Wednesday, March 8, 2017

Confessions of a Dietetic Intern (Dietitian to-be)

Today is National Registered Dietitian (RD) Day! Well, today is actually a lot of different days apparently, but for my profession specifically, it is a day to celebrate RDs!

These days, lots of people call themselves nutritionists. To be honest, as I completed a holistic, Nutrition Consultant program years ago, I do believe there are many good nutrition professionals, who aren't necessarily RDs, out there. But what sets RDs apart is that they have to take rigorous coursework (heyoo science, chemistry, and all that jazz), then complete an accredited, Nationally supervised internship program (this is what I am doing right now), and then take an exam to officially become a Registered Dietitian (this will be what I do this Fall). It really is a lot of hard work. 

As I am a dietetic intern, not quite an RD, I thought it would be fun to do a little confessional post about my life as a dietetic intern right now. So, here goes. 

Most people have absolutely no idea what I do every day at UCSF. I remember one day, telling my friend's now husband, that I would be spending my dietetic internship primarily in the hospital. He looked at me, puzzled, and innocently (and hilariously) asked, "So, do you get called into a patient's room when there is a gluten emergency or something!?" This hasn't happened yet, at least. To clear a few things up, in the hospital, specifically, here are just a few things I do, day to day:

  • Participate in rounds to discuss each patient's case with doctors, case management workers, social workers, nurses, physical therapists, occupational therapists, and speech language pathologists
  • See patients to encourage them to eat while in the hospital, because often, they do not feel well enough to do so and maintaining good nutrition is critically important to positive outcomes
  • Perform nutrition-focused physical exams to evaluate for muscle and fat loss, and diagnose malnutrition
  • Perform a myriad of diet educations with patients, including food safety after getting a liver/heart/lung/bone marrow/kidney transplant, following a low sodium diet, post-bariatric surgery diet, Type 1 and Type 2 diabetes diets, just to name a few
  • Calculate recommendations for tube feeds and IV nutrition (nutrition that goes directly into your bloodstream, often used when your gut is not working)
  • Review pertinent nutrition labs: electrolytes, triglycerides, blood sugars, liver and pancreatic enzymes, etc...
  • Talk about poop. A lot. If you haven't pooped after surgery, you probably can't leave the hospital. Poop is huge. And I love it.
And on that note, working in a hospital is just ONE area for an RD to work in. Part of the reason I made a career change to become an RD is because RDs work in a number of diverse environments. For the next two weeks, I am working with the San Francisco Unified School District on their school breakfast, lunch, and after-school supper programs. Yes, RDs may work in hospitals. But they also work in schools, with sports teams, pharmaceutical companies, private practice, start-ups, foodservice, grocery stores, nonprofits, blogging, government, and so many more cool places. YAY for always having a job.

People think I always eat healthy. LOL. Listen, I will say, I do eat pretty healthy most of the time. As a nutrition professional, I truly feel it would be irresponsible for me to not try to practice what I preach. But what is most important to me, is that I enjoy my food and how it makes me feel. I love 'healthy foods,' partly because I grew up with a Mom who was a health-conscious chef, so my taste buds have been fortunate to be exposed to healthy foods from an early age. However, anyone who truly knows me, knows I absolutely love Hershey's chocolate. It's random and cheap (give me Hershey's over fancy chocolate any day), and I could eat 20 Hershey kisses at a time. And sometimes I do! Thanks, Mom, for instilling this love in me. 

 Sometimes I eat this...beautiful bounty from the Farmer's Market.

Sometimes I eat this...these were the cupcakes from our cake testing for our wedding. This was one of the best days of my life. Give me all the frosting.

I love to self-experiment when it comes to holistic health. I recognize there is a lot of wacky information out there when it comes to nutrition. But, I will say, sometimes I try to weed through health trends by self-experimenting. Whether it is doing whole 30, drinking collagen, natural skin products, or getting colonics, I kind of love trying it all. Things I want to try in the future (aka, when I have a good paycheck), cupping and cryotherapy.

