whoooops.

so i haven't posted in a long time on either of my blogs. i finished up my GI rotation and it was a blast. and went by SO fast! i'm on to neurology, which i have to admit, is the one i've been looking forward to the most. i love working with the ketogenic diet since it's so personal to me and i know a lot about already. i met a patient's mom yesterday who's baby went from having around 50 seizures a day, down to 1 or 2 through being on the ketogenic diet and is on no meds. how amazing is that? the neurology dietitian is amazing. i'm convinced she knows just about everything and is so great to work with. she is excellent at throwing me in and letting me do however much i can and then she jumps right back in without making me feel stupid, and takes over from where i get stuck.

i was at a muscular dystrophy clinic today which was super interesting and i saw most of the patients on my own, yay! there are many forms of muscular dystrophy, but a loose definition is its a group of disorders characterized by muscle weakness and a loss of muscle tissue that gets worse over time. there is no cure for muscular dystrophy and the severity of the disorder depends on the type of MD it is and how fast symptoms progress.

i did see one patient with SMA. Spinal muscular atrophy type 1 or SMA type 1, is a very severe muscular disease and is detected shortly after birth. the mortality rate is around 90-95% by 18 months of age. they lose their ability to suck and swallow, so parents must decide whether to put a feeding tube in or not, depending on the severity of their disease. the saddest part of a lot of these neuromuscular diseases is that the brain is not really affected. so most of these kids are of average intelligence and are not mentally handicapped, however, their bodies just aren't working properly. i really really enjoying working with this population though. so much to learn about and so many ways to help these kids.

i did get a no to the neuromuscular position i applied to, so i was pretty bummed. still waiting on a couple other positions and am looking into nannying too until i find something else. thankfully i have a lot of fabulous people in my life reminding me that the Lord IS good and He is still in this, even when i can't feel Him and feel hopeless. He is good and He is walking through this with me.

new rotation

quick update before bed! i started my gastrointestinal rotation with a faaaabulous dietitian on monday. she is super fun and talkative and makes the work day go by fast. and she is super smart, i've been learning a lot. a tad overwhelmed, but its been great! i would really like to work in a GI setting. i've seen a lot of kids with various issues with their GI tract, so wherever food passes through...constipation, irritable bowel syndrome, crohn's disease, eosionphilic esophagitis, food allergies, intolerances, etc. all very interesting and very nutrition related issues! the gastroenterologists (who study the GI tract and related diseases) really utilize dietitians which is great (most of the time!). i've met most of them and they are super nice. the only drawback is its a lot of phone calls and i hate the phone! so that's taken some adjusting.

still waiting on hearing about those jobs, keep praying! my time at children's is quickly nearing its end...i'm done august 13th, so it's crazy i'm over half-way through. sad :( off to carrollton for the weekend with the newlywed lavelles and seeing jordan! and HOPEFULLY my bestest friends/roomies ever as well :)

rotation #2 done.

i finished up my second rotation with an amazing dietitian in hem/onc and a lot of failure to thrive kids. i learned sooo so much working with this population and really liked it! so sad at times, but i still love what i'm doing. i like having a job in which i feel valued (most of the time!), except when people put a consult in because a 17 year old kid won't eat vegetables. that didn't happen to me, but it did to the last dietitian i was working with. really?! that's not what we do! haha. although working with kids can be very sad and there are so many sad situations, there are lots of funny stories that come of it! one lady said that her child wasn't throwing up on the outside, so the doctors were looking to see if she was throwing up on the inside. hahaha. i cracked up with that one.

moving onto working with a RD who does mainly outpatient GI (gastrointestinal) clinics. i'm anxious to start this rotation, i think it's going to be so interesting and something i would like to do. and the RD who i'm with is super fun and spunky which always makes the work day better :) please keep praying for the jobs i applied for. i know it will work out perfectly, but i'm still struggling with finding peace in that. working with kids is what i'm so passionate about and i know i love....so i hope that i get the chance to do this for real.

new rotation.

i'm onto a new rotation this week, hematology (study of the physiology of the blood & blood disorders) and oncology (cancer). i think i mentioned this in my last post, i can't remember, but the dietitian i'm with also works with a lot of failure to thrive kids. very sad stuff, but i like the challenge of working with families and kids and trying to find what works to get them to grow whether that be through a tube feeding or regular food.

