trust me, I’m a dietitan!

OH HEYYYYYYY TODAY I PASSED MY RD EXAM! Registered Dietitian right here, hollaaaa! I haven’t wrapped my mind around it yet. So in the meantime, here is a long overdue post about my last internship, in which I interned in the Neonatal Intensive Care Unit (NICU) in a hospital in Winston-Salem, NC.

We’ll start with¬†a lovely photo from the corporate lactation meeting I attended, as one does.


To be clear, corporate lactation= meeting of lactation consultant managers from the various hospitals belonging to one corporation. Not some weird business milk-a-thon.

The meeting was really more of a retreat, at one of the lactation consultant’s lovely lake houses. So interesting to see all the complicated aspects of providing this care- both the science of helping mothers, and the management/business side of things of dealing with billing, charging for nursing supplies, etc.

Because the meeting took place in the South, there were of course complimentary meals. Say what you will about the South (and I have plenty to say, especially about the total nonsense that has been going on in NC), I really love the Southern tradition of hospitality. AKA feeding everyone who comes anywhere near your home/office, anytime resembling a meal time. It reminds me of my family’s Greek tradition ūüėÄ

This was chicken chili that was SO SO GOOD. Especially eaten by the lake.


Okay so let’s talk life in the NICU. Here is a bed and an Elmo diaper awaiting a baby!


Working with a NICU dietitian was SO interesting. To review my preceptor:

  1. Does nutrition assessments on the NICU babies and made recommendations to the medical team about feedings. For example, adding extra protein for a baby whose growth was poor, or adding MCT oil¬†for a baby who seemed to be having trouble absorbing nutrients. Sometimes we had to fight with the doctors because they would “forget” about our policy not to ever use powdered formula in premature babies (here’s why) and do other silly things because doctors are sometimes silly.
  2. Conducts hospital based research in the NICU, mostly related to breast feeding.
  3. Serves as a lactation consultant for moms with a baby in the NICU (helping with breastfeeding and pumping).

I was¬†especially lucky because my preceptor was honestly so busy she just let me work independently out of necessity, so I would get to go on rounds with the NICU medical team (attending physician;¬†nurse practitioner and/or resident and/or medical student, who’d present each case; nurses; sometimes pharmacist; sometimes social worker).

Things you worry about in premies (obviously the neonatologists are thinking of a lot more things; managing ventilators and temperatures and crazy things like that. I’m concerned with the nutrition side of things, which is obviously also very important in premies):

  • Intake of the right nutrients. Breast is best, and that’s also true (though harder to document) in premature babies. However, premature infants aren’t really supposed to be out of the womb drinking milk- they’re supposed to be in a uterus, drinking amniotic fluid, not having to breathe, etc. So while human milk is the bomb, in the NICU, premature infants have to have their milk mixed with human milk fortifier, aka HMF, which adds extra nutrients, among them protein and bone-building elements like calcium. As someone crunchy it pains me to see HMF, a cow’s milk product going into a premature baby whose mother has abundant breast milk. Which is why it’s so exciting to see that there has now been a HMF developed that’s made using entirely breast milk!
  • Immature guts. You want to give them breast milk so they get the immune benefits (and because women’s bodies are amazing and worthy of awe, breast milk produced by mothers of premature infants is higher in protein and calories than the milk of mamas of term babies). However, feeding them too much too early can overwhelm the cells of the developing intestines, which can only absorb so much. Your worst case scenario is necrotizing enterocolitis, in which the cells of the intestines literally start to die. This can result in a baby needing surgery (and potentially getting a lot of their gut removed, resulting in short bowel syndrome or other issues with absorbing nutrients). This can also result in the baby’s death. The good news is that babies who get breast milk instead of formula are much less likely to get it (and in our hospital- and many others- we had the policy that preterm babies who were below the age of highest risk of NEC- about 34 weeks- qualified for donor breast milk if their mama couldn’t provide her own milk).
  • Immature brains- it FREAKED ME OUT how routine brain bleeds were. Like, they only treated them if they were severe. Like, wut?!
  • Reflux. I know that’s par for the course with term babies and is just an annoyance; but in preterm babies when they reflux they often stop *breathing*. This is obviously a real big problem.
  • There were babies on crazy amounts of antibiotics. Obviously an infection can decimate even a term baby’s immature immune system and kill them so so quickly, and premature babies are even more at risk- I am not at all critizing antibiotics use. However, it’s a little scary to think of the effects of removing all bacteria, good and bad, from these babies’ newly developing systems. It’s also scary seeing them on vancomycin and other antibiotics of last resort when they’re this little. What happens if they get older and get sick again and the antibiotics don’t work?!

