Outpatient Diabetes

Monday, Tuesday, and Wednesday morning I sat in on a three hour diabetes class. A nurse and a dietitian taught the class and covered various topics about what diabetes is, medications, blood sugar monitoring, insulin, weight loss, carbohydrate counting, and making healthy diet choices. It was a nice refresher class for me. In the afternoons I sat in on outpatient diabetes counseling assessments and follow-ups. For lunch on Thursday, a representative from Omni-Pod came in to teach the dietitian and two nurses how to use it. The Omni-Pod is a tubing-free insulin pump that is wireless and waterproof. It can be used by Type 1 diabetics instead of giving themselves several insulin shots a day. I turned down the offer to wear one for the day, but I still got a better idea of what diabetics go through for their insulin therapy. Thursday was also the day I followed a consistent carbohydrate diet, one like a diabetic would follow to help control their blood sugar. First I had to figure out how many calories I needed to consume in one day. I got 2100 calories. Then I calculated the amount of carbohydrate, protein, and fat I could have. I got 195 grams of carbohydrate, 77 grams of protein, and 30 grams of fat. Next I had to plan a menu for the day, one that includes a variety of foods from every food group. My consistent carbohydrate diet is as follows.

Breakfast: 60 grams
AM snack: 15 grams

Lunch: 45 grams

PM snack: 15 grams

Dinner: 45 grams

Bedtime snack: 15 grams

I would have followed my menu perfectly if I wouldn't have had the lunch that the Omni-Pod guy brought in from Panera Bread. I accidentally had 75 grams of carbohydrate. Oooops. This exercise helped me understand how difficult it can be for a diabetic to plan meals and feel uncomfortable at restaurants. Now I find myself counting carbs at every meal I eat. On Friday morning I got to check my own blood sugar--I was scared. My fasting blood sugar was 93 mg/dl, which is normal. I went with my preceptor to the Federal Reserve Bank of Dallas for an employee health fair. The security was crazy, like an airport. We talked to people about diabetes. I participated in some of the fun things that the health fair was offering. I wore a stress dot for the day...it was black all day, which meant I was very stressed. Go figure. I also had my blood pressure checked...that was not so good either, but I think I was just anxious for Dan's arrival. At least my Bone Density scores are good. Our gift for participating in the health fair was $80 in destroyed money in a little baggy. Federal Reserve Banks are responsible for the destruction of unfit currency and destroy several million dollars each business day.

Dan's Visit

Dan flew in from South Carolina Friday night. Saturday we had an amazing dinner at Suze with intern Megan and her fiance Ryan. We enjoyed lots of delicious food and wine! After dinner we went boot scootin' at Billy Bob's Texas in Fort Worth. Buddy Guy was the main event. We learned how to two-step and country swing dance. I need lots of practice. The country swing dance made me dizzy. There's lots of spins! I had one fall, but I blamed it on my boots because they are slippery. My goal is to master these dances!

Food Service Director Shadow

Monday was a free day for me, but I decided to go to the hospital to help with the start up of the last building for the hospitality program. I also caught up on some homework while I was there. My Valentine had roses delivered to me in Nutrition Services, which is two stories under ground. Apparently he had some help from Kristi, my internship director. Sneaky sneaky =) I worked at Suze on that crazy Valentine's Day night. The whole time I was taking reservations for that night, I was thankful that I wouldn't be the one working. The night went pretty smooth until about 7:30 or 8:00 when six different parties came in and there were no open tables. To avoid complaining I just offered them a glass of wine or champagne.

Tuesday and Wednesday I went to Texas Scottish Rite Hospital for Children to shadow the food service director. It is a small hospital that does Patient Room Service as well as some larger catering/conference events. We talked a lot about budget and inventory, both something I won't fully understand until I actually have to do it myself. It was very interesting getting advice and learning from someone who has been in that position for about 20 years.

Thursday and Friday I was back at Texas Health Dallas shadowing the food service director there. She has a crazy job, always running around to different meetings or calling people to schedule another or deal with situations in the kitchen. I tagged along with her to the meetings and while she did employee rounding. One of my assignments was to write an apology letter for when patients are unhappy with the service they received from nutrition services. Thursday Anna and I presented our administrative project. It is nice to check that off the list. Friday was extra crazy because a case study patient was found for me. The patient has Polycystic Kidney Disease. I don't know anything about it yet, but by the end of this project I will be an expert. Lots of research hours in my near future.

