love

Amy Poehler on Loving Your Body

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Photo borrowed from: inspiredbycharm.com

http://www.upworthy.com/yo-oprah-imma-let-you-finish-but-amy-poehler-has-the-best-body-image-advice-of-a?c=ufb2

I didn’t think I could admire this woman of comedy any more than I already did. But there she goes spreading wisdom, reminding me once again how to be kind to myself. All you beautiful beings who who tend to easily forget what perfectly imperfect beings you truly are (*guilty!*) will benefit from hearing this. Click the link and remember to be gentle.

Peace and Self-Love.
❤ Samantha

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Weeks 13-21: Cardiology, ICU, Eating Disorders, Staff Relief

It seems we’re developing a motif here, as this post will continue to cram 5+ weeks of rotations into one abridged post. But, hey, so goes the life of the dietetic intern.

Week 13: Cardiology

Cardiology was my only 1 week rotation – and man, it went by SO FAST! I do feel like the length of the rotation was appropriate, however, given the patient population. During this rotation, most of the patients I saw were status post heart attacks, CABG procedures (stands for Coronary Artery Bypass Graft, and is pronounced like the vegetable – “cabbage”), or admitted with Congestive Heart Failure (often referred to as CHF). Working in a hospital as a clinical dietetic intern for 13 weeks prior to this, I had already been exposed to most of these conditions, and I don’t feel that having a very long cardiology rotation would have enhanced my experience dramatically. I basically gained more practice giving heart healthy diet and CHF educations, which I welcome more of! My one complaint for this rotation is that it was my only week working on a unit at a different campus than my other weeks, and it was a bit challenging to get used to the different buildings, and a new set of operations in such a short amount of time.

Because the heart healthy diet is the primary need on cardiology units, I’ve created a separate post to provide an overview of the guidelines. You can view the post HERE! The rotation really inspired me to spread the word about heart healthy diets, and catching signs of heart failure, because death related to heart disease is typically so preventable.

If you are in dietetics, I welcome your feedback. And if you are just interested in learning about the diet for your own benefit or that of a loved one, please leave a comment and let me know if you found the information helpful. Questions and comments are ALWAYS WELCOME!

And after Cardiology, it was on to Critical Care!

Weeks 14-15: Critical Care

This rotation was INTENSE, mostly consisting of recommending nutrition support options. The majority of the patients I saw were NPO, so taking in no nutrition by mouth. I had the opportunity the learn about the current nutrition support guidelines according to ASPEN and the Academy of Nutrition and Dietetics, and gained a clearer understanding of what makes each formula unique and appropriate for various individual conditions.

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Lot of calculations and lab values in Critical Care…

Not only was my critical care rotation interesting, but I also felt like a very strong component of every patient’s care team. I attended daily rounds on the ICU floor in which each critical patient was discussed, and the opinion of the dietitian was typically obtained, and highly regarded – usually my recs would be implemented immediately without hesitation! In previous clinical rotations, I recall experiencing frustration when having to recommend the same diet changes multiple times, seeing no orders placed. In the ICU, I felt capable of making a difference in the care of patients, and felt truly empowered as a proponent of good nutrition, particularly as I got to watch the transformation some patients took once appropriate nutrition recommendations were implemented.

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You fellow interns and RDs feel me??

Week 16-17: BREAK!

After Critical Care, I was lucky enough to have a 2 week long break. I spent a nice chunk of that time catching up on clinical readings and assignments, but I certainly got to have some fun as well…

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Went camping…

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…in Morro Bay, California…

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…with my best friends in the entire world (my SISTERS and parents)…

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…who walked all over town with me when I just had to have some Cioppino (it was SO worth it)…

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…We even got to have a little camera fun…

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…and got so many beautiful sunsets…

Then I got to welcome 2014 with my sister and brother from other mothers in Seattle, WA and Vancouver, BC:

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…where I got to see Captain Kirk’s Chair at the EMP Museum

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…climb atop this Space Needle…

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…with THESE two…

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…clean ourselves up for a New Years Eve celebration…

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…and I even found my name in LIGHTS!

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And of course, once returning to San Francisco (<3), had plenty of time left over for tasty coffee, a farmer’s market…

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 …and a little at-home yoga :).

And it’s a seriously good thing I got so much me time over these two weeks. I was definitely going to need it entering my eating disorders rotation…

Week 18-19: Clinical Elective – Eating Disorders

In a happy twist of fate, on my very first day of interning, my CNM offered my fellow intern and me 2 options for our clinical elective: eating disorders, or NICU. I immediately jumped at the opportunity to claim EDs – although I wish I could have experienced both areas of specialty, I’m sure no one is surprised by my choice.

