Tradition (see fiddler on the roof)

Thanksgiving reflections by Johanna:

In alot of ways, my family's Thanksgiving is like the majority of American family's. We eat waaay to much turkey and dressing, we watch football, we chit chat about life's happenings since last Thanksgiving, and we all catch a good long nap. But then again, I dare say we are NOTHING like most American families. As we "watch" football, we realize this is the first NFL game any of us have seen since last Thanksgiving! When we gather around the table, instead of praying, we sing the doxology..and everyone weeps. And as we chit chat, the conversation always comes back to thanksgiving, not so much for the turkey, but for the life we have been given. This has not been an easy year for our family, yet it has been one of blessing and divine provision.

This Thanksgiving my dad had a vision and was determined to bring it to fruition. So, after dinner the whole family gathered around the piano and sang hymns(It would seem my dad has a hymnal for every year of pastoring). The tender moment made me thankful for the tradition of faith and service to the Lord's work that has always been so central in my family.

My "cousin-sister" Emily, also had a vision. Two years ago Jovan Rebolledo joined our family when he married my cousin Keely. It was rumored Jovan has some mad salsa skills, and Emily was determined not to let an educational opportunity pass us by. So, after we closed the hymnals, Jovan was kind enough (and patient enough) to give the WHOLE family salsa lessons. My sweet dad and uncle learning to salsa was without a doubt the most entertaining thing that has happened this year.

I realized in that moment that this year has changed us. Hardship and loss have a way of making you reprioritize and take life more seriously, we don't miss an opportunity to reflect on life's blessings and give thanks to our Heavely Father. Hardship also has a way of making the light-hearted moments once taken for granted so, so sweet.

(Pictures to come!)

Weekly Update

Some fun facts about our week ...

- Jo went through the weight management rotation that Julie did last week... she got jipped and id not get a bag full of bars. On the plus side, she got to counsel some awesome patients going through bariatric surgery and loved it.

- Julie had her week of "staff relief prep". She is on the trauma unit. Her preceptor was gone Thursday and Friday so she had a quick 2 day prep. The little bird is flying solo! The attending/resident are awesome, not intimidating, and are pleasant to be around. Brian the Pharm D is a 6 foot 7 in, saving grace. He is such a nice guy and a great teacher. This tall man is going to be paged more than he even knows it next week!

- Jo had her last week of Healthy Charleston Challenge

- Julie taught first graders with Shelly (another intern) a lesson about a healthy Thanksgiving. Our theme was keeping a colorful plate during the holidays. Turkey Tom was on a poster without his feather, the only way to get his colorful feathers was to eat a colorful plate! The kids got to put feathers on Tom and talk about colorful foods to give them the vitamins and minerals they need to grow big and strong.

- Our enormous bug named Sherman that lived outside our door for about a week has left us : ( We were really starting to enjoy him

- Jo headed home to Kentucky today for her week off.

- Julie is to begin a crazy, busy, stressful, under staffed week in the hospital. YAY!

14 weeks of our internship down! Time is flying...

Perfect Stocking Stuffer

I found a creative, healthy Christmas present for those who adore all things granola! Personalized granola canisters delivered right to your door. I haven't ordered any yet but hoping Santa will bring me one....

http://www.mixmygranola.com/

loving the greek... hehe

So I may be totally late to jump on the Greek Yogurt bandwagon, but I had to enlighten you with my new favorite snack. Dietitians have been tweeting, blogging, and praising this little cup for a few months now. Last week I gave into the $1.40 per cup splurge. It has been love ever since!

PROS: low calorie (100-120 cal/cup), high protein (15 g). This is A LOT of protein per serving. Protein takes longer to digest and keeps you feeling full and satisfied longer.

CONS: $1.20-1.60 per cup. A bit pricey but worth it! I've heard Costco sells it in tubs for a great price.

WHAT TO DO WITH IT?
Mix with berries, honey, almonds, jelly, granola, fruit, cereal.
Substitute for sour cream- the plain has a similar consistency and taste.
Let us know if you come up with some fun recipes!

