Can You Really Have It All?

So disclaimer, this post isn't one about nutrition advice or exercise recommendations. This one is for women out there who have felt that tug between their work/career and their family. For me this is about being a mother, wanting to have kids and continuing in my career. I know I have heard that you can't have it all and I believe that in life we make compromises. We give up things in order to do other things. I wanted to take the time and write up my struggle and feelings. I feel like as women, it is different for us compared to men. We are different beings and that should be celebrated. Lots of times though I feel a sense of guilt about struggling with this choice between a family and work. 

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I, like lots of my peers, finished my 4 year college degree and got a job. I have been a Registered Dietitian for 7 years and I now moved through being a novice in my field into more of an expert. I don't know everything, but after passing that 5 year milestone, I feel like I know some things, but of course have way more I want to learn. I would say that I have a career. I have a specialty area where I work that I love. I am good at it and I enjoy the challenges. I have learned some new things about myself as well - my desire to write and possibly run my own business in the future. I enjoy educating people about my specialty area. I have learned those things about myself over the last 7 years and I have worked hard to be good at what I do. 

I am also a mother and have a child. A 15 month old little one, who I love and enjoy spending time with. Now I have this desire to spend time with him and I have thought about do I want to keep working? Being a mother starts bringing all these questions into your mind that never had been there before. I start wondering if that is something I would want to do? If I didn't have a child, I never would be asking these questions. But now, I feel like I am being asked to choose; between being a Mom or continuing with my career. What I find frustrating is this idea that I HAVE to choose. That some how my desire to continue with my career shows a lack of desire to be the best mother I can be. I know not everyone thinks that, but that is the mindset that society puts on us. 

I believe that as a woman, you have to choose what is best for your family. What do you want from life? What do you want to do? That is what Chas kept asking me the other night. Not what would I would be willing to do for my family. Not what I think I could see myself doing if I had to. The simple question ... where do I see myself in 5 years? Right now, what do I see myself doing? 

As I look into my crystal ball, I see myself working and continuing in my specialty area of dietetics. I would love to have another child, but I understand that additional strain that would put on me as a working mother. I can't help, but want to have it all. I have worked too hard for my career to just step away from that, but at the same time I want to be the best mother I can to my son and hopefully future children. 

I don't have an easy answer to that questions ... where do you see yourself in 5 years? I have hopes and dreams. As a woman, I just want to celebrate other woman out there in that pursuit of "having it all." We give up time with our children to pursue our career and we hope that teaches our children how to be successful later in life. We are mothers, but we are also more than just that vocation. We are still the women that went to college to pursue our dreams and in the end, when our children move out, we will still be those women with our aspirations. Is you choose to stay home with your babies or go to work and snuggle your little ones at night ... doing what is best for you and your family is always the right choice!  

 

Asparagus and That Stinky Smell

One of my favorite vegetables is asparagus. I love it because it is easy to cook and tastes delicious. It looks fun and can even serve as a "fancy" side dish for a nice dinner. It is a pretty green color and contains lots of vitamins and minerals that are good for your body. But what happens after you enjoy your asparagus with dinner? Have you ever noticed that terrible smell when you urinate? It is terrible! It is almost stinky enough that it might make you reconsider enjoying asparagus, as a vegetable at your next meal. 

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So why does that happen? How does it work? I have asked this of myself every time I cook, eat and urinate after consuming asparagus.There is a compound that is only found in asparagus and they have called it asparagusic acid. This is a sulfur containing compound (mercaptan), which explains that terrible odor that occurs in your urine after eating asparagus. Mercaptan is also found in rotten eggs, onions and garlic. It is thought about 22-50% of people are able to smell this compound.

This asparagusic acid compound is "volatile." That does not mean it will explode, but it means that the compound is easily airborne and floats up to your nose very quickly. This means that you can perceive this odor within 15 minutes of eating asparagus spears.

This has prompted the debt about if some people's body produce asparagusic acid compared with the idea that maybe your nose can not smell this compound. After some studies in the 1980s in France and Israel, found that the difference is in the perception of the this asparagusic odor compared with production on this compound. So it is thought that everyone produces this compound, but not all of us came smell it. So some people might not have the olfactory sensors to perceive this sulfur-like smell. They have some genetic mutation that prevents them from smelling this odor. A study was done, by a researcher at Harvard, that included 7,000 participated and out of that group 40% could smell that "stinky odor" after eating asparagus. That left 4,161 who were unable to smell that asparagusic acid. They contribute that inability to smell that compound to some combination of a possible 871 gene variations affecting that sensitivity in the nose. 

So in the end there isn't a clear reason why people can or can't perceive that terrible stink after eating asparagus. There is even doubt on the exact type of compound that makes that distinct odor. In the end, they main take away is ... don't be surprised if you enjoy your asparagus and then have a stinky pee afterwards. You are not weird, that is normal, for ~40% of people. 

Sources: 

  1. Why Asparagus Makes Your Urine Smell. 
  2. Why Your Pee Smells Funny After Eating Asparagus.
  3. Why Asparagus Makes Urine Smell. 
  4. We Unravel The Science Mysteries of Asparagus Pee.
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Finding Balance with Easter Goodies

Easter came early this year! I hope you all had a wonderful Easter yesterday. Often this holiday is filled with candy and sweet treats, just like Valentine's Day. It is so easy to pick up a bag of candy for those Easter eggs and find yourself eating all of those bite size goodies. Two weeks before Easter, I picked up a bag of bite size candies and totally found myself snacking on them at night. Terrible, I know! It was just so easy to pop one in my mouth. Honestly, I didn't need to buy a bag of candy 2 weeks before Easter, because really, did it make it to Easter? Nope! Sure didn't! 

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I am sure that you all had some delicious goodies leading up to Easter and now that the day has come and gone, you probably have some of those candies sitting on your counter or in your cabinet. How do you find balance with those goodies and making healthy choices? 

