Need Help Deciding Which DI's to Apply for? Read These Tips from Amanda Bot!

To contact us Click HERE

With over 200 internships in the country, choosing which internships you want to apply to can be very overwhelming. Here are a few strategies that I, or people I know, used when deciding which internships to apply to:

• Make a PowerPoint document with slides featuring each program you are interested in.  On each slide list the internship’s location, emphasis, unique qualities, cost/stipend and any other information that you deem important in your decision-making.  List all the pros and cons of each internship.  This provides an easy way to compare one internship to another.

• Talk to the people whose opinions you value.   Talking with someone about the decision you are trying to make helps to sort out your thoughts and focus your priorities much better than if you keep your thoughts inside your head.  I talked to my classmates who were also applying to internships and to my RD mentor. 

• Do not let your self become stressed about your decision.  Find a way to relieve your stress, especially if you are feeling the weight of the decisions you have to make.  I have found that setting aside a little bit of time each day for an activity I enjoy such as exercising or reading de-stresses me and clears my mind so that I am able to make decisions with a calm mindset. 

• Most important:  DO NOT PROCRASTINATE.  Procrastinating on your decision of where to apply to a dietetic internship can set the entire process into a tailspin.  Start your research early and be prepared so you have plenty of time to write your personal statements and contact the internships that you feel are your perfect fit.  

By: Amanda Bot

Beginning the Application Process for DI's

To contact us Click HERE
I know it seems like it's a little early to start your DI application via DICAS, but it’s never too early to start thinking about it and planning for it. The portal opens on December 1^st so I’m trying to get everything in order to make this process as easy as possible.  I’ve been talking with people who are either in their internship right now or have been through this process recently. Here are some tips that they’ve told me:

•  Get transcript requests sent right away. It may take a while for some schools to send them, and if you’re a transfer student like me, you’ll have to make requests for multiple transcripts. Not only does DICAS need them, but you also have to input all the courses you’ve taken so that they can calculate various GPAs. You might want to do this part first since it’s the most tedious.

•  Ask people to write your recommendation letters as soon as possible. Hopefully they’ll all say that they’d love to write them for you, but you may come across some problems—they might be too busy, etc. Also ask them what they need to write the letter. You may need to send them your personal statement, past homework assignments or you may need to sit and talk with them about what your goals are.

• If you are applying to more than one internship, make sure you know what each internship’s focus is. You are going to have to write a different personal statement for each one you apply to. I believe that this is going to be the most time consuming part for me—even more so than deciding which internships I am going to apply to. Once they are written, have everyone you know read them! The more eyes that see them, the more feedback you can get before you submit your application.

• Contact the program directors. Either talk with them in person or over the phone. If there is an open house for the internship you’re interested in, GO!!! Meet the people you could be working with! When they get your application they’ll be able to put a face to the name.

•  Most importantly, be yourself. Be genuine about what your goals and interests are. 

This whole application process can be so daunting. Make it easy for yourself and DO NOT procrastinate!

By: Allison Richards

It's Not Just Meat and Potatoes: The Diversity of the Dietetics Profession

To contact us Click HERE
By: Jill Merrigan 
I am constantly asked, “What do you want to do when you finish school, and complete a dietetic internship?”  For me I am asked this weekly but find that I have a monthly response. One of the most exciting pieces of my return to school is the inspiration I have as I continue to learn about all the possible career opportunities I’ll have as a registered dietitian.
The career field for a registered dietitian offers a colorful plate, it not just meat and potatoes. From clinical dietitians, foodservice managers, research dietitians, educators, outpatient nutrition counselors, consultants. It is encouraging and motivating to remember that all my hard work in the classroom will expose me to a broad path of experiences within the dietetic profession.  When I was in the process of leaving my job in ad-sales and transitioning into my new life in Boston at Simmons College I took the time to meet with many registered dietitians, educators, and professors. One of the most important observations I took away was that in the dietetic profession we are not limited to one career path. Many times an RD will choose a position that meets their specific needs and in time branch into another position that suits them, and continue to make changes as it feels appropriate with time.  Some of the unique careers I have discovered that RDs are pursing include a RD – Food stylist, RD – Psychotherapist, RD – Medical Doctor, and RD – Farmer.
The nutrition and dietetic field is versatile, allowing diverse ways to educate and help people eat right. If you are considering a career change into nutrition and dietetics but now sure where the path will lead you then be sure to take some time, learn about the many opportunities that are available, and compare them to your own personal goals, strengths and interests and begin to see yourself living your career dream. 

Amanda's Cardiology Rotation

To contact us Click HERE
I had a great past couple weeks in my cardiology rotation.  I had the opportunity to meet and work alongside an inspirational RD who is not just a clinical dietitian but also an outstanding community leader who holds leadership roles in numerous organizations including the local dietetic association.    Of course I also learned how to plan and educate patients about heart healthy diets, make notes in the charts of patients, and do nutrition assessments on patients with CHF.

One of the main things I have learned is that nutrition care is hardly one-dimensional.   Although a patient may come into a hospital with the initial diagnosis of chest pain and shortness of breath, they may also have diabetes, renal failure, cognitive impairment, trouble chewing/swallowing; the list goes on.  When assessing a patient, it is important to look at the “big picture” and not just the diagnosis that the patient was admitted with.  This is especially important when completing a case study. 
Case studies are some of the best opportunities to learn during clinical rotations.  They give you the opportunity to apply all the information you learned in your MNT classes to a real-life scenario.  Scanning charts and comparing lab values made me feel like a detective; it was up to me to figure out where the patient was nutritionally deficient and what nutrition interventions were needed to restore their health. 
One tool that was especially helpful was my MNT book from college.  This book is filled with so much detailed information that was helpful when completing my cardiac case study.  If you are planning on completing an internship I would definitely recommend resisting the urge to sell your MNT book at the end of the year and hold onto it as it will prove to be a valuable tool during your internship.  
Question (to other past/present dietetic interns): What other resources have you found to be helpful during your dietetic internship rotations? 

Amanda's Career Goals and Reflection over 1st half of DI

To contact us Click HERE
Half Way There!
It is amazing for me to think that one year ago at this time I was putting my dietetic internship application packets together, not even sure which internships I was going to apply to.  Now I am five months into my internship, with only five months to go until I am eligible to sit for the RD exam.  The internship so far has challenged me and prepared me for a career as a dietitian in ways far beyond what I learned in the classroom.
One of the best things I have learned thus far is that I am certain that pursuing a career in school food service is the path I want to take.  The rising need for dietitians in schools and the regulatory changes facing school nutrition programs are two reasons why this career path appeals to me.  Here are a few of the benefits that working as a dietitian in a school nutrition program offers: 

• You get to work with kids!  There were so many people in my college classes who were interested in pursuing a career as a pediatric dietitian.  Rather than working with kids who are already sick, school dietitians can work with kids proactively by promoting nutrition education and nutrition integrity in the meals offered in school. 

