Thursday, January 31, 2013

Good To See You

Sometimes you just need to see your parents, face-to-face miles away.

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Talking to their faces is incredibly different than just hearing their voices.  I really loved being able to chat with them like this.  It was just what I needed tonight.

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Mmm, even the puppy tried to get in on the action.  Her little body just wasn’t quite tall enough.  Her ears were more than visible though.  Adorable.

Questions: Phone or video?
When was the last time you saw your family?

Wednesday, January 30, 2013

Curls

All this moisture in the air is making my hair curl!  It would be nice if frizz didn’t come along with the curliness though. Oh well.

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Today’s eats included a last minute breakfast thanks to my complete absentmindedness and morning rush.

I made a smoothie at home and then walked right out of the apartment without it.  I realized this well on my way to class so I swung through a Starbucks and picked up a protein box.

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I really needed to eat something because I had already taken all my vitamins for the day.  When I do that on an empty stomach I get real sick.  Now why would you have taken them this morning without eating you say?  I honestly thought I’d be having my smoothie in all of three minutes when I got to my car.  Then I forgot it, and my stomach turned.  It was all I could do to keep from hurling before I managed to shove an apple slice into my mouth.

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I enjoyed the hard boiled egg with some provided salt and pepper and squeezed the peanut butter all over the biscuit thing.  Finished just in time for class.  I made it through 3/4 of our first class today then had to skip out and make my way to my clinic site to give my presentation to the medical residents.  All in all, it went well.  I was pleased.  Probably even more so pleased that it was done!  Lunch came after.

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I made a huge loaded salad and had it with a honeyed greek yogurt dressing with lemon pepper seasoning.  This kept me full for a bit but after seeing my first patient I needed an afternoon pick me up.  Protein to the rescue.

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After all I had lifted for close to forty minutes today and burned some calories while building muscle this morning.  My body was probably entirely too thankful for the protein kick in the four o’clock hour.

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Even did way better on my body weight matrix this time around.  By like a minute or more!

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By the time I got home around six I applied for great looking prenatal/reproductive job that was literally just posted.  I was so excited.  I couldn’t even take the time to eat dinner just yet. I held myself over with pickles as I finished up my cover letter.

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Only after I had submitted my CV and such did I have dinner.  Leftover sweet potato cauliflower bisque with a sandwich on the side of edamame hummus and sundried tomato spread.  Really good food.

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A perfect night I’d say.  Well, that is until I started writing my patient letter.  Or should I say bumbling through my patient letter.  I should probably go and focus on that huh?  Yea, off I go.  One more patient tomorrow!

Questions: Ever tried sundried tomato spread?
What is your favorite kind of pickle?

Tuesday, January 29, 2013

Scan Now? Scan Later?

The last two days have been some hard times in clinic.  It’s never easy to give bad news.  You can relish in the sessions you get to reassure patients and say your risk is less than 1 in 1000 but when they’re that one, the odds don’t matter.  Plus, the recent events have made me wonder whether, in the prenatal setting, it is better to have patients go to ultrasound first, counseling second…or to counsel them before their ultrasound.

There are some indications for referral that lend themselves easily to having the patient be scanned first.  For instance, if they’re coming to you because on a previous ultrasound the sonographer saw something abnormal, sure, it makes 100% sense to make darn sure that on the high level ultrasound we can see the abnormality too.  However, there are other things that seem a bit more ambiguous, like first trimester referrals.  Most people are aware that the first trimester can be a poignant time for miscarriage.  Lots of women don’t even tell anyone about their pregnancy until they are “out of the woods”, so to speak.  The risk of miscarriage never really goes away but it certainly decreases after the first trimester.  So when we counsel women during this time about their testing options and such, they sit through these sessions, are open and receptive to the information (most times), and make decisions about how they want to proceed.  Then, just as easy as not, they could go into ultrasound to find out that their baby has miscarried.  In that case, most everything we have just talked about is, sadly, a moot point.

So which is better: counseling first or counseling second?  I’m not sure, still, even after thinking about it for a while.  I do know that one of my prenatal rotations coming up later, as a rule, scans their patients first before talking to them.  It will be interesting to see how that type of appointment works on a across-the-board basis.  And, to be fair, counseling second exclusively also brings its own challenges.  Sometimes women come in for routine counseling sessions and end up having some sort of finding on ultrasound that you have to immediately talk to them about.  That means the counselor needs to be real up on their game and able to adapt easily.  Perhaps there really is no right or wrong answer in this…

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As far as eats go these past two days, they’ve been cheery.  Breakfast on Monday was a protein cake inhaled at the speed of light in order to get to class on time.  Today’s morning meal was a great oats in a jar experience.  Chocolate protein oats with chia seeds and bananas in a not-so-empty jar of PB.