I am a dietitian who does believe that all foods can fit in a healthy diet. Now I don't recommend you purchase candy, when you don't need it, like I did two weeks ago. I would tell you to enjoy a piece or two of candy for the holiday, but don't bring it into your house if it is going to be a stumbling block for you. If you have little ones in your house, then you might think you have to purchase candy to fill up those Easter eggs with, but I am here to tell you that you don't have to put candy in those eggs. We  put Goldfish crackers, grapes and some other little food items in our eggs for William. Instead of having him find candy (which he doesn't need) we decided to try some healthier alternatives. You might think goldfish aren't exciting or fruit is lame, but this kid loves both so I think he will be excited. 

The two take aways from this post are 1) Those extra treats from Easter, come up with a game plan. Definitely enjoy them, in moderation and then if you have to, throw the rest away. Don't feel guilty about that. If it is going to be a stumbling block for you. Get get of rid it and get rid of that temptation.  2) Your kids goodies don't have to be candy. There are lots of things that you can give your child for Easter that isn't just candy. Don't feel like you are depriving your child anything. I think teaching kids to celebrate with items that aren't food is an important lesson as they grow up. 

Hopefully you all had a wonderful Easter and enjoyed the day! I have included some pictures below from our time with family over the weekend! 

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Stretching Your Dollar at the Grocery

Being able to save money when grocery shopping has been a goal for our family in 2018. I love food and I can easily spend lots of money on food. I have been working really hard this year to try to cut down on food purchasing. I wanted to talk about ways to cut down on your food budget and still have healthy and delicious food options available. 

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  • Cook more at home. When it comes to actually cutting down food costs, limiting your eating at restaurants will help. When you eat out, you spend a lot more money. If you are feeding a whole family that can easily add up. Then if you aren't spending a lot (going to a fast food restaurant, you are trading money for high sodium and low nutrient containing food items). Working hard to plan meals to be prepared and eaten at home will go such a long way in saving you money with your food budget. 
  • Plan meals out ahead of time. Being able to eat meals at home requires planning. You obviously can't cook food at home, if you don't have recipes already picked out and food purchased. Sitting down for even 30 minutes a week, picking out a few recipes and writing out what ingredients you need for those foods items will go such a long way in helping you stick with your budget. When you know what food you need to purchase to cook at home, that will help with the next recommendation - creating a list. 
  • Stick to the shopping list. To help you save money, write out your shopping list. When you have a list and you go to the grocery store, sticking with your list will help save money. Lots of time that extraneous spending happens when you decide you "need" things from the store, that aren't on your plan. That shopping is to serve as a guide when you head to the store. Stick with purchasing only what you need and that will help save lots of dollars. 
  • Shop the sales or cheaper stores. If you are able to look through ads and shop the sales, that is a great way to save money. If that takes too much time and you aren't able to run to multiple stores, then try to find the best deals on the store you shop at. I am a huge believer in Aldi. I really like that store and I get all of my staples from Aldi. I am able to spend <$100 most weeks on food because I purchase all my produce, milk, cheese, eggs and most meat items from Aldi. I don't have the time to shop sales at multiple stores. Find what works best for you and your schedule. 
  • Use left-overs. If you take time to cook a meal and you have left-overs, use those for another meal or to take with you to work. That is a huge cost saving measure. Most of the nights when my husband isn't able to come home for dinner, we eat left overs. I will also pack left overs for lunches the following day. That is an easy way to efficiently use that meal you spent money and time on to prepare. 

Half Marathon Training

It is that time of year again. The weather is warming up and the spring marathons and half marathons are starting. Before I had William I ran 1 marathon and then lots of half marathons. I really like the half marathon distance, because I could train, but it wasn't nearly as stressful or take up as much time as training for a marathon. That 13.1 miles is such a great distance. 

I haven't competed in a half marathon or even run 13.1 miles since before I was pregnant. That race as back in October of 2015. I then got pregnant and realized I was pregnant in spring of 2016. At that point in time, I did not feel well enough to run 13.1 miles for fun. It would have been torture. I didn't sign up to run any races in 2016. I continued to run and work out at the gym until the week William was born (December 23, 2016). I took 6 weeks off running completely after William was born. I started back running and even did some PT to help with my pelvic floor. Through out 2017 I didn't run competitively in any half marathon races. I did ran a couple 5Ks and other < 6 mile races at the end of 2017. Now in 2018, I made the goal to run 2 half marathons (one in the spring and one in the fall). I want to get back into competitively running, but at this point in time I don't have the time to train for a full marathon. So that half marathon distance seems like the perfect compromise. 

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Finding time to fit in long runs can be challenging. Thankful, William does really well in the running stroller. He has logged lots of miles in that stroller. He is a great running buddy. The timing of runs can be tough. Sometimes during the week, I just fit in 30 minutes on the treadmill at the gym before picking up William, because that is all the time I have to give to training. On the weekends is when I fit in long runs. I prefer doing my long runs outside. I will fit in a long run on either Saturday or Sunday and then try to pair a recovery run on the other day. That doesn't always happen though. 

I have been trying really hard not to push myself too much. I enjoy running and it is a stress reliever. It is easy though to get caught up in the mileage and if you can't hit that distance one day you can really beat yourself up over it. There is so much that goes into me getting out and running. I have to take William with me and keep him occupied and then of course run. But I also have to try to get my work done quickly that day to fit in that run. I have been trying not to over think it or stress too much about it. It is suppose to be fun and that is important. 

Training schedule - If you have run a half marathon before then you have probably tried to follow a training schedule. I really liked this article from Runner's World about training and fueling for a half marathon. I haven't followed a strict schedule to prepare for this half marathon. I have run 9 half marathons, 1 marathon and countless 5K-6 mile races. I know how often I need to run during the week (4 days a week is a magic number for me) and then I need to do at least one long run (> 6miles). Before the half marathon, I need to do at least one 10 mile run. I have also have to stretch out and try to do yoga at least 1 time per week. This all worked well prior to having a baby, so we will see how it goes post-baby. I have been running with a running stroller, so I feel like also includes some strength training in with those runs. 