In other news, I GOT TO SEE A C SECTION.


A team from the NICU is always present during a C section (and also during vaginal deliveries when they see meconium in the amniotic fluid, and I’m sure other higher risk conditions too). Dude, C sections are INTENSE. I was pleased with myself that I still seem to have a solid tolerance for blood, cause it was all graphic! The incision is small (I mean it’s bigger than baby’s typical exit route- and seriously, GO MOMS FOR MAKING THAT HAPPEN) and it is pretty rough process on the baby- I saw one doctor kind of stick her hands behind this bump in the belly from the outside and start shoving HARD and the other doctor dig his hand inside the incision and yank the baby out by the head. After they announce the baby is out, a nurse hits a timer and they wait 30-45 seconds to clamp the cord (I thought delayed cord clamping was just a practice used for premies but they do it for all babies at this particular hospital). Then they bring baby around to see mama for a minute (they have a big sheet hanging up so mom doesn’t see the doctors cutting into her body, just like in the movies) and then they bring the baby over to the warming table. Ordinarily, this would be pretty much the end of the role for the NICU team- they smack the baby on the feet and rub the baby off with some towels and then the baby cries. BUT. This baby had to be revived and wasn’t breathing. It was amazing watching the NICU team at work- one had a stethoscope to the baby’s chest and would hold up her finger in time with the heartbeat, another put an oxygen mask on the baby and started CPAP, and they continued to try to stimulate and annoy the baby enough to start crying and breathing. But it ended up that the baby needed to be intubated! It all happened SO QUICKLY and SO EFFICIENTLY. I was really in awe of this team.

Fortunately, I followed that baby’s case and the baby was fine and was discharged fairly quickly. However, I’m sure it was terrifying for mom and dad (the mother’s first question was “Can I still breast feed?” because WOMEN ARE AMAZING. And she did!)

While there are circumstances you cannot control (as in the case above, in which they ended up thinking the baby had aspirated meconium and that’s why it was so difficult for the baby to start breathing), there are some you can.

How to keep your baby out of the NICU:

  • Know your STD status! Seriously. They can be managed beautifully, but only if we know about them and mama does what she needs to do to prevent transmission to her baby. I saw HIV positive mamas do a beautiful job with managing their medication during their pregnancy to prevent disease transmission to baby. However, I also saw babies in the NICU because mama had never gotten a herpes diagnosis. Yes, herpes is a drag as a grownup but if you are a baby delivered when there is an active outbreak, or without mom being treated with an antiviral, you are at HIGH RISK of getting encephalitis and dying. It is scary business. And unfortunately we saw a lot of cases where partners have not been honest about their status, so don’t rely on them for truthful information (isn’t that terrible?!)
  • Get your diabetes managed before pregnancy. That means get your sugars tested to make sure you aren’t diabetic before getting pregnant (in general, a pre-conception visit to your medical provider is a really great idea).
    • If your sugars are running high during your pregnancy they are going straight to the bebe. That means you can end up with a really really big baby and increased risk of all kinds of dangers at delivery (the baby getting stuck on the way out and getting shoulder dystocia, which can lead to permanent nerve damage; increased likelihood of a C section and all the attendant risks).
    • Also, glucose crosses the placenta but not insulin. That means that your baby gets a steady diet of SUGAR SUGAR SUGAR while they’re in the womb and their poor little pancreas has to work overtime to get the sugar out of their blood and into their cells. Then, when the baby is delivered and cut off from their mama’s blood supply, their SUGAR SUGAR SUGAR abruptly ends too, but they still have all this insulin. That leads to hypoglycemia, which can make a baby critically ill and mess up their brain. It also usually ends up with baby in the NICU to be observed, separating baby from mama and making establishment of a good breastfeeding relationship much harder.
    • But wait there’s more! Mamas with uncontrolled diabetes also deliver babies with more birth defects (major congenital anomalies¬†occur two to four times more often in infants of diabetic mothers than in infants with non-diabetic mothers- things like mis-formed spinal cords- bad news!) The good news is that a lot of this risk seems to be associated with poor glucose control in the first trimester, so if you can get your diabetes under control before pregnancy, your baby is at much lower risk.
  • Be a healthy weight before pregnancy. Being obese increases your risk of all the dangers of a big baby discussed above. But being underweight is also a problem- it’s a risk factor for preterm birth.