I am not the food police. Often, when I tell people what I do for a living, they immediately reply with a statement about how they eat, usually defending it. I didn't ask! People are also very curious about how I eat. I guess I get that, but it is important to recognize nutrition is highly individualized. This is a very interesting pattern I have seen for years now. I am not the food police.

I do not quite know what I want to do, career-wise, after I become an RD. I want to work more in the Intensive Care Unit. I want to work at a start-up. I want to work at Google. I want to build my private practice business. I want to work with a Naturopathic doctor or healthcare professional. I want to improve my blogging. Lets just say, I have a lot of goals.

Ever since making my career change, I have not looked back. The other day, an RD asked me what my career was before I went back to school to become an RD. I explained to her how I worked in advertising, working with pharmaceutical companies to market drugs to patients and doctors. I told her I wasn't passionate about it and that I was burned out. And kind of miserable. She replied, "Wow, it must have taken a lot to completely leave a well-paying job, go back to school, and do all this. You're so close to the finish line." I am not very good at taking compliments, but I am actually going to graciously accept this one. The past three plus years have been really freaking hard at times, taxing on my relationship with my soon-to-be hubby, bank account, and social life. I've done pretty damn good. But I couldn't have done it without Brent or my family or my closest friends cheering me on. There are days at UCSF when I just think to myself, I never thought I would get here or be able to achieve this. And here I am. So close to the finish line. 


Monday, January 2, 2017

Thoughts On 2016 and Embracing 2017

Although this blog may have taken an unintentional hiatus over the past ~ 6 months, I certainly have not forgotten about it. Rather, I am grateful I can always come to this space to share my thoughts, even if for just a few readers (Hi, Mom). 

This past Thursday night, I did (my beloved, thank goodness for gift cards) Barry's Bootcamp. As always, it was a fantastic class taught by my favorite instructor, and I was joined by Brent, as well as some friends, making the butt-kicking all the more enjoyable. At the end of the class, the instructor led us through a meditation/reflection, where we thought about one thing we were most proud of in 2016 and one thing we were not as happy about. Moving through this exercise triggered me to think more about reflecting on the past year and how I want to move forward in 2017. So, here it goes. 

The accomplishment I am most proud of this year is getting matched to do my dietetic internship at UCSF. After one year of night school while working full time, followed by two years of full-time schooling, volunteering, and waitressing, all my hard work finally felt as though it had paid off. Now, I am five months into my internship and I can honestly say, every damn day I feel so grateful to be learning at UCSF. Not only is the internship exceptionally organized, but I get exposure to so many different areas of nutrition daily. I can write more on my thoughts in another post, but lets just say, I am grateful.

This past year (well, really the past three years) has been difficult as far as school/work-life balance. I feel as though I have had to say no to a lot of events, trips, or get togethers, for not so fun reasons. While of course, there is a time and place for saying no, which can be hard, I am excited about having a little more free time towards the end of the internship and after. I've hit the age where friends are moving out of the city, maybe even out of California, and I want to soak up time with them. And if I am really being honest, I find myself craving more time with my family, including my Mom and my sister. I want to be a more dedicated family member.

2017 will be a big year for me. And for Brent. We are getting married in March after a year and a half engagement. I am excited about our impending wedding, not just because I get to officially marry Brent, but also because we will be surrounded by friends and family from near and far; I don't want to take that for granted for one moment. I want to remember every second of it. 

On July 28th of 2017, I will finish my dietetic internship at UCSF. After finishing, I will likely study for a month or two for my exam to become a Registered Dietitian. Once I pass the exam, I think I will officially feel relieved. Professionally, my big goal of 2017 will be to get a steady paying job. I have worked my butt off the past 3 or so years to put myself through graduate school and this internship. I would be lying if I said I was not excited about a more steady paycheck, even if it is not that much. After all, I'll be starting, from scratch, a new career. 

