A New Week, A New Rotation

This was such an exhausting last 2 weeks, sorry it's been so long since I've updated!  I had to do a 10-pg paper and a 20-min presentation last week.  My presentation was called "Hard to Swallow: A Case of Altered Mental Status, Dysphagia-Related Nutrition Support, and Guardianship."  Sounds exciting, yes?  The presentation went well overall.  I'm so glad to be done with it, a huge weight has been lifted.  I was getting 4 hours of sleep...it wasn't good. But its over with. And it is considered one of the most difficult presentations of the semester, so I'm glad to mark that off my list.  Did I mention that my presentation was video taped and I have to watch it and evaluate myself?  NOT EXCITED.

Now I am in my surgery rotation. I'm with the same preceptor, just a different floor. I've only gotten to talk to 1 patient so far, as I only started my rotation today.  The patient was a man that just had part of his pancreas removed and some re-routing of his intestinal tract. After patients have surgery that involves their intestine, it is recommended that they consume a post-surgical soft diet. This is a diet that consists of easy to digest foods such as simple carbs and protein.  High fiber and high fat foods require more effort for your body to digest, so these types of food are avoided initially after surgery (usually ~10-12 days).  We went to talk to the patient to see if he had any questions about this diet restriction, since he was going to be discharged soon and still had a couple of days to go on his post-surgical diet.  He and his wife were so lovely!  He told us to talk to his wife, since she is "the boss."  She only had a few questions, but then we realized her daughter-in-law is an RD, so we ended up talking about that more than her husband's diet!  They were just really great people and being around them really made me miss my family. I wish all patients were so easy going and easy to talk to!

Me and some of the interns decided to go to Oktoberfest here in Boston for a study break 2 weekends ago.  That was pretty exciting, but ridiculously crowded!  It was in Harvard Square.  Here is a picture from that:

Also, I took a couple of pictures while I was at the hospital.  Here are the patches that we where on our left lab coat sleeve, which we are in charge of sewing on by the way.  This is so everyone in the hospital knows we are students, I guess. Note: I didn't realize that the symbol above "Dietitian" said MGH until about 5 days ago.  Oops.

Here is a picture of me in my lab coat!  Justin takes me very seriously when I wear my lab coat, so I'm glad I really do have more authority when I wear it! This picture was taken in our intern "office."  It's very small and is crowded when we are all trying to access our lockers.

Well, that is it for now.  I don't have anything else that is new and exciting going on right now. I have another project due next Tuesday about Pancreatic Insufficiency that I'm actually really pumped about, so I'm going to be starting that soon.

Oh!  I forgot to tell you.  I found out something the other day.  So when you get a Bachelors in Dietetics, to become an RD, you know how you have to do an internship, right?  Well, 10 years ago about 75% of students got into internships that applied. Well, they just released the data and only 50% of the students that applied to internships were matched with an internship. It's so competitive and it's only getting more so.  I am so thankful that I got matched!

I think I'm going Vegetarian.

Two posts in one day! I couldn't ignore this article that I read just now. You should check this out, if you are interested in what is really in those "Chicken" McNuggets at McDonalds.  Brace yourself...

Pre-McNugget "Meat"

Should I become a vegetarian or should I swear off McDonald's?  I'm not sure, but I will keep you updated. This picture says so much about the current fast food industry.

Are you a "4th Mealer" and completely unaware of it?!!?

Time is flying and I can't believe that at the end of this week, I will be halfway done with my Medicine/Surgery rotation.  So what has happened recently?  Well, I started talking to patients on my floor without my preceptor standing over me.  The first did not go so well, but amazingly I am building up my confidence and starting to talk to patients better and better!  This is so exciting!

Also, I had a really great moment on Friday that I absolutely must share!  A patient of ours was barely eating, probably eating <50% of her breakfast, lunch, and dinner.  But somehow, this went unnoticed by the nurses (scary, I know!)  But at the last minute, before the patient was discharged, a doctor came up to me (yes, yours truly!) to tell me that he wasn't going to discharge the patient until I assessed the patient.  Of course I started panicking.  I immediately dropped what I was doing and started flipping through the chart of this patient.  To our surprise, she was hardly eating anything. I went and talked to her (on my own!) and asked her what was going on with her eating. To make a long story short, she is depressed and has no appetite.  She has tried supplements, such as Ensure, but she just can't stomach them any longer.  When I left the room, I immediately told the doctor that we can't discharge her yet.  She was going to be released to an assisted living home where there isn't really a lot of supervision with meals.  We set it up so we could record everything that she was eating (calorie counts) and I put in my own tube feed recommendation, if she continues to not eat.  Tube feeds are one of the things that interns fear most, but they really aren't that scary!  The doctor agreed with my recommendations and she was still at the hospital today! I felt amazing.  You have to realize how great MGH is for students.  In some hospitals, Dr's don't even consider what the RD says.

So, that was my amazing moment last Friday.  I have a huge presentation next week that I am trying to find time to prepare for.  We have 4 presentations during the entire course of this 1-year long internship.  And I'm about to do 2 of them this month.  Kind of freaked out, but at least, by some miracle, we get Columbus Day off, so I can have extra time to work on it (and sleep in!)

Also, I thought it would be nice to add some pictures on here.  This is a picture of the subway station where I get off to go the the hospital.   MGH is on the "Red Line." My commute takes about 45 minutes and involves 1 transfer (each way!):

Also, here is a picture of MGH...did I mention that MGH is not 1 building, rather a small city?  All of these buildings are part of the campus.  Crazy, I know.

Other more exciting things, we had a party for one of the interns birthday this weekend.  It was so great to see everyone out of the hospital.  Also, Justin, me, and my roommate went apple picking this weekend. Can I just say that the only way that I'm staying sane during this internship is by maintaining a normal life on the weekends?! It's so good to get out of Boston every now and again!

One more thing, I recently read a study that came out of NC Chapel Hill about snacking.  In the past 30 years, the average calories from snacks have increased from 345 cal/d to 547 cal/d.  Can you say 4th meal?? Do you know how much you are snacking!!?!