Outpatient Nutrition Counseling

People require dietary counseling for a variety of medical conditions including diabetes, obesity, high cholesterol, high blood pressure, gastrointestinal problems, and many more random reasons. Counseling is a talent, it takes practice. I strictly observed the dietitian this week, paying close attention to her techniques. Motivational interviewing is used to get the client to find answers and solutions to their own problems by asking them the right questions. Some clients come in to the counseling session expecting the dietitian to come up with solutions to all of their problems. They want the RD to tell them exactly what to eat or what not to eat. Some people have unrealistic weight loss goals and simply don't know that the high fat, high sugar foods they are currently eating are standing in the way of their weight loss success. I assisted the RD with educating a newly diagnosed gestational diabetic. I got to teach her how to follow a consistent carbohydrate diet for the duration of her pregnancy. Being an outpatient RD is interesting and tiring. An initial visit is usually at least an hour or over two hours of hearing about the client's story, motivating, and teaching. When the sessions were done I charted on them using the nutrition care process and then the RD checked it over and faxed it to the doctor's office.
Over the weekend I enjoyed the sunny skies with temperatures in the 70s and went for a really long run around White Rock Lake.

Presbyterian Hospital of Plano--Clinical

This week I got thrown out to the wolves! By Friday I felt like a dietitian! I gained a lot of confidence with this clinical stuff because I got to work independently and at my own pace. Each day I would get a list of 4-6 patients with a variety of problems. Some were assessments, some were follow-ups, and some I had to give nutrition education to. I had some patients that had difficult nutrition problems...for example I did my mini-case study on a man that was admitted with hepatotoxicity (liver damage related to alcohol overdose) and hypokalemia (low potassium in the blood). Here is the story: 46 year old male who has had alcohol abuse for 30 years, lives at home with his wife and 6 kids. He owns a landscaping company and used to fight in warehouses for money. He lives on his couch and drinks 1.75 liters of whiskey ever other day to prevent withdrawal symptoms. He hasn't left the couch or his house since October. He hasn't eaten solid food for three months, but does drink smoothies with raw eggs daily. He frequently falls and has mini seizures. He was admitted due to a fall that gashed his forehead. Interesting huh? It was great experience. I also got to attend my first 'rounds'. That is when the doctor, social worker, case manager, dietitian, nurses, insurance person, and a few others walk around patient's room to talk about how the patient is progressing. Since these were ICU rounds there were several patients on tube feedings which a dietitian plays a huge role in.
Friday I went to Humperdinks with intern, Megan to have dinner and some beers and to chat about our rotations and life. On Saturday I went with her to go boot shopping in Denton. Then we went for a walk in the woods on some paths and had some deeeelishous delicious Thai food for lunch. Saturday evening I had a blast babysitting for my internship director's twins! Sunday I went to intern, Kristin's house to watch the BIG game! GO PACKERS! YAY! The Packers are coming to visit me in Dallas for the SUPER BOWL!!! ......If anyone would like to find me a ticket, I would gladly go and represent Wisconsin.

Diabetes, Psychiatry, Rehabilitation, Pulmonology

I felt right at home this week when there was SNOW and freezing rain in Dallas with temperatures in the 20s and 30s. My car doors were actually froze shut one morning. I didn't sign up for this cold stuff!

This week was full of learning. I got to do nutrition assessments on a wide variety of patients. Some with COPD and Diabetes, a suicidal patient, and a patient with hyperglycemic hyperosmolar nonketotic syndrome. Diabetes is quite the complex disease. I'm learning about medications and their interactions with nutrients and other medications. Psychiatry was interesting. My preceptor and I went walking around on the 5th floor (the crazy floor) and a lady started talking to us, who happened to live in Wisconsin for some part of her life. She told us her life story which included being involved in some cult in Necedah, WI. She knew where Stevens Point was along with all the hospitals in that area....that lady made my day. I got to follow a Respiratory Therapist for about an hour to see what they do. They deal with patients on ventilators (life support) and other forms of receiving oxygen.

Saturday night I went to intern, Kristin's house to watch The Packers!!! What an awesome game! We were screaming at the TV and having a blast. Hopefully I will see the team right here in Dallas in a couple weeks for the SUPER BOWL!!

Administrative Project Week: Isensix

The week of 1/3/11-1/7/11 was spent trying to complete my food service administrative project with my partner, Anna. We will present our project to the food service director, my internship director, and department managers on January 31st. We had a very productive week. We developed training materials to in-service staff about how to use Isensix (a remote temperature monitoring system), made a PowerPoint, wrote a paper, and spent a lot of time working out the kinks of the system. Our project will be implemented on 1/12/11, meaning that when temperatures on refrigerators and freezers are out of range an alarm will go off that needs to be deactivated by an employee. That employee then needs to log their actions taken to solve the problem on the computer. This system saves time and paper. Instead of logging temperatures of hundreds of units everyday with paper and pencil, a manager can simply log onto the Isensix website and check all of the units on the computer and click 'checkpoint' to log the temperatures of every unit in the nutrition department.

