The Next Chapter
It’s not my birthday. However, it is a new chapter. A new chapter in my career. I am leaving my current position and moving
on to something new. I’ve shared
recently in various blog posts about creating a balance between my work and life,
so it should come as no surprise. My
previous job prior to this one required a 150-mile daily commute - amazing views of the Everglades, but it was a long commute.
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| Snake Road - Big Cypress |
And while my job was 8-5 the day ended up being
6:30-6:30 (or later, depending if there was an accident). I went against traffic, so my 75-miles in an
hour and a half was sometimes quicker than people’s 10-mile commute in
traffic. Regardless of the distance, it
was the time that was taken away from me.
Moving forward I vowed I would stay with the job (as I loved teaching
the kids) until I found something I truly, truly loved. After three long years of searching I found
my current position, a dietitian at a diabetes education center, 5 miles from
home. I thought what could be
better? Teaching about diabetes? Close to home? I’m in!
In my first year at my job I learned more than I could have ever
imagined – insulin to carb ratios, insulin sensitivity factors, and that old
notion of three meals/day, three snacks/day was based on an older insulin not
often used anymore! It truly was and has
been an amazing opportunity and experience.
But with the good comes the bad.
And shortly after starting, that short commute didn’t really
matter. I was leaving so late there was
no traffic to speak of. My normal 8-hour
workday was back to 10 and 12 hour days. I love teaching about diabetes and how to
manage it through diet and exercise. I
had a patient the other day who attended our diabetes class ~2 months ago. His A1c at the time was 8.8% (well above
goal) and upon his return to see me one on one, his A1c was down to 7.0%. I asked him what he did to help improve (as
medications had been removed and not added per his chart). He said, “I followed what you and Lory (the
nurse educator) told me to do!” That my
friends, that is what is rewarding. He
literally made my day!
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| Year 1 |
Teaching about diabetes is what I
know I love. There’s nothing better than
helping a person count their carbs and match their insulin to what it is
they’re eating to adjust a dose. Maybe
I’m a numbers geek? Science nerd? Not sure.
But what I do know is that I do not
love teaching a person with a sole diagnosis of “obesity”. Sure I understand that within diabetes the
weight loss talk comes up. How can it
not? If a person does lose weight it
only helps their insulin work that much better.
But I know what my strengths are and teaching/coaching/being a
cheerleader to help people lose weight is not my forte. I had a patient come in the other day and
stated that she gained 80 pounds in one year and there was nothing medically
wrong with her (as she had everything checked out, thyroid, etc.) and she was
asking me why she gained weight. Um, I
don’t know? I feel helpless at times in
talking to the patients and ultimately feel that I’m not helping them. Food is so much more than just the science
behind it. I should’ve been taught more
psychology in my college years in order to be able to better assist
patients. Sure I’ve gained knowledge
over the years and sure my yoga background helps me to teach them to be
mindful. But at the end of the day, I
haven’t been coming to work happy anymore.
And that my friends, is critical (in anyone’s job), to find what you
love and love what you do!
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| Year 2 |
And so I move to the next chapter
in my career. I will be doing group
nutrition education at various events all around South Florida. I will be teaching about prevention mainly
and there will be some pilot type programs that are geared towards some of the
most common disease states within nutrition – diabetes, heart disease, and yes,
weight management. I think the thing
that excites me the most is actually being able to reach a LOT of people all at
once. Teaching one on one can be
rewarding (do not get me wrong…I will miss that to a certain extent). but it can also be taxing when you repeat the same thing over and over. Group education with the premise of
prevention…yes, I get excited just thinking about it. Nutrition dork? Maybe just a little too extreme when it comes
to nutrition? I prefer to think of it as
being passionate – passionate about helping people to be healthy. Isn’t that what you’d want from a dietitian??
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| #TeamPineapple |
So as my time winds down, I started to reflect on my patients and what
they’ve taught me over these past three
years. A few stood out and here’s a few
ditties that I pass on to you:
Working where I work, we get many
international patients. Patients from
all over, i.e. Venezuela, Trinidad, Colombia, Brazil, etc., come to the United
States for their care. Pause just a
moment and think about that for a minute – how lucky are we to live where we do
have access to progressive thinking, state of the art healthcare? (I will not get political in this post as to
the state of insurance with healthcare…just keep thinking that we have access
where many others do not). There really
were too many to recount. The
international patients were something special.
Appreciative of everything we could teach them in order to improve their
health upon returning back to their country.
The marathon runner/yogi. I’ll
never forget the first day we were doing a program that she was attending. Her continuous glucose monitor (CGM) was
buzzing that she was “low”. I nudged my
nurse educator and we looked at each other communicating without speaking,
“should we do something?” It was in that
moment I was taught a valuable lesson - patients know their bodies better than
anybody else. She immediately took out a
cracker and kept watching her CGM – it was her way to nudge the blood sugar in
the right direction, not to over treat, but simply to steer it in the right
direction. Sugar surfing at its finest. She’s one of those patients that already
knows so much, I often wondered if I was ever teaching her something or was she
the one really teaching me?
