Diabetic spirits

DIETETIC INTERNSHIP: Weeks 33 & 34 (of 41)

Intensive Diabetes Management: Week 33

Pediatrics: Le Bonheur Week 34

What type of pills would you like to take?

Let me be honest.  I didn’t take many (personal) notes during the above-named rotations.  I toiled, but I left significant lacunae in my bank of memories.  Here are a few memorable moments:

Intensive Diabetes Management was primarily outpatient driven and functioned like playing a game of Magnum PI crossed with Dr. House.  Patients come in reporting high and low blood sugar extremes with seemingly perfect compliance to medication and insulin.  Dietary compliance?  That is always questionable.  I saw patients with blood sugars ranging from 30 to 460 daily, and supposedly taking the correct dosage of insulin.  Riiiiiight.

Levitt Shell & Cotton

Cotton blossoms in Henning, TN

A funny thing happened as I drove out to Mud Island one late Saturday morning: I saw things flying through the air everywhere, like great big allergens just waiting to cause a giant sneezing fit.  My afternoon plan was to sit outside at a café, read, study for the RD exam, and have a cold drink.  With my allergies, this plan suddenly seemed impossible…  However, I wondered, “Why did I not see all of this air debris at my house 13 miles away?”  I can thank the Mighty Mississippi River for my answer, and more specifically the barge traffic upon her.  It is cotton season, and all of the large and small flying puffs was cotton blowing off of the barges!  Thankfully I successfully sat outside for over 3 hours, with only one incident of cotton inhalation, momentary watery eyes, and a fit of sneezes.

Memphis has a great “shell” in midtown, Levitt Shell, an outdoor amphitheatre.  Young Elvis Presley took the stage here on July 30, 1954, in what historians have called the first-ever rock ‘n’ roll show.  Built during the Depression, it served as an orchestra performance venue in the 1930s and 1940s.  Today they put on more than 20 free summer concerts for the people of Memphis.  On this same Cotton Saturday, I packed up my bamboo mat and headed for a seat on the grassy knoll for my inaugural experience.  I was greeted by 5,000 other Memphis residents, many packing picnic gear and adult beverages.  The Memphis Dawls played, backed by various string players, and the Memphis Doctors Dance Band. They sang and played fun toe-tapping current tunes and covers from the 1940s.  Halfway through the night, dusk started to approach everyone embraced the relaxation and entertainment.

Memphis: World Championship Barbecue Competition

Friday

What a riotous event!  Sheer gluttony!  A weekend dedicated entirely to … BARBECUE!

After work on Friday, I quickly headed to the Mississippi River in search of myoglobin-outlined perfection.  After a 10-minute weaving search for free parking, I stepped out of my car… into what seemed like a meat smoker of goodness.  ALL of Downtown Memphis: Smelled. Like. Barbecue.  WOW!!  I am not kidding. 

You should know that I only eat meat a few times a week for health and ethical reasons– but when I do eat meat, it is often barbecue driven.  I love barbecue.  (I also love pattied sausage, but that is for another post.)  This new downtown aroma smelled like heaven! 

When it comes to barbecue, I have always been a lover, but I have my preferences.  I have never been a huge fan of ribs; they just haven’t had the right taste and texture for me; I am more of a pulled pork kind of girl.  Well all of this changed on Friday & Saturday... 

Welcome to Memphis in May  2013 World Championship Barbecue Competition!

Creative BBQ team names!

Thousands of competitors are on ‘teams’ that complete for various BBQ categories from ribs to whole hog to best tent (see categories and winners here ).  Each team has a ‘tent’ for cooking and, most importantly, for partying.  Team sizes range from 5 to 50, and tent sizes are up to 2 stories tall!

Tell Me What You Eat

DIETETIC INTERNSHIP: Weeks 31, 32 & 35 (of 41)

Foodservice Systems:  Weeks 31 - 32
Culinary : Week 35

Where do Registered Dietitian’s work?  As of Oct 2013, there are approximately 89,000 RDs in the US and abroad, the vast majority of which (~70%) are employed in a clinical field (healthcare in hospitals, long-term care facilities, etc).  The other main RD fields are foodservice systems, and school foodservice.  Research and community dietetics round out the list.  Unquestionably, the preponderance of public opinion associates RDs commonly with “food” only despite its low occupancy.


