way, right?
"This, too, shall pass."
Next Stop: Moving On
I Keep Coming Back to This, I Know...

Respect. Professionalism. Ethics.
As actual or budding health care professionals, we owe it to our patients, to our colleagues and to ourselves to treat each and every person we encounter with the highest degree of those three ideals.
I have an instructor who lacks professionalism almost entirely. During a recent tour of the local hospital where he works (and throughout the term,) we were subjected to comments about how the other large hospital in the area "doesn't care about patient safety," or simply "sucks." I happen to volunteer for that other hospital, so perhaps I am biased; however, it strikes as appallingly unprofessional to repeatedly make snarky remarks about the competition when acting as either an educator or as a representative of the hospital for which he works.
Another example: We tour the pathology lab of his hospital. This is not a pleasant room; it is probably crawling with so many forms of bacteria as to boggle the imagination. It smells of formaldehyde and diseased tissue. Plastic containers full of various removed organs abound, many of which have the lids askew and fluid dripped on the table around them. The walls are a dingy, dirty color that used to be white. There is chicken wire on the window. It is, to be frank, the perfect scene for a horror film.
This just can't be sanitary. I mean, it's not as if these things are going to be put back into people, but still. Practicing some level of lab hygiene seems like an all-around good idea, and this guy somehow missed the memo. Seriously: Bleach solution - look into it.
It is, of course, fascinating to see ovaries, tumors, bone scrapings and even miscarried fetuses in their respective jars. We are allowed to look closely, and each of the students in my class behaves him- or herself admirably. We are amazed at the structures our bodies create, and also at how they can go horribly awry.
The next door down is the morgue, and we all trepidatiously walk inside, unsure of what to expect. The room is very old-school, with tile floor and walls from the 1940's, an old, stainless steel autopsy table, and two full-sized cooling units where bodies would be placed. The coolers are empty, and there is are audible sighs of relief. It's a bit of a creepy room, even for someone like me who isn't squeamish about dead bodies.
In the room, there is also a traditional-looking, standard-sized refrigerator. Looks harmless enough. Naturally, being that it's in the morgue, it is not full of snacks and lunches. It is full of specimens. In the top freezer portion are amputated feet, hands and an entire lower leg. The instructor removes the leg, which is wrapped up in a very leg-shaped package and shows us the heft of it. Decorum, exit stage left.
"Who wants to hold the leg," he almost squeals, offering it to the nearest student. Clearly, this is the high point of the tour for him. There are nervous giggles. She accepts the leg, visibly surprised at how heavy it is, and suddenly, everyone in the room is all about holding the damn leg. The leg that some patient in the hospital is currently quite upset about no longer having.
Here these people are, yukking it up in the morgue with someone's actual leg. Now I get it that the leg is just meat, that we all are just meat, and that the former owner of the leg will never be the poorer off for the students having passed it around like a ham. However, it is the underlying principle I find disturbing; if we're getting all goofy about this simple thing, this disembodied leg... what does that bode for the future, for the quality of care and for the level of sensitivity these people will provide?
Maybe it's nothing, maybe it means nothing at all. Sure, I kind of wanted to hold the leg myself, but not amidst a bunch of guffaws and crude jokes. If there had been any air of respect for the fact that this was recently a part of a living human being, that there may have been agony and tears over the decision to part with it, I would have indulged my curiosity about how heavy a leg really is once it's no longer animated.
Instead, I remained quiet and stepped back a bit from the spectacle. A couple of other students joined me, regarding the scene somberly.
"For God's sake," the instructor said, rolling his eyes and exaggerating his speech, "don't drop it!" He practically tossed it to the next person.
At some point, I'll write about something else of import besides respect and being a decent person, but for now, I am fairly alarmed by some of the actions and words I see in various healthcare environments, and all I can do right now is to rail against it in my limited capacity.
In all honesty, I don't believe it's intentional on most peoples' parts; I think they probably get jaded after a period of time, and they might forget the sensitive nature of the business.
But here's the thing:
It's not ok to be disrespected while under the care of any health professional, and if you feel you are being treated unfairly or unprofessionally, you need to speak up, either to the offending party, to that person's supervisor or to an administrator of the facility.
