Friday, September 14, 2012

Chocolate Coconut Protein Pancakes

So I wanted to make a protein pancake with the new unsweetened coconut flakes I bought at Whole Foods a few weeks ago. I came across a recipe for Carob Chip Coconut Protein Pancakes from Kammie. I didn't have the applesauce or the carob chips that the recipe called for, so I excluded them and they still came out delish. However, the sauce part didn't come out so yummy. Maybe it was the instant coffee I used? I'm not sure but I decided it was OK to leave that out too.

I was inspired to try again this morning. I modified the recipe slightly and added a little Truvia for sweetness (and to bring out the coconut flavor more). I also decided to try to top it with some version of a banana protein syrup/frosting by mashing 2 T banana with 1/2 T vanilla protein powder and a little unsweetened vanilla coconut almond milk. My second attempt was a success although its not as pretty in the picture :/

1st Attempt:



2nd Attempt:



Chocolate Coconut Protein Pancakes

Ingredients:

2 tablespoons coconut flour
1/2 scoop chocolate whey protein powder
1 tablespoon reduced-fat shredded coconut
1/4 tsp baking powder
4 tablespoon liquid egg whites
2 tablespoons unsweetened vanilla almond/coconut milk
Truvia to taste

Directions:

1. Heat a non-stick pan over medium/low heat. 
2. Combine the dry ingredients in a bowl. Add egg whites and combine. Add milk and combine. 
3. Pour mixture into pan (about 1/4 cup each pancake). Cook until the top begins to form bubbles and the edges are set. Flip.
4. Serve!

And the DI update: I've been working with the Clinical Nutrition Manager. She is also the facility's Assistant Food Service Manager. Her floor mainly consists of long-term patients with behavioral problems. She showed me her way of doing assessments. It's more detailed (which I like). I'm feeling pretty confident writing assessments at this point, and apparently there's not much else to learn about assessments at this facility. According to my preceptor: "Great work. You can basically work here now". . . Well, that was quick.

Sunday, September 9, 2012

Dietetic Internship: Long Term Care Week 1

So this is basically what I've done as my first week as a dietetic intern in my long term care facility:

Wednesday 9/5

Today I met with the dietitian I would be working with for the rest of the week. She had just come back from a two week vacation so she warned me that today would not be a typical day for her. First, we did rounds on all of her floors, checked in with the charge nurse, and reviewed 24 hour reports. She showed me how to modify menus on the Geri-Menu database. She printed up several patients records and allowed me to do initial assessments and walked me through how to come up with a care plan. L is very thorough and helpful and provided me with great feedback on my work. The MDS is similar to writing SOAP notes- it is documentation that is required for long-term care facilities and must be submitted within 48 hours of patient admission.

Thursday 9/6/12

First, the dietitian showed me how to look for new admissions. We printed up their records prior to making our rounds that morning. We also looked for any discharges that were made. The MDS requires dietitians to do quarterly and annual reviews. We looked up any patients that were due for assessments. At 9:30 I attended a team meeting that included the doctor, social worker, charge nurse, physical therapist, and speech therapist that were in charge of the particular floor we were on. Next, we visited a new admission. We let her know about our Kosher policies, asked about her food allergies/preferences, and asked her UBW. We entered any modifications into the Geri-Menu database. Throughout the day I did more assessments and care plans.

Friday 9/7/12

In the morning I worked on an initial assessment, and annual assessment, and updated care plans. I sat with a woman who was not happy with the food choices and was unaware that she could choose alternate menu items. I helped her plan for the following week. At lunch, I did rounds with the dietitian and visited the residents in the dining room. We had a few requests from residents about their items and took notes so that we could enter them in the Geri-Menu system. For the rest of the day I worked on assessments and care plans.

Overall, I really enjoyed my week more than I anticipated I would. The dietitian gave me a lot of responsibilities right away. I am truly SHOCKED by the amount of medications that most of the resident's are on . . . one can only wonder why most of them suffer from anxiety, depression and delirium- they are on a ridiculous amount of meds!! I was loopy and moody from taking low doses of Naproxen when I tore my tendon awhile back.