Having a goal and working towards accomplishing it provides such satisfaction. I know that if I put in the miles (>20 miles per week) then I can get out there on race day and do well. I will keep you all posted on things go. My race is the Geist Half Marathon on May 19th. I have never ran on this course before, I know that there are lots of hills, so it will be a challenge. But I am looking forward to it! 

My Nutrition Journey

I thought that it might be fun to have today's post focus on my nutrition journey to where I am today. Most of the time I am writing about interesting nutrition topics (that are near and dear to my heart), but I thought I might give you a little back story about my own journey to becoming a NICU dietitian.

I initially was interested in OT/PT in high school, but after job shadowing several PTs and working in a nursing home once a week for a semester in high school, I decided that wasn't for me. It didn't really enjoy touching people that much. I kind of preferred keeping my distance from the patients that I was working with. My mother encouraged me to look into nutrition and specifically dietetics. She kept telling me that having a credential, like the letters RDN after my name, would open up lots of doors for me. She was right! I went to Purdue and double majored in Dietetics and Nutrition, Fitness & Health. I was most interested in sports nutrition and that is where I wanted to work. I wanted to help athletes optimize their nutrition to improve their performance. After completely 4 years at Purdue, I did my internship through the Purdue Coordinated Program and graduated in August of 2011. After the completion of my internship, I took the RD Exam and passes and started working at St Elizabeth Hospital in Lafayette, IN. I originally wanted a job in sports nutrition, but quickly realized those positions were few and far between. Lots of them preferred a Master's degree as well. I decided that getting a job, starting to earn money and gaining work experience would be most worth my time. Unfortunately, a Master's in nutrition doesn't guarantee that you make significantly more money.

I started working at St Elizabeth hospital and covered the cardiac, pediatric and NICU units. I also worked in outpatient pediatrics. This is where my love for pediatric nutrition started to develop. I really enjoyed being able to make nutrition changes and see the changes within a few days. I really loved working in pediatric outpatient and developing a relationship with those patients. After almost 3 years, I took a new job in Indianapolis, IN at St Vincent Women's Hospital working in the NICU. This was a huge leap of faith for me, but it has proven to be such a blessing. I knew that I enjoyed the NICU, but I being able to work in pediatric critical care full time has been such an amazing experience. I love being able to work with these critically ill patients, provide them with the best nutrition and then watch them grow, over come the odds and thrive to go home with their families. 

 Photo taken by our pediatric surgeon (Evan Kokoska) for an album The People of Peyton Manning Children's Hospital.

Photo taken by our pediatric surgeon (Evan Kokoska) for an album The People of Peyton Manning Children's Hospital.

I have been able to do so many neat things over the years. I have been at St Vincent's Women's Hospital now for almost 4 years (as of April). I have had the opportunity work with lots of amazing people. I was able to give a talk at the Indiana Academy of Nutrition and Dietetics Conference (IAND) last year on NICU Nutrition and the role of the RD in the NICU. I have been able to serve on the Academy of Nutrition & Dietetics (AND) Test Writing Committee for the new Certified Specialist in Pediatrics and Critical Care Exam (CSPCC). I had the opportunity to write a chapter in a Nutrition Communication book that will be published in the next year through the Academy of Nutrition & Dietetics. I have been able to serve on the IAND State Board on the Nomination Committee and exited to be on the local CIAND Board this upcoming year. I have been able to mentor lots of interns and excited to see them pursue their dreams as RDs. I have worked with amazing people and I am so excited for what is ahead for my career. 

Looking back on it, I am so thankful to have parents who cared about my future. Who pushed me to pursue my interests, paid to put me through school and supported me as I took leaps of faith with job and opportunity that has come my way. I have been a Registered Dietitian for 6 1/2 years and it has been such a fun journey! 

National Nutrition Month

March is here! Can you believe it? I am so excited for spring and the start to hopefully some warmer weather. I love all the seasons, but it is always fun to be able to welcome spring in March and look forward to less snow and more sunshine. March also means that it is National Nutrition Month. I have posted about Nutrition on a weekly basis here on RD Anna, but this month is special because the Academy of Nutrition & Dietetics focuses some key messages to spread about nutrition and wellness. Each year there is a theme. The theme for 2018 is "Go further with food." I think that is a great slogan for the year, because all eat and that is a necessary part of life, but what if we try to take that an extra step. What if we focused on making our diet or our habits just a little better. Take it that next step and push ourselves to make even better choices. 

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Key Messages For National Nutrition Month 

  • Include a variety of healthful foods from all of the food groups on a regular basis.
  • Consider the foods you have on hand before buying more at the store.
  • Buy only the amount that can be eaten or frozen within a few days and plan ways to use leftovers later in the week.
  • Be mindful of portion sizes. Eat and drink the amount that’s right for you, as MyPlate encourages us to do.
  • Continue to use good food safety practices.
  • Find activities that you enjoy and be physically active most days of the week.
  • Realize the benefits of healthy eating by consulting with a registered dietitian nutritionist. RDNs can provide sound, easy-to-follow personalized nutrition advice to meet your lifestyle, preferences and health-related needs.

Recognizing Credible Information

Can I just say super fast that this is the second time I am writing this post, because somehow I accidentally deleted the whole thing the first time I wrote it. So let that be a lesson, always, always save what you are writing. 

I was so excited this week to have two people comment about my RD Anna Facebook page and the information that I have shared. They said that they had read some of the articles and really appreciated the great information that I was sharing. That is so exciting for me. First of all, that people were actually reading what I was writing and sharing. Secondly, it was wonderful that people were recognizing and appreciating having evidence-based information that is being shared. 

Our social media feeds are filled with misinformation and with the whole "fake news" phenomenon that has been occurring over the past couple of years, credible information is important. We need people to be sharing accurate information and not propagating misinformation. That is one reason why I share information on my Facebook page. I feel that as a health professional and nutrition expert, you should be getting your nutrition information from me, not some random person on the internet who calls them self a nutritionist. I also wanted to share an example with you that happened to me the other week. Someone at my work was telling me about how they had read information on Facebook about how infectious disease doctors were to blame for people dying from the flu this year. When I tried to clarify, what this person was saying her response was "the article named the specific flu strands, so therefore it has to be true." This is why as health professionals, we must share accurate, credible information and as people on social media, we need to identify misinformation.

