Sight, Smell, Texture, & Feeling

DIETETIC INTERNSHIP: Weeks 24 - 25 (of 41)

Spinal Cord Injury: Weeks 24 & 25

The Spinal Cord Injury (SCI) population is a very unique group that ranges from tetraplegia (formerly known as quadriplegia) to paraplegia, with various stages of injury severity (complete v. incomplete) and mobility.  For example, an incomplete tetraplegic patient may walk with a cane or walker, but a complete paraplegia may not be able to turn him/herself in the bed, nor sit up.  Much of this has to do with injury severity.

I spent two weeks working with inpatient and outpatient SCI patients.  VA SCI individuals are frequently inpatient for extremely long durations; I visited with patients that had been inpatient for over 6 months or more!  Many SCI patients are quite healthy in mind, but uncooperative in body.  The injuries that resulted in SCI are far ranging, from a 32 year old enlisted officer that went butt over teakettle while mountain biking, to an older man that fell out of the top bunk of his prison bed.  One can only imagine that compliance to medication, which includes nutrition, is just as varied.  With some near complete immobility, nutrition is the #1 form of medicine… or the #1 form of disease.  

I had a blog post published nationally under the VA!  Read the original here, or below:

Every Body, Every Day: How to Get Fit

May 9, 2013 by Jessie Furman

How many times in one week do we hear about exercising? Eating right? Losing weight? Keeping our heart healthy? Many have heard and understand that exercising is beneficial for health; however, there are often many questions about exactly how much exercises is needed, the benefits to activity, what qualifies as exercise.

What does it all mean?

If your doctor told you that doing one thing for approximately 30 minutes per day, 5 days per week would significantly reduce your risk of:

Early death, coronary heart disease, stroke, high blood pressure, type 2 diabetes, breast and colon cancer, falls, depression.

Would you consider incorporating it into your life? It would cause no harm, only benefits, including health and financial gains. Would you do it? By now it is no surprise that this 30-minute per day “thing” is Physical Activity!

Watch this video, it is worth every minute:

How much?

Some physical activity is better than none.  For major health benefits the CDC , the American College of Sports Medicine, the U.S. Dept of Health & Human Services, and the American Heart Association recommend that adults:

The Administrative Side

DIETETIC INTERNSHIP: Weeks 20 - 23 (of 41)

Management: Weeks 20 & 21
Professional Development: Week 22
Research: Week 23

The Registered Dietitian’s exam includes various managerial topics, from theory (Maslow, Herzberg) to application (human v. technical v. practical skills).  In a pair with fellow intern Nick, we spent two weeks working with two different managers:  the Chief (of Nutrition & Food Services), and the Clinical Manager.  The tasks ranged from disciplinary proceedings meetings to face-time-only-required meetings to rudimentary analysis of current Clinical Dietitian medical chart documentation.  Meh.  While many people at my age are ready to progress beyond the day-to-day operations in their respective career and move into management, my feelings are slightly ill timed.  I suppose because the dietetics fields is a career change for me, I am entirely interested in solely patient care at this time.  Or perhaps I just want to stay away from financial analysis any time soon!?!  Regardless of sentiment, I like healthcare!

Hair Shopping

When I travel or move to a new place, I am a Tourist, Explorer, Dweller, and Shopper.  When it comes to shopping, my favorite way to spend time and money are at grocery stores and farmer’s markets.  I know, I know, the stereotypical female gods now scream blasphemy as clothes nor malls have entered this favorite list!  Alas, one of my favorite (economical) shopping centers in Memphis has a Kroger, Wal-Mart & Goodwill; I usually park in the middle and stretch my legs walking the parking lot between the stores.  

Yesterday after work, I parked in my standard mid-spot, and walked the 7 or so minutes to Goodwill.  Just as I was about to enter I heard, “Excuse me! Excuse me!”  I assumed directions were needed, but instead was met with a much different non-interrogatory response.  “You are simply beautiful!  Beautiful!” exclaimed a smiling older man.  A childish smile embraced my face. J

Tagxedo & Chasing Jessie awesomeness

I found this great website that allows one to customize a (pre-loaded) shape with words, colors, font types, and themes!  What is the standard shape representation of dietitian?  An APPLE, of course!  Here is the Chasing Jessie (Dietetic Internship only) word art!

Make your own at Tagxedo.com :)
(It is legitimate, this is not a spam posting!)

Rock On: The Kidney Stones!

DIETETIC INTERNSHIP: Weeks 18 & 19 (of 41)

Renal (Kidney) Disease

The renal world (i.e. kidneys) poses a lot of complications for patients in many arenas, from medication management, coordination of many healthcare specialists, and very importantly, drastic nutrition alterations.  Unless you develop some form of kidney troubles, most people have no idea what the kidneys do, where they are located, or how many we have?...  (Psst!  In general, your two kidneys are located in the back of the abdomen (see a picture here), working hard all day long to filter blood (remove waste products, create urine), maintain fluid and electrolyte balance, and secrete hormones to control blood pressure!)  Everything you know about healthy eating recommendations is (nearly) reversed in kidney disease.  Let me explain...

Standard healthy eating advice:

Eat whole grains, buy wheat bread instead of white, brown rice, not white!  Eat more fruits and vegetables!  Consume low-fat dairy 3 times per day!  Limit your sodium intake!

Oh wait, you have chronic kidney disease (CKD) and/or on dialysis?  Screeeeeech!  Cancel nearly ALL of those recommendations! 

MIFA & Meals on Wheels

DIETETIC INTERNSHIP: Week 17 (of 41)
Week 17 - MIFA

The past few weeks/months have been very busy in my world as a VA Dietetic Intern.  Actually, it varies by Intern, as every rotation has different requirements and associated assignments, which may demand a few extra hours that week, or 10-20 hours more.  The latter category was starting to get tiring, in addition to putting in excess hours for research projects.  Just in time, a rotation week away from the VA!

The Metropolitan Inter-Faith Association (MIFA) was founded just after the assassination of Martin Luther King, Jr in Memphis, TN (1968).  This organization manages a number of different programs from emergency family services to Senior citizen assistance, including administration of Meals on Wheels.  Briefly, Meals on Wheels is a government-funded program that provides home-delivered and congregate meals 5-days per week to nutritionally at-risk individuals over age 60 years.  MIFA’s research and studies have shown that congregate and home-delivered meals benefit the community immensely.  It is estimated that there is a substantial 11% return on investment for these programs in a community.  Nutritional programs help seniors in need by reducing malnutrition, falls/fractures, and depression.  According to MIFA, last year they provided 447,967 meals to Seniors!