A few other non-medical conclusions I came to in the NICU

  • Research is horribly difficult and I commend anyone who does it.¬†Obviously it’s no secret that conducting a methodologically sound study requires a lot of attention to detail, but I was kind of blown away at quite how much there was when I helped my preceptor on her manuscript about human milk feeding in the NICU and brain development at 18 months. By the time I came on board the important decisions had already been made about how to track the data, what covariates to analyze, etc., but those decisions had taken relatively little time in the grand scheme of just the lengthy to do list for the project. Sometimes I feel like “Oooh, I’m so fancy, I¬†have a masters degree, I know fancy things about biostatistics” and then I got very humbled doing the actual sausage-making of research. Also, there was a huge capacity for human error! I assume my preceptor will end up submitting spreadsheets we made along with the completed manuscript for publication, but the reviewers basically just have to trust us that we didn’t make up the numbers! That we didn’t make math errors (there is WAY TOO MUCH DATA to check each individual calculation- I did my best to check as I went but I wasn’t about to go back and go through everything!)
  • Breastfeeding is also difficult. Premature babies don’t at all have the reflexes to actually nurse at the breast until ~34 weeks gestation but even then, even at full term, it can be very very difficult! It’s a lot to ask of the baby (creating a vacuum with their mouth, which is impossible if there’s an anatomical defect; properly coordinating sucking and swallowing; staying latched on and in the right position; grabbing enough tissue with their mouth to effectively remove milk, etc.) and it’s a lot to ask of the mama (especially deciphering a baby’s hunger and fullness cues, and figuring out whether baby has actually gotten enough since the whole process is basically invisible). It’s amazing and beautiful and we need to give nursing mothers all the support we can. Everyone who wants the Affordable Care Act/”Obamacare” to be repealed- know that you’re taking away insurance coverage for breast pumps and lactation counseling for new moms.
  • Mothers still die in childbirth. We saw it happen once and it was awful awful awful. The NICU nurses (obvi amazing human beings) did everything they could to support the father and this new baby. And the hospital waived their usual policy not to give donor milk to older babies and gave this sweet little baby donor breast milk. But it is SO TERRIBLE that it happens. I think about everything my mother has been to me, for all 28 years of my life, and can’t imagine the kind of hole that leaves for the rest of a family to try to fill.
  • Watching a family together after the birth of a child gave me All The Feels. You look and you think, God, this should be such a perfect unit. Mama is this amazing baby-grower and milk-provider, and Daddy¬†is there all supportive¬†and anxious on behalf of mama, and they are both so so tired, and so so excited.¬†I would think about how statistically in the coming years many of these unions would not stay intact, and many of these mothers would be left on their own (or fathers, as above). And it made me so, so sad. All these new humans avoided to be surrounded with this safe, protective love. There were lots of extended families at the hospital, which was beautiful and lovely, but honestly there were times I went into a family’s room and there was this exhausted woman who clearly wanted to just pass out and there were scads of relatives sitting on the bed and making noise. There’s something beautiful about just a baby and the two people who made it sharing this little space for awhile. (Caveats: the two people who made it can of course be two men or two women. It’s just so hard for someone to do it all alone, even if they have the support of more distant relatives!)