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How do you identify credible information on social media? 

  • Look for credible sources in the article. When you are looking through an article shared on social media, take the time to see what sources are quoted or what citation they use. Where is the writer getting their statistics? Is this information from credible sources? If you are looking at medical or wellness information are the sources being used from places like JAMA, AAP, CDC, AND or another nationally recognized institution known for presenting evidence-based information? If you can't identify any sources for the information presented, that might be a red flag this article might not be credible. If the sources are not from nationally recognized institutions, that might be another red flag to take the information with a grain of salt. 
  • Who are the "experts" that are being quoted? Most likely whatever, you are reading, as some time of expert that is interviewed or quoted. What are the credentials for that individual? Are they an expert in the field that they are speaking about? If the question to that is no, then that is probably not a credible article to be getting information from. For example, you don't want a podiatrist to be talking about the terrible flu season. That is not his/her area of expertise. Also look at the credentials that the "expert" has. Is this person talking about nutrition, just someone who is classified as a nutritious or is this an actual Registered Dietitian Nutritionist? If your athletic trainer is talking about nutrition, that might not be the best nutrition expert to be getting that information from. Taking the time to identify who is the "expert" is and how they are being quoted is a key way to identify credible information online. 
  • If the information is "too good to be true" then it might not be true. If you are reading a news headline and you just can't believe what it is saying, that should be a red flag. Every writer wants to draw you in, get you to click on the link and open the article they have written. Often writers create crazy titles to get you to click on their article. If you are reading through this information and feel like this information is too good to be true, then pause, step back and realize that it might not be accurate information. This is especially true with weight loss recommendations. Everyone wants a quick fix, but that is just not how it really works. 

Hopefully this information is helpful as you try to weed through all the information on social media and identify what is actually accurate information. You might be wondering what my sources are for these recommendations, well check out some of the links below. 

 

Writing Exam Questions

I have had the opportunity to serve on the committee that is putting together a new board exam for the Academy of Nutrition and Dietetics (AND) for pediatric critical care. This was a brand new experience for me. There was an application process and 10 of us were picked to serve on this test writing committee. This new exam will be in addition to the Certified Specialist in Pediatrics (CSP) Exam. This will be a specialized certification for RDNs in the PICU and NICU. The test will be called Certified Specialist in Pediatrics in Critical Care (CSPCC). 

I had the chance to go to Chicago this past week to work more on the development of these test questions. It is such an interesting process to write exam questions for a national board exam. Like I mentioned earlier this is a brand new experience for me. I never realized the time that went into crafting the perfect test question and providing the best/most plausible incorrect answers.

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I share this with you all for two reasons: 1) To encourage you to apply for things that are outside your comfort zone. I had never done anything like this before, but being able to learn about this process and get to gain these skills has been such a neat adventure. I also got to network with some amazing RDNs from around the country. This isn't something that I imagined I would be doing, but I took a chance and went for it!  2) This additional certification is needed. Having this board exams for RDNs is important to help encourage and support specialty areas in nutrition. Being able to specialize in a certain population or disease state helps you, as a provider, to give the best care to your patients. I am very excited for this to come together and become another certification that RDNs can obtain. From my experience, RDNs are often under-utilized and I think this a great way to show how important nutritional management is for pediatric critical care.

If there is an experience or opportunity that comes up in your career area, then go for it! Don't be scared to apply or think that you aren't qualified enough. Take a chance and go for it! You never know what all you will be able to learn. I am excited to be able to be included in this test writing process and eager to see how this certification helps to build up the profession in pediatric critical care! 

Picking Out Heart Healthy Foods

I had the opportunity this week to speak with Ericka Flye, a reporter for RTV6 about heart healthy foods. I have worked closely with the American Heart Association here in Indianapolis and I was contacted by their media person to see if I could be interviewed. I of course said yes and we put together a fun grocery store tour segment where we walked about Kroger in Fishers and talked about heart healthy food options. 

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Most grocery stores are decided with the fresh foods around the parameter of the store and the processed/shelf stable food items at the center of the store. Try to stick with shopping around the parameter of the store. When you enter the grocery store you normally arrive at the produce section. This is a great place to start because all of these produce items are very heart healthy. They naturally do not contain any sodium or fat! That is a the goal with a heart healthy diet to limit your consumption of sodium (or salt) and fat. Try to pick a variety of colorful produce items. Also try to pick out some new foods that maybe you haven't tried before. If you don't know how to cook or prepare that new produce item, look it up on Google and you can quickly find a recipe or how to cut up that food item. 

From the produce section we worked out way over to the deli and cheese counter. There are lots of options over here that are filled with sodium and added fat. The key is moderation. Dairy items and even processed meats can fit into a heart healthy diet, but in limited amounts. The nice thing about some of the Kroger Marketplaces is they carry Boar's Head meats and cheeses and they have lower sodium options. Check out the deli counter and look for the American Heart Association label on their lower sodium deli options. 

After checking out the deli counter we walked to the meat section. There are tons of options of types of meat from fish to turkey and beef. The key to find a heart healthy meat item is to read the percentage of fat to meat comparison and aim for the higher meat percentage. For example, try to purchase the 90% meat and 10% fat ground meat option compared with the standard 80% meat and 20% fat option. This will be the more heart healthy choice. Lots of people think that just because they are choosing turkey or chicken it is automatically healthier, but not really. Beef can fit into a heart healthy diet as well if is ground sirloin and is a lean cut. 

From the meat section we walked to check out the milk and eggs. These are both an important part of a heart healthy diet. You can have a whole egg a day while still following the heart healthy recommendations. If you want more than one egg in scrambled eggs or an omelet you can take 1 whole egg and then mix in additional egg whites to make a healthier fluffy egg scramble. When picking out a milk option choose 1% or skim milk because that has the least amount of milk fat remaining. This is the more heart healthy option.