The only way to stop someone's unprofessional or unethical behavior is to bring it to light. For my part, I should have said something in front of the whole class. I didn't. Despite the level of disrespect, I didn't want to embarrass the instructor or the students in front of everyone else. Instead, I chose to handle it quietly, after the fact, and with the instructor himself. If there is a next time, perhaps it will be with his boss at the school.
grrr
So its been a very long time since I've posted due to the fact that I lost my great grandmother last weekend and I have just been dealing with all of that...
She was in the hospital for a few weeks and they said that she had pneumonia and fluid on her lungs that was suffocating her so they hooked her up to a life support machine and they drained a tar-like looking fluid from her lungs. Finally they took her off the machines and they said she was most likely going to be okay so I was able to stop worrying so much because I'm away at school and I can't just drive home to see her.
Then on Sunday, my dad shows up at my door and tells me that she passed away that morning at 11 a.m. and they don't even know why?
Not only am I pissed off about it because they can't tell me what happened to her, but I'm upset. And then, I come to find that even though they have no idea what's happened and she died in their hospital, she still has to pay a huge doctor bill.
Why do they do that?!?!!
Summer vacation has started for me...hope everyone is/has a great summer.
Taking Care of You From the Inside Out
This week, Monica wrote about how to eat healthy. This is something I struggle with constantly, especially now that I'm back in school, working two jobs and trying to manage a marginal social life in between. I don't have time to cook. Also, I'm vegetarian, which means grabbing a quick bite on the go can be somewhat of a challenge at the fast food places.
I like junk food, and I am addicted to food. I know that sounds ridiculous, after all - how can I be addicted to something I need to live? Without going into the details, trust me - food can be an unhealthy addiction. Since becoming vegetarian, though, I've found it's almost impossible not to eat more healthy meals. I have to get my protein from somewhere, so I eat a lot of legumes - lentils, soy and other beans - and I also eat a lot of whole wheat pasta.
My usual dinner these days is to throw a big bowl of whole wheat penne into the pot with either some brussell sprouts, spinach or lima beans, drizzle it with olive oil and pepper and call it good. It's fast, it requires no thought whatsoever and it's good for me. Go figure! 
It's so easy these days to be a food slacker - there are snacks and other crappy food everywhere. Hot dogs and burritos at the gas station, fast food sandwiches with two-thirds of our required caloric intake... it's a nutrition nightmare. Being vegetarian takes a lot of those options right off the menu immediately - there's the obvious stuff that contains actual, visible meat, and then there's the more insidious stuff. It's nearly impossible to get away from meat by-products in cheap food, whether it's chicken fat, chicken broth or even the innocent-sounding "natural flavors," those of us who choose not to eat meat have to be very selective.
Marshmallows and most yogurts are not vegetarian - they're made from gelatin, which is made from (among other things) hooves. Many cheeses are made with an enzyme culled from calves' stomachs. Even one of my favorite cereals, Frosted Mini Wheats, contains gelatin - meat is everywhere!
With Earth Day coming up tomorrow, we're all thinking about the environment, and giving up meat is a great way to help reduce to load on Mother Earth. The resources used to raise cows, and the waste they create, is a major contributing factor to global warming.
Turning into a veg-head doesn't mean nothing but tofu these days, either; there are some great meat alternatives, including seitan, Quorn, veggie burgers (Burger King even offers one on their menu,) even (seriously delicious) vegetarian corn dogs, and many more options - even stuff you can just nuke in the microwave. Your local farmer's market is overflowing with fresh, healthy fruits and vegetables that are full of possibilities.
Whether you're interested in becoming more healthy, helping the environment, working to end animal suffering or just love animals too much, becoming vegetarian has some substantial benefits to offer.
Contemplating becoming vegetarian! YAY! Here are some links to give you some good information:
The Meatrix - in a "The Matrix" spin-off, The Meatrix exposes some of where our meat comes from.
GoVeg
101 Cookbooks - Vegetarian recipe journal that is overflowing with amazing recipes
Going Vegetarian Information Sheet
What does a vegetarian label mean?
Order your free vegetarian starter kit!
