Pester makes Profession

So just to refresh your memory (and mine! It has truly been a whirlwind), I ended my employment in Los Angeles, moved cross country, idled in unemployment, started employment at a small hospital outside Atlanta, resigned, and now! have been working about 3 weeks in a new Atlanta inpatient dietitian position.
It was exactly the position I wanted when I left California. And really, there were only two positions of this kind: Academic hospital, inpatient, GI surgery.
Done&Done&Done.
I'll have a dietetic intern soon.
I'll start adjunct teaching at a state university soon! In a very cool department focused on culinary arts, hospitality, sustainability and exercise science.
It's like all my goals of inpatient GI surgery, teaching, hippy dippy culinary/sustainability and exercise science are blending. Who would have thought that could happen...? You really can get what you want. Exhale...
Pester, study, pester some more and there you have it! What you want. Or what you think you want anyways. This is America, I tell ya!

My dear friend/old coworker at the University of Southern California posted an article from the Hospitalist regarding Medicare/Medicaid decision to allow dietitians to order therapeutic diets for hospital patients.

Issued by the Centers for Medicare & Medicaid Services, the revised rule enables RDs to "operate at the top of their license," says hospitalist Melissa Parkhurst, MD, FHM, medical director of the Nutrition Support Service at the University of Kansas Hospital in Kansas City, who says she's in favor of the change.

Reentering this 100% inpatient clinical world, it feels good to be given a bit more control.
Or rather, not have to call a big time doctor when a 90#, 90 year old isn't eating much on fat and sodium restricted diet.
I mean really...Who would?
At 90 years old, give me a lobster roll, banana bread, froyo and wine. Let me be in the hospital as a happy woman.
Even if you have to blend it all up, shove a tube down my nose and bolus it into my belly. Just make me happy. Bowel obstruction or not.

It seems slow but even since I started this career just 5 years ago, I have already seen the advancement of paper to electronic charts. From not being able to order nutritional supplements to ordering them without permission from a doctor. From recommending tube feed to outright ordering them after a consult. Now the therapeutic diet is a hold up...and really so is a multivitamin...but things are coming along!
I just find it interesting that I had/will have less resistance compiling and initiating a solution to feed through someones vein that could render immediate harm if done incorrectly than liberalizing a diet order to regular. Wacky...

And I'm coming along too. It's been a wacky, wacky road. And I'm sure there is more wacky in store for me. But at least for now, I feel a tiny bit more stable. I said tiny.
And I'm ready to come along.
Or the pestering will continue! Good thing I have a good network of RDs running around this nation.

Freedom for Being Scammed and Shot

John Oliver, I don't even know you but I like you.

What is wrong with dumb people and with smart people?

Maybe idiocy is the magical ingredient found in those supplements.

Round&Round

Yesterday a child came out to wonder

Yesterday I ended a job I had just started after ending a previous job. Next week I’ll start a new job. I’ll be a year older on paper when I start. I gave Cat away this week. My fickle companion in Atlanta. I’m on a plane to Chicago.

I’m in motion. Always. In life and in my head.

I took the Marta to the airport today. Was super easy. Walked to the station, transferred once. Getting through the worlds largest airport was relatively painless despite the motion in my head.

The Marta’s PA system was the best I’ve heard. Clear, hospitable, informative. “For Georgia State, Grady Hospital, Children’s Hospital of Atlanta, International Convention Center exit next stop!” The man I struck up a conversation with on the way reminded me that Atlanta is the convention center. That’s why everything was so clear and informative and pleasant. Wish I had a GA PA system in my brain. Maybe everything would be clearer.

On the day I ended my job, I had to race over to HR, employee health and Security at my new job. I was hungover. It was raining. I was tired. Stepping on the scale at Employee Health, I found myself to be exactly 3# heavier than I was when I stepped on the Employee Health scale a little over a month ago. We start and end. We go up and we go down. We go round and round.

My spirits do to. And I start again with a little less enthusiasm this time.