On Thursday we had our intern class in the hyperbaric unit of the hospital. Hyperbaric oxygen therapy is done in a large chamber and is used to heal diabetic and ulcer wounds, treat deep sea divers who may have suffered from air embolism following a dive, prepares athletes for higher endurance (Lance Armstrong, mountain climbers). While in a hyperbaric chamber, pressure is increased while completely pure oxygen is supplied to the patient. Increased pressure drives oxygen into damaged cells so they heal properly.

Friday night I went with an intern, Megan, to pick up her wedding dress. Afterwords, we both got huge, greasy 1/2 pound burgers.

Christmas Break!!

Short and sweet version...with pictures! This 2 week break from 12/18/10 - 1/2/11 was much needed after 3 long weeks of internship craziness. When I checked in at DFW airport on the 18th at 6:30 am it said the current temperature in Wausau, WI was zero degrees! Yay! I am so happy I got to see family and friends that I haven't seen in about 5 months. I finally got to meet my cousin Ty, who is now 2 months old. I stayed busy by visiting with family and friends, going to Christmas parties, having family pictures taken, playing wii, sledding with my cousin Kody, drinking beer, wine, and white Russians, and eating A LOT of delicious food and cookies.

On December 30th Sara and her boyfriend, Tyler, flew back to Dallas with me. We spent New Year's Eve day making appetizers (meat balls, bruschetta, and Bassindale cheese dip). Dan arrived in Dallas at about 9 pm, just in time for the festivities to begin! On New Year's Day we joined a bunch of Horned Frog's Fans at a bar to watch the Wisconsin Badgers get beat in the Rose Bowl. We were entertained by a weird fan getting a little too in to the game. I'm pretty sure we were the only Badger fans in the bar. Sunday we played Monopoly while the Packers beat the Bears. Thanks to Sara, Tyler, and Dan for keeping me company on New Years =)

...And now for the last stretch of this dietetic internship thing...I don't have a break until Memorial day. I hope everybody had a very Merry Christmas and has a great NEW YEAR!

Rotation 14: Cardiology

Sorry for delay. The past month has been crazy. I did my cardiology rotation from 12/13/10-12/17/10. The week was very interesting but difficult for me to deal with. Many of the patients I saw were in their early to mid 90's with irreversible heart conditions nearing the end of their life. Cardiology deals with conditions of the heart like heart failure, coronary artery disease and much more. Patients at risk for these conditions or who have these conditions are informed about adapting to healthy lifestyles and eating a heart healthy diet that is low in sodium and fat. During the week I observed a cardiac stress test and a cardiac catheterization on two different patients. I am enjoy seeing these procedures because it helps me understand what the patients I am talking to are going through.

My favorite part of the week was the Dietitian/Dietetic Intern Christmas cookie exchange! 18 of us participated in the exchange, all with a different kind of cookie. We got to have at least two of each kind. I brought Chocolaty Caramel Thumbprints. They were a very "putsy" or time-consuming cookie. I highly recommend making them, especially if you are in the mood to procrastinate. I took one bite of every cookie during the exchange.

During the last part of this week I had my friend, Kristin, and her cat, Kitty, stay with me because in was en route back to Wisconsin for her. Kristin helped me transport my fishy, Lloyd, to one of the intern's houses so he wouldn't croak on me during my two week break. Surprisingly, there was still water in the bowl after an extremely bumpy, winding ride.

Rotation 13: Oncology/Neurology

This week was full of assessing patients with all types of cancer as well as some with neurological diseases like Parkinson's and Alzheimer's. It was very hard to see so many patients with such pain and suffering due to the side effects of chemotherapy treatments. I felt a lot more confident this week when I went into patient's rooms to do assessments and educations, but I still have a lot of learning to do.
I worked at Suze Tuesday and Wednesday night. I am trying to get to know who the regulars are so I can call them by name. The owners would like me to bring them some cheese curds from Wisconsin.

Rotation 12: Gastroenterology/Surgery

My first week of clinical was about as stressful and hectic as I thought it would be. There seems to be a massive amount of homework that goes along with clinical rotations. I guess its a good thing because I manage my time a lot better. I spent the evenings doing homework assignments like reading, defining terms and medications, writing annotations, completing a mini-case study on a patient that I saw, converting a high-fiber recipe to low-fiber, and converting a low-fiber recipe to high-fiber. Every Friday I will have to take a test on the material I learned throughout the week. I started out a little slow because I had to learn how to use the electronic charting system. I was given a patient with some sort of gastrointestinal disorder then I studied their medical history and all of the doctor's notes. I came up with questions to ask the patient to do either an assessment or a follow-up on them. Based on their condition and symptoms I came up with a nutritional diagnosis then recommended snacks and supplements for them.