The last area that we visited was the frozen food section. This area is where you will find lots of high sodium and high calorie food items. They key is to watch your portion sizes and then to make sure that you are reading how much sodium is in each of the items that you are consuming. Try to limit your consumption of these pre-prepared food items. Always read the labels and know what is in the food items that you purchase. 

We had a great time walking about the grocery store and checking out what items you should put in your cart to make heart healthy choices. You will have to check out the segment that will air on RTV6 at the end of the month. Thanks to Ericka Flye for a great interview and the American Heart Association for reaching out to me to help with this nutrition segment! 

Work, Life Balance

I had someone mention to me the other day ... "I don't know how you do it all?" I am sure from the outside it can easily look like I have it all together. Social media has a way of only showing the highlights of life. None of us just post our boring weekday evenings, washing the dishes or folding laundry. It is easy to compare ourselves to one another. We look at other working Moms and wonder how they find time to take their kids on a walk and then also cook dinner that evening. Often I feel like working mothers feel this constant pull in so many different directions. I know that I will see stay at home moms on social media and I am often jealous that they don't have to fit a traditional work schedule into their routines. 

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This comparison is not healthy. Social media is just a quick snap shot into people's lives and never shows the whole picture. I thought it would be a good idea to just touch on work, life balance and maybe share some recommendations to help you. I do not claim to have everything in order and all of this figured out. I am just a working mom who is going through life, doing her thing and then using this blog platform to tell you about my experiences. 

Time Management 

I think any mother would tell you that time management is part of motherhood. As soon as you become responsible for another little human, you have to start managing your own time. To help with my own work, life balance I have accepted the fact that I do the same things over and over again. Each day I get up at 6am. I get ready before William wakes up. Then I load the car with the bags that I packed the night before. I go to work. Then after work I have about 30-45 minutes that I can fit in some physical activity before picking up William. Then the night time routine starts when we get home: make dinner, clean up after dinner, bath for William, put William down, pack lunches, and get myself ready for bed by 10-11pm. Then this cycle repeats each day. Managing my time each day is the only way that "everything" gets done. Taking the time to figure out what your schedule looks like and then account for each hour of each day will help you prioritize what needs to get done. If I have any tasks left undone and it is already 11pm then I just call it a day and head to bed. I need that 7-8 hours of sleep a night and that is a priority for me! 

Support System 

To maintain whatever schedule you create for yourself and your family, you need help! You need the support of your friends and family. There will be days that things don't go right and the schedule get totally messed up. There will be times you will be asked to help with something that you didn't anticipate. Being able to call on those friends and family members at those times will keep you sane. For example, there was a week day when I decided we needed to go see a family member. I had to make a few extra stops after work and I called up our amazing nanny. She helped me by assisting William with making a card. I didn't have the time to do that with him, but with her help and support we were able to get that done. Having those support people in your life to help you is so important. Even if it is someone you can complain to at the end of the day. Just having a shoulder to cry on is important. 

"Relax Days" 

Having a schedule and sticking to that routine throughout the week is great, but we all need some down time. When we can relax and just wear our pajamas all day and don't care. That is the weekend for me. I try to not set an alarm on Saturdays so that I can just sleep until William gets up. That is so liberating. After the hustle and bustle during the week, that quiet, care free start to the weekend is a must. It provides some time to help re-charge those batteries and gear up for the upcoming week. This past weekend, I came down with a cold. I let myself take a nap on Saturday and Sunday! When William slept I took a 2 hour nap with him. It was the best thing ever. I knew that I need to slow down and take that time for myself. Those "relax days" are an important part to the whole work, life balance dance. Without them, you can easily get burnt out and then be left feeling so overwhelmed. 

Taking Back Your Kitchen

The holidays are over and we are now well into 2018. In fact we are half way through the month of January. I am not sure what your resolutions were for the New Year, but odds are that you have already ditched those resolutions. I am not sure if "cooking more at home" was one of your resolutions, but I want to help encourage you to take back your kitchen. All of us are busy and we have so much competing for our time. Finding time to cook is often difficult. 

What are some obstacles that keep you from preparing meals in your kitchen? For me, it often involves lack of time and if I don't plan ahead, there is no way I will be able to make dinners at home. Identify whatever obstacles that are keeping you out of your kitchen. Then let's work on overcoming those challenges. 

Take Back Your Kitchen 

  • Meal Prep - Taking the time to make out a list of what you want to prepare at home for the week is a must. Think through what food items you love to cook or you have time to prepare and get those recipes. Make out your shopping list using those recipes. That will help ensure that you purchase only the food you need to cook those meals. Making out a list ahead of time can also help to save money when you go to the grocery store. Once you go to the store and purchase your food items, when you get home, take the time to prep some of those foods. Taking the time to cut and prepare your fruit and vegetables can be helpful during the week. Sometimes that cleaning and prep work takes too much time during the week. Doing it on the weekends can help ensure you are able to cook these meals at home. 
  • Realistic Recipes - When you pull recipes for the week, make sure that they are realistic. If a recipe will take you 2 hours to cook then that might not be a recipe to make during the week. If you work or have evening plans the sticking with 30 minute recipes will help ensure you are successful in cooking foods at home. Also during the week, make sure that ingredients are also easy to get. Some times if you forgot an ingredient and if you can't easily pick it up during the week, you might not prepare that recipe during the week.
  • Clean Up - Whenever you cook there is often a mess. Lots of dishes and clean up afterwards. Taking the time to tidy up your kitchen at the end of the day is helpful for the next day. I hate cooking in a dirty kitchen. Each night I try to take the time to clean up from dinner and from putting together lunches for the next day. I like walking into a clean kitchen in the morning and then preparing dinner the following night in a clean kitchen. Is that is something that is an obstacle for you cooking at home, find ways to remove that obstacle. If your spouse enjoys dishes or is able to help with one part of the cooking/cleaning that teamwork is great! 
  • Use the Left-overs - Don't throw out the food that you took the time to cook. You can save these left-overs and use them for lunch the next day. If you have enough left, you can even use it for another dinner that week. If you have taken all that time to prepare the meal, it would be a shame to throw out that food and some what wasteful. 

