So how did it end?

Oh, uh...hey?

Turns out, I'm a terrible blogger. This is no surprise, and I really make no promises to be much better at this, because well, the only readers are likely my friends and family and they can hear me yak ad nauseum whenever they like. But anyway, I realized after post after post about internship, I never really said how it ended.

'She must have failed,' you're probably thinking. 'That's why she hasn't wanted to talk about. That's rather sad.'

WRONG.

Surprised, right?

No, actually, I'm officially an RD(t) these days, which is a fancy few letters after my name that indicate I'm a TEMPORARILY registered dietitian. Temporary because I have to write an exam in November (now THAT I could potentially fail. It has a 97% pass rate, but multiple choice and I are not friends. My odds of being in that 3% are not as low as I'd like. Fortunately, said exam can be written more than once.)

The end of internship ended up segueing into my current job, so time was rather short, although I may post more about it later. I finished my community rotation in Terrace. Turns out I'm great with direct interactions, with a community but ask me something about policy and I'll give you a blank stare and mumble something like 'Blueberries.' Naturally because I'm not very good at half of the job, I'm quite determined to become a community dietitian, although more with the hands-on stuff. Ask my fellow intern, I'm terrible with details.

After that, I came back to PG for my 10 weeks of food service. Anyone who's ever worked in food service will tell you - it's all-consuming. Because I'd already been working in it for over 3 years, they basically gave me a couple projects and free rein. Which was rather smart, actually, because anyone who gets into foodservice sort of has to thrive on being a workaholic, so I came in almost every weekend. Worked out rather well for them, I think, but I loved the staff at the hospital so I had a good time. It did, however, convince me rather strongly that I don't want to be a foodservice dietitian any time soon. It really is all-consuming, you can never 'just leave'. I like it and I thrive on the busy, but it's not a lifestyle I would choose for myself long time. A mat leave? TOTES. Forevers? Non, merci. I did learn how to make a good bechamel, roasted veggie salad, and a bunch of other things since my project was basically trying to cook every item on the new menu and see how it turned out or if there were any huge goofs. I <3 cooks and chefs everywhere. They know how to do EVERYTHING. And I love having a little bit of foodservice in my life - I love the people. You may not even realize how much of a rum go food service and housekeeping staff get. They're treated like GARBAGE by so many health care staff that it makes me absolutely furious. I love it when someone comments on their lack of education too - I've worked with multiple dietary aides with degrees (even a couple with masters). Seriously, if you've got kids at home, it's a job with funny hours that might work well with your hubby's, and the pay isn't bad. What I'm really saying is, DON'T HATE ON FOODSERVICE OR FOODSERVICE STAFF. I'll punch you in the jeans, I swear. The job isn't glamorous, but it's crucial. (Besides, what's the point of being educated if you're a nose-in-the-air little snot, anyway?)

The glories of being in the north mean I was hired for a full-time job two months before internship ended, and actually had to pick between it and two others. The two jobs I didn't take were clinical - and would have been fab, don't get me wrong. I actually took a 1 year contract job putting in dietary software across Northern Health. Why, you ask? My job title is actually food service supervisor - same as my job in Fraser Health (pays the same though, and the job is generally done by dietitians, but they'd never have gotten enough of them up here.) It's actually a sweet move as far as I'm concerned - I get to travel all across northern BC - I decided all the bouncing around I did during internship was insufficient. And now I get PAID to do it - paid the same as a clinical dietitian, so hooray! I'm also a casual clinical RD at the hospital too, usually 1-2 mornings/ week over the summer. Did I mention my boss is my awesome internship coordinator and that we have flexible schedules? Don't be embarrassed at your jealousy, I'd be jealous of me too. Of course, this means I'll have to hunt for another job in a year, but considering there are 4 mat leaves coming up in January, I have a feeling something will turn up.

Now then, what's a blog post without my poor attempts at photography?

Summer in PG is  a time to be outside - we went hiking almost every weekend up until August (when it got too hot, we're talking 30 degrees every day, light out until 11:00, and unlike the lower mainland, it does NOT cool down in the evenings.)

Here are some pictures from Teapot Mountain - just a short hike, only about 1.5 km each way, but that first km is straight up. I did it wearing Skechers, which was fine until we had to come back down. Proceeded to buy my first pair of hiking shoes that same week.

HUGE anthill.

What does one do after hiking? You go to a historical farm and eat pie. Duh. These pictures are all from the Huble Homestead.

That would be a kildeer. There were actually signs basically warning us of its ruthlessness.