     As soon as I utter the words “Dietitian,” most people:
             a) pat their belly or hips, grumbling out regrets regarding dietary intake;
             b) recall what was consumed at the last several meals; and/or
             c) silently, yet assuredly, bring food and weight to mind.
     It has not taken long to recognize this repeating response. :( 

Breastmilk, fiber, and fried rice

DIETETIC INTERNSHIP: Week 30 (of 41)

Women, Infants, and Children (WIC):  Week 30

WIC = Women,Infants, and Children.  Yep, that is all I saw this week during my week at WIC.  WIC serves the financially underprivileged through a nutrition commodity program.  Directly, no money changes hands, only vouchers and education.  Registered Dietitians play essential party to this transaction as the nutrition expert for the pregant and post-partum woman, and the growing infant or child.

In the weeks leading up to this week’s rotation, I was slightly apprehensive.  My assigned WIC clinic was at one of the least desirable shopping malls in South Memphis, known for its crime and tumbling desirability.  Yes, there was Macy’s, Sears, and close to Graceland, but the area has fallen from grace, and several armed security guards roam the corridors.  Two local friends warned me to not stay in the area after dark.  During my lunch breaks, I frequently exercise-walked the thoroughfares and browsed the shopping selections.  I unearthed several bargains, but constantly looked over my shoulder.  During one lunchtime saunter, my security was infinitely unmitigated as I spied one security guard plugged into the wall, focusing intently on his charging cell phone.

Going Back to School

DIETETIC INTERNSHIP: Week 29 (of 41)

School Food Service:  Week 29 - Memphis City Schools

Who remembers what it is like to be less than 10 years old?  What about in high school?  How did you respond in ‘social interactions’?  What did you like to eat?  When did you like to eat?  How much?

What an interesting change of pace to transition from medical maladies to school food service this week!  For one week my mind reverted to sophomoric ideologies and preferences; it was tougher than I remembered!  One day I worked as a Lunch Lady at an elementary school (what fun!), and one day at a high school (a bit nerve-wracking!).  Going back to elementary school was so much fun!  Not only were the cafeteria workers friendly and welcoming, the kids were hysterical.  I walked around talking to them about their favorite foods, favorite snacks, encouraging each to try different foods on their trays… generally forming a personal Inquisitorial Committee.  Before leaving the cafeteria, several kids insisted on sharing their love with me, passing me through lots of hugs, and “I hope you come back!” salutations.  The high schoolers, on the other hand, were not nearly as lovely.  It did not take long for me to read through the words and body language of the kids, recalling the constant turbulence of emotions.  I left that afternoon SO thankful of my age and perspective.  (That was a first; I usually lie about my age! J)

The Old and The Restless

DIETETIC INTERNSHIP: Weeks 26, 27, & 28 (of 41)

Vacation!:  Week 26

Geriatrics & Palliative care: Weeks 27 & 28

These next two weeks were filled with the old, the very old, the young old, and the very sick.  I spent two weeks alternating between Geriatrics (>65 years old, often inpatient 4-6 weeks for rehabilitation) and Palliative Care (less than 6 months to live).  I was full of emotions before this rotation began, knowing my past may interfere with my present.  Daily, valetudinarians dominated my workload, and I wobbled between emotions.

My past includes my father, a Veteran, who passed away at home 8.5 years ago.  He peacefully and painfully died at home, aided by personal administration of palliative sedation.  Any time some of these words are spoken within my earshot (particularly “palliative”), or in regards to a young individual, (my father was 54 years old), my nose begins to tingle and flare, my eyes open widely, instinctively searching my surroundings, reflective of my minds speeding thoughts and connections.  This rotation not only posed professional challenges of a new patient population and goals, but also of managing my own reactions.