• The variety of positions available to dietitians.  As a dietitian you can get a job as a nutrition educator, a manager of school kitchen, an area supervisor for a district or the director of food service for an entire school district.  No two school districts are alike so you can also have a variety of options in the type of school food service program you would like to work in.

• Opportunities for career advancement.  Depending on where your strengths and career goals lie, school nutrition programs can offer many opportunities for professional growth.  This is especially true if you are interested in nutrition management and business.

• Great work schedule.  Depending on the position, school dietitians may get the summer months off and for sure the holidays as wells as most weekends (nutrition conferences may take up a weekend day or two). 

If you are interested in a career as a school dietitian or would like to know more about why I think it is such an exciting career path, please feel free to reach out to me with any questions you may have!  I hope finals are wrapping up well and that the holiday break brings some much needed time for rejuvenation and relaxation.  

Beginning the Application Process for DI's

To contact us Click HERE
I know it seems like it's a little early to start your DI application via DICAS, but it’s never too early to start thinking about it and planning for it. The portal opens on December 1^st so I’m trying to get everything in order to make this process as easy as possible.  I’ve been talking with people who are either in their internship right now or have been through this process recently. Here are some tips that they’ve told me:

•  Get transcript requests sent right away. It may take a while for some schools to send them, and if you’re a transfer student like me, you’ll have to make requests for multiple transcripts. Not only does DICAS need them, but you also have to input all the courses you’ve taken so that they can calculate various GPAs. You might want to do this part first since it’s the most tedious.

•  Ask people to write your recommendation letters as soon as possible. Hopefully they’ll all say that they’d love to write them for you, but you may come across some problems—they might be too busy, etc. Also ask them what they need to write the letter. You may need to send them your personal statement, past homework assignments or you may need to sit and talk with them about what your goals are.

• If you are applying to more than one internship, make sure you know what each internship’s focus is. You are going to have to write a different personal statement for each one you apply to. I believe that this is going to be the most time consuming part for me—even more so than deciding which internships I am going to apply to. Once they are written, have everyone you know read them! The more eyes that see them, the more feedback you can get before you submit your application.

• Contact the program directors. Either talk with them in person or over the phone. If there is an open house for the internship you’re interested in, GO!!! Meet the people you could be working with! When they get your application they’ll be able to put a face to the name.

•  Most importantly, be yourself. Be genuine about what your goals and interests are. 

This whole application process can be so daunting. Make it easy for yourself and DO NOT procrastinate!

By: Allison Richards

It's Not Just Meat and Potatoes: The Diversity of the Dietetics Profession

To contact us Click HERE
By: Jill Merrigan 
I am constantly asked, “What do you want to do when you finish school, and complete a dietetic internship?”  For me I am asked this weekly but find that I have a monthly response. One of the most exciting pieces of my return to school is the inspiration I have as I continue to learn about all the possible career opportunities I’ll have as a registered dietitian.
The career field for a registered dietitian offers a colorful plate, it not just meat and potatoes. From clinical dietitians, foodservice managers, research dietitians, educators, outpatient nutrition counselors, consultants. It is encouraging and motivating to remember that all my hard work in the classroom will expose me to a broad path of experiences within the dietetic profession.  When I was in the process of leaving my job in ad-sales and transitioning into my new life in Boston at Simmons College I took the time to meet with many registered dietitians, educators, and professors. One of the most important observations I took away was that in the dietetic profession we are not limited to one career path. Many times an RD will choose a position that meets their specific needs and in time branch into another position that suits them, and continue to make changes as it feels appropriate with time.  Some of the unique careers I have discovered that RDs are pursing include a RD – Food stylist, RD – Psychotherapist, RD – Medical Doctor, and RD – Farmer.
The nutrition and dietetic field is versatile, allowing diverse ways to educate and help people eat right. If you are considering a career change into nutrition and dietetics but now sure where the path will lead you then be sure to take some time, learn about the many opportunities that are available, and compare them to your own personal goals, strengths and interests and begin to see yourself living your career dream. 

Amanda's Cardiology Rotation

To contact us Click HERE
I had a great past couple weeks in my cardiology rotation.  I had the opportunity to meet and work alongside an inspirational RD who is not just a clinical dietitian but also an outstanding community leader who holds leadership roles in numerous organizations including the local dietetic association.    Of course I also learned how to plan and educate patients about heart healthy diets, make notes in the charts of patients, and do nutrition assessments on patients with CHF.

One of the main things I have learned is that nutrition care is hardly one-dimensional.   Although a patient may come into a hospital with the initial diagnosis of chest pain and shortness of breath, they may also have diabetes, renal failure, cognitive impairment, trouble chewing/swallowing; the list goes on.  When assessing a patient, it is important to look at the “big picture” and not just the diagnosis that the patient was admitted with.  This is especially important when completing a case study. 
Case studies are some of the best opportunities to learn during clinical rotations.  They give you the opportunity to apply all the information you learned in your MNT classes to a real-life scenario.  Scanning charts and comparing lab values made me feel like a detective; it was up to me to figure out where the patient was nutritionally deficient and what nutrition interventions were needed to restore their health. 
One tool that was especially helpful was my MNT book from college.  This book is filled with so much detailed information that was helpful when completing my cardiac case study.  If you are planning on completing an internship I would definitely recommend resisting the urge to sell your MNT book at the end of the year and hold onto it as it will prove to be a valuable tool during your internship.  
Question (to other past/present dietetic interns): What other resources have you found to be helpful during your dietetic internship rotations? 

Amanda's Career Goals and Reflection over 1st half of DI

To contact us Click HERE
Half Way There!
It is amazing for me to think that one year ago at this time I was putting my dietetic internship application packets together, not even sure which internships I was going to apply to.  Now I am five months into my internship, with only five months to go until I am eligible to sit for the RD exam.  The internship so far has challenged me and prepared me for a career as a dietitian in ways far beyond what I learned in the classroom.
One of the best things I have learned thus far is that I am certain that pursuing a career in school food service is the path I want to take.  The rising need for dietitians in schools and the regulatory changes facing school nutrition programs are two reasons why this career path appeals to me.  Here are a few of the benefits that working as a dietitian in a school nutrition program offers: 

• You get to work with kids!  There were so many people in my college classes who were interested in pursuing a career as a pediatric dietitian.  Rather than working with kids who are already sick, school dietitians can work with kids proactively by promoting nutrition education and nutrition integrity in the meals offered in school. 