Think about what stands in your way from cooking in your kitchen. Do you want to take back your kitchen and start preparing more meals at home? Hopefully some of these tips and tricks will help you be successful and accomplish this goal! 

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The End of a Pumping Journey

It has been a little while since I have written about my breast feeding experience with William. We have reached the year mark. That had always been my goal to breast feed William through his 1st birthday. That goal has been accomplished! Such a big milestone and I am so excited and proud of both of us. 

 Photo credit: Karre Ann Photography from William's 12 month photo session.

Photo credit: Karre Ann Photography from William's 12 month photo session.

I started pumping when my milk came in (so the first week of life with William). I know that my lactation consultant that I met with in the hospital said I didn't need to do that, but I was so uncomfortable. When my milk came it the only thing that helped was pumping. Then I would just pump randomly 1-2 times a day over maternity leave to comfort. I would freeze the milk and plan to use that for when I went back to work. 

I ended up having an over supply of breastmilk, but honestly, I was fine with that. I really wanted William to only have breastmilk so that was a "problem" that I was fine with. If you haven't read through my first breast feeding post - CLICK HERE and check it out. I wrote about breast feeding as being a choice and a gift that I wanted to give my child. I am not here to judge, you as a mother, if you breast feed or not. Each mother and child has to decide what will work for them. For myself and William, I wanted to breast feed and that meant also pumping. 

Lots of mothers that I have spoken with hate pumping. They loathe it and it is something they dislike. I tried really hard to look at it has a choice and again, something that I was doing for my child. I wanted to give my child that gift of my breastmilk and when going back to work I knew that meant having to pump. 

At the beginning, I went back to work when William was just turning 8 weeks old. I pumped 3 times during the work day. I also had a 45 minute drive to/from work. Then I would breast feed him throughout the night, in the morning before going to daycare, he would go with 3 bottles and then I would breast feeding twice before bed. William also would get up to eat throughout the night until 6-7 months of age. I was pumping/breastfeeding 8 times a day for about 6 months. Then I started pumping only 2 times at work and continued to do that until William was 12 months old. I wanted to make sure to keep up my supply. Again, I probably didn't have to do that, but I had more than enough milk and it was something I was happy to do. 

Well now I have reached the end of my pumping at work journey. This week I stopped pumping at work. I had decreased pumping at work to only once a day after William turned one. Then after talking with one of our MD/Lactation Consultants I understood that I needed to let that go. There was no NEED to keep pumping at work. I am still breast feeding William in the morning and at night before bed. He enjoys that and it works for us. 

This week I stopped carrying my pump to work. I have a beautiful Sarah Wells Pumping bag that I love and served me well for the last year. It is hard to believe that this part is finally over. I never loved pumping, but I didn't hate it. It was something that I knew I had to do and I made the best of it. Now that it is done, it is bittersweet. I love being able to wear clothes to where I don't have to think about being able to get to my boobs. Today I wore a cute dress and it was awesome. I haven't been able to do that in a year. But at the same time, this change means my baby is no longer a baby, but a toddler. 

I know that I will be able to continue to breast feed for as long as William is interested. That is a blessing and I am fine with that. I just wanted to share about my pumping/breast feeding journey. I know that lots of times you just hear the terrifying stories or people complaining. I wanted to share with you a positive story that came to a happy end. 

If you want any more information about breast feeding and why breastmilk is the best thing for your baby, check out this blog post on The Powers of Breastmilk that I put together earlier in 2017. If you have any other questions, feel free to message me and I would love to help you out or put you in touch with someone who can answer your question.

Being a NICU RD

Being a NICU Registered Dietitian is a very unique job. Lots of people don't fully understand what this job entails. Other RDs often have no idea what all goes into working in a NICU with preterm infants. As of 2013 there were 983 NICUs in the United States (reference). Out of those NICUs not all of them have Registered Dietitians. All Level IV NICUs are required to have a RD involved to help provide nutrition care for those infants. I wasn't able to find a number of Level IV NICUs in the United States, but there are not that many (maybe ~100). I spoken with multiple RDs across the country who are working in NICUs and not sure how to provide the best nutrition care to their units. Often, RDs are asked to step into this role with limited experience.  

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I just wanted to highlight what NICU RDs do and what they offer to the Multi-Disciplinary Team in the NICU. There is a misconception out there that just because babies in the NICU can't talk that somehow the care we provide as a RD is not as valuable or doesn't require communication skills?! Well that is just not the case. We work very closely with the neonatologists, the bedside nurses, the case managers, the social worker, the pharmacist, the therapists and the parents. Being able to communicate with everyone who is in involved in patient care is extremely important.

Job Tasks

  • Attend Multi-Disciplinary Rounds on a weekly basis to provide recommendations on nutrition changes for each patient. 
  • Sit up in the physician work room to serve as a resource for the MDs and the other NICU staff for nutrition recommendations. 
  • Weekly see all the NICU patients and assess growth and if nutrition plan is best meeting assessed nutrition needs. 
  • Keep track of complex GI patients to spreadsheets to monitor ostomy outputs and to micromanage those complicated patients. 
  • Put together discharge feedings plans for tube feeding and TPN home discharges. 
  • Fill out WIC scripts for families being discharged. 
  • Help to oversee and run the Formula Mixing room. Provide education staffing for those formula mixing technicians. We are working hard this year to start using a breastmilk scanning system called Timeless in our unit. Help with hiring staff and making sure they have the tools they need to do their job well. 
  • Sit on several committees and run a neonatal nutrition committee with various leaders of the multi-disciplinary team in the NICU.
  • Serve as a resource for other NICU RDs to help provide support and answer questions, because it can be a tough job and something you just need to run something past another RD. 