saw a patient with ALL (acute lymphocytic leukemia) today. ALL is the most common leukemia seen in kids and is also the most treatable. there is also a type called AML (acute myelogenous leukemia) which is treated much more aggressively and is harder to get into remission. i also will be seeing another patient tomorrow with hodkin's lymphoma (type of cancer originating in the white blood cells, that spreads from one lymph node to another). the survival rate is very high when detected early on. this patient i am seeing is having a bone marrow transplant soon for the treatment of her disease. props to oncologists...although these diseases are super interesting, it has got to be such a difficult job to lose so many patients. i can't even imagine being a pediatric oncologist. it just seems so unfair to these kids, they are perfectly normal/healthy and then boom, their worlds are turned upside down. they are amazing really (the kids that is). i suppose the doctors are too...

i think i'm doing my neurology rotation next which i am SO excited about. i loved working in neurology last year during my internship and really hope i hear back about the neurology position i applied to.

update.

had another great week last week, nothing too new with what i've been doing, but still great! trying to get two little babies to grow who are waiting for heart transplants...their weight keeps dropping and one little one is almost back to her birth weight (she is two months old). so that had been a challenge. but they are doing ok as of now. i am sort of on my own tomorrow checking on our transplant patients because the dietitian i've been with is off...so that's kind of cool, minus not getting paid.

i start a new rotation this week in hematology/oncology, so i'm preparing myself to once again see some pretty sad stuff, but i'm looking forward to it. the dietitian i will be with also works with failure to thrive kids, or kids/babies who just are not growing properly. their height/weights are typically way below where they should be on growth charts. there can be a huge variety of causes of failure to thrive- chromosomal defects, heart/lung problems, kidney issues, GI problems, metabolic issues, etc. or it just may be a environmental factor such as not enough food available, emotional issues, etc. huge variety. it's important obviously to reverse this growth stunting so that they can reach appropriate milestones for their age. anyways, i'm super excited to start this and to continue to get to work with kids.

keep praying (BIG prayers!) for my application at cinci children's...got a no for one application, but my other was sent to a hiring manager, so i'm praying for a phone call this week and maybe an interview. we'll see, i'm focusing on being hopeful this week.

eating disorders.

so i got the chance to sit on a counseling session for a patient with anorexia last week and it was super interesting. when i got to work this morning, the RD i'm working with said another anorexia patient came in over the night so she was ours to follow. i was pretty excited to see how they handle things inpatient because of how strict the protocol for anorexia really is. this patient is very young, and weighs all but 80 pounds. so sad. but seems very open to trying things and doesn't seem to have too many food aversions (things they simply will not eat), which is good. a lot of patients are obsessive about what they will and will not eat and that makes things very difficult.

these patients come in and are kind of thrown into the therapy they do inpatient without having any idea what exactly it is and it's very shocking, especially for the young ones and to the parents. every privilege these patients have revolve around them eating, the therapy they use is called the Maudsley approach. they are weighed every morning (are not told their weight) at the same time in a gown and after they have gone to the bathroom. they are allowed three aversion foods, or three foods they REFUSE to eat. other than that, the RD's pick everything they eat while in the hospital. we start at a very low calorie level, (800-1200 cal) depending on what they have been used to eating at home. we increase calories by 200 each day, working usually up to 2600 cal/day which is what most of them need to steadily gain weight back. if they don't eat all their food (which is eaten in a nurse's office with someone), they must take the equivalent in calories of what they didn't eat in Ensure (a supplement drink). they have 30 min to eat everything and have to stay in this office for 30 min after eating to ensure it stays in their stomachs. if they do well and eat everything, they get phone privileges & a hour of visitation. if not, they get these taken away.

there's a lot more to this protocol, this is just a snapshot of what happens initially. there is no messing around with this, it's so serious and a lot parents think it will just go away and get better. this is a lifelong struggle for these girls, its heartbreaking. i really enjoy working with this population though. frustrating, but very interesting. i love food to much to not be able to eat it haha keep praying for a sweet little baby waiting for a heart, she needs it badly!