Note the lack of snow in these pictures! I think this was actually back in June-ish already, and NOT A TRACE. So there, all of you who are like 'OMG POLAR BEARS AND IGLOOS.'

And no, the name of this post does not indicate this blog is over. Now that I"m not playing outside all the time, I may actually start blogging again. Or not. We'll see!

'You understand people. My people.'

I had sort of an epic day today.

My preceptor and I left Terrace this am (oh yeah, I'm in Terrace now) for Hazelton, a cute little town in the middle of nowhere, about 2 hours out of Terrace. I had a pre-diabetic client who not only was totally focused on what I was saying (Yess!) but also had suggestions of his own (YESSS!!) and was already making changes to his diet on his own (HALLELUJAH, MY SISTAHS!) I love it when people actually want to see me and didn't just show up because they were told to.

I've been going around to quite a few reserves in the last week, Kitimaat Village, Gitwonga, and a couple others and they are some of the most beautiful places I've ever been. Today, we went to yet another reserve to teach some aboriginal kids a cooking class. Sounds not particularly epic, yeah?

It was a rough start. The group was quite late, but one lovely lady met us there on time. They had just gone to a seminar on colonization, and she was almost in tears telling us about what was done to her people. She talked about her principal making advances on her while in a residential school and not knowing that her closest friends were being sexually abused. She told us how they came with a shotgun to take her from her parents. She talked about the shame of growing up thinking her people were a bunch of drunks and not knowing the reasons behind it. That's rather a controversial sentence, looking back, but she went on to explain that with so much horror and loss, how could anyone be expected to respond? Now don't get me wrong, this isn't a spiel on the evils of residential schools. I don't know enough about it, other than to say too many were horrible, evil places where children were horribly abused. On the one hand, she needed to talk about it. On the other hand, hearing the prejudice and trauma she and her family endured at the hands of 'the white man' was hard to hear. Not just the trauma of what happened, but (rather selfishly) knowing that I was included under that blanket. And yet, she bore no particular ill will towards us specifically, despite an obvious and understandable distrust of 'the white man' in general which she voiced on several occasions. Human dynamics are incredible.

So anyway, the kids came and we started cooking - google Martha Stewart Farmer's Beans and Pasta if you're curious (it's delicious). Basically, it's pasta with beans, carrots, zucchini, onion and white beans in a tomato base. Super easy and the kids loved it! (Take THAT, naysayers!) They all begged to take turns chopping and stirring and all that good stuff. Originally we thought they'd be teenagers and be far too cool to participate - this was much better. They were super stoked, and the parents who came along to watch/help got caught up in their enthusiasm. At the end, we were all sitting around chomping down our pasta and oolichans (they're running now between Terrace and Prince Rupert, I guess. Super popular with the native kids), and a guy comes up to me and says, 'Have you ever heard about auras?'

Don't get me wrong, I'm not really a believer in that sort of thing. But I'm on someone else's turf so I'll politely listen to whatever he wants to say, yeah?

Anyway, he says, 'Your aura is bright orangey yellow with a white border and your head is pink.'

I have no idea what any of this means, so I ask 'Is that a good thing or a bad thing?'

He says (this is from memory, so not word for word, but a decent recollection of it.):
'The white is because you are pure of heart. You know who you are, you accept and love yourself so you come across with confidence. Everyone can feel that. It stands out right away.
The yellow is more of that confidence coming through. You stand strong with who you are, you know where you stand, and everyone knows where they stand with you.
The orange is because everyone tries to peel their problems off on you(?), but you know what problems are yours to take and which are not. You are open to everyone, you share everything, so these problems don't bother you because you release them back out into the world. You don't hold them in your head.
The pink is because you're open. Your aura reaches out to touch mine and everyone you meet. You are one with everyone. You understand people. You understand my people.'

Now even if you're like 'sounds like a bunch of airy fairy stuff to me' (which I sort of think, let's be honest), that last bit caught me.

Anyone who's worked on the reserves knows it can be hard to establish a rapport. The amount of tragedies experienced by so many of the people there; not just in the past, with residential schools and general oppression, but with current levels of abuse, be it domestic or drug abuse, prejudice, and the fallout from generations of kids snatched from their parents, raised by sadistic institutions and coming back without knowing or understanding why this happened. Again, I'm not saying this is how it always is, nor am I an expert in any way so forgive me if I'm on the wrong track, but that's sort of how it has been explained to me so far. Why should someone trust a bunch of other people who tormented and repressed them? To have even one person say I might have an inkling of understanding was one of the best moments I've had so far. I've always been interested in marginalized populations (hence volunteering in the DTES and so on), and originally wanted to come to Northern Health for internship because its scope includes more mental health and aboriginal health than the others. The job I'm shadowing now is one I could do forever, if I ever find the opportunity.