On the Marta another thing was clear. Three peoples’ voices close by. I couldn’t determine the relationship of the travelers. The youngest of the three was talking about her grandfather. In the south, you drop the preposition when referring to your family members. “Granddaddy is in assisted living now. He’s 89 years old. He got remarried. She’s 88 years old. He’s 90# soaking wet. He wasn’t always that way…”

The last day of my job I had a 93 year old male patient. He had no teeth, no dentures and a BMI of 17. He had dark hipster glasses on his pale thin face covered a bit with wispy white hair.  He was at risk for aspiration/pneumonia if he was to eat by mouth. The man went from a full liquid diet, which he barely ate, to NPO (nothing by mouth) until he decided on a PEG (a tube placed in the stomach to feed through) or hospice in which he could then eat by mouth. At 93 years old, this is what it comes down to: A feeding tube or hospice.

Hospice won. And I said, “order whatever you’d like!”

Good for him.

I walked through security behind a woman holding a California license. I walked past a group of boy scouts wearing their official uniforms. I arrived at my gate seating a large Navy group dressed in formal white. While waiting to board I listened to Joni Mitchell’s  The Circle Game-3 times in a row. Completely appropriate considering.

I watched people while she sang to me. And the seasons, they go round and round and the painted ponies go up and down. We’re captive on the carousel of time. We can’t return we can only look behind from where we came. And go round and round and round in the circle game.

I sat on the plane feeling disconnected. Between worlds. Being in motion does that. I turned on DeVotchka’s  The Winner Is. I watched the ground crew perform their tasks in step with the music. Watched the dance our humanity plays. The violin present throughout the background. Pluck Pluck Pluck Pluck - step step step step. Chime Chime – luggage throw luggage throw. Drum Beat - shut storage door. Drum Beat - high five coworker.

What a pretty dance. Prettier than my odd mood.

So the years spin by and now the boy is 20. Though his dreams have lost some grandeur coming true. There’ll be new dreams, maybe better dreams and plenty. Before the last revolving year is through.

While high above the world all alone, I listen to DeVotchka sing you already know how this will end….

…go round and round and round in the circle game.

Land Shark

I paws a moment to discuss another creature's nutrition.

This cat I found under my car. We still have a love/hate relationship. More love these days after the Sodashi gave him (it is conclusive "cat" is a "him") the most dangerously awesome mani/pedi. She's pretty much spiritually sent.

I've named him "Mo." Short for "lil Monster." And possibly because "cat" was androgynous for awhile. So if we decide he needs an "s," we're all covered. But really, it's still "cat."

Now as previously stated, I don't know the first thing about cats, let alone kittens. But I got a decent crash course thanks to Paige, Todd Hornberger, spiritually sent Sodashi and Jaxson Galaxy. Oh! And the lovely folks over at Petco. And pretty much anyone else I meet because I end up either talking about my cat or explaining traces teeth marks and scratches. I understand why parents talk about their kids. They are all consuming. And cute. And righteous pains. And a big responsibility.

So let me just give you a little background:
I live in a 490 square foot attic apartment which is kind of like something between a studio and 1 bedroom. It is decorated in a fashion that is a kitten's dream. Lots of scarfs. Lots of drapes. Lots of delicate things to knock over. And it isn't easy to quarantine the thing in another room. So cooking and eating have become a well thought out plan.
The litterbox has no where to go. It is the first thing you see as you climb the stairs and approach the apartment. And this thing can really go. I mean it's so small and produces so much stink. I'm horrified and jealous at the same time.

Anyways, it is a land shark. Period.
It is always on the prowl. We play prior to eating to act as though he killed something and gets the reward. Hunting, stalking, eating, prowling. Repeat. And often times directed at me...

I bought dry food for this critter. Wet food just kind of gives me the creeps. But maybe half dry half wet may be the way to go - as this one may have altered mental status secondary to malabsorption and increased appetite  resulting in increased attacks directed towards me. I'm so lucky.
I gave the lil guy leftover salmon one time and he went nuts. It was like an instant addiction.

So I'm reminded that while doing dietetic school in St. Louis, there was a dietitian on staff at the St. Louis based Purina company. It makes sense. I didn't know how much to feed this thing. I didn't know what it's little body would have trouble absorbing. I don't know what would be good for his teeth. I didn't know how to transition to a new food brand.
Or that having a worm may be causing malabsorption, diarrhea, deficiencies resulting in an increase need to bite my ankles.
Unfortunately for Purina, when I switched brands, the cat calmed down a bit but it was also at the time of the top shelf mani/pedi. Who can say for sure.

Either way. This thing needs food. And I'm not letting it climb a tree to find it. So if I have to give it to him, I want it to be good. So that he can be good. And I can be good.