The coolest part of the week was watching medical procedures. I got to watch a colonoscopy and an esophagogastroduodenoscopy(EGD). They are both the same type of procedure except one goes in the mouth to the small intestine (EGD) and the other goes in the butt(colonoscopy). It was very neat to see the whole inside of the GI tract! The doctor doing the procedures explained what he was doing and pointed specific parts of the body out. I also got to watch a Percutaneous Endoscopic Gastrostomy(PEG).

Thursday night was my first night to work at Suze Restaurant. I got hired to work there as a hostess during the week.

Saturday the interns had to be to the hospital in the morning for the internship open-house. We gave prospective interns tours of the hospital and answered questions they had....brings back memories. Saturday night the interns had a Christmas party at my internship director's house. There was lots of good food and great conversations. We played Catch Phrase...let's just say I need practice...I think my team wanted to trade me :) We did a fun ornament exchange. I got a big pink glittery jingle bell!

A Visit with Dan in South Carolina!

I arrived in Florence, SC by 11:30 on Saturday. After a quick lunch we headed to Charlotte, North Carolina to explore the town. The city was rowdy and swarming with Baltimore Ravens football fans. We had some drinks and an appetizer at a Mexican restaurant then went to an Asian bistro/sushi bar for dinner. It was yummy!! On Sunday we went out for breakfast then hung out at Borders Book Store until the Packer game. We watched the Packers and enjoyed some drinks at a bar in uptown Charlotte then went shopping at South Park Mall. During the week we watched lots of movies and made delicious meals together. On Thanksgiving Eve we went to a turkey frying party. We brought some turkey drumsticks to be fried and apple bars to share. Once all the turkeys were done the southerners started throwing the oddest things into the fryer...sliced bologna, hot dogs, corn on the cob, and biscuits. I swear people fry everything down south. Dan is going to introduce them fried cheese curds-something they haven't tried yet. Thanksgiving morning we ran the Hartsville YMCA 5K Turkey Trot together. We ran 3.1 miles in 30:27 minutes and got 146th and 147th out of over 400 runners! The rest of the day was spent preparing dinner and watching movies. We made Cornish hens, cornbread stuffing, green bean casserole, mashed potatoes, gravy, dinner rolls, and pumpkin pie with a spiced nut crust. We also had sweet potato souffle from Dan's friends. What a delicious dinner...Dan has leftovers for the next week. Friday we made home-made pizza and Andes Mints cookies. I hope my pants still fit after this holiday season!

Rotation 11: In-Service and Clinical Management

I got to spend this week with my internship director, Kristi! Throughout the busy week we talked about payroll, budget, scheduling, and CQI studies. We attended the weekly manager meeting, the monthly department manager meeting, and the weekly RD meeting. I did an in-service for the supervisors and data entry operators about the bariatric diet name change. We ordered test trays to check temperature, taste, and portion sizes of the diets we ordered for. During the week I worked on various assignments. My favorite one was the Food and Nutrition Services Department Newsletter. I got to be creative and have fun by interviewing employees and managers in the department. Friday afternoon Kristi and I gave a student interested in the internship a tour of the hospital. It was fun answering some of the same questions that I had when I was in her shoes.
Friday night I had to pack for my 5:45 a.m. flight to see Dan in South Carolina!!! The first thing in my suitcase was the GI/Medical Surgery binder...I start clinical rotations the week after Thanksgiving...YIKES...wish me luck! I'm very excited and nervous about the mass amount of learning that is about to happen!

Rotation 10: Patient Meal Services: Week 2

Week two of patient meal services was quite busy. Monday was spent working on projects and homework. I visited a total of 40 patients to do patient satisfaction surveys. I asked each patient to rate the hospital's food on temperature, quality, courtesy of staff, and overall satisfaction with the food service. It's truly amazing how one patient will think the food is absolutely wonderful and the next patient thinks the food is just horrible. I had a fun time listening to everyone's comments and thought of some ideas to help improve the food service! Tuesday we had orientation at Meals On Wheels so we know what to expect when we have our rotation there. Wednesday was full of meetings; weekly RD meeting and weekly supervisor meeting took up much of the afternoon. I stayed late through the dinner hour to do tray audits. I checked food trays for accuracy to see if what was put on the tray matched what was on the tray ticket. Thursday I went in early so I could do the same for breakfast. From 8-12 I went to an interesting Leadership Behaviors-Managerial Courage Workshop. Amberlee invited me over for dinner at her apartment that night. She and her husband made delicious fish tacos with rice, beans, guacamole, and chips. Friday I did late-tray audits in the morning-tracked the amount of time it took from when the patient called the kitchen to when they received their meal. I worked a hostess position that night because they were four people short. I loaded trays and delivered them until 6:30...in heels. I was exhausted so I went to bed super early. Saturday morning I volunteered at a diabetes health fair in Plano. Jennifer and I helped demonstrate the Actifry. We made french fries and random vegetable mixtures. It cooks fresh homemade french fries in about 30 minutes only using 1 tablespoon of olive oil. The Actifry is an awesome appliance for heart healthy cooking. In the afternoon I tagged along with intern, Megan, and her friends while she tried on wedding dresses.