Hit the Gym, Jack
In summary: FIVE FOODS YOU SHOULD EAT EVERY DAY
- Whole grains (at least 3 servings)
- Dark-green leafy vegetables (at least 1 cup)
- Nuts & seeds
- Low-fat milk and yogurt (at least 8 ounces)
- Tea (green tea, up to 4 cups)
Last but not least, one overlooked factor that every person trying to get in shape needs is...MOTIVATION! MOTIVATION! MOTIVATION!
So whether it be that yellow polka dot bikini, or that t-shirt in SMALL instead of the usual baggy look, figure out what it is you're doing this for...and GIVE IT ALL YOU'VE GOT!
birth control prices, my report on it for journalism class....
KALAMAZOO, MI—College students are facing high prices for birth control leaving health centers and pharmacists concerned that the use of contraception will stop completely.
Green said “now that we have run out, prices have become significantly more expensive.”
Dlyphe said, “Planned Parenthood encourages the use of Emergency Contraception but does not feel its okay to make that your main source of contraception.”
"...But The Other Nurse Said...."
I'm not sure if it's a polite, Midwestern trait, or if people visiting the Emergency Department just don't pay attention to identification badges. I grant you, we Midwesterners are raised to be excruciatingly polite, and taking more than a passing glance at a name tag could conceivably be construed as an invasion of privacy in our minds.
If someone doesn't introduce him- or herself, perhaps it's none of our business. Or, if we learn someone's name once, and subsequently forget it... then we're rude. We're a strange breed here, no doubt.
So, on basically every occasion when I volunteer in the Emergency Department at the local mega-hospital, I am mistaken for a nurse. Patients and their loved ones often solicit advice, and preface their queries with things like, "Well, the other nurse said," or "Nurse, could you please tell me if."
There is a strange attraction to being mistaken for a nurse - it feeds some bizarre ego thing, deep in my id. I am absolutely not a nurse, obviously, so the ego rush is completely false and pointless. The first time it happened, I was half-tempted to allow the illusion to continue, to play along... and then I realized how utterly insane that would be. Insane, and dangerous.
There is a concept within the health profession called "scope of practice." One of the more concise definitions of this term is from the Texas Department of State Health Services, which explains it thusly: "The level of medical responsibility and/or health services a practitioner is legally authorized to offer to the public."
As a volunteer, the level of medical responsibility and/or services I am legally authorized to provide is ZERO. I can neither offer any opinion nor give any medical advice, and rightly so; I don't know anything! I have no training!
What was it about being mistaken for a medical professional that appealed to me? Perhaps it was just a brief glimpse into the world where I will, with luck, someday exist. Maybe it was some kind of external validation - if this person sees me as a possible nurse, then maybe it's not so far away after all. Maybe I am just bat-crap crazy.
There are so many opportunities to utterly screw up in this profession I'm going to take up, and I hope my awareness of them continues to expand. I hope I don't fall into any traps along the way, being lured into doing something for which I am not qualified.
I have a really great blog to link for you this week, but it does come with a warning for bad language - if you're not a grown-up who can take a frustrated doctor's occasional cussing, please do not follow this link. If you can handle adult language, and are interested in a behind-the-scenes look at an Emergency Department doctor's crazy world... please go ahead and Figent Figary's LiveJournal. She's funny, she's brilliant, and she reflects the kind of medical professional I want to be someday; compassionate, thorough, kind-hearted. I just love her.
Christmas in the Springtime

Dear Santa,
Do you want to know what I want more than anything in the world right now?
Two letters. That's right, the letters "R" and "D" after my name. I can see it now... Monica, Registered Dietitian. Especially after attending workshops for 2.5 days in order to attain my Certificate of Training for Childhood and Adolescent Weight Management, and being surrounded by Dietetics Professionals from all over the nation. Especially now after networking with people who genuinely love what they do. I want it now more than ever.
I've been a good girl. I promise. I've been doing anything and everything that crosses my path just to get to Emerald City. And frankly, I've never been this sure about wanting something in my life!
The conference was held about ten minutes east from my hometown. A historic little city they call Evanston. Trendy little place with a handful of family-owned businesses. It was held in the grand ballroom of Hotel Orrington. One of the questions in the evaluation survey asked why I decided to come and I wrote: "For me. For fun." I didn't have to go to this conference. After all, it did cost me $345 which I wasn't even sure was going to be reimbursed by my job. I'm at that point in my life when I want to explore the possibilities. My ambition is driving me to unexplored territory, and I'm loving everything about it. I get to "do me" now, finally. I get to do whatever I want. And it's scary. It's really, really scary.