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Lunch on Monday was leftover chana masala with an apple in the car and today’s was a tuna salad sandwich (tuna, edamame hummus, chipotle mayo, green onions, garlic powder, salt, and pepper) with pepper jack cheese, pretzels, carrots, and an orange.  I ate with the counselors though, so no picture of today’s masterpiece.

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I have found that snackage is key during prenatal.  Those afternoons are long without some pick me up in my system.  Sweet potato wedges and sunbutter = awesome letter writing fuel.

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As for the last meal of the day, I have been developing a whole new outlook on it.  It’s a completely different experience to come home at 5:30 or 6p and just be utterly wiped from the day.  Then you realize that you have to make dinner.  Blah.  Who wants to do that?  The answer is, me, I do, sometimes.  Like last night I was craving salad hardcore so I made myself one with all sorts of veggies, beets, chickpeas, cranberries, and goat blue cheese with a honeyed greek yogurt dressing.

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But then there are night’s when I just don’t have the energy for much of anything that takes longer than a minute in the microwave.  Today was one of those days so I heated up chana masala and mixed spinach with olive oil and lemon pepper seasoning.

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Done and done.  Sadly, I wasn’t overly satisfied so I grabbed a banana, split it in two and then four, and had half with sun butter and half with almond butter.

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Now with eats out of the way, let’s play the life update card.  It has been really wet around here lately.  I walked into the parking garage this morning and there was fog in the basement.  How weird?  I’m not sure the picture does it justice but I walked through the fog to get to my car only to see that the whole thing was covered and I couldn’t see.

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So not only did my friend move to China but my cousin moved to Germany.  Another city added to my phone’s world clock.  And, I must admit it is very weird to be coming back from the gym at 6:45 in the morning and realize that your friend has already lived her entire day (that you’re just starting) and your cousin is eating lunch (when it isn’t even light outside where you live yet)!  Just so interesting…

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Also in the news, gas prices were scheduled to shoot up today so I busted out a gift card and loaded up yesterday.  Paid with the $25 card and then added another $12 on my my pink credit card to top off my tank.  Good thing I did too, everything was a good 20+ cents more expensive today during my drive.

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And finally, I have been obsessed with candles lately.  I lit a few last night and just stared at them.  Then I realized I should do work so I just let them backlight my homework session.  How soothing.

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All told, I hope your first two weekdays were a little more encouraging than mine.  Tomorrow is hump day (Wednesday) and I have two patients as well as class.  I also have to give my presentation on AEDs and epilepsy in pregnancy to a bunch of pharma and MFM residents and doctors.  I’m a wee bit nervous about it.  In fact, I should really go and time myself.  I’ll make you a deal: dessert first, presentation second, bed third.  Ready, go!

Okay, well, Tune Tuesday first.  This week’s offering comes from my Vampire Diaries obsession as of late.  I seriously love this song.  It sounds like slow motion, like silk.  Enjoy it.

Question: How do you prepare for presentations?

Sunday, January 27, 2013

Healthy Living Survey

Found this survey a few days on Tina’s blog.  Looked interesting and I was searching for something to do tonight to relax before hanging up my fun shoes and slipping into my work ones for the week.  Darn Sunday nights…

1. What did you eat for breakfast?

I tried some new pancakes this morning.  I found the recipe somewhere but I didn’t write it down because it was the simplest thing ever.  Two ingredients: banana and two eggs.  My banana was kind of small so I did one whole egg and one egg white.  In retrospect I probably could have used only the one egg.  I also added some cinnamon, nutmeg, allspice, and ginger.

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So the pancakes turned out thin.  Not really my style.  I like my pancakes thick and fluffy.  Also, because they only had egg and banana going on, they tasted kind of like awkwardly scrambled eggs.  And the didn’t cook fast enough to flip without the bottoms being a bit burned.  Oh well.  The almond butter and maple syrup kind of helped.

2. How much water do you drink a day?

I drink at least 60 ounces a day, if not 80.  Fairly sure I read somewhere that you should shoot for half your body weight in water.  Well, I’ve got that covered.  A few of these big guys and I’m done.

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3. What is your current favorite workout?

I don’t know that I really have a favorite workout.  I have workouts that I do but nothing that super calls to me, you know?  At this point I’m in the middle of Stage 5 of New Rules of Lifting for Women (NROLFW) and I guess the body weight matrix at the end of each 5A workout is pretty cool.  You do a full set, then rest, then do another full set.  I think I like it because even though it makes my legs feel like jelly, I am shaving seconds off and that feels pretty awesome.

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4. How many calories do you eat a day?

