Why I like Oncology (rotation)

This week we started our clinical rotations, which is where we will be until September. We are still in the hospital and will make occassional “field trips” to other specialities (in which Mayo doesn’t specialize). Examples include pediatrics and community (WIC). Every 2 weeks we change specialities, so like this week and next I’m in Oncology, then after next week I’m in cardiology for 2 weeks. Pretty cool, ja?

I am starting to really enjoy the oncology specialization. Why?

1. I get to see the same patients at least every other day. They are on chemo, so appetite changes, nutrition status, etc changes frequently, thus they need to see us more than once a week (sometimes, not all the time). The average patient stay is 4.4 days, so for several other rotations, you only see a patient once, diagnose them, and never see them again.

2. I like being the cheerleader/encourage to patients. Sometimes patients don’t have a family member or friend to stay with them. Imagine going through chemo, which is already really tough on your body, and not having someone there to support you? Wow. I can’t even imagine. Part of me enjoys the nurture part too. Just talking to a patient, seeing how he/she are doing, what his/her disposition is, etc. I also like to see if they are progressing are not. Maybe it’s because I like people in general (***moves hands in a circle to indicate world/globe***) and genuinely care about them.

Not really in my R.D. job description, but definitely ingrained in my personality. I JUST LIKE PEOPLE, okay?

I haven’t done just oncology this week. I’ve also seen patients with renal, lung, liver, heart (basically, all organ) problems, so we get to see a variety of patients across the board. It’s amazing how many different nutritional needs there are for each disease state. Please keep in mind that we aren’t on staff relief yet, so there is always a dietitian with me making sure that I ask the right questions. I have interviewed several patients, then the dietitian jumps in and fills in the cracks that I left. With time, I’ll get the interview down pat!

Picture found at http://www.flickr.com/photos/araleya/2053280825/

Protein Confusion

Whenever I look up weight lifting exercises for women on the internet, I always stumble on protein powder ads. I do use a scoop of protein powder (only 11g/serving) in my morning oatmeal, but that’s it. It’s a good thickener for my thin oats and has a nice serving of protein to start off the day.

A few weeks ago I had a general practitioner talk to me about my protein intake. I have found this to be common in the clinical setting (MDs giving nutrition advice when they lack the proper training that R.D.s have) but was not prepared for my personal doctor to talk to me about it. Guess she thought that, since I am a vegetarian, I must be starved for quality protein. We talked about the sources of protein, where it comes from, and why I should be careful. Despite my insistence that I got an undergraduate degree in nutrition and am currently studying/doing my internship to become a Registered Dietitian, this meant nothing to her. Unfortunately, I handled the situation poorly and was rather, er, sarcastic with the doctor. It’s all in the delivery, must work on it. I’ll do better next time, promise ¬†ūüôā

Anyways, I did a little research tonight about the different types of proteins, why body builders use them, etc. As you are probably aware, bodybuilders and fitness enthusiasts swear by protein

powder. They want that “ripped” look and put protein in everything. Some sites recommend up to 2 g of powder per pound of body weight. That would be 300 g of powder for a 150 lb person. Wow. (P.S., That’s a lot!!) ¬†See the below links for more information. Or just keep scrolling and read my thoughts…

Comparison table

Bodybuilding.com protein type explanation

Contrary to the body builders,¬†Askthedietitian.com says that people fall for the myth because they¬†listen to individual testimonials and not science. She suggests that¬†informed consumers read “The Homocysteine Revolution” by Dr Kilmer McCaulley. “Thirty years ago, he compiled the research on homocysteine (an amino acid) that is an intermediary in the breakdown of methionine (an amino acid). Homocysteine appears cause and advance arteriosclerosis (hardening of the arteries) as a result of high protein diets. Weight lifters or body builders take protein or amino acid supplements, thinking that it will make them ripped. These supplements do not build¬†muscle and combined with an already high protein intake, often stress kidney function. The RDA for protein is 63 g (males) and 50 g (females), based on kg of body weight, not pounds (as mentioned at the beginning). Keep in mind it’s not just body builders that observe a high protein diet. Remember the low-carb craze? Well, if ya ain’t gettin’ calories from carbs, ya probably gettin’ it from protein in the prescribed diet.

Even scarier, once protein is absorbed, the kidneys filter out the remainder and if it’s not used to build/repair muscle tissue, is converted to energy or stored as fat. Thus, if you eat excessexcessexcess X 10 protein (like the 2 g/lb of body weight example), you are making expensive fat.

The infamous fat block

Ew. Cue the picture of the fat block (dun dun DUNNN).

What does this mean for you, the average consumer? No more than 20% of your calories from protein, unless you have some sort of muscle wasting (i.e. a life-threatening illness like cancer). And don’t be giving out nutrition information unless you are licensed to do so. And please let the vegetarians go and don’t harass them. They are probably starved anyways and salivating over your hamburger.

People’s lives are at stake, for cryin’ out loud!

Why musicals are funny

Just listen to the lyrics and you will appreciate it. If you don’t find these selected parts funny, then I question our friendship. Or lack thereof.