love my job!

still LOVING what i am doing!!! i'm beginning to be able to function/think on my own without having to ask questions every other second. was able to see a couple heart patients yesterday on my own-check their ICU flow sheets, see how they were tolerating feeds, see any weight gain, etc. it's cool with little babies because they have a certain growth velocity they should be gaining every day (example-20-30 grams a day) and so you can really chart whether their formula they are on is working for them or not. and i wrote and signed my own notes! i feel like a little kid getting excited over that...but it's exciting for me haha.

i completed my own consult today too for an EIGHT day old baby-eek! so so tiny! he was in the hospital because he had been feeding really poorly and losing weight-he isn't below his birth weight yet, so hopefully he starts gaining instead of losing. i called the medical team taking care of this little guy and explained why we needed to up his formula rate to give him more calories and protein...annnd get this, they asked ME if i wanted them to change the order! what is that?! typically doctors completely write me off with any suggestions. it was great to see the order change within 10 minutes of talking to them! i was a nervous wreck before they called, but i survived :)

anyways, that was my day today...i love it! i applied to a job at cincinnati children's yesterday, so please say a prayer. i'm not counting on getting a peds job right out of this fellowship (even though that would be ideal), so we'll see what happens.

quick update.

four days into everything and still loving it!!! like i said before the dietitian i am with is a saint and is ammmmazing at being patient with me and she is super smart. i'm doing my cardiology rotation right now and working mainly with cardiac transplants. i LOVE it! i don't know how long it's been since i've had four straight days of work that i love...a long time, that's for sure. haven't done TOO much, still just shadowing, but i have my computer access, so i should be able to do a little more! a patient waiting for a heart was listed on the transplant list thursday and got a heart saturday!!! so that is WAY exciting- hearts don't come around that quickly usually. pray this little guy stays healthy and recovers quickly.

i am currently applying to a job at Cincinnati Children's, so please say a prayer if you remember. i am trying to be hopeful about it and think positively...i've been stuck in a hopeless rut lately and don't want that to be hanging over my head when i start reapplying again. more soon once i have INTERNET on wednesday, ptl.

day one!

day one started out terribly and ended wonderfully!! i had my physical this morning and then had to get bloodwork drawn for my titers (hep A, rubella, chicken pox, etc) so if i don't have antibodies to them, i can get a free vaccination. kind of nice, but i don't like getting blood drawn. however, i am not scared of getting it drawn...i've had it taken so many times over the years that i'm OK with it. i sat down and told the nurse "i'm not so good with needles, but i've never passed out". so what do i do?? I PASS OUT! i was soo embarrassed! she had to stick me twice and made me squeeze a ball so i think i got freaked out thinking about how i was pumping blood out of my body. and i fainted. and woke up to four nurses holding my head up, holding ice packs on me and fanning me. haha horrible.

but i worked with a fabulous dietitian and she gave me a tour of the hospital, showing me where everyone covers, what unit clerks to avoid and what she does. i'm SO excited to really start getting into it and learning how to function on my own there. she was telling me how much more dietitians are valued over there and how they are more involved in the patient's care. i am going to enjoy working here so much, i can already tell. i was a tad overwhelmed just because not only do i need to get back into writing assessments, but i need to learn how to assess pediatric patients. MUCH different than adults.

i have a feeling i am going to appreciate my health and the health of those kids in my life that are healthy. the dietitian i was with was telling my how a couple of patients have already died on her and how upset she was. these poor kiddos were dealt a rotten hand for the beginning of their lives and i have a feeling i'm going to be doing a lot of praying as i come into contact with these kids. say a little pray for a sweet two month old baby girl i met this morning, she is waiting for a new heart. i'm so excited though to be doing this. i finally felt the Lord's blessing on this opportunity today.

here we go!

welp, i start monday with my pediatric fellowship at the Children's Hospital of Michigan! i'm pretty excited and no where NEAR as nervous as starting my internship (thank you Lord.). otherwise, i wouldn't have eaten much the past month and that hasn't seemed to be a problem :) i'll be doing four three week rotations in neurology, gastrointestinal, cardiac and hemotology/oncology. not sure of the order yet, but i'm working with some awesome dietitians and am really excited!! tune in next week for an update :)

new blog!