• The variety of positions available to dietitians.  As a dietitian you can get a job as a nutrition educator, a manager of school kitchen, an area supervisor for a district or the director of food service for an entire school district.  No two school districts are alike so you can also have a variety of options in the type of school food service program you would like to work in.

• Opportunities for career advancement.  Depending on where your strengths and career goals lie, school nutrition programs can offer many opportunities for professional growth.  This is especially true if you are interested in nutrition management and business.

• Great work schedule.  Depending on the position, school dietitians may get the summer months off and for sure the holidays as wells as most weekends (nutrition conferences may take up a weekend day or two). 

If you are interested in a career as a school dietitian or would like to know more about why I think it is such an exciting career path, please feel free to reach out to me with any questions you may have!  I hope finals are wrapping up well and that the holiday break brings some much needed time for rejuvenation and relaxation.  

Hemoglobin A1C Blood Test Isn't Perfect

To contact us Click HERE

The hemoglobin A1C is a great blood test for type 2 diabetics, but not for diagnosing diabetes.

Don't misunderstand. I love the hemoglobin A1C blood test. It doesn't require fasting. It can be done in the doctor's office with a fingerstick just like your glucose monitor, and you can know the results before you leave the office. And it lets you know how your blood sugar has been doing over the past two or three months. It sounds perfect.

But it isn't. For diabetes management you and I need to know what our blood sugar is doing all the time, not just every three months. A great HGA1C reading does not mean there have been no hyperglycemic or hypoglycemic episodes over that time. So the hemoglobin A1C cannot replace daily checks with a glucose monitor and log book records.

Taken together with daily readings, the hemoglobin A1C gives an accurate picture of whether you are keeping your blood sugar in the ranges that will keep away the complications. There is more and more evidence that an HGA1C between 6.5 and 7 will do just that.

And here's an encouraging fact. If your A1C was 9 and you lower it to 8, there is a 20% reduction in risk of complications even though you aren't in the target range yet. That's good to know. You should also know that the American Diabetic Association says to get the test done every three months if your are diabetic.

Here's how it works. Hemoglobin is the medical term for red blood cells, and glycated hemoglobin is the term for red blood cells with sugar stuck to them. Over the life of a red blood cell, which is 120 days if all goes well, more and more sugar sticks to it as it travels through your bloodstream.

The amount can be measured accurately, and doctors know how much should be on each normal cell. If the level is high, that signals diabetes. The amount is reported as a percentage. That is why HGA1C numbers are so different from the readings you get from your glucose monitor.

So What's a Good Number?

This is where things get a little muddy. Depending on where you go for numbers, you'll get slightly different answers. The American Diabetes Association says a number under 7%, or 7, is a good target for a diabetic. Endocrinologists (M.D.'s who are diabetes specialists) have agreed that 6.5% is a better goal.

Non-diabetics have numbers in the range of 4-5.9%, and when the test number goes over 6.0%, some doctors tell their patients they might be diabetic. This is the danger of using the HGA1C to diagnose diabetes. Here are some reasons why.

There can be at least a half percentage point difference between two tests depending on how they are done. With home testing (a kit you can buy), the blood from a fingerstick is put on a card and mailed away to be tested.

The doctor's office test is done with a machine that gives results in 6 minutes but can be off a little because of the method. The most accurate test is done with a vial of blood at a testing facility or hospital, because they have national standards for constant recalibration, and the test is read using a more sophisticated method.

But even after an accurate test, the numbers can be read in different ways. For example, one expert says that a 6% reading means your blood sugar average for the past two or three months is 126, but another says it is 135. At 7% it might be 154 or 170. Which one is "right?"

Small discrepancies are not a problem if you know you are diabetic and are just evaluating how tight your blood sugar control is long term. But when 5.9% is normal and 6% means prediabetic according to what your doctor tells you, that tenth of a percent matters a lot for your peace of mind.

And there are other problems too. Anything that affects the life or health of red blood cells can make the hemoglobin A1C tests inaccurate for diagnosing diabetes. Any kind of anemia or illness, a change in medication, and even donating blood can affect the test. It is not used for testing gestational diabetes because of its limitations, and doctors still use the glucose tolerance test for that.

For diagnosing diabetes, the glucose tolerance test is still the best choice. Endocrinologists agree on this. So why does a family doctor use the hemoglobin A1C for diagnosing? Perhaps because he or she is not usually a diabetes specialist, and if the HGA1C is sold as the newest way to diagnose diabetes, it's going to be hard to resist.

Diabetes is probably in half of the patients over 40 in a doctor's practice, and the machine is cutting edge stuff. But the glucose tolerance test is still the best way to know if you are prediabetic, diabetic or just fine.

It takes a while but it is an accurate picture of how your body reacts to glucose. You don't have to worry. It isn't painful (unless you count fasting and a few fingersticks). So if you know someone who has been diagnosed by a hemoglobin A1C test, I hope you advise them to get the GTT test for a confirmation and to look for an endocrinologist.

I do love the A1C test, being a type 2 diabetic, because when I'm below 7 I know I'm doing well, and I have seen proof of that good blood sugar control in my own peripheral neuropathy symptoms. When the test is used for that purpose, it's fine. I love it when my doctor says, "Do you know your hemoglobin A1C?" and I say, "Yep, it's 6.8," and the doctor says, "Wow, that's great!"

Those are words I don't hear from my doctor often enough.

Martha Zimmer invites you to visit her website and learn more about type 2 diabetes, its complications and how you can deal with them, as well as great tips for eating healthy that will make living with diabetes less painful.

Go to http://www.a-diabetic-life.com and find out what you can do to avoid many of the pitfalls of this life-changing condition, like paying for cures that don't work and spending money for things you could have gotten free. Martha has made the mistakes and done the research so you don't have to.

Article Source: http://EzineArticles.com/?expert=Martha_J_Zimmer

Beginning the Application Process for DI's

To contact us Click HERE
I know it seems like it's a little early to start your DI application via DICAS, but it’s never too early to start thinking about it and planning for it. The portal opens on December 1^st so I’m trying to get everything in order to make this process as easy as possible.  I’ve been talking with people who are either in their internship right now or have been through this process recently. Here are some tips that they’ve told me:

•  Get transcript requests sent right away. It may take a while for some schools to send them, and if you’re a transfer student like me, you’ll have to make requests for multiple transcripts. Not only does DICAS need them, but you also have to input all the courses you’ve taken so that they can calculate various GPAs. You might want to do this part first since it’s the most tedious.

•  Ask people to write your recommendation letters as soon as possible. Hopefully they’ll all say that they’d love to write them for you, but you may come across some problems—they might be too busy, etc. Also ask them what they need to write the letter. You may need to send them your personal statement, past homework assignments or you may need to sit and talk with them about what your goals are.

