OB/GYN and NICU

3/7/11-3/11/11

* *Each week in the United States, 9,246 babies are born premature.

I spent the week in the Neonatal Intensive Care Unit (NICU) figuring out calorie needs, enteral, and parenteral nutrition support (tube feedings) for teeny, tiny babies. They are so tiny they are weighed in grams. One of my babies weighed only 980 grams (2.14 pounds). Babies born prematurely, before 37 weeks, are at increased nutritional risk due to poor nutrient stores, physiological immaturity, and/or illness which increases nutrient needs. They usually have under-developed lungs, requiring them to have breathing support as well as an under-developed gut. If they are born before week 34 of gestation, infants demonstrate uncoordinated suck/swallow which requires tube feedings. Parenteral nutrition (food through veins) is often started right after birth. It consists of separate solutions of protein, carbohydrate, and intravenous lipids (fats) as well as electrolytes (sodium, potassium) and minerals (calcium, phosphorus). Enteral feedings (food fed through tube that goes into stomach or small intestine) consists of special or premature formulas or breast milk. Some of the special formulas need to be mixed. This is done in the formula room by the diet technicians. I got to help out one day. In the picture above I am weighing out the correct amount of formula to be blended with a specific amount of distilled water...my favorite is the hairnet :) Basically, the week consisted of lots of calculations. While doing some calculations for homework, I was reminded of the days of algebra back in high school when I was crying at the kitchen counter because I didn't know how to do it. It was quite frustrating at times.

The other part of the week was the OB/GYN part. This consisted of learning about the nutrition requirements during pregnancy and breast feeding. I got to observe a breast feeding class. I thought this was just remarkable and very interesting!

On Saturday I ran the Saint Paddy's Day Dash Down Greenville 5K run with Megan, Anna, and her husband. There was lots of green. People were handing out Jell-O shots to the racers during the race. Afterwards, I hydrated myself with beer and spent the day walking down Greenville in a sea of green people. I've never seen such a huge party. I spent the entire day Sunday doing nutrition support homework. It was rough.

Texas Health Allen & Radiation Oncology

Monday I had the day off, meaning I didn't have to go anywhere, but there was work to be done. I used the day to catch up on folders and evaluations and to get my car's air conditioning fixed again.
Tuesday I went to Texas Health Presbyterian Hospital Allen. It is a small 80-bed hospital about 20 miles north of Dallas. My preceptor at Allen is the one and only dietitian on staff there. She sees all the outpatients and inpatients as well as gets involved in the community. I did a few assessments and a diabetes education on patients.
Wednesday and Thursday I was with an outpatient radiation oncology dietitian at Dallas. She is only there two days a week and catches patients as they are arriving or leaving from radiation. I was surprised to learn that many radiation clinics don't offer the services of a dietitian. A dietitian plays a huge role in the success of cancer treatment by helping with symptom and side effect management. Some side effects of radiation and chemotherapy include: loss of appetite, changes in sense of taste and smell, constipation, diarrhea, dry mouth, nausea, sore mouth, sore throat, difficulty swallowing, vomiting, and weight loss. During this time a patient can eat whatever they want as long as the can tolerate it. If they can't get enough calories by eating, tube feeding may be required. One of my assignments is to taste-test and evaluate two nutritional supplements. One is a vanilla flavored powder for weight gain. It says to mix with milk. I'm going to try mixing it with orange juice and hope that it tastes like a dreamsicle. All together it will equal 520 calories and 20 grams of fat, but only 8 grams of protein.
Friday was another day with the Allen dietitian. We spent the day in McKinney, TX at Collin College for their health fair. We had information on healthy eating, cholesterol, how to lower sodium in your diet, and tips for healthy grocery shopping. I was amazed by all the crazy questions that people had for me.
I spent the weekend resting up, baking, doing homework, and going for some longer runs...that 1/2 marathon is right around the corner!