Another goal, professionally, and a bit personally, in 2017, will be to get back to my holistic health roots. I have always been passionate about holistic health and preventative medicine, as evidenced by my completing Bauman College's Nutrition Consultant Program and my I-ACT certification as a Colonic Hydrotherapist, but it has been hard to focus on this in my dietetic internship, which emphasizes Western medicine (which of course, I expected going into it). There is a time and place for both, I just want to make sure I am still delving into both.

And really, that is about it. I don't have a long list of other goals really. 2017 will be a year of embracing big transitions - entering into a marriage and becoming a Registered Dietitian. 

For anyone with health-related resolutions this year, I leave you with this thought. Throughout my internship thus far, I have seen many very sick people (and of course, some not as sick people) and people who have been dealt some real shitty cards. Please treat your body with kindness because you deserve it. And never, ever take for granted any workout you do, whether it's walking or bootcamp or yoga. Your body is truly a gift and you should be thankful for every time you are able to move it in a way that feels good. These days, after each workout, I find myself thanking my body over and over again, for allowing me to move it. Please consider doing the same. 

Happy New Year! 


Tuesday, July 5, 2016

Summer Bucket List

I have 2 months off in between my post-bacc dietetics program and the beginning of my dietetic internship at UCSF and I am trying to make the most of my so-called free time. I'm still working two jobs, but my life is far-less packed and crazy than it was a few months ago. And while I have a bit of studying to do (like, starting now) to prepare for my first week of my internship, I have been focusing on enjoying my Summer as much as possible. Specifically, I have been trying to take care of myself; the past two years were very stressful, and while the next year will be stressful too, I felt as though my body probably needed a little love, and now was the time to show it.

In the spirit of making the most of my Summer time off, here is what is on my Summer bucket list!

1. Prioritize my own nutrition + health + a little self-experimentation/learning: In progress
Two weeks ago, I visited with my favorite RD and mentor, Lisa. I made an appointment with her and it was so lovely to drive to Sebastopol and spend the afternoon with her. We talked a lot about my stress and the impact the past two years have likely had on my adrenal health. We formulated a realistic plan, involving food, lifestyle changes, and supplements to help me feel more restored. I am also trying to sleep and take days to really relax, knowing I will be very busy the next year. Slowing down is incredibly hard for me, but I know it is what my body needs. In regards to my long-term health, last week, I sent in my saliva sample to 23andme. I think nutrigenomics is fascinating and am very interested to receive my report back from 23and me - in probably a month and a half. Lisa and I will work together to review the information received, and I hope to be able to implement some nutrition tweaks from there. I think 23andme is a great option for people, but I do recommend going through the results with a healthcare professional, based on what you're interested in learning more about.

2. Plant a fire-escape garden: In progress
As soon as Brent and I got back from our vacation at the beginning of June, I headed out to a nursery in the inner richmond neighborhood to get some planting supplies. I haven't gardened since I was maybe ten years young or so, and was itching to try to grow some of my own food. The young man at Clement Nursery was extremely knowledgeable and helpful, and I now have two beautiful planters illegally placed on my fire escape. I love watering them - it's the little things! And, it's been nearly a month - my little kale plants have been turning yellow - does anyone know what is up with this? I plucked them off, cleaned the plant up, added some organic fertilizer, and am hoping that will help. Help me! I don't have a green thumb...

3. Train for and run the San Francisco Half Marathon: In progress
My best friend Kelsey and I, as well as Brent and some of his work team, are running the San Francisco half marathon at the end of July. It's been years since I have run a half marathon and although I feel in decent shape, I definitely need to work on my endurance. Kelsey has been my running buddy so we've been trying to do at least one long run together every week. I just ran ten miles last weekend, and plan to do at least another 10 miler and 12 miler before the race. Can't wait for that post-race endorphin high!