This is a great job because you get to work with such small patients who grow and change so quickly. I think that is one of my favorite parts of the NICU. When you make a change or adjust feedings you see changes right away.  It is a fast paced environment and things are always changing. There is nothing more satisfying than seeing a little 24 week infant who is < 1000g grow, reach full term age and then get to be discharged home. That is an amazing journey to get to be a part of! 

New Year, New You!

Setting goals for the New Year is always a tradition. You look at your life, decide what you want to work on in the new year and then come February you are find yourself back in your old habits. Nothing ends up changing and maybe you are wondering if you should even make resolutions this year. 

Well I have some tips for you as you plan for setting goals for 2018. I think you should set goals for yourself. What do you want to accomplish this year? Where do you want to be at the end of 2018? Hopefully this suggestions will set you up for success and help you reach those personal goals! 

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Writing Goals for 2018

  1. Write down your goals.
    • May sound so simple, but posting your goals and looking at them frequently will help keep you focused on what you want to accomplish.
    •  Some people make “vision boards” and what I love about these is that it shows pictures of your goals. Either write down your goals or create a vision board with what you want to accomplish and post this in a post where you will see it on a routine basis.
  2. Set SMART goals. 
    • Specific - Avoid anything too broad. Write your goal to clearly state your goal. “I want to increase the number of days a week that I exercise.”
    •  Measurable - After you decide on your specific goal, you need a time frame associated with that goal. “I want to go to the gym 3 days during the work week.”
    •  Attainable – Whatever goal you set for yourself, make it something realistic. If exercising 3 days during the week isn’t possible, adjust that goal and set it at 2 days a week. Start with something realistic that you know you can accomplish.
    •  Relevant – Make this goal for yourself that is something you really want to accomplish. If a goal about fitness isn’t really important for you, then set your New Year’s Resolutions around things that you feel passionate about.
    •  Time-based – Give yourself time limits for your goals. “I want to go to the gym 3 days during the week for the next month.” That way at the end of the month you can evaluate if you met your goal or not. If not, then change around your goal and try again.
  3. Hold yourself accountable.
    • In this say of social media, it is totally possible to post about your goals and that can serve as a way to help hold you accountable.
    • Have a support group that can follow up with you and help keep you on track. Going to the gym with a friend or planning on running a race with a friend can help keep you focused on your goals.
  4. List out your obstacles/challenges. 
    • Just like you write out your goals with what you want to accomplish, write out what challenges you might face.
    •  If you know what might keep you from accomplishing your goals that will help you in successfully meeting your goals.
  5. Plan a time to re-evaluate.
    • Lots of times people make goals in January and totally forget about them in February. Put a reminder in your phone/calendar to look back through your goals and see if you accomplished.
    • Take this time in February to revamp your goals to help set yourself up to be successful going into the rest of the year.
    •  Plan to check back in each month to see how you are doing and if you are meeting those goals you set for yourself.

2017 Year In Review

It has been a wonderful 2017. It has been a BIG year for RDAnna. Got use to life as a parent, came back to my full time job after maternity leave, my husband graduated with his Master's, he landed his first job out of graduate school, we moved and you all have gotten to be apart of it. I have been able to share lots of posts with you over the year and here are some of the fun 2017 recaps and highlights. 

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Blog Statistics 

  • Published 48 blog posts in the last year. 
  • The most people on the website were in February of 2017 when 238 people were checking out my website. 
  • 51% of people viewing RD Anna are doing so on their phones. 
  • 55% of people are getting RD Anna from social media links. 
  • There were more people (2000 page visits) in the last year visiting RD Anna compared to the previous year. 

Favorite Blog Posts

Media Segments 

  • Had to chance to work with FOX59 throughout the year last year to do several nutrition -related segments. 
  • Also got to do a New Year's story with RTV6 which was a great way to end 2017 and looking forward to 2018! 

Goals for 2018 

  • I am excited to be able to continue to bring you guys a weekly blog post each week. I love blogging about nutrition topics that I run into in my personal life. If there are topics that you want me to address or look up, let me know. 
  • I am hoping to continue to work with local news outlets to serve as that nutrition resource for St Vincent in mass media. 
  • I am excited to be working on writing a chapter in a Nutrition Communication book that will be published in 2019 with the Academy of Nutrition and Dietetics. Hopefully I can share about that experience here on the blog as well. 
  • I will be to writing test questions for a national board exam (CSPCC - Certified Specialist in Pediatrics in Critical Care) and I will definitely share that experience with you as well. 

Merry Christmas!

I just wanted to share our Christmas card with you for 2017. I wanted to wish you all a very Merry Christmas and thank you for taking time over the last year to read my blog. I have really enjoyed having a place to share nutrition advice and wellness information with you all. It is so great to have a platform to share from and I am glad that you all take the time to read what I write. It is amazing to see how this blog has changed over the years and I am eager to see what the future holds.

Hope you have had a wonderful holiday season and a very blessed New Year! Looking forward to a great 2018! 

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Healthier Holiday Baking

I am a sucker for a good Christmas cookie. I love baking around the Holiday Season and having an excuse to eat a delicious little Christmas cookie is just what I want to do while sipping hot tea on the sofa. Have you thought about what you are putting in those yummy little treats that you make each year. There is normally quite a bit of sugar and fat that is goes into making a yummy, Christmas cookie. There are some ways that you could make some healthy substitutes and work on making your holiday treats a little bit healthier. I found some of these recommendations from Eating Well Magazine.