• If you are applying to more than one internship, make sure you know what each internship’s focus is. You are going to have to write a different personal statement for each one you apply to. I believe that this is going to be the most time consuming part for me—even more so than deciding which internships I am going to apply to. Once they are written, have everyone you know read them! The more eyes that see them, the more feedback you can get before you submit your application.

• Contact the program directors. Either talk with them in person or over the phone. If there is an open house for the internship you’re interested in, GO!!! Meet the people you could be working with! When they get your application they’ll be able to put a face to the name.

•  Most importantly, be yourself. Be genuine about what your goals and interests are. 

This whole application process can be so daunting. Make it easy for yourself and DO NOT procrastinate!

By: Allison Richards

It's Not Just Meat and Potatoes: The Diversity of the Dietetics Profession

To contact us Click HERE
By: Jill Merrigan 
I am constantly asked, “What do you want to do when you finish school, and complete a dietetic internship?”  For me I am asked this weekly but find that I have a monthly response. One of the most exciting pieces of my return to school is the inspiration I have as I continue to learn about all the possible career opportunities I’ll have as a registered dietitian.
The career field for a registered dietitian offers a colorful plate, it not just meat and potatoes. From clinical dietitians, foodservice managers, research dietitians, educators, outpatient nutrition counselors, consultants. It is encouraging and motivating to remember that all my hard work in the classroom will expose me to a broad path of experiences within the dietetic profession.  When I was in the process of leaving my job in ad-sales and transitioning into my new life in Boston at Simmons College I took the time to meet with many registered dietitians, educators, and professors. One of the most important observations I took away was that in the dietetic profession we are not limited to one career path. Many times an RD will choose a position that meets their specific needs and in time branch into another position that suits them, and continue to make changes as it feels appropriate with time.  Some of the unique careers I have discovered that RDs are pursing include a RD – Food stylist, RD – Psychotherapist, RD – Medical Doctor, and RD – Farmer.
The nutrition and dietetic field is versatile, allowing diverse ways to educate and help people eat right. If you are considering a career change into nutrition and dietetics but now sure where the path will lead you then be sure to take some time, learn about the many opportunities that are available, and compare them to your own personal goals, strengths and interests and begin to see yourself living your career dream. 

Amanda's Cardiology Rotation

To contact us Click HERE
I had a great past couple weeks in my cardiology rotation.  I had the opportunity to meet and work alongside an inspirational RD who is not just a clinical dietitian but also an outstanding community leader who holds leadership roles in numerous organizations including the local dietetic association.    Of course I also learned how to plan and educate patients about heart healthy diets, make notes in the charts of patients, and do nutrition assessments on patients with CHF.

One of the main things I have learned is that nutrition care is hardly one-dimensional.   Although a patient may come into a hospital with the initial diagnosis of chest pain and shortness of breath, they may also have diabetes, renal failure, cognitive impairment, trouble chewing/swallowing; the list goes on.  When assessing a patient, it is important to look at the “big picture” and not just the diagnosis that the patient was admitted with.  This is especially important when completing a case study. 
Case studies are some of the best opportunities to learn during clinical rotations.  They give you the opportunity to apply all the information you learned in your MNT classes to a real-life scenario.  Scanning charts and comparing lab values made me feel like a detective; it was up to me to figure out where the patient was nutritionally deficient and what nutrition interventions were needed to restore their health. 
One tool that was especially helpful was my MNT book from college.  This book is filled with so much detailed information that was helpful when completing my cardiac case study.  If you are planning on completing an internship I would definitely recommend resisting the urge to sell your MNT book at the end of the year and hold onto it as it will prove to be a valuable tool during your internship.  
Question (to other past/present dietetic interns): What other resources have you found to be helpful during your dietetic internship rotations? 

Amanda's Career Goals and Reflection over 1st half of DI

To contact us Click HERE
Half Way There!
It is amazing for me to think that one year ago at this time I was putting my dietetic internship application packets together, not even sure which internships I was going to apply to.  Now I am five months into my internship, with only five months to go until I am eligible to sit for the RD exam.  The internship so far has challenged me and prepared me for a career as a dietitian in ways far beyond what I learned in the classroom.
One of the best things I have learned thus far is that I am certain that pursuing a career in school food service is the path I want to take.  The rising need for dietitians in schools and the regulatory changes facing school nutrition programs are two reasons why this career path appeals to me.  Here are a few of the benefits that working as a dietitian in a school nutrition program offers: 

• You get to work with kids!  There were so many people in my college classes who were interested in pursuing a career as a pediatric dietitian.  Rather than working with kids who are already sick, school dietitians can work with kids proactively by promoting nutrition education and nutrition integrity in the meals offered in school. 

• The variety of positions available to dietitians.  As a dietitian you can get a job as a nutrition educator, a manager of school kitchen, an area supervisor for a district or the director of food service for an entire school district.  No two school districts are alike so you can also have a variety of options in the type of school food service program you would like to work in.

• Opportunities for career advancement.  Depending on where your strengths and career goals lie, school nutrition programs can offer many opportunities for professional growth.  This is especially true if you are interested in nutrition management and business.

• Great work schedule.  Depending on the position, school dietitians may get the summer months off and for sure the holidays as wells as most weekends (nutrition conferences may take up a weekend day or two). 

If you are interested in a career as a school dietitian or would like to know more about why I think it is such an exciting career path, please feel free to reach out to me with any questions you may have!  I hope finals are wrapping up well and that the holiday break brings some much needed time for rejuvenation and relaxation.  

Hemoglobin A1C Blood Test Isn't Perfect

To contact us Click HERE

The hemoglobin A1C is a great blood test for type 2 diabetics, but not for diagnosing diabetes.

Don't misunderstand. I love the hemoglobin A1C blood test. It doesn't require fasting. It can be done in the doctor's office with a fingerstick just like your glucose monitor, and you can know the results before you leave the office. And it lets you know how your blood sugar has been doing over the past two or three months. It sounds perfect.

But it isn't. For diabetes management you and I need to know what our blood sugar is doing all the time, not just every three months. A great HGA1C reading does not mean there have been no hyperglycemic or hypoglycemic episodes over that time. So the hemoglobin A1C cannot replace daily checks with a glucose monitor and log book records.

Taken together with daily readings, the hemoglobin A1C gives an accurate picture of whether you are keeping your blood sugar in the ranges that will keep away the complications. There is more and more evidence that an HGA1C between 6.5 and 7 will do just that.

And here's an encouraging fact. If your A1C was 9 and you lower it to 8, there is a 20% reduction in risk of complications even though you aren't in the target range yet. That's good to know. You should also know that the American Diabetic Association says to get the test done every three months if your are diabetic.