4. Catch up with friends + family: In progress
This was probably one of the most important things I have wanted to do this Summer. During the school year, I was always stressed about upcoming projects or exams. My volunteer and work schedule did not afford me a lot of free time, therefore, my social life definitely suffered. Luckily, my friends have all been so supportive, but I miss them! While I truly enjoy being alone, maybe a little too much, I am trying to get out of hermit-mode and see my wonderful friends during this free time.

5. Try some new recipes: Not yet started - help me please!
I am definitely in a dinner food rut. I make the same few recipes all the time. I know once my internship starts, I am going to want quick, easy meals that don't require a lot of prep - or I am going to have to start Sunday food prep. With that being said, anyone have any favorite go-to 30 minute meals? Please let me know!

6. Get rid of stuff: Done!
Our apartment is oh so tiny, so I have been trying clean out various areas of it to ease the clutter. I recently cleaned out my closet, sold some clothes for $80, and donated three huge bags of clothes to Goodwill. And now...I have no clothes (because I didn't shop for two years), so yeah. But, at least my closet is filled with only clothes which bring me joy. 

7. Pay it forward, a lot: In progress
Paying it forward has become my motto in life, after the past few years. Every day, I think of ways to be extra kind or thoughtful, and I think about how so many people have been so gracious to me over the past few years. So, I am focusing on paying it forward. I am trying to cover shifts for people who need help at the restaurant I work at, because lord knows so many people covered my shifts when I was studying for an exam! I am also trying to reach out to fellow students the year behind me, and give them information about the dietetic internship application process (one phrase describes it: not hard, but tedious). 

So, what is on your Summer bucket list?

Tuesday, June 21, 2016

The Next Episode: What's Next After Finishing My 2 Year Dietetics Program

It's been about a month since I finished my two-year post-bacc dietetics program. It is hard for me to believe that two years ago, I was secretly plotting my career change and escape from my pharmaceutical advertising job, getting ready to become a full-time student working towards obtaining her license to be a Registered Dietitian. I knew this transition would be difficult, but holy moly, it has been a busy two years. During this post-bacc program, I quickly discovered, I was so much more than a full-time student. 

I was also a full-time girlfriend ---> turned fiancé. He put a ring on it last September and I'm keeping it and him forever. Thanks B!

I was a part-time server. 

I was a part-time volunteer at three different organizations in San Francisco. 

I was a full-time daughter, friend, sister, new godmother (the best), and struggling constantly to find balance in maintaining some sort of social life.

Everyone keeps saying, "I can't believe you're done." I can. I was pretty burned out at the end of these two years. Even though it was tough, I also can confidently say, I never looked back after taking the leap. 

When you finish your dietetics coursework, the next step toward becoming a Registered Dietitian is to land an accredited internship which can last anywhere from six months to a year. These internships are all over the country, at different institutions, and are highly competitive. In fact, only 50% of people who apply to dietetic internships get matched (it's a lovely match system, similar to medical residency). For example, 120 people may apply to one internship, which lets 6 people in. Ouch. Even worse, a majority are not free, rather, you pay for the internship. You pay to work for free (while of course, gaining invaluable experience). 

The internship application process, seemingly daunting, is more tedious than anything. It is essentially a big detailed job application, with letters of recommendation, a resume, tailored personal statements, and more. After numerous talks with my number one guy, I decided to apply to four internships, all of which were local to the bay area. I ranked them 1-4, putting my top choice, aka my reach school as number 1. 

In all honesty, I almost did not apply to my first choice internship. I didn't think I would get in because it is an especially competitive program. And though I had a 4.0 (I wasn't the only one), a well-written personal statement, and an interesting yet questionable background (Prior to school, I was a walking contradiction, marketing pharmaceutical drugs while studying holistic nutrition), I completely bombed (not intentionally) the GRE test required for this one internship. In fact, after receiving my scores this past February, I thought about not applying. I also was very candid in my personal statement about my desire to practice integrative, holistic nutrition, and I worried this would be off-putting to some programs; it was too important for me to not discuss my passion for holistic health to not write about it. I ended up applying; Brent told me to go for it, as did my advisors and mentors. 