soo im graduating this blog and am starting a new one :)
i have no clue if anyone reads or checks my blog anymore, but my new blog is http://megs486.blogspot.com/. happy blogging!

so close.

i can almost taste freedom!!! its at the tip of my fingers...only 2 1/2 days until i am DONE with this internship!!! i can't believe it. yes at times it seemed to draggg on, but it has FLOWN by otherwise really. tina, dave and taylor are coming up thursday for graduation and then we all go out to dinner with all the dietitians and families, etc thursday night. it should be fun!! still waiting to hear about the part-time job....say a prayer for me. i really want to hear about it! if not, maybe i'll get a christmas-nothing job to earn a little christmas money. who knows...im trying not to worry about money right now. if i think about it too much, i'll start freaking out and i don't need that yet. i want to actually EAT thanksgiving dinner this year...last year i was so stressed out and sick that i didn't eat much of thanksgiving dinner. or anything of that matter until i moved to michigan ha. that sucked. but im trying to stay calm, patient and remember that im in better hands than mine, better hand than i can even imagine. so thats what i keep reminding myself when i feel the need to take over and plan everything out. its not in my hands and when i really think about it, im glad in not in charge, i don't think i'd do a very good job.

four days til i move HOME, five days til i get to spend more than a weekend with jordan (and see helen/brad/everett & go to church), 8 days til im reunited with my best friends ever, annnd 2 weeks and 2 days til im reunited with kimberly!!! good couple of weeks ahead :) :)

purpose.

so frustrated with my staffing. i feel like my job is worthless. like i don't make any bit of difference with what i am doing. i never get very many consults and feel like dietitians are not really utilized where i am. i hope thats not the case at every hospital. i don't like working with adults who don't care at all about their health and thus have put themselves in the position they are in...i.e. having diabetes, high blood pressure, kidney failure, liver failure because they drink too much. maybe this is a bad attitude for a dietitian to have, but when a person has had diabetes for 10+ years, have never done anything to control it, and are in the hospital for a couple days...i feel like my efforts to see if they want diet education are futile. maybe inpatient clinical is not the place for me with adults...maybe its the population of detroit...maybe i just need to remember how i loved my pediatric rotation. i don't know. and i hate feeling this negatively so much towards this when im so close to being done. but its scary to me that i feel like this and am ready to go out into the real world. i don't want to go back to school...but don't really know if this is what i'm called to do. if it isn't, then what is it??

enough complaining already. i just want to have a job i love. something that i ENJOY doing. not that i dread going to work for and feeling like i need to hide because i don't want to look stupid in front of a doctor. i want to make a difference. i want to do something that the Lord is calling me into, where i can affect people's lives in some way. and where i feel CONFIDENT in what i am doing and confident in who i am with whatever job i am doing. i don't feel that where i am right now and i don't like that feeling. seven more days...can't wait to be done.

on a happier note, jordan came up for one last time and it was a perfect weekend. he took me to the melting pot for graduation and it was AMAZINGGG!!! it was so delicious. and just so nice to be together for a weekend, hang out, be a normal couple. can't wait for four whole days in c-town soon and a week with my best friends then a weekend with kimberrrly!!! yay for perfect friends.

update: 3 weeks and 1/2 day!!

so close! we started our staffing rotations and i am at detroit recieving hospital...the trauma hospital at the DMC. we are in charge of two floors for four weeks...and its gone well so far. i actually really like having my own floors and being able to figure out what patients i am going to see and organizing my floors. now the next step is...lets pay me for the work im doing!!! haha still waiting to hear about the part time job i applied to in steubenville by jordans house...keep your fingers crossed please!