  • Now for a briefly horribly depressing note. One day I was taking the elevator upstairs to the NICU and sharing it with me were a pregnant woman in a prison uniform and the police officer accompanying her. My sincere hope was that she was there for a prenatal appointment and would be out of jail by the time she delivered. It still upset me- but that wasn’t even the part that I’m writing about. I told my preceptor how I’d winced seeing the woman. She said, “Yeah, what we see is typically that women who are victims of abuse are the ones who get in trouble with the law. They are in abusive situations and try to get out but don’t do a very good job.” Then she shared a horrifying story with me which you have permission to skip.¬†So two new parents went and visited their brand new, preterm baby in the NICU. Then they walked back to return to the mother’s room in Mother Baby. As the mother walked through the door with her back to the father, he pulled out the gun he had brought to the hospital and shot and killed first her and then himself (story about the case here). I have actually struggled to talk to anyone about how much this upset me.¬†At this point, my preceptor began explaining to me about the new safety precautions the hospital was taking since that incident (the NICU will be a locked unit, people will have to present their ID each time they want to come in, people with a criminal record will be banned. Though I heard no talk of metal detectors or anything preventing guns coming in, *sigh*). As my preceptor wisely pointed out, people in hospitals are VULNERABLE. They’re sick, they’re weak, they may have been hospitalized because they’d already been victimized in some way. I have unfortunately witnessed in my personal and professional life that domestic violence may come to a head during a pregnancy. When I was at Wake Forest (more on that later), there was a baby born with a brain bleed that was attributed to the physical abuse inflicted on his mother. SO. Public service announcement. Those of us who are RDs, or RNs, or anyone in health care, we¬†come into contact with vulnerable populations EVERY DAY. Regardless of your setting, think of who you encounter: Older adults. Children. Pregnant women. People who are poor. People who are homeless. People with disabilities. If nothing else, we need to have the statistics in the back of our mind and we have to be aware that if it’s that common, we should be looking out for it. 1 in 3 women and 1 in 4 men are victims of some form of physical violence from a partner in their lifetime. In the last year tracked, there were 108 cases of domestic violence related homicide in North Carolina. The NC Coalition Against Domestic Violence has some warning signs to look for here. Let’s be real- it’s probably fairly easy to miss domestic violence in many patients. Yes, most hospitals work some kind of screening into the questions they ask a patient on admission (i.e. “Do you feel safe at home?”) but a bored looking CNA asking this question to someone who’s likely in physical pain and just wants to get to a doctor is not likely to elicit the most meaningful information (especially if the abusive partner has accompanied the victim to the hospital). Once the medical team gets to a patient, they’re very focused on the “Problem List” of physical ailments. Hopefully the nurses can catch something- Lord knows, they seem to know everything about patients! But I still maintain that if we’re going in to patients, we’re asking open-ended questions and coming across as sympathetic and like we may have more time to listen to someone than the average doctor who zooms in and out of their room, that we should pay attention if we end up getting a cry for help from a patient. However small. I’m not suggesting any of us go in and try to save the day, but a well-timed phone call to social work tipping them off that you got a weird vibe may be helpful. Other settings may have other things RDs can do which could help protect victims of domestic violence. Arranging for a ride for someone who has no car, who has been socially isolated by an abusive partner, who just wants to get to her mom’s house (which my preceptor did for a WIC mother last summer at the health department). Providing information on safety planning ( <— this site has really good information for pregnant women) for someone who may not be ready to leave an abusive relationship today but wants to maybe start taking steps toward doing it in the future (and needs to protect him/herself as much as possible in the meantime). Finding a pretense to get a patient alone to make sure there isn’t something that they want to say but are afraid to have an abusive partner witness.