Rotation 10: Patient Meal Services - part 1

I just completed week one of two in the patient meal services rotation. It focuses on the process of food delivery to the patient in the hospital and patient satisfaction. I worked with and shadowed the Patent Services Manager who is a Dietitian. I worked on my assignments a little bit every day because there is a lot for this rotation. I got to attend meetings with the food service director, managers, supervisors, and Human Resources throughout the week. One meeting was about setting up the Room Service screens in CBORD. I was able to offer suggestions about it because I worked with that at Saint Clare's. The meeting in HR was about re-organizing the nutrition department for the hostess program starting in January. It was really cool to be a part of big decision making. After work on Wednesday I went to Kohls just to shop around and I found a massage chair by the shoe department...I totally sat in it for about 45 minutes....much needed! I might make this a weekly thing until I get kicked out :)

I spent my Friday night at the mall getting a haircut at Regis. This might seem like no big deal to some of you, but it was the best hair cut experience ever for me! The girl who cut my hair was so fun! She Texified me. Apparently every girl in Dallas has big hair but me. She cut my hair to fit that style and now I can't do it on myself. I might have to break down and buy a can of hair spray and a teasing comb.

On Saturday from about 5-9 the intern, Amberlee, and I went to Zoo To Do to help out Suze Restaurant. It was an event held at the Dallas Zoo that cost $350 to get into. The theme for the night was "Under the Serengeti Sky." Delicious food was provided by top restaurants and chefs from Dallas. There was music, dancing, entertainment, open bar, and silent and live auctions to raise money for the zoo. Amberlee and I helped serve Roasted Tomato Curry Soup with pulled bread and 4 cheese Truffle Sauce with the owner of Suze. For most of the time we got to walk around and enjoy ourselves by checking out the animals, having drinks, eating lots of yummy food, and trying to stay warm.

Rotation 9: North Texas Food Bank

Texas is #4 in the top 10 hungriest states in America. The North Texas Food Bank feeds and educates the hungry in 13 north Texas counties. It serves 45 million meals per year and about 25,000 people each day. There are many programs that include nutrition education, budgeting, and cooking classes and then the participants are sent home with a bag of groceries. This week was a true eye-opener. It made me realize how lucky I am to have food when I want it. I spent my week driving all around North Texas to some of the worst poor areas. The south side of Dallas has high rates of poverty and crime. For the first time in my life I saw a person sleeping under a highway bridge, covered in a blanket with their belongings in a garbage bag beside them. The mission of the employees at the food bank is to eventually work themselves out of a job.

On Monday my first task was to tag along grocery shopping with the nutrition education coordinators. We went to Fiesta Foods and bought a cart full of ingredients to make banana quesadillas and tuna boats. We had to buy enough food for the cooking demo and enough food to be sent home with the participants in their grocery bags. (60 cucumbers, 30 bunches of green onions, 30 cans of tuna, 30 bananas...etc) My job was to observe and help out during the Cooking Matters classes. These classes are 2 hours long once a week for 6 weeks and each class has a different target audience. The first one of the day was at a Diabetes Health and Wellness Center for under privileged diabetic adults. This brand new center with a fitness center and dietitian services is free to use by diabetics in the area. It was a very sad looking community. No grocery store within a 5 mile radius of where we were. Where do these people get their food? Convenience stores or gas stations. What types of foods are at those kind of stores? Usually not healthy ones, maybe bananas, but otherwise chips, candy, pop, and hot dogs. This answers the question of how people can be hungry and obese at the same time. The afternoon class was held at an elementary school that had trailer homes for overflow class rooms. This after school program was for kids over age 6 and their parents. They learn about healthy eating, safe food handling, and how to make food. The kids loved helping prepare the food!

On Tuesday I helped with two more classes. The morning class was at the Lewisville Senior Activity Center for senior adults. It was their graduation class so I got to eat a lot of yummy food that they brought in for the pot luck. The afternoon class was at another Elementary school. It was a class for 8-11 year olds. Kind of mass chaos, but they are all very excited to learn and cook. From 6:30-8 us interns had to give presentations at a Diabetes Support Group held at the hospital. Each group of 2 gave 10 minute presentations on various herbal supplements. Mine was vanadium...in case you are wondering...I wouldn't recommend taking it because more research needs to be done.