My elective week brought up a whirlwind of emotion, both positive and negative. But the greatest thing I took from these two weeks was that I felt right at home. It was incredible to be reassured that ED treatment and recovery is the field I am meant to be in, because of my passion, my skills, and my own personal struggle. I feel blessed to have found this so early on in my career, and am so glad to see I still feel the way I did at the start of this journey.

Most of the week involved a lot of shadowing. Given the high specialization and touchy nature of this field, at the start of my rotation it was unclear whether I would have the opportunity to counsel one on one. However, after a few days of sitting in on sessions and observation of groups, in addition to spending time note writing and reviewing the past medical histories of the patients, I was able to conduct supervised one on one sessions with a number of people. This experience was anxiety-inducing, incredibly exciting, and limitlessly humbling. I was reminded of the love I have for this field, and was also reminded that I am quite good at it naturally! But I also saw how much I do have left to learn, and look forward to the career ahead of me.

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^This is what note taking looks like in an eating disorders rotation…

Weeks 20-21: Staff Relief – FINAL WEEKS IN CLINICAL!

Staff relief… What to say about staff relief. Well, I’m sure I grew from it, and I can say that. There were also a lot of tears coupled with self-doubt and feelings of inadequacy. Not to get all negative Nan on ya, but this experience is what it is, and I’m here to share it with you.

I must say, now that staff relief is behind me, I could not be more appreciative of those two weeks. I think it is so important to have them under your belt before entering the field as a clinical dietitian. But it was TOUGH!

For those of you who are unfamiliar with the term, staff relief is the rotation that usually comes at the end of your clinical rotations. During staff relief weeks, the intern is to act as dietitian, covering a unit on his or her own. It’s really the first taste you get of working independently as a clinical dietitian.

After discussing my staff relief rotation with my internship director, I learned that my experience was atypical. This may be one of the challenges of being in a distance program – my director is unaware of how things are going unless I share the information with her. During staff relief, most interns will cover 1 unit – ICU, Oncology, Med/Surg, etc (per my director, interns typically cover Med/Surg floors). During this rotation for me, things were organized a bit differently. The dietitians from each floor would assign me about 2 patients, totaling up to about 6-8 patients per day. I found that the most challenging part of this was having to switch mental gears from oncology to critical care to cardiac to CVAs so many times per day. I feel this brought down my level of efficiency, and made it challenging for me to do a quality job while also seeing the appropriate patient load each day. This impacted my confidence significantly, and I really had moments when I doubted whether I have what it takes to be successful in the field of clinical dietetics.

The good news is, once I spoke with my director (2 weeks AFTER completing this rotation), she assured me that my experience was not typical, and that seeing so many different types of patients each day in fact WAS quite challenging. I was so relieved to hear this, and felt I could reassure myself that staff relief did not indicate that I had made a catastrophic decision in choosing to become an RD.

Let it be a lesson to me – to give myself a BREAK, and not jump to thoughts of failure so immediately at the first sign of struggle.

So, that’s a wrap for my clinical rotations! I cannot believe that one of the biggest challenges in my path toward my RD is behind me. My next post will talk about my experiences working in long term care and community nutrition. Please check back for updates soon!

And all you DI hopefuls applying through DICAS right now, you are in my thoughts as programs sift through your applications. Next will be interviews for many of you! Remember: smile, stay calm, and be yourself – you’ll do great :).

Stay happy :).

A Quick Reminder for Self-Compassion

Sometimes it’s easy to forget that we all are human beings. And some days we need to have a little more self-compassion.

Just reminding us all to be gentle with ourselves, especially when we’re having a particularly rough day. Think of treating yourself with the same compassion you might show if a friend or child came to you with your same fears, anxieties, and stressors.

Now have a wonderful Wednesday!

Oh So Thankful

Thanksgiving is one of my very favorite holidays. It may be true that the story didn’t go down exactly as we were taught in our childhood, but I’ll take any excuse to gather my entire family in one place, and enjoy some delicious fall favorites (sweet potatoes and pumpkin pie–come to Mama), surrounded by loved ones and autumn colors.

This year, as I find the holiday quickly approaching, I’m noticing a number of stressors in my life. I’m finding it easy to get wrapped up in the whirlwind my life has felt like recently. My mind is becoming saturated with panic as I think about the case study I have due, the travel plans I have yet to finalize, and what I feel is a pretty unreasonable amount of personal issues I’ve been faced with over the past month.

But today I had a truly awakening experience while speaking to a patient who is over 60 years my senior. The conversation started as most of mine in the hospital do–wanting to check in on appetite, diet at home, and so on. As my preceptor and I had literally stepped one foot each out the door at the end of our interview, the patient said something funny that made her chuckle. Her stretched out smile, without any warning, transitioned into a somber lowering of the eyes, and then slowly turned to tears and sobbing. We sat back down, and asked her what was happening for her. She started to tell us about how sad she was in ending up where she was, with health problems she’d never dreamed would be hers.