Lolly

This is a special post for someone I love most. Throughout the past few years of transitioning into different phases of my life, growing up, gaining friends and losing friends, making mistakes, learning who i am, and realizing who I want to be, I've had a friend to stand by me. It's not often you are blessed enough to have someone in your life who is a constant. I've never had a sister but I got pretty close. I am blessed for good fortune and my good friend. I spend my days in the hospital watching people grieve over the ones they love. It is a reminder for us to be thankful of the best gift we have in our life- our friends, family, and health.

Jo and I loved the flowers. Thank you : )

Tastes like fall

After a brisk walk through the crisp fall air, a hot plate of pumpkin spice pancakes hit the spot! Yes, my experiment was a success! I'm posting the recipe since I know you'll all just be itching to give it a try!

Whole Wheat Pumpkin Pancakes

1 C whole wheat flour
1/2 C white flour
1 t baking soda
2 t baking powder
1/4 t salt
1 t ground cinnamon
1/2 t ground ginger
1/2 t ground nutmeg
1 C buttermilk (I only had soy, so I just added a little lemon juice)
1 C canned pumkin
2 eggs
2 T oil (I halfed this with no problem)
1 t vanilla
2 T dark brown sugar

Mix first 8 ingredients (flour through nutmeg). In separate bowl whisk together remaining ingredients. Pour wet ingredients into dry and mix JUST UNTIL COMBINED. Over-mixing will bring truth to the phrase "flat as a pancake!" I let my batter sit for 5-10 minutes before dropping by spoonful into a skillet preheated to medium. I find this lets the batter rise and makes a fluffier pancake. A few pecans and a drizzle of syrup, and you're ready to eat!

flap jack

Julie has been on a blogging rampage! So, this is my attempt to catch up! I have a little down time today during my weight management rotation and am spending it in the intern office looking up recipes. Ironic?

It all began last night when I decided that I was going to have breakfast for dinner tonight. I am a pancakes once a week kind of girl, but have fallen behind lately with all my travel. Thus, tonight I am taking the opportunity to sit down and enjoy a piping hot stack of pancakes.

Now, I will admit with limited space and funds for groceries, along with a somewhat chaotic schedule, the made-from-scratch buttermilk pancakes of my childhood fell to the wayside back in college. Besides, to put so much love and attention into a batch that my dad wasn't around to cook in the shape of micky mouse ears just seemed like a waste. It was at that point that Aunt Jamimimah entered my life. Bless her and her just add water pancake mix!

But tonight, tonight is different. I have decided to combine two of my favorite culinary treats: pancakes and pumkin. I have been eating pumpkin in all forms this month. Coffee, icecream, cheesecake, toasted seeds, muffins, cupcakes, so why not pancakes?!? I found a great recipe for whole wheat pumkin pancakes that I will be trying tonight. I'll keep you posted!

new found treat...

Now, being the Italian daughter that I am (Julie), I am very familiar with ricotta cheese because I was basically raised on lasagna. I had no idea the many other things you can do with it. Also being the Italian that I am, I had no idea it came in low fat form! Ricotta cheese made with skim milk has 45 cal, 0 g fat, and 6 g protein (per 1/4 c serving). 1/4c just isn't enough for me so I doubled it! I have added jam and berries to make a sweet treat.

Here's what I had for dessert tonight:
1/2 c ricotta cheese
splash of imitation vanilla (if you were Jo, you'd use almond extract... she loves that stuff!)
dash of cinnamon
a few choc chips

Be creative!

The next Serena and Venus...

Jo and I had a lovely Monday with lots of roommate bonding. I was eager for her to return from her fun filled, beach weekend visiting Anna Banana in Florida. Jo made it back safely last night... and unfortunately brought a large, rodent sized insect with her. What a wonderful welcome home! As I hid in the hallway, Jo aggressively sucked that bug up into our vacuum. And that was that. We tucked the vacuum away and continue to hope that will never happen again...

After a leisurely day of class, we emerged from the classroom at about 2 o'clock to find sunny 78 degree weather. What a perfect day for tennis! Yes, we finally broke out our rackets and had some fun on the courts. Unfortunately we have no pictures for your comic relief. But we did make sure to place our rackets at the front door as a reminder to take advantage of our amazing apartment complex, nice weather, and young bones!







