10/18-10/22 Surgery Week One
*Oriented myself to the Phillips House surgical floor. This is my FAVORITE floor in the hospital. It's on the 22nd floor and it is exclusively private rooms. If you go to the solarium, you can see almost all of Boston. I love this room. I will go here on my break and get lost in the view. Sorry I don't have any pictures of it just yet, or I'd show you...
*Performed some educations on post-op surgical diets. Liquid diets for esophagus surgery patients. Low fiber, low fat diets for intestinal surgery patients. Proper nutrition for ostomy patients.
*Watched a swallow study!! Dietitians work closely with speech pathologists. These are the people that determine whether or not patients can adequately swallow by performing swallow evaluations. Basically, the study that I watched used a camera that was placed through the nose to the top of the back of the mouth. The patient was then asked to eat/drink a variety of foods that were dyed with blue food coloring so we could see the substance being swallowed. They record video of the patient swallowing the foods on the computer and then will review what the patient is allowed to eat-- only thin liquids (watery liquids), nectar-thick liquids (honey), etc. Very exciting!
10/25-10/29 Surgery Week Two
*Basically acted as an RD and functioned as staff relief for my floor. It was pretty exciting and stressful at the same time. I got to see a lot of interesting things such as: a gastric bypass surgery gone wrong, pancreatic cancer, heroin abuse, brain tumors, etc. Not all things had to do with surgery but they were interesting and rewarding, nonetheless.
*The rest of my week was basically consumed by my preparing for my presentation on pancreatic enzymes and pancreatitis. I did really well on the presentation and received really great feedback! Good story: I practiced my presentation in front of Justin the night before I performed it. The next night, after I had done my presentation earlier that day, I got to witness Justin explaining to a friend how pancreatic enzymes work. This might be one of the best moments of my life. No joke. He then attempted to explain the Whipple procedure, which was so awesome because he was so excited about it. (Basically it is a procedure that is performed when a pancreatic mass has been detected. The surgeon removes the portion of the pancreas containing the mass and then cuts the bottom of the stomach to attach it to a point further down the intestine. By moving the opening of the end of the stomach further down the intestine, you get less complications of the now malfunctioning pancreas, but it often causes malabsorption of fat and weight loss. Very complicated, but very interesting.) Fun fact: Steve Jobs (Apple guy) had this done and it is why he is so skinny. Here is a picture of the outcome of this procedure:
I'm sad to be done with the Medicine and Surgery rotation. But don't get me wrong, it was one of the most exhausting things that I've done in a while. My typical schedule was:
6:00a - Wake up, get ready, eat breakfast
7:00a - Catch train to work
8:00a - Work
6:00p - Catch train to go home
7:00p - Home/eat/take break
9:00p - Read, work on project
12:00a - Sleep
Yes, I typically work 10 hour days, only get a 30 minute lunch break and no pay. Why am I doing this again?
Anyways, yesterday and the Monday prior, the interns and I attended a workshop at Children's Hospital in Boston. It was all about pediatric nutrition. It was a great 2 days and I'm really glad that I attended. I learned a lot about breastfeeding nutrition, baby formulas, pediatric intensive care nutrition, and special needs infants. It was awesome!
This week I started my Intensive Care Unit rotation. This rotation lasts 2 weeks. Today I was oriented to the Burn Unit. Words cannot describe what I saw here. Very intense, depressing, overwhelming. I really enjoyed the atmosphere here though. It was surprisingly calming. Briefly, I saw a 24 year old patient today with 80% of his body covered in 3rd degree burns, he was flown in from another state after he lit himself on fire. He was put on a feeding tube that is providing him with ~2700 kcal and basically enough protein for a wrestling team. He has such high caloric and protein needs due to the extensiveness of his body breaking down his muscle in attempt to reform the skin that is missing. I think that is all I can really say about that for now.
Now for happier things...Last weekend I ran a 5k with my friend from Joslin and a fellow intern. I finished in 28:00. Not my best, but not my worst either! We got cheesy medals and free beer after finishing the race.
This weekend, I will be going to ADA's FNCE (pronounced Fence-eee). This is an acronym for the American Dietetic Association's Food and Nutrition Conference and Expo. It is held every year and happens to be in Boston this year. Convenient, right? It starts this Saturday and lasts for 4 days. It is a great time to network and meet with other interns from all over the US, meet RDs, and attend lectures. The guest lecturer this year is Anthony Bourdain! Google him if you don't know who he is. Also, MGH is having a reunion for all the previous interns. So, I will be going to that (did I mention that I am in the 101st class of dietetic interns at MGH?) Hopefully I will meet some great people here (and establish connections for future job opportunities!!)
So, that is what is new. I have yet ANOTHER presentation next week. It's funny, this internship only requires 8 presentations during the entire year-long program yet I have 3 within the first 2 months. Oh well! After this next presentation, I am set until after Christmas, as far as presentations go...
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