To cap off my time in Charleston, I had to complete a Case Study on a patient of my choosing. I ended up choosing a patient that was just recently diagnosed with pancreatic cancer. I had the opportunity to meet with the patient and the patient’s family multiple times. Each day for entire week I went to visit this patient and each time I saw him his health was declining. However, his personality was always very lively. Because of his diagnoses he had a very decreased appetite. As a dietetic intern I am able to suggest supplements but he did not like the taste of any of them. The last day I saw this patient the MD consulted for any type of nutrition intervention. His prognosis did not look good. So I went and talked with the patient and he wanted milkshakes and chicken noodle soup for every meal. I was a little puzzled but I thought if he’ll eat it then why not. He just needed calories at that point. It was very rewarding to develop such a strong relationship with a patient. Unfortunately, the day after I put in the order for the milkshakes and chicken noodle soup, the patient was headed to a Hospice center. If you know anything about Hospice you know what a hard decision it is to make. It comes down to the quality of life of a person and no so much on the quantity.
Right before I headed down to Charleston, I actually experienced this with my one and only Grandpa. He had been on dialysis for about four years and he reached the point where he did not want to go anymore. A few days before he made this decision, he asked me if I would blame him. I never thought that I would be having a that type of conversation but of course I said I would not blame him and respected his decision. He had fought long and hard. He went three days a week, four hours each time to have his blood dialyzed just to spend a few more days with his family. For an 85 year old man to be able to do that, I would say he was one tough cookie. Quality over Quantity.
The past couple of weeks I have been down in Charleston, WV completing the clinical portion of the internship at Charleston Area Medical Center. This rotation has been very eye opening and I’m being exposed to a lot of different aspects of nutrition. One experience, involved attending a Dean Ornish Program Meeting. Dean Ornish is a lifestyle change program. It is composed of four sectors; nutrition, exercise, stress management, and support. It emphasizes that no one sector is better or more important than the other. It is important to have a balance in all four areas to establish optimal health. Those who know about Dean Ornish know that it is not the easiest plan to follow and many struggle with the nutrition sector of the program. However, the people that I have met in the program are very motivated individuals and are ready to make a life style change. The program really could be for anyone but it is designed to prevent and/or reverse heart disease. Therefore, most people in the program have had open heart surgery, abnormal lipid panel, high risk factors for heart disease, etc. Being an outsider and not having gone through those kinds of experiences, I can still really appreciate the program. It is like life, in the sense that we need to have balance. Not too much or too little of one thing or we can become unstable. Well that’s all for now folks. Stay balanced. Go with the flow. Be healthy.
Over the past few weeks the other dietetic interns and myself have been working very hard trying to recruit for iCook. We have been going into all of the grade schools and trying to get 8,9, and 10 year olds to participate in our project. Also, those who have signed up for the project, we have been completing their baseline assessments which include, weight, height, waist circumference, and blood pressure. As one can imagine, all of this work can be quite tiring. Therefore, today was one of the first days I had off and I took full advantage of it. One of my favorite things to do is bake. I find is very therapeutic and enjoyable. Today, I made dark chocolate cupcakes with a peanut butter whipped frosting and a drizzle of chocolate syrup. Yum!! Recipe provided below and hope you all take a little “me” time. Good for the mind, body, and soul.
Pretty good recipe but I did not have bitter sweet chocolate so i just used semi-sweet, tastes just as good. I also added a little extra vanilla.
Make it your own. Be creative!
Chocolate Peanut Butter Cupcakes!
Ingredients for Chocolate Cupcakes:
3 ounces semi-sweet chocolate , chopped fine
1/3 cup cocoa
3/4 cup hot coffee
3/4 cup flour
3/4 cup granulated sugar
1/2 teaspoon table salt
1/2 teaspoon baking soda
6 tablespoons vegetable oil
2 large eggs
2 teaspoons white vinegar
2 teaspoon vanilla extract
Directions for Cupcakes:
Adjust oven rack to middle position and heat oven to 350 degrees.
Line standard-size muffin pan (cups have ½-cup capacity) with baking-cup liners.