 

Southern Evolution

I'm living in Atlanta. I never thought I'd write that. Not because I don't like Atlanta or anything just never thought it would be a place I'd live really. I didn't know much about it. Or I had my own thoughts about the South in general. 
Does one capitalize the "s" in south? 

I may have pulled off the ultimate 180 change. Well, I don't know if I "pulled it off" but did/am doing it, I guess..?

I've gone from LA and running around a bit glitzed up indulging in all of its stereotypes to Atlanta and some of it's stereotypes.  It's funny how a place like LA can make you "cool" to everyone simply by living there. You don't even have to do anything but be there and spend money. Of course it's a beautiful playground that I still love, I'm just saying. My cool points took a nose dive and yet, I think I may actually become more me. So if A equals B and B equals C...yikes!

I've temporarily lost my identification as a dietitian. The one thing I've been trying to truly master and focus on in the past 5 years. The so called formative years. What are you when you are unemployed, living alone (correction living with a kitten named "bad cat"), without a group of friends or family, in a foreign city....? It's laughable on a lot of levels. The absurdity makes everything so much better. 

I guess I will tell you what I AM or at least Am Doing. 
Along with not working (sounds like a choice compared to unemployment. It's all about the attitude. Or connotation in my head. And I do have work coming...), I'm decreasing my exercise by 75% if not more, sleeping in, eating fried potatoes and pulled pork BBQ sandwiches, having beers in really annoyingly smoke filled bars, going to a Meryl Haggard concert and the Coco Cola Factory, killing cockroaches with a "I'll get you" attack attitude, finding a cat under my car and taking it in (for now), buying actual furniture and googling "LED vs LCD"...

It'll be my first TV, people. I'm not saying this in an "I'm so cool and hipster" sort of way. I actually just never owned a TV. Maybe as independent as I thought I was throughout my serial transitions, I've also depended on so much. Roommates furnishings, the city's direction of what to do and see and eat and think and dress, my job's schedule and perpetual drive to master it. This is my first place alone, my first time sans garbage disposal and dishwasher, my first kind of odd step back but maybe into place?

I'm wondering how much of my current life is just because I'm in an odd transition phase or p…æ¢∞∞∞???????^^7 (<-cat on keyboard. Absurdity continues. Add "youtubing Jackson Galaxy" to the queue of what I am/what I am doing. As opposed to "who I am?" hmm. I'd like to think that is always evolving) or because I'm living in the "South."

I suppose it's amazing how one can think they're open minded living in a place like Los Angeles and also be close minded to my current life. It's been good. Somewhat a struggle. I have scratches all over my hands from the cat and bruises in weird spots from moving furniture to prove the struggle.

I found an article this morning Why are Southerners Less Healthy? which stated that Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee are national leaders in preventable deaths from heart disease, cancer, chronic lower respiratory disease, cerebrovascular disease (strokes) and unintentional injuries (such as car and motorcycle accidents).

This may totally dull you but I found this graph (at the bottom of the page) insanely interesting. But then again, I'm living alone without a whole hell of a lot happening. 
It showed me that 18.9% of either deaths or preventable deaths in CA are due to chronic lower respiratory disease compared to 47.7% in GA. May I remind you that Santa Cruz banned smoking in 1987 and CA banned smoking in 1994. 1994! You'd think that GA would be a bit more progressive as it is on the East coast but it is in the South. 
It is slow but I think the entirety of the South is having or will have gentrification with northern youngsters looking for better property value. If they don't die from second hand smoke first. 

Anyways, that was one example. Of my 180. Of Coco Cola's presence and a potential attribution to heart disease in GA. 
I feel similar in ATL as I did in STL. Both Monsanto and Coco Cola allow a presence and economy and jobs and some kind of solution to starvation. 
Coco Cola seems to bring in much more pathos about the whole thing of course. And it works! The video they play in the theater before your visit begins makes you want to cry but never once shows coke or says coke. It's taken a "we unite the world and share in your happiness" sort of marketing sheme. 

And it did!

There I was, howling over the outcry to the "New Coke" introduced in 1985 with my brother who randomly flew into my lonely town for business-as ATL has the largest airport in the US. Who knew that's why when they brought back "Old Coke" they called it Coco Cola Classic. A questions that has been plaguing me since 1986. Why the classic? What makes it classic!?!?!