Working with the elderly is a nice wake-up call: Seeing the resident's gives me even more motivation to take care of myself and appreciate my fully functioning body and brain!!



Wednesday, September 5, 2012

TVP Oatmeal and Protein Paninis

Started my morning again with a 5:30 workout. I love waking up when its still dark and everyone is sleeping. The house is quiet and calm so my workouts seem more peaceful. I started pondering what I wanted for breakfast in between sets of push-ups and thought- I kind of want a warm stick-to-your-guts type of breakfast. I suddenly got motivated to revisit my lonely stash of TVP that I've been trying to figure out how to use. My first TVP oatmeal test failed a few months ago- mostly because I was impatient and tried to quick-cook it in the microwave and skimped out on the added water. Gross. Anyway, I decided to let 1/4 cup of TVP granules soak in hot water while I showered. After about 20 minutes of soaking, I placed the TVP in a pot and added a little more water and Unsweetened Vanilla Coconut/Almond Milk (super tasty and only 45 calories per cup!). I brought it to a boil and added 3 T PB2 (OBSESSED), Truvia, cinnamon, nutmeg, and a few slices of banana. It was warm peanut buttery deliciousness! Next time I think I will use 3 T of TVP and 1 T dry oats, 1/2 a scoop of vanilla protein powder, and 2 T PB2- the variations and possibilities are endless!



Is it sad that one of the reasons I'm most excited to be a dietetic intern is the fact that I get to pack lunches again? I promised myself I'd take a picture of my pretty lunch when I took it out, but I wound up feeling awkward because I didn't think I'd be sitting near so many other people. However, I discreetly pretended I was checking e-mails and shut off my flash to sneak a picture of my yummy protein panini with Veggie Ham slices and a Light Laughing Cow wedge. I say protein panini because the main ingredients are egg whites, pea protein powder, psylium husk powder, and coconut flour. With that, I had my zucchini noodles tossed with a creamy avocado sauce, tomato, and fresh basil. What did my preceptor have for lunch? A giant kaiser roll with butter... I guess not all dietitians are foodies??


Protein Panini Bread

Ingredients:

2 teaspoons coconut flour
1/2 teaspoon psylium husk powder
1 teaspoon pea protein
3 tablespoons plus 1 teaspoon egg whites

Directions:

1. Whisk all ingredients together in a small bowel.
2. Coat a small non-stick pan with cooking spray and heat over medium-high heat. Pour mixture into pan  Cook about 30 seconds and flip. Cook another 30 seconds on the other side until done.
3. Fill with whatever you like!
4. Heat a panini grill/George Foreman grill, or just heat a small pan. Fold your "panini" in half and grill until browned.

I actually worked today at my internship. I shadowed my preceptor as she did rounds on her floors, learned how to use "Gerimenu" to create and modify the resident's menus, worked on nutrition assessments and care plans, and got a taste of how to write an MDS (required for all long-term care facilities). I also learned I will not be using SOAP notes- the information that was DRILLED into my head in school as one of the most important parts of the nutrition assessment. Oh well.

Tuesday, September 4, 2012

Dietetic Internship Day 1: Long Term Care

Today was the first day of my Dietetic Internship- which means in nine months my name will read: Adena Neglia, MS, RD. My first rotation is Long Term Care. I'm excited to start assessing patients and becoming more familiar with lab values, tube feeding regimes, and planning diets. However, I am DREADING the day that I have to see a pressure sore (very prevalent in the geriatric population). My internship director mentioned that a few interns have passed out in the past after seeing them. That will definitely be me. Ugh.

Anyway, I started my morning with a 5:30 a.m. work-out (I don't remember the last time my alarm clock went off that early). I came home all motivated and made myself some Vanilla Flax Protein Pancakes to get me started for my big day:


The dietitian I am supposed to be working under isn't coming back from vacation until tomorrow so the other dietitian gave me a MONSTER handbook to read followed by another MONSTER book about medical nutrition therapy for long term care (which I've been reading about for the past week to re-eduate myself). When she asked me if I wanted to audit some dietary medical records I nearly jumped for joy. I must've done them fast because she acted quite impressed...not sure why because it was super easy. I really hope tomorrow is more exciting!