Right now I’m shooting for 1500 a day.  I’d like to lose some weight before graduation and this seems to be working right now.  A pound of week is the plan.  When I’m not eating to lose eight I suppose my intake is around 1900-2000 some.  (Admittedly that sounds pretty scary right now.  Makes me nervous that I’d just gain weight as fast as you know when eating all that.  Also, some days it takes a lot just to get me to eat close to 1500.  What would I do with another 400-500 calories?)

5. What are your favorite healthy snacks?

Sweet potatoes with sunbutter.  Carrots with peanut butter and/or barbeque sauce.  String cheese and apples.

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6. What do you usually eat for lunch?

Gosh, that really depends.  I love leftovers, hot ones.  Mostly that’s because my clinic site right now is incredibly cold, like all the time.  I also have been known to do salads a bunch while at school.  Or sandwiches…like today’s sunbutter and banana one!

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7. What is your favorite body part to strength train?

Hmmm.  That’s a good one.  If I want to feel real strong, I’ll do my legs.  If I want to feel challenged (and subsequently proud of progress), I’ll take my shoulders.  YTWLs are killer.

8. What is your least favorite body part to strength train?

Hm, off the top of my head, nothing.  But I’m also sure that I probably haven’t done enough lifting to find an exercise that I really don’t like.  Come to think of it though, I suppose I really don’t like step ups.

9. What are your “bad” food cravings?

All the “normal” stuff: cake, cookies, frosting (straight from the jar), marshmallow fluff, Ben & Jerry’s…

10. Do you take vitamins or supplements?

I do.  Actually quite a few.  I take a multi; vitamins C, D, and B complex; extra virgin fish oil; zinc; potassium citrate (for my kidneys!); iodine; and one to promote healthy estrogen metabolism by the liver.  The kicker: I down them all in one gulp.  That’s how I’ve always done it.

11. How often do you eat out?

That really depends.  Lately, I haven’t been going out too much because I’ve been doing a ton of stuff for clinic and school.  However, a little over a week ago Jack and I went for froyo and just yesterday Jess and I went for lunch.  So I guess it’s probably close to once a week if you average stuff out, maybe less frequently this semester.

12. Do you eat fast food?

Not unless froyo counts as fast food!

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13. Who is your biggest supporter?

I’m happy to say I don’t just have one.  I have plenty.  To name a few: my parents, Jack, my best friend Joshua.  They are all incredible and I couldn’t do half the stuff I do without them!

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14. Do you have a gym membership?

No gym membership, just a fitness center at my apartment complex.  I have been really happy with that decision.  I think I’ll definitely put a complex gym on my must-have list for my next place.

15. How many hours of sleep do you get a night?

I am an eight hours a night kind of lady.  I seriously don’t function on less than seven but eight really leaves me feeling satisfied and capable of doing my early morning workouts.  Thanks to my iHome, I even have the stats to prove that beautiful eight hour record.

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16. Do you have a “cheat” day?

I don’t know that I would call them that.  It sounds so illicit. I know that I have days where I might eat more than my 1500 but I still try and stay within the amount of calories I’m allotted for the week (1500 x 7).  Part of that is out of fear of gaining weight, part of that is out of fear of losing control, and probably part is because I’m afraid of blowing all of my progress.  Its hard sometimes because I seriously love food (obviously if you’ve been around this blog for any length of time you get that) and being anxious about it on those days that I eat more than I typically do is really annoying and discouraging.  Some day I hope to be free of that anxiety, somehow.

17. Do you drink alcohol?

Sure.  I love wine and an occasional beer (like the bourbon one from a cool Tavern across town).  Amaretto is great and 43 is seriously some of the best stuff on the planet.  For as much as that sounds like, I have maybe a three drinks a month.  Except when I’m home, then it is a glass of wine every night with dinner.  =D

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18. Do you have a workout buddy?

No workout buddy most days.  Not many people around this apartment complex brave the 5:45am cold gym.  I have been known to work out with Jack when we’re together, one of my classmates when we were at the national conference together, Joshua when he’s around, and even my momma (we do pilates together at her normal studio).

19. What is the best thing that has changed your life since coming to a healthy lifestyle?

Gosh, I don’t really know how to answer that question.  I suppose becoming the most fit I have ever been would be the best thing.  I played sports in high school and such but I have never had this much muscle on me or worked out this often, this consistently.  I like that sense of dedication, that commitment, that control.  I dare say that spreads throughout other parts of my life.