I really got to know one of the dietitians who attended the workshops. I shall call her "Koko." Koko is 28 years old, married, and loves traveling. Koko attained her Masters in Nutrition and Dietetics and did her dietetic internship at Ball State University. Koko gave me some really great advice about things I should consider if I don't get into an internship the first time around. "Look for the programs that are still accepting applications, and CALL THEM RIGHT AWAY."
Koko asked me a question I've been subconsciously avoiding for some time now: "So you mean to tell me, that if you do get into an internship in Boston, Seattle or Florida, you're willing to just leave everything and start a new life? On your own?"
Monica: (pauses, ponders, and exclaims confidently) "Yes."
And for the sake of paying it forward, I leave you with this:
"Desire is the key to motivation, but it's determination and commitment to an unrelenting pursuit of your goal - a commitment to excellence - that will enable you to attain the success you seek." -Mario Andretti
So if it isn't too much, this Christmas, I'd like just that.
Love,
Monica, (RD)
Cha-Cha-Cha-CHANGES!
Today marks my 6-month anniversary working as a WIC Nutritionist. Coworkers say that it isn't often that nutritionists my age last this long working for WIC primarily because of the fact that "they're young, they're still trying to figure out what to do with their lives." My take? There's only one way to figure it out...give it a shot, a genuine shot, and decide from there. For the same reason why you shouldn't judge a book by its cover nor throw away a decent pair of brand new shoes just because they're a little bit tight, you shouldn't give up on a job too soon. Read the synopsis on the inside cover, break into those heels, and that new job that you're almost sure you're going to quit after your first week? Tough it out. Trust me, it's worth it.
I find out in less than two weeks whether or not I got into a dietetic internship program. This is it. This is my chance to find out if the next path will lead me to becoming a Registered Dietitian. And to be brutally honest? I'm expecting the worst possible scenario. I just want to be prepared for rejection, but still hope for the best. I'm anticipating chaos, so I can more easily return to state of sanity. It's my way of setting myself up to allow myself to handle the situation "like an adult" (still haven't figured out what that means). It's like being rejected after spilling your heart out to that "special person" in your life. You don't want to be that person who locks themselves up in their room beating themselves up about it. You want to be that person who accepts it for what it is and moves on with their lives, head-on. And the best way to go about doing it is to let go of all your expectations, and just go with it. And because they put it best, in the words of Eternal Sunshine of a Spotless Mind (movie):
"It's like, there's all these emotions and ideas and they come quick and they change and they leave and they come back in a different form and I think we're all taught we should be consistent. Y'know? You love someone -- that's it. Forever. You choose to do something with your life -- that's it, that's what you do. It's a sign of maturity to stick with that and see things through. And my feeling is that's how you die, because you stop listening to what is true, and what is true is constantly changing. You know?"
Focus, Focus, Focus!
My lab partner in Phlebotomy yesterday had a lot in common with me; we're both older students, both not interested in having children, both love the outdoors, blah blah blah. We hadn't spoken before that day, and were enjoying the nice warm, fuzzy feeling of a new friend. I drew her blood first, and then sat down for her turn on me. She missed on her first poke.
Not being a needle-phobe, and knowing what a missed poke can do to one's self-confidence, I let her try again on a different vein. As she tied the tourniquet, she was talking away about something or another. She palpated and we decided to go ahead with the poke without loosening the tourniquet.
This isn't unusual, but when one does this, it is important to get the poke over with quickly for a variety of reasons. First of all, circulation is reduced to the affected area, obviously, but also, pressure is building up inside the vein. With my veins, the tourniquet is pretty much a formality - blood leaps out of them, and they're visible at the surface. During the first couple of weeks of class, another partner had tied the tourniquet quite tightly, and then stalled a bit before the poke. As she punctured the vein, blood shot out of the puncture site and burst through the skin at her. It also stung quite a lot, and I ended up with a nice bruise.
So I knew what was coming.