More intense business: I¬†also got an opportunity to spend a few days at Wake Forest’s hospital because they have a Level IV NICU. That means I got to see babies with more serious conditions such as:

  • Babies with congenital abnormalities that are beyond what can be addressed at a smaller hospital (there was a baby who they were wondering could’ve been affected by Zika aaagh!)
  • Babies who need ECMO. I did my case study on ECMO this summer and it’s crazy- like dialysis but it’s doing the job of your lungs and/or heart instead of the job of your kidneys.
  • Babies who needed surgery. Sometimes due to congenital abnormalities, sometimes due to complications they’ve suffered due to prematurity (like necrotizing enterocolitis, brain bleeds, retinopathy of prematurity etc.) Look at this gorgeous diagram below!


Seeing the RD in action at Wake Forest was AMAZING. She was definitely practicing at the top of her field and they actually had HER teaching the MEDICAL RESIDENTS how to do things (this is a big deal; if you work in health care or know anyone who does you are probably aware of the many God Complexes on display in the medical field).

However, it was really intense seeing how sick these babies were. When trying to feed the babies, the dietitian and doctors¬†have a LOT they are working against- fluid restriction is common with the lung complications many babies have, many of the babies end up fat restricted (we saw one baby whose triglycerides were over A THOUSAND- normal is 150 or less- so they quickly had fats removed from their IV¬†for a few days), many end up dextrose restricted (because they end up with crazy high blood sugars and insulin in neonates doesn’t tend to support lean body mass growth, only the growth of fat cells; so they tend to try to restrict the dextrose rather than adding insulin), they have all kinds of acid-base imbalances which can only be addressed so much with manipulating the oxygen-carbon dioxide exchange in the ventilator and also involves manipulating what’s added to the IV. All of these things result in babies getting LESS nutrition, and it’s horrifying seeing these shrinking babies (there was one baby who did not gain any weight for a MONTH- the prognosis was very poor).

In the long run, I don’t know if it would be too sad working with these sick babies with such limitations in their recovery. But I know it was really energizing being in a teaching hospital where amazing research takes place. Seeing all the medical teams bustling around was really exciting (and let’s be honest, there were some extremely good looking surgical residents. Greys Anatomy in real life!)

Something else that stuck out to me about Wake Forest was their AWESOME cafeteria. Stealth health at its finest- check out this gorgey burrito bowl!


So it looks pretty standard buttttt…

  • It contained a ton of veggies (I chose butternut squash and asparagus), lean protein (black beans and shrimp), tasty but heart-healthy toppings (hot peppers, corn salsa, and guacamole; and no cheese!), and portion controlled fatty stuff (just a wee bit of the chip strips was enough to give a satisfying crunch)


The hospital where I was most of the rest of the time was much less exciting, and expensive, cafeteria-wise.

So I mostly went to the Starbucks and got too many pumpkin spice lattes and (SO GOOD, why had I not known about these before?!) bean chips.


As for the ol’ social life, as I did this summer, I joined a gym just for the duration of my internship. Working out is so so good for mental health. Also, honestly, in a town with not that much to do in the vicinity of my housing, I might as well do something life-affirming (exercise) instead of something self destructive (watch Netflix every day from 6pm til I go to sleep).

Sometimes my legs die and I have to sit like this for awhile.

Photo on 10-10-16 at 5.47 PM

I didn’t super socialize with my roommates in my student housing- I was lucky enough to not have to share a bedroom the whole time, which was SO NICE and SO not a guarantee- I just got lucky. I did, however, learn that one of my roomies had a birthday two days apart from mine so we and our other roomie at that time embarked on an Italian cuisine adventure at Di Lisio’s.

I got the gnocchi with pesto which was BOMB and lasted me two delicious meals.


Then one other night my friends Kyle and Shaylen were in town (Kyle was looking at Wake Forest Law School) and we met up for dinner. They asked me for a recommendation and I was like “Er, I mean the only place I’ve really gone is Krankie’s but I know it’s delicious and a fun hipster scene.” So I went again!

This was a hoppin’ john esque creation: rice, black eyed peas, greens, and YUMMY chow chow (kind of a tangy/sweet onion relish?) on top. Plus cornbread.



and so it begins

Scenes from the Women’s March on Washington:


Huge (yuuuuuge?) crowds


My date (of course at the angle taken I look like a chipmunk but you have to see our fabulous pink pussy hats, knitted by a dear friend of the family who wished to remain anonymous because she runs in conservative crowds [hahaha it’s not Melania Trump but wouldn’t that be great?!]


Like many of the people there, we were not able to get anywhere neeeeear the stage, so I only have heard about speeches/performances/raves after the fact. So here’s what I was able to capture on my trusty iPhone!

First of all, there was a *lot* of¬†of wit on display in the signs, some of which is a bit unprintable for this blog ūüėČ

Something we can all get behind, though, Beyonce lyrics:


And there was some seriously high quality Christianity on display




Love Thy Neighbor [it reads]:

Thy Homeless Neighbor
Thy Muslim Neighbor
Thy Black Neighbor
Thy Gay Neighbor
Thy White Neighbor
Thy Jewish Neighbor
Thy Christian Neighbor
Thy Atheist Neighbor
Thy Racist Neighbor
They Addicted Neighbor


There were some amazing men present:


(My mom was tickled pink by the sign above)

More sweet children with woke parents:


And BEARS! Here’s a reeeeeeally high quality polar bear costume! And another angle of the pink pussy hat; me in the foreground! The pink pussy hat was clutch because it was too warm for a coat but a bit cold for a sweater.