I felt united! I felt happy! I was laughing with my brother in the Coco Cola Factory. And often thinking of my mother, who I am turning into. Cringing at how overwhelming and ADD the "world of Coco Cola" is and how I could not walk across the 5 continent tasting room without losing my ballet flats on the sticky floor. Worst nightmare realized.
And! on some level, forgetting I was a dietitian. A dietitian that believes that sugary beverages are the main culprit for obesity in the US. And feeling like a kid again. And then very quickly, feeling like my mother again.

The world of Coco Cola is a world. Just as city gives you a feeling. 
Even if you don't know what the feeling is yet. 
A desire to have a community. 
To root for a basketball team. 
To know the best way to get somewhere on the highway or subway system.
A way others can comprehend who you are so they feel like it/you makes sense to them. Living in a city can make you cool or down to earth or wear North Face or despise North Face or smoke cigarettes or drink wine or take the subway or go on hikes or know what's going on in foreign politics or know what's going on in Hollywood. 
It gives you an identity. A stereotype. It's an odd thing. 
But it makes people proud or allows them to be something even if they're not: To be strong enough to handle the NY attitude or be socially conscience enough for Portland or to be the most hospitable southerner yet. 
Or maybe people just like to be where their values are and interests are represented the most. 
Which perpetuates the stereotypes. 
Which continues to make southerners unhealthy. 
Which makes living in places you never thought you would interesting.

It's a little uncomfortable being where I am at. Losing an enormous sense of myself. Living in a place I never thought I would that has a lot of preventable deaths that I have dedicated to strive against. At least strive against on a personal level. 
The weird part is I think I've gained a big sense of myself. Being a little lost by yourself is sometimes less lonely than being an actress amongst actors (don't read too much into the gender situation going on right there) in a beautiful city where sometimes rules don't apply to certain people and you can't tell if it's fall or spring. As humans, we have the capacity to love and hate something, for example a city, at the same time. We do a lot of comparing because then we can "place something" in our heads and feel better about it. More certain. When you live somewhere, you take a part of that city with you and that city puts a part of itself in you- your memories, experiences, bittersweet complicated feelings and your capacity grows. I'm pretty sure we just want to be the best and most honest versions of ourselves. And again, I believe cities give you an identity or push an identity on you. But the thing is, I'm not sure how much identity ATL has to give? Or I'm just so not even aware of it yet.

It has allowed me time to really consider what I do want, what I do think, how I can potentially make an actual difference, who I really am. 
I said "think". I didn't say "figure out." As I said before, I'm always evolving.
My last stage in particular was an unbelievable amount of fun but I had this weird feeling that it was just one step. And I had to continue. To evolve. On some personal level. 
When all the fun and glitz is laid out for your taking, the "taking" is what you're "doing."

At least I am "doing" or feel like I "will be doing" instead of just "participating in." It aids in real personal evolution. 
And fingers crossed, a smoke free revolution. Which preempts the sugary drink revolution. Which is possibly all a product of gentrification. Which is all a product of saturation. Which is all revolving in a circle. As is life.   

Which is probably why I'm turning into my mother...

A New, Sweet Suprise

I'm sitting in my new kitchen.

Drinking a Restoration Pale Ale complements of Melissa Rose (space) Mary Coyle. Rose after one grandmother and Mary after the other. Not to be confused with the nonexistent grandmother "Rosemary." So Irish having so many names.

And I'm eating a home made pizza: garlic, shallots, artichokes, pine nuts, marinara, pesto, some chili flakes, some basil sprinkle, mozzarella, Parmesan (with a capital P, people), evoo (not to copy RachelR) and S+P (not 500) on a TJs crust that really needed a rolling pin that I don't have...
Will put on my shopping list next to accent chair and collect desk and couch.

And I'm listening to The Very Best of Otis Redding. Wish it were on vinyl. Must put record player on shopping list or collection list from dear old dad. In particular, "That's How Strong My Love Is." Doesn't get any better than that. Or maybe "Mr. Pitiful" -which might be what I am.

Regardless of a "coming together house," or "coming together life" for that matter, I have a decorative basket full of Easter Eggs complements of Julie Murphy better known as Mama Murph. There's also a tray in the basket (which is really a pink mixing bowl) that says "Have an Eggcellent Easter." Please tell me you read my last post. Or don't. You're eyes will glaze over. And lord knows I can't lose another reader or I'd be down to none.