This week's partner was a little flustered from having missed the first time, and was not in any hurry to do it again, despite the tourniquet. I said supportive things to calm her and so forth, all the while wondering about the blood accumulating in my basillic vein. Several minutes had passed.
I thought about saying something about what was going to happen, but I wondered if the experience of seeing what happened would have a greater impact on her than me simply telling her. I decided to take one for the team, and just let it happen.
I would say 4-5 minutes passed from the time she applied the tourniquet to the time she poked me. It stung pretty viciously when she poked, and then, to make matters worse, she backed out of my skin! She pulled the needle right out! And THEN, she stuck it back in! By the time she was going back for the second poke, blood had already spurted out rather impressively, and her teeth just about fell out of her head from surprise. "It's ok, it's alright, just grab the cotton ball," I said calmly, "I'm ok."
From across the room, the lab instructor raised an eyebrow at me, looking askance. I shook my head slightly and started talking my partner through what had just happened, Needless to say, she felt awful, and I thought having the instructor take her to task for it would only make her feel worse. I applied sustained heavy pressure to minimize bruising and then gave her one more chance on the other arm. She got blood, and she didn't dawdle after applying the tourniquet, either. "I'll never forget that again," she said, wide-eyed.
Sometimes, you have to touch the hot stove in order to fully grasp what "hot stove" means. Had I told her, "oh, hey - the tourniquet's been on a bit too long, and here's what'll happen," she might not have taken it fully to heart.
Which is NOT to say that you should run around letting people screw up medical procedures on you! My point here is that we have to keep focused and not let our attention wander during procedures. Give the patient the respect of focusing on the task at hand, and performing it correctly.
There can be some pressure to make small-talk, but don't do so at the expense of your patient's well-being. We can all think of ways to politely deflect chit-chat, and sometimes it's necessary to do so. This isn't the hair salon - we're doing procedures, collecting samples and giving treatment that can potentially mean the difference between life and death.
Autism.. is it really genetic?
I've been reading a lot in the news about Autism. I've heard stories saying that a little girl that was born completely "normal" somehow was diagnosed with Austism after a series of vaccinations. I have also heard stories about a man who was diagnosed with autism as a freshman in high school but never showed any symptoms or signs of the disorder before.For those of you that aren't familiar with autism, it is a brain development disorder that impairs social interaction and communication, and causes restricted and repetitive behavior, all starting before a child is three years old. really showed signs of it before that.
A common myth of autism is that Autism is solely caused by environmental factors like vaccines. According to CNN's report with Dr. Julie Gerberding, "there's been at least 15 very good scientific studies at the Institute of Medicine who have searched this out. And they have concluded that there really is no association between vaccines and autism." Dr. Gerberding says that all signs point to genetics.
The interesting story that I read, bringing me to the point of this blog is a story I read a few weeks back on MSNBC about a family in Atlanta. The family says that their daughter, Hannah Polings was a very bright child who was speaking clearly at a young age and could whistle on command. Hannah was given a series of 5 vaccinations in July 2000. She was about 18 months at the time and the Polings say that almost immediatley after these vaccinations they saw signs of behavioral changes.
"It wasn’t like a switch being turned off. It was more like a dimmer switch being turned down," her father said.
Hannah who is now 9-years-old has been diagnosed with Autism almost 8 years after the vaccinations. Government officials conclude that the vaccines Hannah received exacberated an underlying condition and the government has agreed to pay the Polings from a federal fund that compensates people injured by vaccines.
Even after hearing this story, Dr. Julie Gerberding, and the Centers for Disease and Prevention still believe vaccinations cannot cause Autism. They also say that just because of this case, there is no change in that position and they still feel vaccines are safe and helpful for children.
According to MSNBC Hannah has a disorder involving her mitochondria. The disorder, which can be present at birth from an inherited gene or acquired later in life, impairs cells’ ability to use nutrients. It often causes problems in brain functioning and can lead to delays in walking and talking.
Nothing says that Hannah could never live a normal life. I know first hand that, even with a disorder such as Autism you can lead a normal life depending on the severities of it but the chances of it are very unlikely in most cases. There isn't even a cure for it. All you can do is try your hardest to get your child the best education available and hope for the best as most parents do for there children.