Wednesday was a busy day. First of all I showed up and SURPRISE-you will be doing a 15-30 minute workshop for about 40 seniors on fiber-here's a handout and there's the fiber kit, we leave in a half hour. I was nervous. While doing the workshop most of them didn't really care what I had to say about fiber because line dancing and Bingo were on the agenda next. I could have just smiled and waved up on stage and nobody would have noticed. I spent the afternoon sitting in on the Nutrition Education Department meeting.

Thursday I drove all the way to the food bank for a 10 minute tour then drove back to where I came from for a Comer Bien Cooking Matters class. This class is taught completely in Spanish so I didn't have any idea what was being said. It was another graduation class so there was a pot luck of lots of Mexican food. All of those dishes should have had CAUTION signs on them because this Wisconsin girl is not used to foods of such spiciness. My lips and mouth were on fire and I had tears. I also tried the ceviche. Ceviche is typically made from raw fish marinated in citrus juices such as lemon or lime and spiced with chili peppers, onions, salt and pepper. Except this ceviche was made with ground beef....I was very unsure about it, but I tried it. I guess it could be compared to wild cat.

Friday I finished up my homework for the rotation. I made a recipe packet using squash, potatoes, and onions as main ingredients, made a lesson plan on nutrition and immunity, and summarized my experiences for the week. In the afternoon I had my evaluation with my preceptor.

Saturday I went for a long run with one of the interns, Amberlee. Dan's sister, Katy, Amberlee, and I all signed up for the Dallas Rock n' Roll 1/2 Marathon on March 27th so we have to get practicing.

***Congrats to my Auntie Donna, Uncle Nathan, and big brother Caden!!! Tyler Dean was born on 10/28/10!! I cant wait to meet him =)

**I had my share of Dallas traffic for a while. I spent over 15 hours in my car this week, most often stopped on the highway because of accidents.

*Go RANGERS! (World Series)

Rotation 8: Neva Cochran Consulting

This week I was honored to be invited into the home of Neva Cochran, MS, RD, LD. Neva is a very experienced and well known nutrition communications consultant. Her current clients are Woman's World Magazine, Maximum Fitness Magazine, the Egg Nutrition Center, and the Corn Refiners Association. She is also very involved in the media, taking part in roughly 800 magazine, newspaper, radio, and television interviews about nutrition. It is an exciting career that is something I would love to do some day.

I spent the majority of Monday working on a meal plan for Maximum Fitness Magazine. The theme was Savor the Flavors of Summer. I had to come up with 2 breakfasts, 3 lunches, 3 dinners, 2 snacks, and 2 shakes emphasizing fresh produce of summer and minimum amount of time in the kitchen.

Tuesday was a 'work from home' day so I went to the hospital bright and early to be productive. On top of all of the rotation assignments, us interns also have to do an administrative project. My partner, Anna (pictured left), and I are doing our project on Isensix remote temperature monitoring. It includes making sure all the monitors and systems are working correctly, writing department policy, in-servicing staff on how to do the monitoring, and doing a final write-up and presentation. The system was set up in early 2009 but hasn't been used and since then a lot of the freezers and coolers have been moved around or put into storage so we had to go hunt for them. Tuesday we had to go collect monitors off of 10 units that are not in use. It doesn't sound like a physical job, but it was...I shed blood. We had to move speed racks and heavy equipment out of the way to get to the monitors, climb on ladders, cut zip ties, and touch yucky dusty cords. I'm glad all that's out of the way. For Neva, I worked on completing several reading assignments and finishing the meal plan. Neva picked 19 foods from the meal plan that I had to find interesting facts on.

Wednesday I watched DVDs of Neva in many different interviews throughout her career to learn about the proper techniques while doing an interview. Next I received two research articles to summarize for Woman's World. A major part of Neva's job is to take complex scientific information and put it into words that the general public will understand. This task was quite a challenge, but it is something that takes practice. Neva asked me if I would be interested in helping her with a reception she would be having at her house the day before. So at 3:30 we started prepping, about 40 people were expected to show up. To prepare for the party, I made a hummus vegetable dip and plated cheese, cookies, and sandwiches. During the party I served water, iced tea, and wine to her friendly guests and took a group picture. Say Cheese! I was done by 7:30.

Thursday was a very busy day. Once again, I went to the hospital to do my work because if I stayed home I would be too distracted. I finished up the food facts for the Maximum Fitness article, wrote up the two research summaries, answered questions from a Today Show interview that took place 5 years ago, and wrote the key messages for my mock interviews. Intern class was from 2-4 about the North Texas Food Bank. I stayed at the hospital until 6:45 to finish assignments. My goal was to be done before CSI =)

Friday was the day of mock interviews. I picked two topics of my choice: home canning and gout. Then Neva interviewed me about them. I was pretty nervous before we started because I had no idea what she was going to ask me. I tried to use techniques for giving good interviews like bridging, hooking, and flagging. Luckily I picked topics that I am fairly familiar with. The interviews took less than 5 minutes a piece. I did better than I did in class a couple weeks ago, but I still need a lot of practice. It was an awesome learning experience. I would love to have an exciting career and be as accomplished as her some day. I was done by noon and then went to the hospital until 7 pm to finish up some assignments from past rotations. They were starting to creep up on me.