Here's how it works. Hemoglobin is the medical term for red blood cells, and glycated hemoglobin is the term for red blood cells with sugar stuck to them. Over the life of a red blood cell, which is 120 days if all goes well, more and more sugar sticks to it as it travels through your bloodstream.

The amount can be measured accurately, and doctors know how much should be on each normal cell. If the level is high, that signals diabetes. The amount is reported as a percentage. That is why HGA1C numbers are so different from the readings you get from your glucose monitor.

So What's a Good Number?

This is where things get a little muddy. Depending on where you go for numbers, you'll get slightly different answers. The American Diabetes Association says a number under 7%, or 7, is a good target for a diabetic. Endocrinologists (M.D.'s who are diabetes specialists) have agreed that 6.5% is a better goal.

Non-diabetics have numbers in the range of 4-5.9%, and when the test number goes over 6.0%, some doctors tell their patients they might be diabetic. This is the danger of using the HGA1C to diagnose diabetes. Here are some reasons why.

There can be at least a half percentage point difference between two tests depending on how they are done. With home testing (a kit you can buy), the blood from a fingerstick is put on a card and mailed away to be tested.

The doctor's office test is done with a machine that gives results in 6 minutes but can be off a little because of the method. The most accurate test is done with a vial of blood at a testing facility or hospital, because they have national standards for constant recalibration, and the test is read using a more sophisticated method.

But even after an accurate test, the numbers can be read in different ways. For example, one expert says that a 6% reading means your blood sugar average for the past two or three months is 126, but another says it is 135. At 7% it might be 154 or 170. Which one is "right?"

Small discrepancies are not a problem if you know you are diabetic and are just evaluating how tight your blood sugar control is long term. But when 5.9% is normal and 6% means prediabetic according to what your doctor tells you, that tenth of a percent matters a lot for your peace of mind.

And there are other problems too. Anything that affects the life or health of red blood cells can make the hemoglobin A1C tests inaccurate for diagnosing diabetes. Any kind of anemia or illness, a change in medication, and even donating blood can affect the test. It is not used for testing gestational diabetes because of its limitations, and doctors still use the glucose tolerance test for that.

For diagnosing diabetes, the glucose tolerance test is still the best choice. Endocrinologists agree on this. So why does a family doctor use the hemoglobin A1C for diagnosing? Perhaps because he or she is not usually a diabetes specialist, and if the HGA1C is sold as the newest way to diagnose diabetes, it's going to be hard to resist.

Diabetes is probably in half of the patients over 40 in a doctor's practice, and the machine is cutting edge stuff. But the glucose tolerance test is still the best way to know if you are prediabetic, diabetic or just fine.

It takes a while but it is an accurate picture of how your body reacts to glucose. You don't have to worry. It isn't painful (unless you count fasting and a few fingersticks). So if you know someone who has been diagnosed by a hemoglobin A1C test, I hope you advise them to get the GTT test for a confirmation and to look for an endocrinologist.

I do love the A1C test, being a type 2 diabetic, because when I'm below 7 I know I'm doing well, and I have seen proof of that good blood sugar control in my own peripheral neuropathy symptoms. When the test is used for that purpose, it's fine. I love it when my doctor says, "Do you know your hemoglobin A1C?" and I say, "Yep, it's 6.8," and the doctor says, "Wow, that's great!"

Those are words I don't hear from my doctor often enough.

Martha Zimmer invites you to visit her website and learn more about type 2 diabetes, its complications and how you can deal with them, as well as great tips for eating healthy that will make living with diabetes less painful.

Go to http://www.a-diabetic-life.com and find out what you can do to avoid many of the pitfalls of this life-changing condition, like paying for cures that don't work and spending money for things you could have gotten free. Martha has made the mistakes and done the research so you don't have to.

Article Source: http://EzineArticles.com/?expert=Martha_J_Zimmer

Amanda's Career Goals and Reflection over 1st half of DI

To contact us Click HERE
Half Way There!
It is amazing for me to think that one year ago at this time I was putting my dietetic internship application packets together, not even sure which internships I was going to apply to.  Now I am five months into my internship, with only five months to go until I am eligible to sit for the RD exam.  The internship so far has challenged me and prepared me for a career as a dietitian in ways far beyond what I learned in the classroom.
One of the best things I have learned thus far is that I am certain that pursuing a career in school food service is the path I want to take.  The rising need for dietitians in schools and the regulatory changes facing school nutrition programs are two reasons why this career path appeals to me.  Here are a few of the benefits that working as a dietitian in a school nutrition program offers: 

• You get to work with kids!  There were so many people in my college classes who were interested in pursuing a career as a pediatric dietitian.  Rather than working with kids who are already sick, school dietitians can work with kids proactively by promoting nutrition education and nutrition integrity in the meals offered in school. 

• The variety of positions available to dietitians.  As a dietitian you can get a job as a nutrition educator, a manager of school kitchen, an area supervisor for a district or the director of food service for an entire school district.  No two school districts are alike so you can also have a variety of options in the type of school food service program you would like to work in.

• Opportunities for career advancement.  Depending on where your strengths and career goals lie, school nutrition programs can offer many opportunities for professional growth.  This is especially true if you are interested in nutrition management and business.

• Great work schedule.  Depending on the position, school dietitians may get the summer months off and for sure the holidays as wells as most weekends (nutrition conferences may take up a weekend day or two). 

If you are interested in a career as a school dietitian or would like to know more about why I think it is such an exciting career path, please feel free to reach out to me with any questions you may have!  I hope finals are wrapping up well and that the holiday break brings some much needed time for rejuvenation and relaxation.  

Image of the Month - Pathology

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A 60 year-old woman with a longstanding history of hypertension, scleroderma and MGUS presented to the emergency room with diarrhea, vomiting and AKI (creatinine increased from baseline of 1.5mg/dl to 3.1mg/dl). She had a distant history of membranous nephropathy diagnosed on a renal biopsy 25 years previously. She had been worked up in the renal clinic for CKD and had a renal US showing relatively small kidneys. Her medications included an ACE inhibitor.

On admission, she had no hematuria. Her BP was elevated although she had a significant postural drop. She had dipstick proteinuria and she was empirically started on oral steroids for a possible GN. A renal biopsy was performed:


The image above is of the renal cortex. A single glomerulus is seen (A) which is hypoperfused. There is significant dilatation of the tubules (B) indicating acute tubular injury. There is attenuation and degeneration of the tubular epithelial cell layer. At the lower end of the image is an atrophic tubule with a hyaline cast.






This image again shows a hypoperfused glomerulus. However, the main finding here is an extremely damaged arteriole (A). There is multilayering within wall of the vessel (that was replicated throughout the biopsy). The vascular lumen is almost occluded with endocapillary proliferation and remodeling of the vessel wall.