You see why today was a hell of a day.

If I hear '[food] is TOXIC! GET YOUR PITCHFORKS!' one more time...

...I will rearrange that person's face. For reals. I may be only 5'6 and 150 lbs, but I'm scrappy, homeslice. TRY ME.

If you can't rant on your own blog, where can you rant, really?

What is the deal with everyone trying to say one food is evil? Goodness knows it changes every day, depending who you ask. This internet nutritionist says wheatgrass will cure cancer, this one says milk will give you cancer, and this one says we should all be vegetarian.

Let's get one thing straight, first. What's the diff between a dietitian and a nutritionist? Surely it's the same thing, you say? WRONG. Why? Dietitian is a protected term - you have to have completed a full degree and an accredited internship. You need to know your stuff! This is not to say all nutritionists are full of rubbish - I know multiple people with nutrition degrees without the dietitian designation who know mountains of good info. However, if you're chatting up a 'nutritionist', for all you know, they could just be someone with their foodsafe certificate. There are quite a few (QUITE a few) who took some sort of 3-6 month holistic nutrition course, or perhaps even 2 years, if you'd really like to stretch it out. After 7 years of school, and a bunch of people telling me how smart I am, I still cannot fathom so many things about the human body and nutrition and how they relate. I'm learning every day, but you just can't know it all in that time.

Six months, you say? Please. Again, not to say said nutritionist couldn't have some good stuff to say, even after only 6 months. It's amazing what exposure can do and inspire in people! But a lot of people like to give advice that sells.

Know what sells? (*cue eyeroll* 'Yes, April, fine, go ahead.")

Insta-solutions. What's easier than picking one or ten evil foods and cutting it out in your diet? If you're cutting out, say, eggs, you have the glorious knowledge that you can go eat McDonald's till your liver croaks - because it won't croak right? It's only EGGS that are evil. All that processed stuff? No dairy! I'm good!

And for all you gluten-nuts out there (and no,. I don't mean you, gluten-intolerant folks, or even people just giving gluten-free living a try *nods to my sister-in law*), butter is gluten-free, generally. Does that mean you're going to fill up on that?

Now, in case you hadn't noticed, I'm slightly opinionated. I may be proved wrong about the whole gluten thing one day. But nothing gets my back up more than people trying to share their opinions without a solid scientific basis. And no, I DON'T mean a news release from CBS or the Vancouver Sun or whatever the hell. I want articles from PEER-REVIEWED JOURNALS. Just because a doctor on the internet (credentials, please!) says that acai will add 20 years to your life, think about it! Aren't doctors just as susceptible to fads as any other human? And aren't we all really amazing at extrapolating data that applies to us personally (e.g. I'm allergic to hamsters) and using it on other people ('Hey, don't eat hamsters, pretty sure they're toxic.)

I recently scampered away from a debate on facebook (Hah, I know right? Someone is WRONG on FACEBOOK. How can this be?) about whether or not milk is evil. The person who disagreed with my saying that milk is NOT evil said they had looked and looked and looked for info that milk isn't evil and couldn't find it ANYwhere. I scarpared, because I'm starting to learn that stubborn people is stubborn (I would know, I'm one of them.) One of the sad things is, they may have a point. It's HARD to find info, especially if you aren't a university student. Being in my last year, I still get access to every flipping journal index and database that UBC has to offer. (LOVE!) But I wouldn't be able to even see half of these things if I didn't have said access. Ovid, EBSCO, Pubmed - where would I be without you?

But here's a few:

'A dietary pattern that incorporates higher low-fat dairy products may lower the risk of type 2 diabetes in middle-aged or older women'
Liu et al, 2006. A Prospective Study of Dairy Intake and the Risk of Type 2 Diabetes in Women. Diabetes Care, 29 (7).

'Dairy consumption is inversely associated with the risk of having metabolic syndrome.'

Azadbakht et al, 2005. 

Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults. The American Journal of Clinical Nutrition, 82 (3).

'Dietary patterns characterized by higher dairy intake, especially low-fat dairy intake, may lower the risk of type 2 diabetes in men.'

Choi et al, 2005. Dairy Consumption and Risk of Type 2 Diabetes Mellitus in Men. Archives of Internal Medicine, 165 (9).