Here is Neva's website: http://www.nevacochranrd.com/

Rotation 7: SUZE Restaurant

I've been looking forward to this rotation for about 2 years! This is the restaurant I wrote about in my first blog where Dad, Mom, Sara, and I had dinner. I got to learn from 2 extraordinary chefs, Gilbert Garza and Jeffery Hobbs, and eat a lot of yummy, mouthwatering food all week. I worked Tuesday, Wednesday, Friday, and Saturday from 2:30-10:30.

On Tuesday I worked in the "back of the house" (in the kitchen). I did a lot of observing and listening to the lingo of the kitchen. I helped make Sticky Toffee Pudding and sliced and diced vegetables. I tasted a very interesting delicacy...Foie Gras...aka...Duck Liver with aged balsamic dried cherry cassis reduction. I loved the flavor, but I did not like the texture. I got to go take home dinner: Almond crusted Idaho rainbow trout with red quinoa, artichoke, capers, poached tomatoes, and a citrus Italian beurre blanc.

On Wednesday I went to a Holiday Food Show in the afternoon. It had tons of food samples from food vendors. I was stuffed from all the delicious desserts, fried foods, ice cream, cheese, meatballs, ham, and prime rib. From that food show I went to SUZE to help prepare for the March of Dimes Signature Chefs of Dallas Auction. The 15th annual event cost $300 per person and was held at the Frontiers of Flight Museum where 20 top local chefs showcased their culinary masterpieces to the 600 guests who attended the event. The culinary creations were paired with 40 different wines from Napa Valley. SUZE Restaurant served seared expresso rubbed Cervena venison with braised Japanese eggplant, poached lemley tomato, and basil. I got to plate up the eggplant and tomato. I wish I could have taken pictures, but I was busy till the end. For the auction each of the chefs created a special package to be bid on. They sold for $5,000-$30,000! I got to see some of the richest in Dallas. After the auction some of the chefs and I stayed after and finished off some opened bottles of wine...Oh and I also tried on a $135,000 yellow diamond ring.

On Friday I worked the "front of the house" (in the service area) as a hostess. It was slow for a Friday night because everyone was probably watching the Texas Rangers play the Yankees in the World Series. It was still interesting. I got to seat people and take reservations. I enjoyed a nice dinner with wine and champagne on the patio with the hostess, Melanie, and Chef Jeffery. I had Oven roasted baby rack of lamb with rosemary roasted new potato, lemley tomato relish, and mint gremolata.

On Saturday I created descriptions for 5 specialty cheeses to be included on the appetizer and dessert menu. I named the menu: Say Cheese! The different cheeses on the menu are Buttermilk Blue(Wisconsin cheese), Roaring Forties Blue, Chevre Purple Haze, Prairie Breeze, and Kunik. We made sample cheese plates so the waiters knew what they tasted like. I had a hard time choking down the blue cheeses, I think blue cheese tastes like moldy basement floor. The Purple Haze (goat cheese) tasted like how sheep smell, ahhhh yuck! I also got to try some jalepeno jelly. It is bright green and has a sweet taste at first, but then it kicks you. HOTT stuff! It was a very busy Saturday night. The tiny restaurant served 108 guests! I got to end my night by eating Cast iron roasted King Salmon with chilled cucumber mint salad, chilled rice noodle, wasabi rice wine vinaigrette and toasted sesame seeds. Check out http://www.suzerestaurant.net/ to see the menu and the chefs I got to work with.

Kristin's Visit to Dallas

My friend, Kristin, who works in Rockdale, TX on a deer farm came to Dallas for a Sugarland concert. I was lucky enough to have the day off on Friday so we got to go the the State Fair of Texas!! I took the day off of being a dietetic intern and consumed six times the amount of calories I should be allowed for a day. Please don't tell my colleagues. The fair had lots of cool exhibits to check out such as the Museum of Nature and Science, Farmer Mike the Pumpkin Carver, a stunt dog show, and pig races. I loved The Food and Fiber Building, it was filled with lots of food samples and food facts. There were no fried cheese curds to be found at the State Fair of Texas, but I did try a Corny Dog, a Fried Peanut Butter, Jelly, and Banana Sandwich, a Fried Snickers Bar, Frito Pie, and a Deep Fried Margarita. My favorite was the Fried Snickers Bar-it was so warm and gooey and chocolaty! A few other weird foods at the fair were Fried Beer, Fried Club Salad, Fried Lemonade, Fried Chocolate, Fried Butter, Texas Fried Fritos Pie, and Deep Fried S'mores Pop Tart.