Friday night Megan and I went for a walk and then went to The Village Country Club for dinner and drinks. Everyone at the bar was extremely nice. We had many good conversations with people we had never met before. There was also a karaoke contest that night. A Mexican lady kicked off the night by singing The Star Spangled Banner. That was hilarious! We sang All I Wanna Do by Sugarland with a girl we met. We did not win. That was a hard song to sing, I can't even sing Happy Birthday in tune. Saturday I went to yoga then Megan and I went for a jog/walk around White Rock Lake (9 miles). After that we were moving slow so we got a Gatorade and went to Humperdinks for some food and a margarita. We got some fried pickles served with jalapeno-ranch sauce. YUM! Today I am sore.

The Green Bay Packers Super Bowl XLV Victory in Dallas!

I didn't get tickets to get into the Super Bowl--they were a little out of my price range. I did get to tailgate with Kristin (intern) and her fiance in the Panda Express parking lot with The Big G. http://www.thebigg.info/ We got to the tailgate area at about 11am. Such an awesome experience!! It was a huge rush to be around a bunch of craaaazy Packer fans at Cowboy's Stadium. News stations came by the RVs to interview fans and check out the inside of the RVs. I think I might have made it on TV in London. I tried on some guy's championship belt. I ate DEEElishious Miesfeld's Brats from Sheboygen, WI. I walked around the perimeter of Cowboy's Stadium through massive crowds of Packers and Steelers fans and street preachers. I had a memorable bathroom experience. Weirdest thing, everywhere I went the line for the men's bathroom was out the door. I walked right up, did my business, and then walked out with a huge grin-the boys were so mad. Seriously, when have you ever seen a line for a men's bathroom? Oh yeah, I also met Randy Jackson and got a signed picture of him. I watched my first episode of American Idol five days prior to meeting him. He's a cool guy. I watched the Super Bowl on a TV between two RVs with Cowboy's Stadium in the background. I got teary eyed when the Packers scored the first touch down. It was cold. Then it started to rain. No more TV outside. TV got moved inside the RV along with 20 craaazy Packer fans, including me. I screamed a lot. Then the Packers won and I screamed some more. Holy cow. That was neat! We all celebrated in the rain until about 11pm then sat in traffic for the next two hours to get home. I didn't feel tired the next day because I was so excited, but my throat hurt probably due to all my screaming and cheering.

2-Week Administrative Staff Relief

For my two week administrative staff relief I chose to be with Emily, the manager of patient meal services. I was very fortunate to be a part of the implementation of the hospitality food service program at Presby Dallas. What is it? The host/hostess takes patient meal orders 1-2 hours before meal time using a touch screen notebook right at the patient's bedside. The host/hostess reads the patient his meal choices and enters them into CBORD. The host then goes back to the kitchen to assemble the trays and then delivers the trays to the same patients at designated meal times. This style food service essentially improves tray accuracy and patient satisfaction. Accountability is another important factor because the host that takes meal orders and prepares each tray is the host that serves it to the patient. No passing the blame! The hosts and hostesses also got new uniforms that look very sharp.

We started slow with the implementation process by doing one building at a time. I helped with computer training of employees and went with them during their first few days of taking patient's meal orders. This was a bit of a challenge for me because some of the employees don't have much computer skills and on top of that they don't speak very good English. During the implementation process it becomes clear that the way the plan looked on paper is not how it is played out. Throughout the two weeks I offered many suggestions and opinions about other ways to go about things. I also got to participate in employee job interviews by asking the applicant questions and taking part in the decision making process. Being a manager also means that you have to deal with upset/needy patients and employees needing corrective action. It was interesting to observe how these situations were resolved. These two weeks were an awesome experience for me. I love the hustle and bustle of being a manager. Even though it can be very, very stressful at times, I like it because there is always something going on that needs your attention. I think this is definitely what I want to do some day!

So, that was a summary of my two weeks. Now lets talk weather. YUCK! In my 23 years of living in Wisconsin I have never seen such a mess! On Tuesday February 1st, after it had poured all night, a nice dusting of snow came along to make things extra slippery. I planned on going in early because I just knew it was going to be bad. That plan failed because it took me about 30 minutes to de-ice my car. It was covered in an inch of ice with the doors froze shut. I had no other choice but to start kicking my doors. It worked. I gave the two Chinese men who were taking a picture or video of me two thumbs up. The roads were terrible. No salt on them, just ice, so slippery. Bad roads also means that a lot of people don't go to work. I would estimate that the kitchen was working at about 40-50% of its normal workforce to feed the same number of patients. On Friday February 4th, with the ice from a few days ago still lingering, a predicted one inch of snow somehow became six! In Wisconsin these six inches would have been cleared off the road during the night to make them safe. Not in Texas! They just let it sit. Wednesday February 9th there was another slippery sleet/snow storm. There was a big accident blocking the driveway to get out of my apartment complex. I had to turn my flashers on to turn around. That's another long story, but my flasher button is now broken.

P.S. Olive Garden lets you try a bunch of wine for free in 2 ounce portions =)