Now what does this prove, you ask? (or in some people's cases, ARGUE VORACIOUSLY.) Nothing. It's a bunch of correlations, not causation. This may all be proved wrong later. There are SO many confounding factors. I could also find a bunch of articles saying how milk ISN'T great. Or a whole bunch with no conclusive results! All I'm asking is, STOP with the preaching about how this food and that food is wrong and 'OH, you still eat THAT?' I may have no actual concrete proof that whatever food is good for you, but you have only likely an equal amount of proof to say it's evil. So stop pushing the message as if we already know for sure! 

And what about real-life confounding factors? Are you going to tell some lovely old thing with osteoporosis to stop drinking milk and pop a bunch of vitamin D? (Think it through. If her diet is poor because she doesn't have much appetite but likes milk, she'll maybe slowly starve to death but have healthy bones? How is this helpful? What if the person is vegetarian but hates tofu and beans? Where do you recommend they get their protein? Protein supplements or dairy?)

Ok, so the end of this rant really comes down to - eat how you like! If it makes you feel good to be vegan or gluten free or whatever, sweet. Do it. Tell everyone how much you like it! But DON'T go around making false claims or listening to other people's false claims that such and such is toxic. Ask for their credentials. Better yet, ask for their sources! It's amazing what people take out of context. Read this review of Wheat Belly. A couple of my fellow interns spent months looking up his sources. Turns out, this dude is really good at picking and choosing what info he'd like to highlight. 

We all know this info changes like mad. Just think about the butter/margarine debate. Pretty sure it's gone both ways twice each in the last 10 years :P. By eating a balanced diet with a bit of everything (except the really obvious stuff - nitrate-packed processed meat burned to charcoal, anyone?), you won't be stuck with a fridge and belly full of rice cakes when they decide they're the latest carcinogens in a few years.

If you actually made it through this whole post, you've earned this bit of hilarity:

What NOT to look for in your nutritionist :-)

(Just a note, one of the somewhat ironic things about this point is I'm quite lactose-intolerant and grew up with an allergy to the milk protein. I drink soy milk and generally limit dairy, or it gets ugly. I argue heatedly in defence of milk mostly because I hate to hear any poor defenceless food attacked without good reason.)

The best way to be healthy? Have money.

Oh hey, you say. BEEN a while, you say.

GET OFF MY BACK, I say.

Nah, I'm just kidding, but honestly, I just either didn't have time to gather my thoughts or may have simply not had any interesting thoughts for the last couple months. Would you really want me to make up a blog post where I ramble on about nothing in particular? Of COURSE not. (We have Facebook for that, amirite?)

Fortunately, nothing inspires me quite like Weighty Matters (the blog by Dr. Yoni Freedhoff). He posted a a couple days ago this article, Why Doctors Should Screen for Poverty. This is a big sore point for me. Not because I'm well, poor, although I am like every student in that there have been times where your dinner consists of rice with a bit of seasoning. I was even incredibly lucky in that my parents paid for my first degree - I had it SO good in comparison to most. That said, I've worked with a lot of people in the downtown eastside in Vancouver, and even here in PG where a lot of people aren't so lucky.

Here are a few of the main points from the article:

• Cardiovascular disease: there is a 17% higher rate of circulatory conditions among the lowest income quintile versus the average
• Diabetes: prevalence among the lowest income quintile is more than double the rate in the highest income quintile
• Mental Illness: the suicide-attempt rate of those living on social assistanceis 18 times higher than higher-income individuals
• Cancer: low-income women are less likely to access screening interventions like mammograms or Pap Smears
• Development: infant mortality is 60% higher in the lowest income quintile neighborhoods

Now, a lot of my chums who work in healthcare would agree with this, at least to some extent. Look at your lower income, less educated populations and there is a definite trend toward major health problems.

What kills me? SO many of them are related to food.

As a university student, what do we live off of? Kraft DInner, McDonalds, Mr. Noodles, etc. Why? It's cheap and easy. What a lot of us don't realize is plain unprocessed foods aren't actually all that expensive!! Why oh WHY do we pay $4 for a cheeseburger and fries when that could buy a bunch of lettuce ($0.99/bunch), a tomato ($0.50?), a carrot ($0.25?), and a bag of dried beans from the bulk section ($0.32/100g, so say $0.50) and a whole wheat bun ($0.50)? Obviously, these are ballpark prices, but there we have a meal with all the nutrients with a grand total of $3.75. 