On Sunday April 4th, it was D-day, known as match day. At 4pm PST, I logged onto the match website which was flooded with traffic of thousands of other dietetic students, to learn my fate for the next year or so.

Would I match or would I not match? If I matched, where did I match to? At this point, I was pretty confident I would match to my number two program, which accepted a lot of interns, was lower in cost, and would keep me in the city of San Francisco.I was coming off of being sick the previous week, and barely had a voice left from coughing. When I saw the results, well, shocked is a light term for how I felt. I was in disbelief as I saw I had been matched to the University of California, San Francisco (UCSF), my number one ranked choice; they accept ten interns and I was lucky to be one of them. Brent's reaction was my favorite. 

And in that moment, everything finally felt worth it. The two years of my life spent constantly revolving around exams and projects, studying, with my signature 'study bun' so fondly nicknamed, in place; two years of saying no to fun things to study 90% of the time, living frugally in this amazing but expensive all clicked.

I am finally getting over the shock of my fate and have been feeling extremely grateful ever since. Quite honestly, though I am terrified to start my internship August 1st for fear of failure, I am trying my best to approach it with an open mind, desire to work hard, and succeed. I want to soak up every bit of this learning experience at this wonderful institution I am so lucky to have earned.

I think anyone who has gone through graduate school can identify with the notion that you truly do have to sacrifice a lot in order to persevere. And listen, I know my life is pretty damn good, but going from a steady career and paycheck to becoming a full-time student at 28 is definitely a transition. But if you're committed to the end goal, you make it work. The financial component of graduate school is no joke, and often left me feeling guilty for missing things, as well as embarrassed. It was and is all temporary though. And an important lesson, I learned, is to ask for help when you need it. A lesson I am still working on, is not feeling guilty for missing out; there have been a few friends, along with my big sister and Mom, who have been especially encouraging and understanding when it comes to this lesson, and I thank them every time they remind me I continue to be on the right path.

My fellow, favorite RDs to be outside of our classroom home for the 2015-2016 school year

And of course, I am so lucky to have had Brent by my side cheering me on and even throwing me a (total) surprise graduation party. I don't think either of us anticipated how much my schooling would change our lives, and he stuck by me the whole time and was so patient, supportive, loving, and generous. Can't wait to write my book, make millions, and move to Hawaii with you, B. 

As of August 1st, I will be a full-time dietetic intern at UCSF. There will be a steep learning curve, which I plan to embrace. And while, I know I will also be a full-time fiancé, daughter, sister, and friend, I also know I will be one step closer to becoming an RD.

For more posts about my journey to become an RD:
Journey to Become an RD: My First Week of School
Journey to Become an RD: The Second Semester
Journey to Become an RD: 7 Things I Learned in the First Year of My Dietetics Program

Tuesday, March 8, 2016

A Day In The Life: On a Tuesday...

Sometimes I am totally nosy! I love peeking into other people's lives to see what is going on day to day, so I figured I would document my own day in the life post...on a Tuesday. 

5:23am: Alarm goes off - I wake up. Think, "why did I sign up for 6am Barry's Bootcamp?" I roll out of bed, put workout clothes on, and head to the kitchen to make coffee. Priorities, people. By a quarter til I am in my car on my way to bootcamp. 

Coffee gives me life

6am - 7am: Barry's Bootcamp Butt and Legs class. I only go to 6am classes maybe once or twice a month, but I really wanted to get a workout in today because it is a busy day.  Those who know me well have heard me say this, but, Barrys Bootcamp has been a lifesaver throughout the past year. It is my absolute favorite workout, but more importantly, re-investing in my own health and wellness by regular workouts has helped me deal with the stress of my dietetics program. Butt and Legs day means lots of squats, lunges, and fast treadmill runs. After class, I shower in their swanky locker room, and get dressed in my not-as-swanky volunteer outfit.

