This is not Grey's Anatomy. Let's talk about GERD while we're at it too!

Survived day two without dropping any trays, getting lost, or tripping over anything; winning.  Today I brought a notebook with me during menu selection rounds.  I got this tip from one of my favorite teachers who always had one with her when she did clinical hours during her internship.  I wrote down some things quite frantically and probably won't be able to distinguish it, but writing tends to help reinforce new things for me.  Although I didn't encounter any therapeutic dogs, I did get to see the babies again.  I even discovered a Starbucks in the hospital!  I had just assumed I was lost and had accidentally left the hospital, but to my surprise they have one on premises.  Babies and coffee, what more could I ask for?!    

I have to admit, sometimes I think I wound up in the world of Scrubs or Grey's Anatomy.  I'll see a janitor pass by and think he's going to sabotage me for his own amusement like the one on Scrubs.  Or I'll be eating in the cafeteria and expect to see McDreamy or McSteamy gazing at me.  That hasn't happened.  Yet.  No, working in a hospital is not as glamorous as they make it on TV.  Shenanigans do not occur in supply closets and actors/models do not double as surgeons.  Medical staff aren't there to entertain, they are there to help, serve, and treat patients.  Speaking of patients, I was deeply touched by one today.  We had seen this patient the day before and she knew I was on my first day of training.  Today she told me she was so happy to see me and asked how my first day had gone.  I replied that I was loving it.  The patient was incredibly happy for me and said they had prayed for me the day before that I would have a great first day.  I was blown away.  Here was this patient, sick and bedridden in a hospital bed, thinking of ME, someone healthy and walking around.  I know there will be more difficult patients in my future, but the fact that it is day two and I am already finding this job so personally rewarding puts the hugest smiled on my face.  

What I learned today:
1.  Hospitals typically do not carry pina colada flavored yogurt.
2.  There is a difference between a red and silver fire extinguisher.
3.  Thank God I remember my Spanish food vocabulary from high school.  Now if only I could casually pick up Vietnamese.
4.  When you ask one of the nurses in ICU how they are, said nurse responds, "The best I've ever had."  I just love nurses. 

Clinical Refreshers:
GERD (Gastroesophageal Reflux Disease): reflux of gastric contents into the esophagus 

• caused by things such as obesity, smoking, meds, and certain foods
• symptoms include dysphagia (difficulty swallowing), heartburn, increased salivation, belching, aspiration
• can be treated with medication such as antacids containing the 3 basic salts Mg, Ca, Al (Tums), foaming agents that coat the stomach to reduce symptoms (Gaviscon), H2 Antagonists to block histamine receptors which allow acids to be secreted (Pepsid AC), Proton Pump Inhibitors block enzymes that support HCl (acid) production (Prevacid), and prokinetics which speed up the stomach's ability to empty/decrease anything coming back up like nausea (Reglan*)
• Patients can also undergo surgery such as nissen fundoplication where the fundus is sutured to strengthen the lower esophageal sphincter (sphincter won't open as easily and allow acid to reflux)
• Nutrition therapy aims to do two things: avoid foods that relax the esophogeal sphincter (chocolate, peppermint/spearmint, fried foods, high fat foods, alcohol, decaf and regular coffee) or avoid foods that increase gastric acid secretion (dairy, alcohol, pepper, decaf and regular coffee).
• May also avoid these foods if they worsen symptoms: carbonated beverages, eggs, pastries, fried meats or fatty meats.  May also want to avoid large meals, laying down after meals, wearing tight clothing

On a completely unrelated note, these are the sturdy,
black, unattractive clogs I wear.  They're actually more
for nurses, but are suited for the kitchen while also
being comfortable for being on my feet all day.  I got
them at a medical supply store that sells scrubs.  They're in
my car because I don't want to bring any hospital
germs into my house.

*One time when I was in my medical drama phase, I wound up in the ER after I couldn't stop vomiting, which was causing me to immediately lose consciousness.  It had to do with a fluke recombination of low blood pressure and a flu bug.  According to my mom after I threw up, my pupils would roll into the back of my head, my eyes would stay open, and I would pass out.  Cute, right? Anyways, in the ER I was given Reglan to stop said vomiting and attractive eye ball rolling.  The nurse told my mom and I there was a 1% chance of an anxiety side effect, but it was extremely rare and we didn't have to worry about it.  Guess what, I am the 1%. (Jealous Eli Balaban?)  About 30 seconds after the Reglan was added to my IV, I got an intense and panicked feeling that I could not be in this ER and needed to go home.  I was focused on one thing, and that was getting out of bed and running home.  As I was about to rip my IV out, I was immediately sedated.  Good night.  I have a nutrition classmate who also had side affects with Reglan, however I'm pretty sure she was taking it at the time for GERD.