In some areas of the biopsy (better perfused), the glomeruli looked relatively normal. There was some mesangial expansion with irregular capillary loops but no evidence of membranous disease.




IF showed some minimal deposition of IgG in the mesangium but equal kappa and lamda light chains.



Finally, the EM showed multiple mesangial deposits (A) of uncertain significance but again, no evidence of membranous disease. Notably, there were was no evidence of active inflammation in the biopsy.

Following the report of the biopsy, the steroids were stopped. The patient's blood pressure was controlled and her renal function returned to baseline within a few days. It is likely that this acute episode was related to volume depletion and acute tubular injury exacerbated by her severe underlying vascular disease. Interestingly, she now has no albuminuria and she is back on her ACEi. The significance of the mesangial deposits remains unclear and she will be followed on an ongoing basis in the renal clinic.

We often see patients like this on consult who present with AKI following a GI illness while on an ACEi. However, we don't normally get to see the pathology in these very common case.

Click on any image to enlarge

Fruit Flies and Kidney Stones

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Developing accurate animal models of human diseases is a well-established research goal but a recent paper reporting a new animal model of nephrolithiasis caught my attention. Kidney stones are an important cause of morbidity and dealing with them is estimated to cost more than $5 billion yearly in the US alone. The majority of cases are due to calcium oxalate stones which variously results from increased urinary calcium excretion or increased urinary oxalate (which may be due to increased production or gut absorption of oxalate).

A group in the Mayo clinic and Glasgow have developed a fruit fly model of calcium oxalate nephrolithiasis. Fruit flies have a single transparent kidney tubule and feeding the larvae a diet high in oxalate for just two days leads to the formation of visible calcium oxalate kidney stones.

The upper panel of the image above shows a renal tubule dissected out from a fruit fly fed with oxalate compared with one fed with a normal diet. The second panel is a high power view of the tubule along with a nice picture of some calcium oxalate crystals. The lower 3 panels are a series of pictures of a tubule kept in a bath high in oxalate where you can see the crystals forming over a period of hours - the authors helpfully included a video if this happening in the supplemental data of the manuscript. There are also some micro-CT images of the fruit flies with the stones in situ. The rapid formation of stones in these flies makes it an excellent model for the study of nephrolithiasis.

Also, it's really cool.

Visitor Poll

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Every once in a while we like to get an idea of who our audience is. As a result, we have started a poll which will remain open for the next 7 days. The website was originally started with a nephrology fellow audience in mind but we know from the comments that our readers come from a more diverse group. We would appreciate if anyone visiting the site over the next few days could take a second and click one of the answers on the right hand side of the screen. This poll is completely anonymous.

Thanks from RFN.

Hemoglobin A1C Blood Test Isn't Perfect

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The hemoglobin A1C is a great blood test for type 2 diabetics, but not for diagnosing diabetes.

Don't misunderstand. I love the hemoglobin A1C blood test. It doesn't require fasting. It can be done in the doctor's office with a fingerstick just like your glucose monitor, and you can know the results before you leave the office. And it lets you know how your blood sugar has been doing over the past two or three months. It sounds perfect.

But it isn't. For diabetes management you and I need to know what our blood sugar is doing all the time, not just every three months. A great HGA1C reading does not mean there have been no hyperglycemic or hypoglycemic episodes over that time. So the hemoglobin A1C cannot replace daily checks with a glucose monitor and log book records.

Taken together with daily readings, the hemoglobin A1C gives an accurate picture of whether you are keeping your blood sugar in the ranges that will keep away the complications. There is more and more evidence that an HGA1C between 6.5 and 7 will do just that.

And here's an encouraging fact. If your A1C was 9 and you lower it to 8, there is a 20% reduction in risk of complications even though you aren't in the target range yet. That's good to know. You should also know that the American Diabetic Association says to get the test done every three months if your are diabetic.

Here's how it works. Hemoglobin is the medical term for red blood cells, and glycated hemoglobin is the term for red blood cells with sugar stuck to them. Over the life of a red blood cell, which is 120 days if all goes well, more and more sugar sticks to it as it travels through your bloodstream.

The amount can be measured accurately, and doctors know how much should be on each normal cell. If the level is high, that signals diabetes. The amount is reported as a percentage. That is why HGA1C numbers are so different from the readings you get from your glucose monitor.

So What's a Good Number?

This is where things get a little muddy. Depending on where you go for numbers, you'll get slightly different answers. The American Diabetes Association says a number under 7%, or 7, is a good target for a diabetic. Endocrinologists (M.D.'s who are diabetes specialists) have agreed that 6.5% is a better goal.

Non-diabetics have numbers in the range of 4-5.9%, and when the test number goes over 6.0%, some doctors tell their patients they might be diabetic. This is the danger of using the HGA1C to diagnose diabetes. Here are some reasons why.

There can be at least a half percentage point difference between two tests depending on how they are done. With home testing (a kit you can buy), the blood from a fingerstick is put on a card and mailed away to be tested.

The doctor's office test is done with a machine that gives results in 6 minutes but can be off a little because of the method. The most accurate test is done with a vial of blood at a testing facility or hospital, because they have national standards for constant recalibration, and the test is read using a more sophisticated method.

But even after an accurate test, the numbers can be read in different ways. For example, one expert says that a 6% reading means your blood sugar average for the past two or three months is 126, but another says it is 135. At 7% it might be 154 or 170. Which one is "right?"

Small discrepancies are not a problem if you know you are diabetic and are just evaluating how tight your blood sugar control is long term. But when 5.9% is normal and 6% means prediabetic according to what your doctor tells you, that tenth of a percent matters a lot for your peace of mind.

And there are other problems too. Anything that affects the life or health of red blood cells can make the hemoglobin A1C tests inaccurate for diagnosing diabetes. Any kind of anemia or illness, a change in medication, and even donating blood can affect the test. It is not used for testing gestational diabetes because of its limitations, and doctors still use the glucose tolerance test for that.

For diagnosing diabetes, the glucose tolerance test is still the best choice. Endocrinologists agree on this. So why does a family doctor use the hemoglobin A1C for diagnosing? Perhaps because he or she is not usually a diabetes specialist, and if the HGA1C is sold as the newest way to diagnose diabetes, it's going to be hard to resist.

Diabetes is probably in half of the patients over 40 in a doctor's practice, and the machine is cutting edge stuff. But the glucose tolerance test is still the best way to know if you are prediabetic, diabetic or just fine.

It takes a while but it is an accurate picture of how your body reacts to glucose. You don't have to worry. It isn't painful (unless you count fasting and a few fingersticks). So if you know someone who has been diagnosed by a hemoglobin A1C test, I hope you advise them to get the GTT test for a confirmation and to look for an endocrinologist.