She portrayed the decline of her health as a loss, “like losing a child,” she said, “it’s gone, and I’ll never see it again–I’ll never get it back.”

Choking back my tears, I stood back as my preceptor held the patient’s hand, comforting her until her smile returned.

I certainly don’t know where I stand on my belief in God and the ways of the Universe (I’m still working it all out). But today, I feel some force was on my side in placing this woman, and the lessons she had to learn in front of me.

Today, I can be thankful for my health. There may be many things in my life that are imperfect. But I can stand, and walk, and even run if I want to. I can make myself dinner, and can drive myself to work. I am self-sufficient, and it wasn’t until this afternoon that I learned what an incredibly beautiful and special thing that is.

So, what can you be grateful for today?

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Week 1: Orientation

Week 1 of my dietetic internship has officially been completed. This past week has been filled with too much information, not enough sleep, and some seriously tasty Southern BBQ (note: if ever in Atlanta, go to Bone Lick!). I also had the opportunity to meet and get to know my incredible fellow Morrison Chartwells interns. While there is some sadness about having to leave, and not getting to spend more time with new friends, I have no doubt that we will remain a strong support system for one another.

Here, an abridged recap of the week:

Day 0: My flight arrived into Atlanta from San Francisco at 9:00pm Monday night. Completely out of chronological whack, I remained awake late enough to meet my roommate for the upcoming week as she arrived around 1am (which felt like only 10pm). After some extended introductions, we turned in, both eager and terrified for what the week had to bring.

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Ready to go…

Day 1: The morning went leisurely, as we did not begin orientation until noon. Little did we know how much we would long for the liberty of having those morning hours back throughout the week. Our first day was… let’s face it… basic and boring. All logistics–things we all know, but need to hear again. Adjourning at 5pm, my roommate (who I already miss!) and I joined some of her local friends for a Braves game (they won! … don’t shun me, Dodger fam), and the BEST BBQ and jalapeño-bacon mac & cheese I have EVER had. My introduction to the Southern United States did not disappoint.

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Outfitted in Business Cas for Day #1

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Still surreal…

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Everything in moderation–including beer!!

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OH! And did I mention they put us up on the JUMBOTRON??? All we had to do was agree to air guitar when relief pitcher Kimbrel walked onto the field, as Welcome to the Jungle was played. Check out the video here! Embarrassing? Yes. Worth it? Totally.

Day 2: Wednesday captivated our interest just a bit more–and also managed to spike our cortisol levels significantly. Today we learned more about our School Nutrition Management rotation, of which I will personally not have the pleasure until mid-February. Chartwells is the sector of our overarching company (Compass Group) that oversees K-12 school accounts. Throughout the day we heard lectures from a number of accomplished (and YOUNG!) people in the field of dietetics who happen to be a major component of the Morrison Chartwells program. We were introduced to the inter-workings of the company, and taught who does what from Directors to Regional RDs to Resident Dietitians. We had the pleasure of being introduced to the Morrison CEO, followed by an introduction to the Cornell Plate Waste Study through the university’s B.E.N. (Behavioral Economics in Child Nutrition Programs) Center in which we will be participating. Cue 35 Type-A stress-induced heart attacks. As we learned about what would be involved in this study, and what our responsibilities would include, many of us began to panic at the sheer magnitude of information we would need to be collecting. The study basically focuses on how much food is being thrown out in schools across the country. After a solid hour-and-a-half or so of rapid-fire questions, and confusion-inducing answers, we were reassured that, as important as our contributions were, we were but a “data point” on the B.E.N. Center’s graphs, and an error did NOT in fact indicate epic failure. After learning as much more as we possibly could about our School Nutrition Management rotation, we headed back to the hotel to freshen up for a group dinner at Sage. We looked forward to some fun after such a rough day!

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Our yummy desserts… And the “Sage” in the olive oil above is written in Balsamic!

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Me, with the best roommate ever!

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Day 3: Thursday was the day I both looked forward to and had been dreading. It was the much anticipated CLINICAL NUTRITION DAY! Bright and early at 7:30am, we all met at the office, and began guzzling down mediocre coffee (sorry, Compass group–it is what it is). Each of us had worked LONG hours completing to the best of our abilities four clinical modules: General Medicine, Cardiovascular, Endocrine, and Renal. Although a thorough review was expected, we were greeted with a game of clinical nutrtion Jeopardy instead! Fortunately I am a total Jeopardy (and nutrition) NERD, and didn’t mind this at all. We concluded the day with FOUR HOURS of information from Abbott Labs, the company who provides many of the enteral nutrition (tube feeds) and supplements that are often used in clinical as well as non-clinical settings. Some of the products we learned about and/or had the opportunity to taste included Ensure (we tried Clear and Complete), Glucerna, Vital, and Pediasure.