Jo made a lovely dinner tonight - seasoned veggies and potatoes with grilled pork. I thought you'd like to see her portioned out leftovers. yummm

Please Reference "Mean Girls"

Last week, I (Julie) had my weight management/bariatric rotation. Half the week was spent following dietitians who work in MUSC's beautiful and Gold Standard bariatric clinic. I listened to classes given to patients contemplating which surgery they prefer: Gastric Banding (placing a removalable/adjustable band around the top of the stomach to limit the amount and speed of ingested food) or Gastric Bypass (more intense, surgical procedure to remove and re-reroute the stomach). I hate to say it, but before this rotation I felt these surgeries were an "easy" way out. Although I will always be an advocate for a well rounded, healthy lifestyle, most of the bariatric patients have an addiction to food and are at risk of death. They've failed diet after diet. This is their last resort. These surgeries are not a quick fix, as I assumed before. Patients are only expected to lose 40-70% of excess weight (actual weight - calculated ideal weight). I enjoyed this rotation because dietitians are a crucial health personnel in their surgery and success. Patients must make extreme lifestyle changes that continue long after surgery. For the many successful patients, I saw a fair amount of people who regained the weight. I love how Nina and Debbie (bariatric RD's) conduct support classes, education classes, newsletters, and form relationships with their patients.

The other part of the week was spent with Tonya, an RD who is the weight loss expert. MUSC has weight loss programs: working with RD's to make food plans, consulting exercise physiologists, lab testing, weekly weigh-ins. One of the more intense programs, FOCUS, asks patients to eat 3 protein rich bars, 2 shakes, 6 oz meat, and 2 servings of veggies, each day for a month. Tonya gave me a HUGE bag of sample bars and shakes. I thought to myself: "Yess! I am a poor intern and this can be my food for the next week. Easy as that." Well let's just say... i was miserable! I felt bad for the dietitians I ate with all week. I was constantly hungry, complaining, and craving my standard lunch: salad, granola bar, yogurt, and a piece of white chocolate. I felt unhealthy and like I was in Mean Girls (if you've seen this movie - you'll laugh). I ended up cheating all week and loved going to the grocery this weekend.

I realized how overwhelming it must be for people to lose weight. It would be like someone giving me $3,000 and telling me to invest my money. I would be clueless! This must be how people feel when attempting weight loss. The bars and shakes ae good way to start them off understanding how hunger feels and smaller portions. It is not a realistic way of living but makes a smoother transition into independently choosing their foods.

As future RD's, it's crucial to understand where our patients are coming from and erase prior judgements. Everyone has their own battle. It's not our job to judge, but it is our job to help.


Jo has this rotation this week - let's see if she does it! I'm going to bet she feels the same way

Hope you all like the new web design!





See ya later bars!

My long lost friend

STOP. Put the salt shaker down. Do those veggies really need that?!

Yes, you are reading this right. I, Julie Alessi, have put the salt shaker down. For those of you who have not spent enough time with me, you may not realize the severity of my salt addiction. I’ll eat it on anything, everything, and by itself. I go to work everyday educating people on the effects of a high sodium diet: high blood pressure, heart health, edema (fluid retention), and ulcers. It would be unfair for me to not practice what I preach. It’s been a gradual process, but I am proud to say this was my first almost salt-free week.

The combination of less salt and more water = a less bloated Julie. It’s amazing the difference I feel, even in my fingers. The only shaking that should be done in the kitchen should be coming from your booty!

- - Use other herbs/spices to season your otherwise bland food.

- - Mrs. DASH makes new tasty marinades and seasonings. They are a great substitute for otherwise salty dressings. I realized last week that my Teriyaki Marinade had 480 mg per 2 tablespoons... yikes! Not good - especially with salt added on top.