I do love the A1C test, being a type 2 diabetic, because when I'm below 7 I know I'm doing well, and I have seen proof of that good blood sugar control in my own peripheral neuropathy symptoms. When the test is used for that purpose, it's fine. I love it when my doctor says, "Do you know your hemoglobin A1C?" and I say, "Yep, it's 6.8," and the doctor says, "Wow, that's great!"

Those are words I don't hear from my doctor often enough.

Martha Zimmer invites you to visit her website and learn more about type 2 diabetes, its complications and how you can deal with them, as well as great tips for eating healthy that will make living with diabetes less painful.

Go to http://www.a-diabetic-life.com and find out what you can do to avoid many of the pitfalls of this life-changing condition, like paying for cures that don't work and spending money for things you could have gotten free. Martha has made the mistakes and done the research so you don't have to.

Article Source: http://EzineArticles.com/?expert=Martha_J_Zimmer

Need Help Deciding Which DI's to Apply for? Read These Tips from Amanda Bot!

To contact us Click HERE

With over 200 internships in the country, choosing which internships you want to apply to can be very overwhelming. Here are a few strategies that I, or people I know, used when deciding which internships to apply to:

• Make a PowerPoint document with slides featuring each program you are interested in.  On each slide list the internship’s location, emphasis, unique qualities, cost/stipend and any other information that you deem important in your decision-making.  List all the pros and cons of each internship.  This provides an easy way to compare one internship to another.

• Talk to the people whose opinions you value.   Talking with someone about the decision you are trying to make helps to sort out your thoughts and focus your priorities much better than if you keep your thoughts inside your head.  I talked to my classmates who were also applying to internships and to my RD mentor. 

• Do not let your self become stressed about your decision.  Find a way to relieve your stress, especially if you are feeling the weight of the decisions you have to make.  I have found that setting aside a little bit of time each day for an activity I enjoy such as exercising or reading de-stresses me and clears my mind so that I am able to make decisions with a calm mindset. 

• Most important:  DO NOT PROCRASTINATE.  Procrastinating on your decision of where to apply to a dietetic internship can set the entire process into a tailspin.  Start your research early and be prepared so you have plenty of time to write your personal statements and contact the internships that you feel are your perfect fit.  

By: Amanda Bot

Beginning the Application Process for DI's

To contact us Click HERE
I know it seems like it's a little early to start your DI application via DICAS, but it’s never too early to start thinking about it and planning for it. The portal opens on December 1^st so I’m trying to get everything in order to make this process as easy as possible.  I’ve been talking with people who are either in their internship right now or have been through this process recently. Here are some tips that they’ve told me:

•  Get transcript requests sent right away. It may take a while for some schools to send them, and if you’re a transfer student like me, you’ll have to make requests for multiple transcripts. Not only does DICAS need them, but you also have to input all the courses you’ve taken so that they can calculate various GPAs. You might want to do this part first since it’s the most tedious.

•  Ask people to write your recommendation letters as soon as possible. Hopefully they’ll all say that they’d love to write them for you, but you may come across some problems—they might be too busy, etc. Also ask them what they need to write the letter. You may need to send them your personal statement, past homework assignments or you may need to sit and talk with them about what your goals are.

• If you are applying to more than one internship, make sure you know what each internship’s focus is. You are going to have to write a different personal statement for each one you apply to. I believe that this is going to be the most time consuming part for me—even more so than deciding which internships I am going to apply to. Once they are written, have everyone you know read them! The more eyes that see them, the more feedback you can get before you submit your application.

• Contact the program directors. Either talk with them in person or over the phone. If there is an open house for the internship you’re interested in, GO!!! Meet the people you could be working with! When they get your application they’ll be able to put a face to the name.

•  Most importantly, be yourself. Be genuine about what your goals and interests are. 

This whole application process can be so daunting. Make it easy for yourself and DO NOT procrastinate!

By: Allison Richards

It's Not Just Meat and Potatoes: The Diversity of the Dietetics Profession

To contact us Click HERE
By: Jill Merrigan 
I am constantly asked, “What do you want to do when you finish school, and complete a dietetic internship?”  For me I am asked this weekly but find that I have a monthly response. One of the most exciting pieces of my return to school is the inspiration I have as I continue to learn about all the possible career opportunities I’ll have as a registered dietitian.
The career field for a registered dietitian offers a colorful plate, it not just meat and potatoes. From clinical dietitians, foodservice managers, research dietitians, educators, outpatient nutrition counselors, consultants. It is encouraging and motivating to remember that all my hard work in the classroom will expose me to a broad path of experiences within the dietetic profession.  When I was in the process of leaving my job in ad-sales and transitioning into my new life in Boston at Simmons College I took the time to meet with many registered dietitians, educators, and professors. One of the most important observations I took away was that in the dietetic profession we are not limited to one career path. Many times an RD will choose a position that meets their specific needs and in time branch into another position that suits them, and continue to make changes as it feels appropriate with time.  Some of the unique careers I have discovered that RDs are pursing include a RD – Food stylist, RD – Psychotherapist, RD – Medical Doctor, and RD – Farmer.
The nutrition and dietetic field is versatile, allowing diverse ways to educate and help people eat right. If you are considering a career change into nutrition and dietetics but now sure where the path will lead you then be sure to take some time, learn about the many opportunities that are available, and compare them to your own personal goals, strengths and interests and begin to see yourself living your career dream. 

Amanda's Cardiology Rotation

To contact us Click HERE
I had a great past couple weeks in my cardiology rotation.  I had the opportunity to meet and work alongside an inspirational RD who is not just a clinical dietitian but also an outstanding community leader who holds leadership roles in numerous organizations including the local dietetic association.    Of course I also learned how to plan and educate patients about heart healthy diets, make notes in the charts of patients, and do nutrition assessments on patients with CHF.

One of the main things I have learned is that nutrition care is hardly one-dimensional.   Although a patient may come into a hospital with the initial diagnosis of chest pain and shortness of breath, they may also have diabetes, renal failure, cognitive impairment, trouble chewing/swallowing; the list goes on.  When assessing a patient, it is important to look at the “big picture” and not just the diagnosis that the patient was admitted with.  This is especially important when completing a case study. 
Case studies are some of the best opportunities to learn during clinical rotations.  They give you the opportunity to apply all the information you learned in your MNT classes to a real-life scenario.  Scanning charts and comparing lab values made me feel like a detective; it was up to me to figure out where the patient was nutritionally deficient and what nutrition interventions were needed to restore their health. 
One tool that was especially helpful was my MNT book from college.  This book is filled with so much detailed information that was helpful when completing my cardiac case study.  If you are planning on completing an internship I would definitely recommend resisting the urge to sell your MNT book at the end of the year and hold onto it as it will prove to be a valuable tool during your internship.  
Question (to other past/present dietetic interns): What other resources have you found to be helpful during your dietetic internship rotations? 