i finished my marathon last weekend!!!!! i was SO happy, i almost teared up when i crossed the finish line :) it was so great!! granted i was barely able to walk monday & tuesday...but it really was great. the first 13 miles were fine cause i was more focused on getting tay though her half, which btw she did AMAZING!!!! i was SO proud of her. oh and i have the BEST roommate/running coach ever...colby flew up from va beach to see the race. it was SO good to have her there. after mile 13 it really hit me, oh my gosh...i still have 13 more to go, that was a little daunting. miles 16-19 were really painful and dragged on, then jordan jumped in at mile 20.5 and kept me going...if not for him, i probably would have walked. colby ran the last 1/2 mile and i was even able to sprint the last .2 miles. it hurt like hell, but i will do it again! it felt so good to finish and know all that training i put in paid off. i can't wait to get running again.

three weeks...i can't WAIT to move home. and spend time with my family, jordan and best friends. i miss being able to see them all the time. almost there!!

t-minus 5 weeks and 3 days!!!

yep, five weeks and three days til GRADUATION!!!!! and until im RD eligible and able to get a J-O-B!!!! hooray! im SO ready. im so ready to be done with this school thing. im also nervous about being my on my own...like no one to look over and correct my notes. am i really ready/smart enough to actually be a real dietitian?! i guess we'll find out...

i applied for a part time clinical position in steubenville, ohio...which is about 45 minutes from jordan's house. so if i do get it, i will be living in morgan's old room at the lewis residence haha. hopefully i'll be doing the fellowship at children's hospital come may, or i'll find a pediatrics position sometime soon so it would only be temporary, but would be great to only have to work part time so i can study for the RD exam. and i'll get some quality time with the lewis family...hopefully they won't want to kick me out after a couple weeks :) not giving my hopes at all on this though, we'll just have to wait and see what happens.

im in my last regular rotation-oncology. its really sad, but its good so far. i really like the dietitians who work in karmanos, the cancer hospital here. i was placed at detroit recieving hospital for my staffing rotation which im happy about...just a little nervous cause i don't work very fast over there! it will be good though. i present my case study to all of the RD staff thursday...say a prayer for me. can't wait to get it over with. the next several weekends will be great-tay's homecoming/babysitting my boys, marathon weekend, tina comes to visit then jordan comes up and we go to the melting pot, YUM! yay for good weekends :) i had my last over an hour run today (10 miles to be exact) before the marathon which felt good. yay for four and less mile runs! ok, its bedtime! nighty night.

fall is here.

fall has made its entrance today! its rainy, cold and yucky outside. but i am ready for it. well maybe not the super yucky and rainy part, but im for sure looking forward to fall-y weather and everything it entails...like soup and sweatpants and fires and hot tea! i met a family tonight that i am going to babysit for every wednesday til i move back....mainly i'll be watching their eleven month old little girl, shes SO cute. and they have a three and a half year old girl with the most BEAUTIFUL long blonde hair, i was jealous. im excited, just wondering why this didn't come along before september 28th!! bahh. oh well...it'll be fun at least for the next 7 weeks til i move.

20 days til the marathon!!! :)

20 mile run? check.

so i got up at 7 and was on the road by 7:40 to start my seemingly endless 20 mile run and finished at 11:05ish. i was nervous about it since i haven't had a long run in about three weeks. well, i ran 11 on monday, but i mean like a long long 15+ mile run. i know 11 seems like a lot, but i would gladly take an 11 miler over a 15-18 miler any day! i sort of split it up into three parts and started out really slowly and i felt awesome the whole entire way. of course towards the end i was a little bored and feeling it in my knees/hips, but other than that it was awesome. the aftermath is a different story, i haven't felt so good today unfortunately. i have been eating everything in reach though! perfect weather, 55-60 degrees with no sun and all clouds. definitely a blessing in the weather department :) it misted on me too for a good 3-4 miles so that felt nice towards the end. tay ran nine today and ran the whole way! i am SO proud of her for sticking with it, i couldn't have done it for my first half without someone there making me run (colby dearest). and i have colby to thank for getting me hooked on this sick addiction. i really love it though, it is such a good feeling of accomplishment completing longer and longer runs and working towards a goal. one that i thought i NEVER EVER would have been able to achieve. so, lesson learned, never say never! its great though and i am looking forward to october 18 at 7:30 am when i get to run my marathon!