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  1. Add Some Fiber
    • Lots of times people don't think about adding a little bit of additional fiber to increase the "bulk" of the cookie. This an easy way to work up on your fiber intake and this can benefit your heart health. You can replace some or all of your flour with whole wheat flour. This is a simple substitute that would make your breads or cookies even healthier. If you make that switch you add get 4 times the amount of fiber compared with the all-purpose flour.
    • If you don't like whole-wheat flour or are gluten free, you could try rolled oat flour as well. This would increase your fiber intake and also could be gluten free.
    • They other thing you could add could be flaxseed or chia seeds. Obviously, both of these options could change the texture of the cookies or bread, but if you add a little you could give a little boost to your fiber intake per cookie. 
  2. Cut Down on Added Sugar
    • Any type cookie or quick breast, typically calls for lots of added sugar. Cut down on the total amount of sugar you add into the recipe and try to replace with some extra flavor enhancers (almond, vanilla, orange or lemon extract).
    • Play with the recipe to try cut down the sugar a little bit at a time. You could also use "natural" sweeteners like agave, honey or molasses. That is still treated as sugar, but is a natural source that you could use. 
  3. Add a Vitamin Boost
    • Flaxseeds are a great source of omega-3 fatty acids and fiber. This is a great additional to a cookie that has texture, like oatmeal or a highly flavored cookies (gingersnaps or something with molasses). That will help to hide the texture and the flavor from the flaxseeds. You could also use flaxmeal for a smoother texture. These omega-3 fatty acids are great for heart health and can help with cholesterol levels. 
    • You could also work to decrease your use of processed trans fats by using canola or olive oil. These also have more heart healthy fats.

There are lots of way to tweak and change your favorite holiday recipes around to make them a little healthier. Obviously, if you want to keep your recipe the same and enjoy it this one time a year, that is fine too. I don't want to be a Scrooge about it, but I also want you to know that there are ways to make small changes that can have big impacts on your overall health. 

First Birthday Party

It is hard to believe that we are now celebrating William's first birthday. It has been awhile since I have posted about William. I did several pregnancy posts throughout my pregnancy and then some breastfeeding and baby lead weaning posts over the last year. I wanted to take a moment and put together a fun post highlighting William's First Birthday. William was born on 12/23 and yes it is SUPER close to Christmas. We wanted him to have a separate birthday celebration and so we officially celebrated his birthday on 12/16. 

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This party was mainly for use (William's parents), family and friends. William won't remember this party, but I know he will lose seeing the pictures when he is older. I wanted to do something fun and have this get together as a "thank you" for all the support from our amazing friends and family. 

 Photo was from William's 12 month photo shoot we did with Karre Ann Photography in Noblesville, IN.&nbsp;

Photo was from William's 12 month photo shoot we did with Karre Ann Photography in Noblesville, IN. 

So here are the party details. The theme - Dr Seuss! It kind of started with Cat in the Hat and expanded to include all Dr Seuss characters. We held the party at our house and there able to get some cupcakes made that we super cute. Shout out to Abby's Cakes for her amazing work. The menu included deviled eggs (green eggs/ham), cheese sticks (with the cat in the hat on them), relish tray, fruit salad, cheese ball. 

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For the decorations we put up a wall decal of the Cat in the Hat that my Mom had used at a baby shower she hosted previously. It was great to have that to use again. I also got Dr Seuss books that we used on the table as decoration. I painted the letters "ONE" for some other decorations. We got a little Cat in the Hat plush toy to serve as a decoration. I also made the Christmas tree Dr Seuss themed. I had the ornaments all red, white and blue and then made some fabric embroidery hoops with Dr Seuss fabric on the inside.  

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I put together a few goody bags for the 3 kids that were able to come to party. I used blue bags with a hat on the front of them and filled them with some goodies (Dr Seuss pencils, stickers, playdough and snacks). It was an easy and fun way to send the kids home with some treats. 

It was such a great day to get together with family and friends and we have been so appreciative of everyone's love and support. It is so special to get to have William in our lives and get to celebrate him on this special first birthday. 

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Managing The Holiday Stress

This was a very timely topic for me this week. I wasn't able to sleep the other night, because I was thinking through everything that I needed to do. Working full time outside the home and then coming home, there is SO much to do. Having the time to get things done is tough. With limited time that means that often stress levels can go up and even more so around the holiday season, because we like to try to "special" things like bake cookies, put up special decorations or spend more time with family. All of these "special" things are great, but can increase your stress level. 

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So what can you do to help manage your stress around the holiday season? Here are some helpful tips and tricks that you will hopefully find helpful. 

  • Make a "To Do" List
    • This is such an important and simple things to help clear your mind and decrease worrying about all that you have to do. Simply taking the time to put your thoughts onto a piece of paper helps you take those concerns and set them aside. You don't have to worry about forget anything, because you wrote that "To Do" List down and you can come back to it when you have time. When you are able to come back to that list and start accomplishing things, check off what you have gotten done so you can experience that sense of accomplishment. 
  • Prioritize Your Activities
    • This is easiest to do, after you put together your "To Do" List, take a look at what you need to accomplish and then rank them in order of what NEEDS to happen first. There are always something on that list that takes priority compared to other items. For example, I had to get leaves raked in my yard and the lawn mowed one last night by the weekend. That was a task I wasn't wanting to do, but NEEDED to do before the weekend. So I needed to take time and do that activity before I go out Christmas decorations. I would have much preferred decorating for Christmas, but in terms of priority levels, decorating fell below the leaf raking. 
  • Embrace the Mess
    • In the craziness of life, things gets messy. Sometimes your house is a disaster and some times that needs to be ok. If you have made out your "To Do" List and you have other things that NEED to happen first, then do those things and bump cleaning down on the list. Or if you have the ability to get help with cleaning through someone coming into your house or even have your spouse help you. Sometimes delegating this task is helpful. For example, I have embraced the fact that when William is up and wake the house will have toys everywhere. Then at the end of night, we walk around pick up toys and that is when things get cleaned up. So embrace the craziness and then try not to stress too much about it. 
  • People First
    • This is a life motto that will always make you happy. Put people in your life first. Relationships with people you work with, people in your family, and your friends are important and that will bring you more happiness then anything else. When you make time for people, that is always the right choice. Taking the time to go out of your way to see that friend (you only see a hand full of times a year), that friend who lost their mother, your aging grandparent or a friend who might be lonely .... that always is the most important thing. 

With the craziness of the holidays, remember that you are not perfect and things won't go perfectly and that is OK! The main things are taking time for those people you love and everything else will get done and it will be a fantastic end to the year! Now excuse me while I go tackle my "To Do" List - first up, Christmas decorations.