You could save the rest of that and buy a chocolate bar, if you really want. 

Even as university students, some of us grow out of this and start making real food. But even of university students, not all of us figure it out. Eating healthy is more work, admittedly, than eating convenience food. And if you're a bit less educated, you may not know the bazillion benefits, including lower chances of diabetes, cardiovascular disease, and just generally feeling better. I can't totally fathom this even now, but I have extolled the virtues of vegetables to many a person whose response was, 'So?' What if you don't know salt isn't so good for your heart? What if you don't know pop is THAT full of sugar? What if you think juice is a pretty healthy way to go so you drink a litre of fruit punch every day because 'It's healthy!'? Especially in our lovely western world we have some skewed ideas on vegetables. I read somewhere (if I find the article I'll attach it) saying even healthy-eaters in North America will generally respond to psychological testing indicating that healthy food is 'gross' and junk food is 'yummy'. We all start out this way as kidlets, but somehow in France, that idea gets reversed as adults so junk food becomes 'gross.' 

However, that little meal idea I rattled off was only one example. A lot of healthy foods ARE more expensive. Brown rice? Defs more expensive than white. Omega 3 supplemented eggs or even free range? Like, DOUBLE. And if you're struggling financially, we tend to go for things we associate with satiety. A cheeseburger sounds a lot more filling than my tasty salad.  If you don't know how far your food budget is going to stretch, you want to be FULL. I know this to be true from the various places I volunteered in the DTES. I volunteered last January at a women's centre, and there were people crying because they came late for the waffle breakfast and were going to have to wait 10 minutes for us to pack up food in take home packages. One lady threw an absolute tantrum. It's understandable if you think about it; when you're hungry, it's hard to think about something else. If your whole life revolves around getting access to food, you're going to be RIGHT PUT OUT if it disappears in front of you. 

One of the places I volunteered, the Neighbourhood House, only served vegetarian meals because A) they wanted to make sure everyone could have some, and B) they went by what was donated - know what's cheap to donate? VEG! and C) people need to see how to make simple healthy foods tasty and easy. It didn't cater to homeless people so much during the hours that I was there, simply to people who were struggling. A lot of people in that situation may have the desire to eat healthily, but what do you do if you don't have transportation to go get it? And if you do, what if you can't afford the equipment to cook it?

THAT sort of blew my mind. Working with dual-diagnosis patients who were moving out form a treatment centre: this lady has no teeth. What if she can't afford a blender? Some people are working with a spoon and a hot plate. Or if you've got 6 kids and a limited budget? You might be going for the peppers in that bag under the counter that need some, ahem, doctoring. In that case, those peppers probably don't taste so sweet, and while you're doing the best you can, your kidlets may grow up thinking peppers are gross. People with less money also tend to be less educated people who are potentially more easily swayed by whatever advertising/people telling you useless nonsense/I swear this pizza is GOOD for you, etc, because you're not always taught to think critically.

UGH. It's so damn HARD.

Obviously, this is only a small part of why you need money to be healthy. If you're sick and you can't afford to take time off, you go to work anyway. If you're lucky, you'll shake it off. If you're not, you're not getting any time to rest, and you get sicker, until you HAVE to be off work. Then you lose money because you're too sick to work, and by the time you're well enough to work you're completely in the hole so you make yourself sick by working overtime or simply from stress. THEN you can't afford the medication, and so on and so on. It's bad, folks. I'm just hitting the tip of the iceberg, here. And this is not the case with everyone, of course. But which populations do YOU correlate with obesity? Think about it.

And now, to end this post on a funnier and less aggravating note, here are some pictures of my first attempt to make macarons. Not macaROONS, macaRONS, those aggravatingly cute little French cookies. I have since made another batch that came out much better - this one I WAY overwhipped the egg whites after completely misreading the directions, but even now I seem to either get the cute little feet at the bottom OR a smooth top. I have yet to manage both. Sigh. Stil dericious with raspberry jam or nutella in the middle. For all you other would-be-macaron-bakers out there, learn from my failures. It gets better, I promise.

FEET!!

The slightly better ones from the first batch. They had
said feet, but are terribly cracked. More recent ones are less
cracked, but no feet (these were WAY overbeaten, though.)

Poor sad overbeatn macaron.

This is what happens when April gets hasty and takes them
out of the oven way too early, then tries to pick them up.

Bad idea. These were chucked.

Also, a boss picture of my walk to work. My first time seeing hoar frost, it
was absolutely beautiful!