Aaaaand speaking of bears, a clever (disturbing?) Secretary of Education nominee joke.


Half a million+ people there, so naturally I ran into my friend Claire in line for the bathroom with no prior planning. One of the friends she was with had had her birthday on Inauguration Day (yeow) and I was able to present her with an extra pink pussy hat, which seemed to really make her day ūüėÄ

Note that while in this picture I am in my pink pussy hat (can you tell I’m trying to use that phrase as often as I can in this post? :D) Claire was wearing a hat she got at a Dixie Chicks concert (!) in North Carolina where, following our cluster**** of a trans-hating law’s passage, the band passed out every concertgoer a hat that said “No Hate in Our State”.


There’s not a lot I can say that hasn’t already been eloquently put across by other attendees:

  • Everyone in attendance was really kind- I saw an irritable looking bro in a Make America Great Again hat making his way through the crowd and no one bugged him (which probably disappointed him, ha!)
  • There was a really great diversity of ages, races, and viewpoints- who knows if the women with the Love Thy Neighbor shirts from their church really had all that much in common with the ones with obscenities on their signs- the point was, they had come together to march for women. I feel good about a cause when it brings so many people together (and inherently suspicious about it when it systematically excludes people based on their race/gender/religion/viewpoints- ahem).
  • The organizers were clearly like “HOLY COW SO MANY PEOPLE SHOWED UP” and were very creative about communicating messages with the crowd- one woman was doing call-and-response with a bullhorn with phrases like “If you need a doctor” “If you need a doctor!” “Please see me!” “Please see HER!” (we responded, pointing our fingers)
  • There were a lot of people with signs about¬†an issue of particular concern to them- climate change, LGBT issues, disability rights, protecting Planned Parenthood, unions, etc.- and I’m hoping people wiser than I¬†can make a road map of¬†we can help advance those diverse progressive causes despite the current political climate.
  • I saw a band set up with paper mache instruments that included Fallopian Tubas and it made my life
  • The experience was incredibly encouraging and fed my soul!



My aunt Kathy and uncle Tom came down to NC to build a cat tower for Malindi and Eric’s cat Mearl!


He loves it! Kind of! He’s a little blind so he doesn’t totally get it.


Okay I jest that was not actually why they came to NC (though they were indeed roped into it).

They came down to see Alejandro Escovedo. Oh and my sister and me, I guess ūüėČ

They were nice enough to bring us along and Alejandro was AMAZING in concert. I always feel like a plant that’s been watered after I see live music. And the acrobatic strength of his drummer was quite inspiring.


They spent Friday through Sunday with us and besides cat-ing and concert-ing (though obviously those things took up awhile) we enjoyed additional fun activities such as:

  • Exploring The Scrap Exchange, which is amaaaazing
  • Having a campus tour led by Malindi and me
  • Walking around adorable Hillsborough and admiring various art galleries
  • Visiting the always lovely Carolina Inn which was all gussied up for the holidays, including various displays for the Twelve Days of Christmas.


Three French hens= hilarious

Always yummy food too of course.

Pre-concert, we had dinner at the reliably excellent Venable.

I had this dreamy salmon with spinach ‘n grits. Quite the balanced plate!


Later we had a stellar brunch at the beautiful Guglhupf, where it was (just about, at least) warm enough to eat outside.

Grilled veggie ‘n mozz sandwich was lovely.


And their last day we had yet another brunch at Acme, which was amazing.

Malindi, showing that she is a confident woman not easily intimidated, ordered the special, in which they made a salmon hand pie (!) by filling a pastry crust with salmon and various cheeses and creaminess. Then took that salmon hand pie and topped it with poached eggs and hollandaise, a la eggs benedict. Then they accompanied that salmon hand pie with hash browns. And salad. And THEN she ordered a side of mac and cheese! (To be fair, I earnestly informed the whole table that Acme has incredible¬†mac ‘n cheese)

Anyway, Malindi was eating this meal for quite a few days


I got the biscuit ‘n gravy (I opted for their hippie veggie gravy which was delicious) ‘n eggs (opted for runny poached, mm). Also with breakfast potatoes and salad. This lasted about two meals, but I won’t admit how close together those two meals were.


And as always when my fun family visited what was the best part was just hanging out with them ‚̧ ‚̧

celebration upon celebration

First of all, I GOT ENGAGED!