The Sugarland concert was Awesome!!! Randy Montana and Little Big Town opened for them. We had a blast dancing and singing along.

Rotation 6: Dealey Child Care Center

I spent the last week being called Miss Amber =) I was the most popular person on the playground. I had double lines with about a 10 minute wait to be pushed on the swings and was forced to play Duck-Duck-Goose and Ring Around the Rosie. The Dealey Child Care Center is located right on the hospital campus and provides care for children of the hospital staff, ages six weeks to five years, and also has a unit for mildly ill school-age children. The four day rotation was focussed on nutritional needs and feeding methods for children during these important developmental years. I did a lot of observing of the 3-5 year-old kids during their snack and lunch time. It was a very fun week , but the homework load was overwhelming. I'm a little behind. I had (still have) to evaluate a weeks menu, log the temperatures of food served, evaluate family style food service, do an inservice for food service staff, do a lesson plan for the kids, annotate two nutrition articles, evaluate three kid's nutrient intake for two days, observe, compare, and evaluate kids to standard growth charts, write an article for the parent newsletter, write an ethical situation summary, and finally evaluate myself. Also, I am hoping that I don't get sick.

The letter of the week was 'W'. The teacher has the kids bring in something from home that starts with the letter of the week for show and tell on Fridays. During circle time we all went around saying things that we would bring. I said I would bring a Whisk. One little boy shouted, "I'm gonna bring Whiskers." Then another boy shouted, "I'm gonna bring WHISKEY!"

I wore my hair curly on Tuesday and a 4-year-old girl said to me, "Your hair looks messy today Miss Amber." Kids really do say the darndest things =)

Rotation 5: Technology

This week I discovered what I would rather not do in dietetics. For 8 hours each day I was either on the computer, sitting in on a phone conference call, sitting in on a meeting, or eating lunch. My preceptor gave me plenty of projects to work on each day so I was very busy and the days went fast. I spent one entire day creating and revising 'Other Food Choices' menus for nine different diets. Throughout the week I evaluated new recipes for nutritional compliances, evaluated recipes for accuracy and made sure they were being sold at the proper price, analyzed recipes for nutritional content, and processed purchase orders and invoices. They were all great experiences and I learned a lot, but I don't see myself sitting in an office in front of a computer all day. My mind just can't grasp interfaces, computer systems, and how one program somehow talks to another program....too much.

On Tuesday I met one of the interns, Amberlee, at a Girls Night Out event held at the Village Country Club where we both live. We got a free bag of goodies, a yummy sandwich, pizza, and Pinkberry frozen yogurt. There was also a waxing station. I thought I would give it a try...yeah, it hurt! I screamed a little.

On Saturday I babysat for my internship director's three-year-old twins. We had lots of fun! We watched Ice Age, drew pictures, built forts in closets, walked to the park, and played hide and seek. When I left I got two hugs, a regular kiss on the cheek from one twin, and a cow kiss from the other twin. FYI a cow kiss is when you get your cheek LICKED! He was eating a muffin right before this happened so I was also lucky enough to also get lemon poppy seed muffin smeared on my face.

Rotation 4: Texas Health Presbyterian Hospital Plano

This week my rotation was at the Texas Health Presbyterian Hospital of Plano, which is about 17 miles from Dallas. The drive takes anywhere from 20 minutes to over an hour during rush hour traffic. I worked with the food service Director, Mary Spicer and Chef, Gary Vorstenbosch. The food service is room service style and all the food is made to order for patients. It is called Five-Star Dining and it won the Ivy Award in 2008. The Ivy Award is given annually by Restaurants and Institutions Magazine to a select group of restaurants, hotels, and noncommercial food operators that exemplify the highest standards of excellence in food service.

My main assignment for the week was to interview at least 40 patients about their satisfaction with the temperature and quality of the food. The patients varied in age (20-89), type of diet, and duration of stay. Some patients have been there for three months or more for pregnancy complications or long term illness, these people had a lot to say about the food because they've tried everything on the menu. It was really fun spending about two hours a day talking with patients. I learned a lot and was able to point out problems and recommend changes for the menu.

Throughout the week I followed random food service staff around doing many different things. I prepared and delivered floor stocks, set up for caterings and cleaned up after them, assisted on tray line and in the call center, delivered trays to patients, made sandwiches, served on the cafeteria line during lunch, flipped cheeseburgers, dropped french fries in grease, garnished desserts, ate yummy food, had lots of great conversations, and put food orders away in dry storage and in the freezer...again.

Chef Gary is Dutch and grew up in The Netherlands. He recognized that I am also Dutch from my last name. After talking with him, I definitely hope I make it there some day to explore my heritage and get a pair of wooden shoes.

