This week was my second week working in bariatrics! To find out what I did in my first week of bariatrics, check out DI: Week 2 – Bariatrics, Research, and Mental Health First-Aid.
My week looked like this:
Monday:
At the beginning of each day this week, I reviewed the charts of the patients I was assigned for the day. Once again, my preceptors had me take the lead in our appointments and helped me figure out how to structure pre-op, post-op and medical weight loss appointments.
After lunch, I had the opportunity to shadow the pediatric weight management dietitian. Pediatric weight management is very different from adult weight management. In pediatrics, the focus is more on family behaviors instead of individual ones: increasing number of family meals, having children help their parents in the kitchen, promoting physically active, family time, etc. Children are encouraged to be more physically active and meet with an exercise physiologist who helps them develop exercise goals. From a nutrition standpoint, they also work on eliminating sugar-sweetened beverages and eating more fruits and vegetables. The most important difference is that children are not encouraged to lose weight—the goal is for them to maintain their weight so that as they continue to grow their height catches up to their weight.
Tuesday:
I spent the morning practicing writing the appointment notes for the patients I saw Monday morning. Throughout the rest of the week, I updated patient’s charts both in the morning, when I first arrived for the day, and in the afternoon. Then, I continued to practice leading counseling sessions and helping patients come up with goals for their next appointments.
Goals for medical weight loss are generally eliminating sugar-sweetened beverages, making sure not to skip meals (breakfast and lunch are the most commonly skipped meals), and including more fruits/vegetables in the diet with fewer refined carbohydrates. Pre-surgical goals include: tracking protein intake, eliminating sugar-sweetened, caffeinated and carbonated beverages, consistently eating 3 meals/day, and getting into a consistent exercise routine. Post-surgical goals include: advancing through the post-op diet phases, tracking protein intake, drinking at least 60 fl oz of water per day, exercising consistently and incorporating strength training, adhering to lifelong vitamin supplementation, and avoiding high sugar foods.
Wednesday:
Today, I was back to seeing patients—this time doing the entire appointment start to finish by myself. My preceptors were still in the room though, just in case. One of the patients I saw had been very noncompliant up to that point and pretty non-responsive to questions—surprisingly, during our appointment, I was able to get him engaged and set some good goals for his next appointment. It was so exciting to actually be able to help a patient progress towards their goals. I’m finally starting to feel more like a dietitian and less like a student (even though I’m still a student for another year). After completing all my appointments, I left early to get to my night class. This week we talked about the role of nutrition in public health and played “Dietary Guidelines for Americans” Jeopardy—my teammate and I placed second. The prizes? Dijon mustard, olive oil, and cans of beans (I won a can of beans). :P
Thursday:
Today, I started practicing doing some charting while in the appointments. It’s definitely a balancing act; I need to take some notes during the appointment, so that I get all of the most important information in their chart. However, I still need to maintain eye contact with the patient and make them feel heard. Some patient appointments are easier based on how much information the patient shares during their appointment. For the patients that aren’t as talkative, you really have to rely on Motivational Interviewing skills, like asking reflective questions, to get all of the information you need to make sure the patient is progressing towards their goals. This afternoon I was finally able to catch up with all of my appointment notes—they start getting easier with practice.
Friday:
Fridays are generally slow days at the bariatric clinic. After doing chart review and getting through three morning appointments, I finished my appointment notes. Then I spent a couple of hours doing readings for my public health class before our afternoon appointments. After my two afternoon appointments and finishing up my notes, I was able to go home early! Yay! Spencer, my partner, drove from Minnesota to visit me, so when I got home he was here!
Weekend:
Spencer came to visit! We went hiking at Starved Rock State Park, which is about a 2 hour drive south from where I live in Illinois. We brought a picnic lunch to enjoy before hiking for a couple of hours. It was so nice to be out in nature getting some good exercise—even though it was pretty hot out! We hiked along the river, and saw some of the cool canyons. We’ll definitely be back in the winter to see the ice falls. We also watched a lot of Parks and Recreation–one of our favorite shows. (I even bought Spencer this poster because we love the show so much.) Overall, we spent some quality time catching up on the happenings over the past couple of weeks. Spencer is living in Minnesota while I’m interning at Loyola—he works as a Psychiatric Associate at Fairview Hospital in Minneapolis.
That’s all I’ve got for this week! Tune in next week—I’ll be jumping around between a few different rotations. I’ll finish up in bariatrics and start two of my other rotations. Until then!
*This post contains affiliate links–I will never promote something I don’t believe in, thank you for your support!*