Learn from others and look around,
there’s always something new to learn.
I used these measuring cups for every session I taught
patients. They were my special gift. I received
them from a kid with Type 1 diabetes that used these cups on repeat. He wanted other kids to not have to go
through what he went through and help transitioning to “counting carbs” to be
as easy as possible. He donated a whole
box of these measuring cups for us (the nurse educator and myself) to pass out
to newly diagnosed kids with Type 1.
Read the note. You’ll see how
special a kid he was.
This particular patient was sugar
surfing before she knew she was sugar surfing. We do a 4-day intensive program with patients
in teaching them how to manage their diabetes.
Teaching them all the key concepts about real life situations and how to
manage their diabetes, i.e. insulin adjustment guidelines, how to check their
basal, etc. This patient came in pretty
much on the brink of giving up (as she described) because all of her doctors
had told her that what she was doing wasn’t “right”. The truth?
She was doing exactly what we were going to teach her to do – manage her
diabetes, sugar surf, and make in-the-moment decisions about how to better
control her diabetes. She gained the
confidence to know that she was in fact managing her diabetes and doing it to
the best of her ability. She has since
communicated to us that through the use of the CGM and using multiple daily
injections (versus a pump) her last A1c was as low as it’s ever been (without
having hypoglycemic episodes). She was
writing to thank us. Giving patients the
tools to better manage their diabetes, yeah, that’s the rewarding part.
The local grocery store here in
Miami has a program to give some medications free of charge and with others at
a minimal cost. Think that’s not a big
deal? For many of my patients it’s a
REALLY big deal. I had this one
particular patient that kept continuously calling me in regards to her low
blood sugar levels. After various
probes, I finally realized what was going on.
Her medication (for her DM) could induce lows as it was working for
24-hours. This patient only ate once/day
as she didn’t have enough food to have more meals than just one. BINGO.
Her lows were due to lack of food access. I found a food program here locally that the
patient was able to get one free hot meal/day due to her age. I taught her how to
use the “Buy One Get One Free” at the local supermarket in order to get more
food for the money that she did have (so she could have food for the
month). I was teaching her smart
shopping and showing her ways to extend the money that she did have. And at the end of the day, I taught her not
to take her medicine if she wasn’t going to eat. This patient taught me that it’s really easy
to tell someone what to eat, but at the end of the day what do they really have
access to in order to make that happen?
Compassion and empathy are key.
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| I wish I could give ALL the needy patients free food! |
To all the kids with Type 1 DM –
you are amazing, resilient, and capable beyond your means – you CAN do anything
you want. For whatever reason your own
body decided to attack it’s beta cells so your pancreas doesn’t work anymore,
but that should NOT stop you from doing anything your little hearts
desire. In one of those 4-day programs
this one particular kid was thanking his parents for buying him his supplies. What 12-year old has to think about where he
is going to get his supplies from? And
yet he was here thanking his parents for being selfless and giving him what he
needed before buying things for themselves.
These kids, surprise me every time. Sometimes the kids would call us super heroes, when in reality they are the real heroes. In case you're wondering, I was Super Girl.
In addition to the international
patients, I receive what are termed VIP patients. While I should preface and say that to me ALL
patients are VIP, these particular patients are deemed to be a little more
important (whether it’s their financial contribution to the university or
whether they truly are famous). There
are some that come in and demand to be seen yesterday, when my schedule is
booked for the next three months. And
then there are some that don’t want a big fuss at all made about their VIP
status. I think what the VIP patients
have taught me is that no matter what your background might be or where you
might progress to be, always remain humble.
Fame and fortune shouldn’t make you think you’re any more important than
someone else. We all need to be educated
and helped at some point.
Last but certainly not least, my
co-worker. We started within in a few
months of each other. Who would’ve known
that we would get along as well as we did?
Luck of the draw? Not sure, but
what I do know is that I’m beyond grateful for having met Lory. I describe her as THE best nurse educator
around. She’s been given the nickname,
“Flo” and “Wonder Woman” because she is just that, always going above and
beyond in helping patients in their care.
It’s hard to put into words just what Lory means to me, but I know that
I am forever changed having met Lory. I
have had other great co-workers (don’t go getting jealous out there Jill or
Lance!) but when you have just each other to rely on, we were truly lucky to have had
each other. So glad you were my co-worker, but beyond that, I'm truly blessed to call you my friend.
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| WBFF4L |
I am truly grateful
for these past three years and all that I’ve learned. As I said, I’ve felt in these last few months
that it’s time for me to move on. Sometimes
people look at change and are fearful. For me, I’m hopeful of what’s to come and look
forward to all the opportunities that lie ahead!
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