It's a small world...Mary Spicer is a friend and colleague of my boss from Saint Clare's Hospital back in Weston, Wisconsin. In the middle of having a nice chat with her about her history and accomplishments, which is amazing--she is famous in the food service world, I randomly asked her if she knew Dale Evert. It was so funny, she was completely surprised.

To sum up the week, it was very busy, fun, interesting, and motivating....minus the rush hour traffic and crazy drivers. I was thrilled to be invited to join a couple other interns on Friday night at the mall to drool over expensive shoes and clothes. We also checked out the food court, which also just happens to have beer :) Great way to end the week.

Rotation 3: Purchasing and Production

Monday morning when I showed up in the kitchen at 7:30 in my white scrubs I was sent to work with Jorge to do inventory in the FREEZER-which is kept at about -10 degrees! I woke up fast. In an oversized puffy jacket and thin gloves, I stood in the freezer calling off 140 items from a hand-held palm pilot and recorded the number that Jorge shouted back to me. Things were not going smooth. The hand-held device lost reception twice while in the freezer...once on item 33 and another time on item 60 something. It does not have an automatic save, meaning we had to start over each time. A lot of the kitchen staff joked around about how I should be used to conditions like that since I'm from Wisconsin. If you know me well, you know that my fingers and toes turn white and lose circulation when they get cold. It was miserable! At least we got the worst over with first. From the freezer we moved to the produce cooler, then the dairy cooler, then the meat cooler, and finally dry storage. When all the inventory was taken we had to place the order through U.S. Food Service. I got to leave at 12:30 because I had to be downtown for WIC (Women, Infants, and Children) orientation at 1:30. I went home for lunch and said my goodbyes to Dan since I couldn't take him to the airport. The WIC orientation lasted three hours. We learned what WIC has to offer and what we will be doing during our one week rotation there.

Tuesday I had to be there at 7 am. This time I was more prepared to be in the freezer. I showed up with my winter hat on. I worked with the store room clerks to put away one and a half semis worth of food. The food comes in boxes on wrapped pallets. It then needs to be put away in the proper storage area (freezer, meat, produce, or dairy refrigerator, or dry storage). I got a great workout from lifting all those boxes and my fingers stayed a healthy red color because I was moving around so much. When I was done putting the order away I met with Chef Kelly (my preceptor for the week) and got a tour of the kitchen and tasted food along the way.=)

Wednesday I was in the kitchen by 5 am to help prepare a breakfast for the third shift employees. I buttered biscuits and panned up bacon and sausages then helped set it up in the cafeteria and helped serve the breakfast. For the rest of the day I followed Chef Kelly around. We met with a representative from True Lemon for product testing. True Lemon is a crystallized form of lemon to replace fresh lemon wedges and lemon juice packets. It was very sour, I puckered my lips. It can be sprinkled on fish, used in iced tea, or used in recipes. The packet looks like a sugar packet and is much easier to open than a lemon juice packet, this would be very beneficial for patients and it only costs a tenth of a cent more per packet. At lunch we did more product testing, this time with sweets. Desserts! There was a mango sorbet cheesecake, chocolate bomb, chocolate peanut butter torte, chocolate truffle, red velvet cake, tiramisu, apple cake, and strawberry shortcake. I think I would be a great professional food taster.

I had to be there at 5 am again on Thursday to work a production shift. The morning cooks get there at 4 am! I got to help Brenda, a cook who has worked at Presby for 30 years. I made a cilantro, tomatillo, jalepeno sauce to go over the tortilla tilapia. It was very fun to make and very delicious! I got to use a huge hand held blender to make the sauce smooth. I made a Jamaican jerk pork sauce that I didn't want to claim because it wasn't very good. It needed about a cup of salt and it would have been better, but I could only add spices because it was the Healthy Choice for the day. Next I made a tomato basil soup. Sound healthy? Don't let it fool you. It has about two pounds of butter and two gallons of cream. I also panned up cookies and ate some frozen cookie dough =) I was done with my shift by 1:30 but I stayed to work on homework because I had a counseling class with the interns at three. The class was done at five, but I stayed until 6:30 to finish the homework I wanted to get done. I passed out as soon as I got home!

It felt like I slept in on Friday because I didn't have to be there until 7am. I worked with the storeroom clerks to gather floor stocks and then deliver them to places around the hospital for two hours. After that Kelly and I did a safety and sanitation checklist in the kitchen. When that was done we went around to the cafeterias and tray line to taste food. I was done for the day at 11 except I stayed to work on assignments and to got to an employee forum. Everyone got cool free backpacks and a foam #1 finger. It was a very exhausting week. I totally went to bed at 9 pm on a Friday night. I still have a lot of homework to catch up on, hopefully next week will be a little easier!