Archive for tag: diet

Intern Skills - Dietary Assessments and Modifications

One of the many skills that we develop while here at NUHS, and perhaps one of the more important, is taking an assessment of a patient's typical diet. Once we have a good diet recall or diary from a patient, we can determine the benefits and drawbacks of the patient's diet, the impact (for better or worse) upon the patient's health, and then we can make modifications as necessary to help the patient return to a basis for health.

2013-10-30_intern
Intern Heather Bautista taking a dietary assessment from Intern Jerrica Sweetnich.

We start by getting a log of a patient's typical weekday and weekend diets as many people eat differently on the weekends than they do during the workweek. After a review of the diet with the patient, we consult with our clinicians regarding the patient's chief complaint, review of systems, health stressors, and treatment plan. Part of the treatment plan involves modifications in a patient's diet and may include the following:

  • Water Intake or hydration
  • Meats (unless vegetarian/vegan)
  • Vegetarian/vegan sources of protein
  • Vegetables
  • Fruits
  • Avoidance of grains (if necessary)
  • Healthy fat (Omega 3 Fatty Acid) sources
  • Dairy sensitivities
  • Estrogenic food intake and impact upon estrogen levels
  • Sugar intake
  • Fiber intake

...just to name a few.

Dietary modifications are a key tool to help our patients return to a basis for health. Our health begins with the nutrients we provide our bodies for building strong muscle, bone, nervous tissue, and preventing or fighting infection.

With that said, I'll grab a healthy bite to eat and make my way to clinic for the afternoon shift. This evening its time to carve pumpkins by the fire pit and make ready for Halloween!

Another Trimester

Well, everyone, now is the time to close out yet another trimester of classes. Next week is finals week and we will have a two-week break before returning the second week in May. 

This trimester has seen some short-range changes in schedule, work and diet in order to affect long-term outcomes for the better with regard to clinical learning, finances and health for years to come. 

The classes this trimester have been brutal with the workload between exams, quizzes, papers, presentations, prescribing, assignments, and attendance. At the same time, I feel like our studies have come full circle and we have applied all of the facts that are thrown at us in the basic sciences portion of our studies.  We have prescribed, differentially diagnosed, treated and critiqued both our own work as well as that of our classmates. We have delved into complex topics such as the impact of biofilms on the human organism, the impact of an improperly functioning methyltetrahydrofolate reductase (MTHFR) enzyme and its necessity within the human body as well as the efficacy of liposomal delivery of supplements, just to name a few topics. 

When I took a firm look at my finances currently and projected them to graduation day, I knew I needed to take action to change the situation. When assessing the income opportunities while attending medical school, I weighed staying on a "full tilt" schedule versus slowing down to finish classes before clinical rotations and working a part-time job. Finally, mapping out the resources necessary for moving back to North Carolina, gaining a residency position or joining a practice, allowed me to be prepared for any situation I could think of. Of course, things may come up or ideas may come about that I didn't fathom before. This is when I will take time to pause, reassess and adjust the plan as conditions warrant. 

My diet has changed for the better. I have established the habit of taking a long hard look at the foods I put into my body. I have had to make some hard decisions as eating healthy, organically produced whole foods is a bit more expensive and time consuming to purchase and prepare. I plan my shopping trips better, don't waste time or fuel on multiple trips to the store, all while maintaining enough food without it going bad. Disclaimer: I have tripped up a couple of times when I felt rushed or simply too lazy to take time to cook properly. Good lesson for future patient care and "patience with patients" in there somewhere. :) 

I suppose the primary thing I have learned from the last 15 weeks is that we can accomplish what we need with the resources at hand. We simply need to look at our options, see what is available, then map, develop and proceed with the plan. Take a few stops along the way to measure progress, reassess direction and make changes if necessary. No rigid dogma required; flexibility and ability to admit error is key, as long as corrections (and progress) are made. I'll be working, then heading home to western North Carolina for the break. I'll definitely catch up with family and friends back home, do some work around the property and relax mostly. I hope each of you has a wonderful spring season! See you next trimester when I will be entering clinical rotations (for certain this time!) and sharing a bit about the "clinic life"!

2013-04-10_ducks

In the spirit of getting by and excelling with what one has, here is a pic of two early ducks in a tiny puddle on campus after a rain and a quote from Ralph Waldo Emerson! Make do with what lies "within"you, develop and excel those traits and be your best! 

What lies behind us and before us are tiny matters compared with what lies within us. -- Ralph Waldo Emerson