pray that i stay injury free as well...my mileage decreases big time these next 3 weeks and i get two whole days off in a row after today...but a lot of injuries happen towards the end. i would be so so devastated if something happened (stress fracture, strain, etc.) and i couldn't run. i've been working at this for too long for something like that to ruin this. my friend has a stress fracture in her hip and can't run in the chicago marathon she's been training for. yuck. off to bed at 10 on a saturday, im exhausted.

crazy life.

whoops, its been a little while since i've posted. here's a quick recap of what's happened the past couple of weeks...i finished at detroit receiving hospital last week. it was a really great rotation, lots to do, crazy patients to see. we got to see a PEG tube (feeding tube into the stomach and through the abdominal wall) placed, and i almost passed out lol. then we got to see a skin graft which was cool. i was overly cautious though to watch it so i didn't hit the floor in the OR. it was like 1000 degrees in the operating room though, burn patients have a hard time maintaining their body heat, so we were sweating buckets and the thing they used to harvest skin looked like a cheese grater. sick. but it was neat to see. saw some pretty sad stuff though. its a whole different world here in detroit that the majority of the US is sheltered from.

i started at the rehabilitation institute of michigan (RIM) this week and its been alright. kind of boring, but easy stuff so far. i have one more week there then onto oncology for 2 weeks, then staffing for 4 weeks where i'll basically have my own floor to manage, eek! am i ready for that?! so only 7 weeks until graduation...SO weird. i present my case study 2 weeks in front of all the RD's and im ready for that to be OVER. i have my 20 mile run on saturday morning and i am readyyy! can't wait for the marathon.


went to steve rader's wedding a couple weeks ago, he is kyle's old roommate and one of nick and jordans good friends. it was a great time and SO weird to see him get married. he's the first of the group to get hitched, i cant wait for nick and beth's wedding in may, it will be AWESOME! i got to surprise my roomies and go to the morgan county fair a couple weekends ago and it was perfect. they had NO idea and i love surprises like those :) i miss them, can't wait for november 18th.

code blue.

so i saw a patient code today. or for those non-medical folks, his heart stopped and required CPR to get a heartbeat. and it was absolutely nothing like what you see on grey's anatomy. i think this patient really wasn't expected to survive, so that might be why it was so laid back, but it was so calm. a lot of people were gathered around the bed and looking in outside of the room. three or four people kept switching on and off doing CPR while others were handing in meds and really big needles/syringes of serious stuff. i've been certified in CPR for a long time, but have only seen it once besides this time, and the person came to after a few minutes. this went on for a while and we left before we saw what happened. it was just weird to see in real life in a hospital. its nothing like it is in the movies. it was a weird feeling seeing someone die. a patient i saw at the beginning of the week died the next day too, he was only 39. things like this make me appreciate my health so much more. a lot of these people's lives changed in the blink of an eye.

anyways, thats my depressing post for the day. we have to be at work at 630 tomorrow so its to bed at like 9 tonight. sick. can't wait for the weekend though!!! its going to be greattt!!!! :)

i feel God in this chiles tonight.

bahaha im watching the office right now, season two dundees award and its pretty funny :) lori and i played the office trivia game last night too, i cant wait for new office episodes!! my butt is currently parked on the couch, my knees are throbbing and i ran 17.5 miles this morning! the weather was perfect, 55 degrees when i started, 60 when i finished and very little sun. gorgeous! it took me quite a while to get into my groove where i felt good, but it was overall a fairly good run. i feel better now than i did when i finished my 16 miler a couple weeks ago. only 6 weeks til race weekend...im pumped! i kind of wish i had gotten my act together and ran for a charity or something, the cbus marathon didn't have any that i could find that took runners on unfortunately. so i totaled my miles from i think may 25th up until now and i have logged 358 miles!! craziness!!!! that seems like SO much!! its been a perfect perfect summer for training, im very thankful for the cooler weather this summer. tay and i are going to get crazy running tights to run in...possibly pink zebra tights :) what color do you think?? running funky i like the cow and giraffe, but they aren't very colorful!

off for a nap, and then babysitting at 4:30 for ethan and aidan. hopefully they don't have much energy tonight...not sure i will be able to keep up with them lol. can't wait for next weekend, i get to see some of my favorite people! (nick, beth, j!) and our crab cake dinner is next weekend toooo :)