Dietetic Internship: Inner Door Week Four!

Dietetic Internship: Inner Door Week Four!

My first rotation is officially over!!

It's crazy. I keep thinking that I have to wake up at 6:30a when I go to bed, then I remember that I have nothing going on! Well, almost nothing. I have this entire week booked with fun things since my boyfriend leaves for AZ on Sunday :( We are making the most of our last week in Ann Arbor, of course including kayaking, blank slate ice cream, playing frisbee, going to the quality 16, and seeing a concert at DTE (not A2, but still a classic).

My last week at Inner Door continued as the previous three had, including running the nutrition group centered around fat. We discussed an article examining some of the evidence on saturated fat -- is it really that bad for us, or is it the research that is lacking? Conclusion - moderation (as most studies end with). Saturated fat is healthy to an extent. One of the clients made an interesting observation that coconut oil is touted as a cure-all to just about anything, but the majority of fat in it is saturated. Nobody seems to mind it when it's coconut oil saturated fat, but cookie dough saturated fat means sound the alarms (shh, don't tell them it's the same thing).

I finished my case study on one of the clients, and I'm pretty proud of it. I was able to cover the beginning, starting with a nutrition assessment, all the way to my second to last day. The client is definitely moving forward through her recovery; her determination is what really drives her forward, which was refreshing to see. Some of the other clients can be a little more difficult. We had one check-in appointment last week that went a little like this...

So how's the week been? 
Fine.
Have you been facing any challenges lately?
Not Really.
What does this weekend look like for you?
Well it's my birthday. So me and some friends are going to hang out and everything.
That sounds like fun, how will you support yourself?
Well I could tell you a bunch of things I could do but I'm not actually going to do them.
Why is that?
Well my mom is going to be asking for me to eat cake and everything so I'm probably not going to eat anything tonight and we'll be out drinking tomorrow.
Why do you think the weekend will go this way? 
I don't know. I'm just exhausted and I don't care and I just want to have fun.
What are some things you can give yourself credit for this past week? 
I don't know. I came to the appointment today.

So it's not all sunshine and rainbows. And this is still a fairly easy interaction, sometimes clients can be very defiant and resistant. ED behaviors are stubborn to say the least. It was really good for me to see this kind of appointment to experience just a taste of the difficulty of counseling with this population.

I had a phone conversation with the founder, Beverly Price, RD, RYT, as well during this last week. She was honest and easy to talk to. I asked her about some of the challenges when starting your own private practice, and naturally she responded with insurance. That was a theme when it came to challenges. We also talked about the difficulty of getting doctors and therapists on board with the "chakra" modality for treatment. She said there have been people who haven't been a great fit, and both parties involved realized that fairly quickly. Bev said that's one of the reasons interviews are so important, so that they can get a feel for the commitment to this new way of treatment. Bev said she stays in this kind of work because it's not about her, it's about the clients. That's what keeps her going. Her answer surprised me; I was expecting to hear about how rewarding it was or how it gave her joy to see clients graduate, which I'm sure are also true, but to hear that it's more of a selfless action for her--that was powerful. If I want to pursue this field, I think I would do so in a program like this one where you are with the clients often and for appointments, but it doesn't consume your entire day. You have time for notes and team meetings and a variety of other activities. I could see myself even accepting a part-time position if that's all that was available. Bev said she could possibly connect me with some of the treatment centers in Tempe/Phoenix area... sign me up!

Lastly, I got to teach the yoga class on my final day! Awesome awesome!! I was so excited. The teacher who observed me during the class gave some candid, great feedback. Initially my walls went up -- why do I take everything personally? -- but as I contemplated what she said, I think it will help me even through my other classes. She mentioned that this population needs to be challenged. They feel fragile, but you can't always treat them that way. If they are given permission to do nothing and not participate, sometimes they will. It's the defiant nature of EDs again. She said don't be afraid to push them, to challenge them, it helps them in the long run. Be gentle but firm. She also said that I'm extremely articulate and have absolutely beautiful word choice -- but sometimes my personality gets lost in that persona. She told me, "Don't be afraid to let you shine through your teaching, that uniqueness that you bring to the table." I think that I do this more when I teach in A2 because those are my comfort zones. And I definitely push people in my vinyasa classes, but I'm not always going to be in a comfortable zone. So this is an area of development during the next few months before I move.

Overall I absolutely loved my rotation at Inner Door Center. I found it to be an opportunity for growth, challenge, discomfort, cooking, eating (lots of eating), learning, mentoring, and increasing my confidence. I couldn't believe that hemachromatosis came up at one point, although the RD and I were pretty certain that was not the culprit of the new high iron value (nor were the ensures, that the client had been drinking for months). Shout-out to Dr. Cole, one of my grad school professors, that taught me more about micronutrients than I ever imagined, and it's actually applicable. Also shout-out to Susan Aaronson, who taught me eggs are amazing (complete protein, healthy fats, lots of B vitamins). There will definitely be rotations where I feel helpless or lost, but I just have to come back to my training and know that I got my MPH from UMich for a reason. Even if my first degree was an accident (ha), they wouldn't have made the mistake twice ;)

Counseling tip: Rather than, what are you proud of, it's what can you give yourself credit for. Sometimes it's hard to feel proud when you feel downtrodden, like you aren't making progress, or even those who are extremely humble. What can you give yourself credit for means even if you aren't super proud of it, that bowl of mac and cheese was a huge step in the right direction.

If you're an avid reader for DI posts, they will resume the week of July 11th, orientation. Until then, I'll be posting about my summer capsule wardrobe, musings in yoga (especially my new YTT experience since I'm a teacher teaching teachers!), and some coffee shop thoughts that have been rolling around in my brain.

What does an RD2Be eat?

What does an RD2Be eat?

Capsule Wardrobe Check-in: Almost Done!

Capsule Wardrobe Check-in: Almost Done!