- - Watch your labels. As a rule of thumb look for <5%>

- FACT: The recommended sodium intake is less than 4 g or 4,000 mg (less than 2 tsp) per day. If on a low sodium diet for heart health: 2 g or 2,000 mg per day. You’d be appalled to see how much sodium is in processed foods. Even if you aren’t adding it on top, it may be hidden in your foods. Do your research and become educated in the effects of the things you put into your body. If I can do it, so can you.

Everything in Moderation

My long awaited visitor arrived this weekend - LOLLY made her first trip to Charleston. We enjoyed the weekend with our high school girlfriend, Lindsay. We found a great new treasure on Market Street called Amen Street Grill (historic fact - apparently this was once a road downtown). We indulged in shrimp corndogs and a champagne calamari ceviche salad. These appetizers were so good we ordered seconds! The rest of the weekend was spent strolling downtown, eating Fresh Berry, catching up on stories, organizing Lindsay's closet (if you knew Lindsay, you would realize how difficult a task), and most importantly - watching the Bengals win : )

While Lolly and I spent the weekend in Charleston, I missed being with my Jo who did not return home from work until almost 6:00 on Friday. Although we missed her at dinner on Friday night, I understood the exhaustion of a long day. Jo and the interns had a lovely weekend in Myrtle Beach for a quick night away. They hunted down picnic space for a packed lunch of BBQ, hummus, and cupcakes (they are so cute!). While Dana and Krista attended a concert, the rest of the girls relaxed at a Cracker Barrel with a great, cozy atmosphere. They then started off their Sunday with a Gospel Breakfast. Apparently there were biscuits, pancakes, omelettes, hand clapping, and even some "Alleluias". Perfect for a group of hungry dietitians! Everything in moderation.

The girls taking a break from driving to picnic

Me, Lolly, and the shrimp corn dog.

Extra to Your Ordinary

After a long Sunday of shopping, measuring, spilling, baking, and licking the bowl... The interns completed our first Bake Sale yesterday. We had 2 locations: MUSC main hospital and Ashley River Towers Hospital. Our creative bulletin boards, ribbon-wrapped baked goods, and beautiful smiles made for some awesome sales! Our donations jar allowed us to make a $300 profit. Not too bad for our first time! Our zucchini brownies were the best seller... even with some accidental "problems" in the j&j kitchen.

Here's the recipes for our faithful readers...

2 Ingredient Pumpkin Spice Muffins

Prep time: 10 minutes
Total time: 29 minutes
Serving: 18 muffins

1 Box Duncan Hines Spice Cake Mix
1 12oz can pumpkin puree

Preheat oven to 350 degrees. Spray muffin pan with non stick spray or use cupcake paper.
Place ingredients in a bowl and stir or beat until mixed well (takes some arm strength to mixed completely).
Divide mix evenly into 18 muffins. Bake 17-22 minutes.

White Chocolate Chip Cookie

1 cup all purpose flour

¼ cup wheat germ

½ teaspoon baking soda

½ teaspoon salt

¼ teaspoon ground ginger

1 large egg

¾ cup packed dark brown sugar

1/3 cup canola oil

1 teaspoon vanilla extract

½ cup oats, quick cooking or old-fashioned (not instant)

2 ounces white chocolate, chopped

1/3 cup dried fruit- antioxidant mix of blueberries, cranberries, plums.

1. Position racks in upper and lower thirds of oven; preheat to 375°F.

2. Whisk flour, wheat germ, baking soda, salt and ground ginger in a small bowl. Whisk egg, brown sugar, oil and vanilla in a large bowl. Add the dry ingredients to the wet ingredients; stir to combine. Add oats, chocolate, blueberries and crystallized ginger; stir just to combine. Drop by rounded tablespoonfuls onto 2 ungreased baking sheets, 1 1/2 inches apart.

3. Bake the cookies until puffed and barely golden around the edges, about 16-20 minutes. (?)

Beet Cake

2 Jars baby food beets or 1 whole beet cooked and pureed

2 squares semi-sweet baking chocolate melted

1/2 C oil

1/2 C apple sauce

1 1/2 C sugar

1/4 tsp vanilla

3 eggs

2 C flour

1 1/2 tsp soda

Preheat oven to 350 degrees. Mix all ingredients together and pour in greased 9x13 bundt pan. Bake for 25-30 minutes. Cool and frost with your favorite frosting.