Amanda's Career Goals and Reflection over 1st half of DI

To contact us Click HERE
Half Way There!
It is amazing for me to think that one year ago at this time I was putting my dietetic internship application packets together, not even sure which internships I was going to apply to.  Now I am five months into my internship, with only five months to go until I am eligible to sit for the RD exam.  The internship so far has challenged me and prepared me for a career as a dietitian in ways far beyond what I learned in the classroom.
One of the best things I have learned thus far is that I am certain that pursuing a career in school food service is the path I want to take.  The rising need for dietitians in schools and the regulatory changes facing school nutrition programs are two reasons why this career path appeals to me.  Here are a few of the benefits that working as a dietitian in a school nutrition program offers: 

• You get to work with kids!  There were so many people in my college classes who were interested in pursuing a career as a pediatric dietitian.  Rather than working with kids who are already sick, school dietitians can work with kids proactively by promoting nutrition education and nutrition integrity in the meals offered in school. 

• The variety of positions available to dietitians.  As a dietitian you can get a job as a nutrition educator, a manager of school kitchen, an area supervisor for a district or the director of food service for an entire school district.  No two school districts are alike so you can also have a variety of options in the type of school food service program you would like to work in.

• Opportunities for career advancement.  Depending on where your strengths and career goals lie, school nutrition programs can offer many opportunities for professional growth.  This is especially true if you are interested in nutrition management and business.

• Great work schedule.  Depending on the position, school dietitians may get the summer months off and for sure the holidays as wells as most weekends (nutrition conferences may take up a weekend day or two). 

If you are interested in a career as a school dietitian or would like to know more about why I think it is such an exciting career path, please feel free to reach out to me with any questions you may have!  I hope finals are wrapping up well and that the holiday break brings some much needed time for rejuvenation and relaxation.  

Beginning the Application Process for DI's

To contact us Click HERE
I know it seems like it's a little early to start your DI application via DICAS, but it’s never too early to start thinking about it and planning for it. The portal opens on December 1^st so I’m trying to get everything in order to make this process as easy as possible.  I’ve been talking with people who are either in their internship right now or have been through this process recently. Here are some tips that they’ve told me:

•  Get transcript requests sent right away. It may take a while for some schools to send them, and if you’re a transfer student like me, you’ll have to make requests for multiple transcripts. Not only does DICAS need them, but you also have to input all the courses you’ve taken so that they can calculate various GPAs. You might want to do this part first since it’s the most tedious.

•  Ask people to write your recommendation letters as soon as possible. Hopefully they’ll all say that they’d love to write them for you, but you may come across some problems—they might be too busy, etc. Also ask them what they need to write the letter. You may need to send them your personal statement, past homework assignments or you may need to sit and talk with them about what your goals are.

• If you are applying to more than one internship, make sure you know what each internship’s focus is. You are going to have to write a different personal statement for each one you apply to. I believe that this is going to be the most time consuming part for me—even more so than deciding which internships I am going to apply to. Once they are written, have everyone you know read them! The more eyes that see them, the more feedback you can get before you submit your application.

• Contact the program directors. Either talk with them in person or over the phone. If there is an open house for the internship you’re interested in, GO!!! Meet the people you could be working with! When they get your application they’ll be able to put a face to the name.

•  Most importantly, be yourself. Be genuine about what your goals and interests are. 

This whole application process can be so daunting. Make it easy for yourself and DO NOT procrastinate!

By: Allison Richards

It's Not Just Meat and Potatoes: The Diversity of the Dietetics Profession

To contact us Click HERE
By: Jill Merrigan 
I am constantly asked, “What do you want to do when you finish school, and complete a dietetic internship?”  For me I am asked this weekly but find that I have a monthly response. One of the most exciting pieces of my return to school is the inspiration I have as I continue to learn about all the possible career opportunities I’ll have as a registered dietitian.
The career field for a registered dietitian offers a colorful plate, it not just meat and potatoes. From clinical dietitians, foodservice managers, research dietitians, educators, outpatient nutrition counselors, consultants. It is encouraging and motivating to remember that all my hard work in the classroom will expose me to a broad path of experiences within the dietetic profession.  When I was in the process of leaving my job in ad-sales and transitioning into my new life in Boston at Simmons College I took the time to meet with many registered dietitians, educators, and professors. One of the most important observations I took away was that in the dietetic profession we are not limited to one career path. Many times an RD will choose a position that meets their specific needs and in time branch into another position that suits them, and continue to make changes as it feels appropriate with time.  Some of the unique careers I have discovered that RDs are pursing include a RD – Food stylist, RD – Psychotherapist, RD – Medical Doctor, and RD – Farmer.
The nutrition and dietetic field is versatile, allowing diverse ways to educate and help people eat right. If you are considering a career change into nutrition and dietetics but now sure where the path will lead you then be sure to take some time, learn about the many opportunities that are available, and compare them to your own personal goals, strengths and interests and begin to see yourself living your career dream. 

Amanda's Cardiology Rotation

To contact us Click HERE
I had a great past couple weeks in my cardiology rotation.  I had the opportunity to meet and work alongside an inspirational RD who is not just a clinical dietitian but also an outstanding community leader who holds leadership roles in numerous organizations including the local dietetic association.    Of course I also learned how to plan and educate patients about heart healthy diets, make notes in the charts of patients, and do nutrition assessments on patients with CHF.

One of the main things I have learned is that nutrition care is hardly one-dimensional.   Although a patient may come into a hospital with the initial diagnosis of chest pain and shortness of breath, they may also have diabetes, renal failure, cognitive impairment, trouble chewing/swallowing; the list goes on.  When assessing a patient, it is important to look at the “big picture” and not just the diagnosis that the patient was admitted with.  This is especially important when completing a case study. 
Case studies are some of the best opportunities to learn during clinical rotations.  They give you the opportunity to apply all the information you learned in your MNT classes to a real-life scenario.  Scanning charts and comparing lab values made me feel like a detective; it was up to me to figure out where the patient was nutritionally deficient and what nutrition interventions were needed to restore their health. 
One tool that was especially helpful was my MNT book from college.  This book is filled with so much detailed information that was helpful when completing my cardiac case study.  If you are planning on completing an internship I would definitely recommend resisting the urge to sell your MNT book at the end of the year and hold onto it as it will prove to be a valuable tool during your internship.  
Question (to other past/present dietetic interns): What other resources have you found to be helpful during your dietetic internship rotations?