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Above squiggly line: end of day. Below: new day. The difference between tired and awake.

We adjourned slightly early around 4:30pm, at which point most of us headed out to the vans that had been transporting us throughout the week. I stayed after for what I thought would be a few minutes to chat with the internship director, Karen. Unfortunately, a situation arose that could have been easily avoided with the implementation of the BUDDY SYSTEM, and I was left behind!

Karen politely offered to take me back to the hotel, and it turned out to be a great opportunity to get to know my director a bit more in the short time we had together.

That evening, four other interns and I decided to experience Atlanta the best we could during our limited stay; we hit the town with some friends of one of the interns, learning some more about the city’s delicious food and nightlife!

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A beautiful Southern evening.

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On our way!

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5 of us at a great taqueria–amazing fried pickles and jalapeños!

Knowing how much we might regret our decisions to be out late the night before our travels home, we gladly owned our choices, and arrived back to the hotel just in time for a solid 4 or so hours of sleep.

Day 4: Our FINAL DAY commenced around 6:30am, as we needed to pack our bags, check out, and make it to the office in casual Friday wear for some last-minute information by 8:00. After scarfing down my last complimentary breakfast (courtesy of Staybridge Suites), we crammed those of us remaining at the hotel into a van along with each of our sets of luggage, and enjoyed one last ride together.

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Still unclear on the reasoning for limes at the breakfast buffet, always next to the coffee… Insight, anyone?

We learned about our Long Term Care rotation, and had a nice long lecture on wellness coaching and motivational interviewing. We were able to close things up early around 1:30pm or so, at which point we all said our goodbyes and migrated to MARTA (Metropolitan Atlanta Rapid Transit Authority) to head toward the airport.

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On the way we got a solid last peak into the ways of the urban south, as we were graced with a man shouting the gospel at us on the train (rather inaccurately, per my friend who knows the Word pretty solidly). Fortunately, we were all rescued by this guy:

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We made it to the airport, and said last goodbyes as we boarded our respective flights, and I prepared for the long hours I would spend sitting in a seat in the sky.

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I like to make fun, but seriously SO GLAD I bought this…

After a long half day of travel, I finally made it back, safe and sound, to my very favorite place: home to San Francisco. I have wrestled with some regret over applying to a distance program, and feeling as if I may be missing out on the “real” dietetic intern experience. But after this week, learning what an incredible program I am lucky to be a part of, I could not be more excited to get to remain in the first place I have truly loved living, and have felt as if I fit. I love this city, and all of the diverse experiences it offers. Sorry, San Francisco–you’re stuck with me!

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And made it home just in time for the uncharacteristically beautiful weather! And also for a date night with my favorite guy on the planet :).

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Sandals? What??

Now, time to get myself re-situated, and ready to begin my clinical rotation at Alta Bates Summit Medical Center in Oakland TOMORROW!

Stay tuned for updates on what I am sure is to be an eventfully crazy week.

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Great group! Morrison Chartwells 2013-2014

P.S. My Instagram is @realfoodisthebest. Follow for more like this blog!

Coffee Drinking Associated with Lower Suicide Rates in Some

Coffee Drinking Associated with Lower Suicide Rates in Some

I now feel absolutely NO reason to defend my coffee drinking to anyone! Drink up, coffee fiends. Happy Saturday!

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Happy Birthday to ME!

Today, I begin my 25th year of life on this often times lovely planet. And I am pleased to report that I find myself in good spirits, and very happy with where I am right at this moment. I think back to my younger years, when we girls were planning out the age we’d be at our weddings, how many kids we’d have, and how we’d manage being an actress, a scientist, a journalist, being a mom, AND being a circus acrobat all at the same time, all by this very date–my 25th birthday (anyone else?). Naturally, my life is nothing like what I had pictured then for 25-year-old Sam. But the incredible thing is that I am OKAY with it. And my complete acceptance of where I’m at now only creates more happiness for me, as I feel I can truly call myself an adult. I understand that there’s more to come, and that I do have so much time left. There are endless opportunities ahead of me, and accomplishments, challenges, and joys I will have that I have no way of even expecting now. But I can also see that in order to create positive change for myself, I must act now, learning about myself more and more each day, no matter how much it hurts sometimes.

The best is yet to come, and I have a fantastic feeling about year 25.

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Oh what a day is today…