Recipe makes about 12 servings.

Zucchini Brownies

1 cup flour

3/4 cup whole wheat flour

1/3 cup baking cocoa

1/2 tsp baking soda

1/2 tsp salt

Combine in large bowl

Stir in

2-3 cups shredded zucchini

Combine in separate bowl and beat with fork.

1 egg

3/4 cup sugar

3/4 brown sugar

1/2 cup plain yogurt

1/2 cup oil

1 tsp vanilla

Stir in zucchini mixture. Spread evenly in greased 9 x 13 pan.

1/2 to 1 cup semisweet chips

Sprinkle on top of batter and bake in preheated 350 oven for 35-40 minutes.

microwave eggs

Julie finished her last inpatient rotation this week, while I concluded my first week of outpatient rotations. I worked with two incredible dietitians who sincerely love their jobs and passionately serve their clients. Each worked with cardiac patients. One focused on adults while the other ran a heart health program for kids. They both had an incredible ability to relate to each patient individually, educating, motivating, and facilitating change. It was such a breath of fresh air.

In talking to Amy, one of the dietitians, today, I had an epiphany of sorts. She told me a story of a doctor who had been commenting to her husband (a surgeon) about just how smart Amy was. The doctor went on to state that Amy should have gone to med school. Her husband pointed out that, in fact, it was good that she had not gone to med school because it is important to have smart dietitians as well. Dietitics is not the path for those who cannot quite cut it in med school. It is a respectable profession that should be regarded as integral to the medical team. Don't get me wrong, I was not previously under the impression that dietitians were dumb. I was, however, frustrated with the limited patient interaction I was having and with the seeming lack of regard given to our work. Our conversation revealed that my standing among the medical team is in some ways my choice. It is my responsibility to build repor with other medical personell, it is my job to challenge myself and continue to learn not only the latest nutrition recommendations, but general information that will help me treat my patients in light of the full clinical picture. It is my obligation to lay eyes on my patients and to include them and their family in discussions regarding their care. If I want to have influence and voice in patient care, I must take initiative to establish myself as a competent and indispensible no matter what job I take.

Not only did I have this epiphany today, but I fell in love. The most precious couple came to the clinic this afternoon. The wife had a laundry list of conditions, surgeries, and "events," and her husband was so clearly devoted to her care. It really did remind me why it is I don't want to spend my life with just anyone. This man took notes at every doctors appointment, combed the grocery isles for the best products to make his wife well, and gently reminded her that she infact was not having turkey sandwiches for lunch, but rather had been taking peanutbutter and bacon on rye. He also mentioned she sometimes has egg salad. Consequently, I was inspired not only to hold out for a faithful, compasionate man, but also to microwave eggbeaters for dinner with a little mustard and mayo. It tasted like my Dad's egg salad. Mostly.

In class a few weeks ago we learned the basics of performing a general physical assessment (breath sounds, bowl sounds, heart sounds). The gastroenterologist who manages the dietitians at MUSC wants all dietitians perfoming these skills on every patient.

Affordable and quite tasty...

Jo stumbled upon this treasure while shopping at Publix. She added a little of this and a little of that... try it and see what you think!

1 onion coarsely chopped

3 tablespoons chili powder

1/2 tsp seasoned salt

1/2 tsp pepper

some garlic

1 can condensed tomato soup (low sodium/fat)

2 can diced tomatoes (undrained)

1 (16 oz) chili beans (undrained)

1 (15 oz) can black beans (drained)

1 can of corn

2 stalks celery

1. Saute onion, celery, garlic.

2. Stir in remaining ingredients. Bring to a boil, stirring often.

3. Reduce heat to low: cook 10 more minutes, stirring occasionally.

Add meat if you want a more hearty chili! It makes a big pot and lasts for lunches all week.

boo-yah

Halloween has come and gone, another testiment to just how fast time flys! This year Julie dressed as Beyonce while I dressed as a deer, antlers and all. I feel this gives great insight into our relationship