Place chocolate and cocoa in medium bowl.
Pour hot coffee over mixture and whisk until smooth.
Set in refrigerator to cool completely, about 20 minutes.
Whisk flour, sugar, salt, and baking soda together in medium bowl; set aside.
Add flour mixture and whisk until smooth.
Bake until cupcakes are set and just firm to touch, 15 to 17 minutes.
Ingredietnts for Peanut Butter Frosting
1/2 cup of butter, softened
1 cup of creamy peanut butter
3 Tablespoons of milk, or as needed
2 cups of confectioners’ sugar
Throughout these last two weeks, I have been in the community/research portion of the internship. My advisor is involved in a project called iCook. This project revolves around the importance of physical activity, family meal time, and cooking skills for 9 and 10 year olds. If they do decided to participate in the study they are asked to come in for a pre-assessment and if they are put in the intervention group then over the next few months they are able to participate in 6 iCook lessons. These lesson include cooking, physical activities, and a “simulated” family meal time. During my time in working with this project the most difficult task has been trying to get people participate in the study. The best part of this experience has been being able to interact with the kids and seeing the smiles on their faces when they find out they get to cook and eat their own food! It is very cool to see how the smallest things can make a kid happy. Being involved in this project I have learned a lot. How to work with different people, how to work a variety of different kids, and presentation skills. It has been a humbling and challenging experience. Stay tuned for more updates on iCook!
So this is the last week with Keegan and Associates and it has been such an eye opening experience. I had the opportunity to visit a small hospital in Spencer, West Virginia and let me tell ya, it is not easiest place to get to. It is about two hours south of Morgantown on the interstate and then another 40 minutes through the mountains of West Virginia. However, when I got there I was pleasantly surprised. It was such a nice hospital; small but new and everyone treated you like you had known them for years. It must be a small town thing. This was a great facility to experience because we were able to do an outpatient session with a client to discuss their nutritional concerns. As the session went on it blew my mind how much the patient did not know about nutrition. Their eating habits were not the best but the patient was very interested in gaining more knowledge. However, you cannot blame someone for their actions because they simple do not know any better. Due to their zip code and upbringing they were not always provided with accurate nutrition information. That is where our job comes into play. We provide information and support for our clients. Stay tuned for the community/research portion of the internship. Stay healthy, mind, body and soul.
Last week and this week have been quite the adventure. I am currently rotating Keegan & Associates Inc, which is a consulting dietitian company. The dietitians employed by Keegan & Associates visit long-term care facilities and small hospitals throughout the state of West Virginia. This rotation has been a great experience thus far. I have been able to receive long-term care, outpatient, and acute care experience. It is also a great rotation for learning how to work with many different types of people. Each day is at a different facility, with new nurses, patients, and administrative staff. This really hones in on communication skills and confidence. Look forward to the new encounters each day. Keep ya posted!
As of June 24th, I started my first dietetic rotation at Mon General Hospital. The first week was learning about patient services. Throughout the week I was assigned to complete multiple projects and duties related to the hospitals patient services. Some of those tasks included, menu planning, tray assessments, meal rounds, and sanitation audits. It was a different side to dietetics that I had never experienced before. The clinical nutrition manager was the preceptor for this rotation and it was very interesting to learn about the managerial side of nutrition in an acute setting. The next two weeks will be a short clinical rotation. I will be shadowing the dietitians, completing a mini case study, and refreshing up on medical nutrition terminology and calculations.
During this time, I have learned what it means to persevere. Two weeks before this rotation began, I had ACL surgery. It has not been the easiest task to be able to get around the hospital and focus on what I need to be doing. However, in a way it has been a rather humbling experience. Waking up everyday knowing I have to put aside the pain and focus on the task at hand. I look forward to everything I get to experience these next few weeks and will keep posting about the journey ahead!
There are six of us first year dietetic interns and we are from all over. Even though all of us are very different and come from different backgrounds, we enjoy getting to know each other and realize we are all here at West Virginia University for the same reason. That is to further our career in the dietetic profession, making a change in how people view nutrition, and to have fun doing it!