As being alone in a new city will do to you, I wikipedia'd (It's def a verb. Don't fight me on this) "Easter Eggs."
As I'm staring at them and as I helped my cousin put on an Easter egg hunt for my little second cousins yesterday. They were pretty fast at finding those eggs. And I heard the 4 year old use the word googleplex. And I heard the just-turned-6-year-old use onomatopoeia not too long ago. I guess they're just fast in general. Growing up.

Eggs in general are super interesting. Not only do they rhyme with yours truly but they also act as an emulsifier for cooking and baking, contain two macronutrients but can be separated super easily unlike other combination foods, can be cooked like a googleplex amount of different ways, are considered a home for something to grow and if that something doesn't grow it's food and if it does grow it's food. It's just kind of an amazing food.

And on top of all that! Along with spring, it's a symbol for rebirth and the empty tomb of Jesus. Who knew! Give it time and I'm not too sure that egg would be empty.

It's funny how something that is comprised of protein and fat turned into plastic loaded with sugar like Jelly Beans. One more interesting fact about it. I guess I'll have to revise my statement and say it can be easily separated into three macronutrients. Especially at the hands of 4 & 6 year olds.

These girls are such good eaters for their age. Sure they like sweets but they eat far more and far better than other kids I've babysat in the past. It's too bad that sugar is introduced as a reward or holiday treat at such an early age. Is it because we're a wealthy enough country that we don't find real eggs exciting? Or is it just another example of capitalism on the hunt?
But as I heard the 6 year old say after dessert "that has 2 grams of sugar but you have to look at total carbohydrates." I can't even teach my patients that. I guess education is the key even though in my current state "knowing is not controlling" as repeated often by mama murph. 

I think it's the adults who changed the Easter egg hunt into a Sugar egg hunt. It's too bad. Guess I shouldn't be speaking-This is my first home alone and the first thing I put in my mouth today was dark chocolate covered pistachios. Just because I could. I got them at the World Famous Dekalb Farmer's Market-next post to inform and delight. Leaving LA is also calling falling off a healthy eating trend... 
And leaving LA is also a rebirth of sorts. I needed new windshield wipers as mine had dried up in Southern California. Apparently something does change and gets old in that environment. Who knew.
I'm on the hunt for my own new life. Wonder what will be inside. And despite everything I wrote, I hope its a sweet surprise.

mEgg, All Cracked Up

Anyone who's read this blog or talked to me for five minutes knows how funny I think puns and bad jokes are. I know most of you think that's redundant. But don't hate on the puns. 

This humor theorist PhD I've been spending my time with does not find puns nearly as funny. I get the ole eye roll from time to time. Ohhhh the irony. He doesn't even admit he's amused by how funny I think they are.
Apparently they don't live up to Lenny Bruce, Richard Pryor or Howard Stern..
I could do a little play on him being satired of me telling my jokes. But I won't. wink wink.

But he does think Fozzie the Bear is pretty funny. And maybe the only pun that does get him is the one my brother and I used to double over telling:
Fozzie is on the stage telling terrible jokes (also known as puns) to a packed audience, including those geezers up in the balcony, when the crowd starts throwing tomatoes, cans & fish at him. He picks up a fish and says "why am I doing this? Ohh just for the halibut!"

...As mama murph would say after she told a silly pun "Corny, Corny, Corny." 
(see it's still all food). 
  

I was emailed a BuzzFeed this morning from a great one. 

Many compliments Mr. Kent & viral buzzfeeds. 

C'mon. Hilarious.

Alright. Stop it! 

This one kills me. It's on fire.

 Alright, I admit this one isn't the best...

Think I'm al dente?

Unfortunately not.

Being a pun connoisseur, I find these last two to be a bit raw & immature..

Pretty ridiculous post. But puns are fun. 

Even when you get the back-&-forth head shake and disapproving smirk.

One more for the audience. I need some fish for dinner tonight. 

This last one is so bad but it's kind of a hoot...I mean, everyone knows, chicks can't drive.

 

Maybe my humor theorist PhD doesn't know a good pun but he's a damn good cook. Last night he made the best salmon burger I've ever had. 

And I got to make the sunny side up egg to top the patty. 

The end product reminded me of the Playmate Kitchen Set plastic eggs. 
Seems appropriate for me. 

All sunny side and playful. 

This mEgg was all cracked up. 

.waka.waka.waka.