20. What was the last healthy thing you did?

In the grand scheme of things, I’d say that last healthy thing I did was decided to regain control of my eating habits after the past few months of craziness and holidays.  If we’re talking something a bit more acute, I’d say making myself a pretty balanced three bowl dinner was pretty healthy.  One bowl for salad: spinach, lemon pepper, and extra virgin olive oil.  One bowl for mashed sweet potato with cinnamon, vanilla, and a pinch of Stevia and salt.  One bowl for leftover chana masala

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Devour

Twice a year my city does a special event when a bunch of the city’s big name restaurants put out sweet 2 for $30 or $30 per person (for the REALLY expensive places) menus.  When one of my classmates asked if I wanted to hit up a new place, I couldn’t resist!  So yesterday Jessica and I hit up a high end sports bar for a three course lunch.  First up: chicken lemongrass potstickers.

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These little pockets of deliciousness had chicken and corn and green onion and probably lemongrass but I honestly don’t have the best palate to pick up on everything.  Regardless, they were tasty.  The soy-uzu sauce was particularly great with the potstickers.  Only complaint: there were only five, and two of us.  Obviously we split the last one but we both felt like if you were going to make a 2 for $30 menu, the least you could do is adjust the numbers of things that are being shared to reflect that they will likely be split evenly.

For entrees, Jessica and I were both gravitating toward a few of the same things so we decided that we would just split two halfsies.  Our choices included a steak taco salad with iceberg, roasted corn, tomato, avocado, black olives, jalapeƱos, green pepper, cheddar jack cheese, red onion, and cilantro lime skirt steak.  The other dish was a beer battered shrimp mac and cheese with tomatoes and spinach.

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Jessica isn’t the biggest fan of raw veggies so we got the salad with everything on the side so we could make it at our table.  How sweet of the chef to be so accommodating.  With the extra plates, we split the salad and the steak up and then added our own toppings.  I took all the tomatoes and avocado and we split most of the other stuff.  No black olives for either of us though.

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We had the dressing on the side too, an ancho chile dressing, was thick and added a subtle hint of flavor to the dish.  In all, we both agreed the salad was the best part.  The mac and cheese was kind of disappointing.  The spinach and tomatoes were nice in the sauce but in all I thought it could have used a lot of salt.  It really just didn’t jive with either of us.  I admit I kept taking bites, hoping it would get better, but I only ate my half.  Still more than I should have eaten because it wasn’t all that great but oh well.  I’ll take the victory of not eating the whole thing just because it was at the table.

Dessert was up next.  We had the choice of a chocolate lava cake or a key lime pie.  I’m a fan of both but I usually only order key lime pie in one place: Key West.  So, even with that in mind, we asked the waiter what his favorite was and he told us, hands down, the chocolate lava because it came with ice cream.  Haha.  We went with it.

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When the cake arrived at our table it was obvious the ice cream had slide around a bit, as evidenced by the strewn powdered sugar, but nevertheless the taste was great.  The dessert was the perfect blend of moist cake, gooey chocolatey sauce, and a cold vanilla bean ice cream.  Nomnom.  All in all, it was a wonderful late lunch.  We even stayed a while after paying the bill just talking and carrying on.  I’m sure the waiter was really happy when we left.  The place was really starting to fill up when we headed out.  The place was popular and, for the most part, delicious.

In other news, this Friday concluded my third week of my first prenatal rotation, my second full week of counseling.  Feels good to be flying through.  I even have a full patient list for next week with a variety of indications, not just the typical ones.  It should be interesting and informative.  As far as eats go, Friday’s breakfast was probably one of the best I’ve had in a while in the smoothie world.  I made a peanut butter and honey green monster.  I threw together some chia seeds, vanilla protein powder, vanilla almond milk, spinach, peanut butter, and honey; Vera whirled away.

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It was stellar.  The honey taste was perfection.  Made me want to make another one right away!  Another yummy addition to the kitchen, crock pot chana masala.  I love me some Indian food, and now that I had garam masala in my spice cabinet, I figured it was time to go for it.

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There were more spices than I knew what to do with but every time I put another one into the pot the aromas grew.  I was in love.  There were a few spices I didn’t have but that’s where my substitution book came in.  It worked like a charm.

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The rest of the day the chana masala cooked down, the flavors bloomed, and the smells permeated my entire apartment.  It was awesome.  When I finally got a chance to sample it, I was pleased.  Tomato-y, spicy, chickpea-y deliciousness.

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I paired it with a piece of toast smeared with goat blue cheese (yum!) and a very simple salad made of only spinach, lemon pepper seasoning, and a drizzle of olive oil.

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Greatness, every bite.  I swear, all this good food has been a driving factor in keeping me happy, full, focused, and in control.  I’ve done a much better job of menu planning, making leftovers, and keeping on track.  I hope I can keep this up throughout the rest of these prenatal rotations.  Here’s to it!  Hope your weekend is going well.  I’m off to go and bake for the cutest little boy in the world.

Questions: How do you feel about simple salads?
What have you been doing this last weekend in January?

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