“Gaston”: Beauty and the Beast

LeFou:¬†No one’s got a swell cleft in his chin like Gaston
Gaston:¬†As a specimen, yes, I’m intimidating!

As you see I’ve got biceps to spare
LeFou:¬†Not a bit of him’s scraggly or scrawny
Gaston:¬†That’s right!
And ev’ry last inch of me’s covered with hair
Chorus: No one hits like Gaston/Matches wits like Gaston
LeFou:
In a spitting match nobody spits like Gaston
Gaston:
I’m espcially good at expectorating!”

“Practically Perfect”: Mary Poppins

“Both prim and proper and never too stern
Well-educated yet willing to learn
I’m clean and honest, my manner refined
And I wear shoes of the sensible kind”

“Make’em Laugh”: Singin in the Rain

Make 'em laugh, Cosmo

Though the world is so full of a number things,
I know we should all be as happy as
But are we?
No, definitely no, positively no.
Decidedly no. Mm mm.
Short people have long faces and
Long people have short faces.
Big people have little humor
And little people have no humor at all!
And in the words of that immortal buddy
Samuel J. Snodgrass, as he was about to be lead
To the guillotine:

Make ’em laugh
Make ’em laugh

Vegetable Visions

And sometimes, I have free time during internship. So I draw. And I draw really “creative” things, like happy vegetables and

"Ripped" apple pushing squash, broccoli and fish

pumped apples.

C’mon, whadidya expect?!?! I am around food all day.

Please note that the apple has a “tattoo” of where he has been. Must’ve had a tough life, then broke out of the grocery store, taking some friends with him.

"happy" vegetables

All nerded out

As if it wasn’t evident already…what with the LOST fetish, a slightly more advanced knowledge base about Star Wars (original) than the generic 22 year old female, and a desire to know all that is computers and technology at CNET, I’d say that I pretty much nerd out the apartment complex for the median aged 32 year olds (and 2.3 kids).

But my newest nerdy thing is…and don’t say “I didn’t see this coming,” because you totally did…

NPR.

That’s right. Get used to it.

I got some super cool podcasts like All Things Considered and Wait, Wait, Don’t Tell Me ¬†along with a few from non-NPR sites like howstuffworks.com and The Moth. I listened to the JAX NPR today which informed me that in February there will be a special on the early days of surgery…what surgeries were totally botched and how they got to the modern operating table.

Maybe it started with watching a special about Louisa May Alcott (author of Little Women). Or maybe with (begrudgingly) watching Antiques Roadshow with my mom. No es importa.

So now what’s an out-of-the-closet-nerd to do? Embrace it. ¬†Wear spandex around the condo to keep warm and use earplugs at night to block out sound. Listen to NPR on my 6 minute commute to work.

Wait, did I just lose a bunch of friends?

I don’t wear glasses, have a calculator on my person at all times, or headgear at night (does a retainer count?). But my name is Christine, and I am a nerd. So there.

The Best Thing About Falling Off the Horse…

Occassionally, I’ll have an “eating slip” and it throws me way off. Aka, too many calories, not letting my body tell me when to stop eating, etc. It makes¬†my mind feels all helter-skelter. (Do people even use that term anymore?) First thing I do when this happens is to analyze why this happened, what were the circumstances, and the¬†results of the situation (what I learned from it).

WHY: I was traveling this past weekend to FL and we didn’t really eat regular meals/snacks, (though I did choose healthy options at the restaurants). It really messed me up not being at home and preparing my own meal. Who knew that such a small thing as preparing my own meals could make me feel off key for a few days.

RESULT: Turns out, meals are kind of a big deal. So is eating. And eating right keeps your body and mind feeling good. Think Maslow’s hierarchy, what’s at the base of the pyramid to satisfybasic human needs? Physiological things: sleeping, eating, breathing, etc.

So, really, your meals ARE a big deal. This makes sense as to why I have felt really off yesterday and today.

So, back to the title of the postCan you finish that phrase? Hint: Think optimism…

Belly flopping off the horse

The best thing about falling off the horse…Is getting back up again. My slip-up today can be viewed as a mess up, a time to beat myself up on the treadmill tomorrow to compensate for too many calories, a time to really pound on my body and my emotions…OR it can be an opportunity to analyze what happened, how I slipped, and how I can pick myself up and how I can try again tomorrow. It’s a time of reflection, of breathing in and out, of thanking the Lord for a safe/fun trip, and reflecting on the week ahead of me with my last undergraduate finals.

One of the worst things you can do is to tell yourself ¬†“I’ll start dieting tomorrow” OR “I can cheat today, but tomorrow will be different” and then watch yourself make excuses and NOT DO IT. Or time gets away from you. Or an office party ruins your plans for eating clean. Or you’d rather watch Oprah than go outside and walk.

Want to change? Take proactive movements/thoughts toward that goal. I fell off, but tomorrow I’m gettin’ back up, and ain’t nothin’ gonna stop me.

Baby steps…

One day at a time.

Breathe in, breathe out.