7:35 am: Grab my smoothie, hop in my car, and head to the San Francisco Veterans Affairs Hospital. In my PB + J smoothie, peanut butter, unsweetened almond milk, berries, and vanilla rice protein powder. Yum. 

8 am: Arrive at the VA Hospital. Since January 2014, I have volunteered here weekly and right now, I come every Tuesday from 8 am to 11:30 am. It is great clinical dietetics experience, and has been an incredibly humbling to work with the veteran population. My responsibilities differ, but today I interviewed newly admitted patients to determine food preferences. 

11:45 am: I drive home from the Hospital. Normally, I would head straight to class, however, I have a midterm to take and my teacher decided to administer it online, which was completely unexpected. It is for a Human Resources Management class which I have to take for my program; nothing too exciting, unfortunately. 

12:15 to 2pm: I make myself a big lunch of leftover kale salad with raisins, pecans, and a lemon garlic vinaigrette, plus some rotisserie chicken. I. am. starving. And I failed to pack morning snacks, so get this salad needs to get in my belly! I take my online midterm, which honestly feels pretty rushed. I hate timed tests. 

2 pm: Begin laundry downstairs because per the embarrassing picture below (somewhere underneath that pile is a hamper), when two people living together are both active, laundry piles up real fast. Then, I walk to go pick up the dry cleaning. Correction, Brent's dry cleaning. He has upcoming travel and is running low on work shirts. I am a good fiancé. 

I can't even.

3 pm: I have a phone call with my financial advisor, which sounds fancier than it is. This only happens once to twice a year. I recently took on a second job as an independent contractor (because I am nuts) and wanted to discuss how to properly set aside money for taxes. 

Trail Mix (just for the chocolate pretty much) + La Croix - ride or die

3:30 pm - 5 pm: I use this time to multi-task and continue to do laundry while also working on homework for my Community Nutrition Class. My group partners and I are going to be teaching a nutrition education class to a group of seniors in April, so I work on a portion of our research paper for the project. As our audience will be low-income, our class will either focus on healthy, dentition-friendly breakfasts or food access.

5 pm - 7:15pm: I walk over to MD Weight Management, a clinic where I have been volunteering at since 2014. I help Karen, the RD on staff who counsels patients one on one about weight loss, weight maintenance, gastrointestinal disorders, and also leads weekly weight-loss support groups. Occasionally, like tonight, I observe her in action. Karen has been so supportive of my journey, and I love observing her with patients because she is great at integrating scientific research into her talks. Tonight, Karen talked with her group about a study that reiterated the importance of sleep on metabolic health. To summarize, not getting enough sleep means our body produces more endocannabinoids. This process peaks at 2pm in the afternoon and happens throughout the day. More endocannabinoids means more hunger. Think, cannibis and appetite stimulation. Moral of the story, try to stay well-rested (7 to 8 hours sleep) for optimal metabolic health.  

The view from the office where I volunteer. Not too shabby, SF March.

7:30 pm - 8:30 pm: Once I get home, I begin making dinner. I have been wanting to try out Juli Bauer's tortilla recipe (highly recommend all her recipes) from her cookbook I got for Christmas, so I give it a whirl. They turned out great, but I put too much garlic powder in (I didn't think this was possible). I make a quick stir-fry, top it with nutritional yeast, and serve it with my warm, crispy tortillas. It hits the spot and I set out to do some more schoolwork. 

 Mixing tortillas on the stove because our kitchen is that small

Chicken apple sausage, cauliflower rice, and broccoli stir-fry with 3 mini-tortillas

9:30pm - 10 pm: Brent is home, yay! I need his help for a nutrition lab homework assignment, so I perform a dietary recall with him which means I record everything he ate that day. Maybe not as fun for him as it is for me. Lucky for him, he went to Kokkari for dinner... 

10 pm - 11pm: As Brent falls asleep on the couch, I finally put my computer away and turn my brain off with some mindless TV. I am pretty exhausted, and around 11pm, I climb into bed.