With gummi savers. For about two minutes (til my groom-to-be ate his ring). Oh also, the groom-to-be plays for the other team.

But doesn’t he look ecstatic at the prospect of our union in this lovely pic?


No? Fine, a few days later I went hiking with him and his real-life boyfriend. We got a nourishing breakfast first.


(A pimiento cheese biscuit- holy richness, Batman- and 1/2 a pumpkin spice latte donut which I split with Colton. Plus coffee of course)

Though I am nowhere in the sphere of engaged, I have nonetheless had a variety of fun social gatherings in the previous few weeks (ok, months) that I’d like to recall on the ol’ blog.

First, a cat party:


I had sweet Bill and Angela the kittens finally down in NC, meeting potential adopters (they are happily ensconced in their new home, together forever, hurray!)


And in the meantime, Clovis’s adopter Andrieu decided to bring Clovis by to see if he remembered his onetime siblings. And Malindi came too, to hang with kittens. It was a cat party.

The kittens did not at all remember their erstwhile siblings. Hilarity ensued.

Anyway, it was SO FUN in those few days I had little Angela and Bill at my place before they went home with their new human parent.


When you are a kitten, everything is a toy.


Your sibling is, too.


I love this picture- Bill is all “I AM SO EMOTIONAL I AM BURYING MY FACE IN MY PAWS”


They all have lovely forever homes now, and I am lucky enough to get the occasional photo update from the adopters.


Speaking of thankful, another party: Friendsgiving! Reliably fun and delicious at my friend Steph’s house. I clearly focused on the carb portion of the meal.


Her friend created this turkey stencil to top an almond cake! Talk about classy.


Next, a party that my family was all together for the Thanksgiving holiday break!

We kicked things off with a delivery from Malindi’s boyf, who was forced to stay in NC through the interminable gubernatorial recount (which has, at last, resolved, but not without the psycho NC legislature making us a national embarrassment a few more times).

Anyway, Eric sent Malindi (and thus all of us) chocolate covered strawberries!


I nestled myself into the bosom of my family, relishing the omnipresent avocados in my mother’s home.


We went to the BEST Chinese place, A+J. Pictured, clockwise:

  • wheat gluten¬†and mushrooms
  • pickled seaweed salad
  • edamame, spinach, and tofu skin
  • thousand year old egg with yet another texture of tofu


  • Fan-tabulous spicy peanut noodles


  • Dreamy fried chive pancake


  • dumplings!


Then it was time for the party of actual Thanksgiving!

Mama laid the table all nice.


Small crew this year: myself, Malindi, Ma, and Ma’s boyf.

Traditional mashed potatoes and gravy with… salmon?


Yes cos salmon is delicious.


Artichoke parmesan sourdough stuffing


Poorly photographed green bean casserole, made using all Trader Joes’ ingredients: French-style green beans, fancy portabella mushroom soup, and fancy fried onions.


Malindi’s yummy sweet potato casserole with oat and pecan streusel atop


General gorgeousness of the table, along with a peek at my homemade cranberry sauce.


My plate. So lovely!


Malindi’s apple cake for dessert. A little cream poured on top, why not?


Now we have reached the Christmas season. Which means cookie parties, apparently!

First to my friend Leesie’s house, where she had a very impressive array of cookie decorating supplies and a delicious homemade dough that involved nutmeg.


Then to my friend Lesli’s, where we also got a feast in the savory department before the cookie swap began.


My friend Emily made these adorable cookie shots: a chocolate chip cookie cup (bake chocolate chip cookie dough in a mini muffin tin) filled with grown up “milk” (Irish cream I think was involved- don’t know what else).


For the cookie swap, I used the abundance of eggnog leftover from my graduation party to make eggnog whoopie pies (note that I ad-libbed a filling that omitted marshmallow fluff and included actual eggnog)


And there was LOTS of additional bounty!


Sam and Alex, cute newlyweds, arrived to the party wearing matching antlers. Their cuteness inspired a group photo. It was imperfect but nonetheless amazing (see Boo the cat, and the caption!)


A party break:

I was scared after a day when I literally only ate cheese and crackers for the whole day that I was going to develop diverticulitis. So I went to Weaver Street Market and made myself this fiber bomb of a plate:


  • BBQ-seasoned lentils
  • roasted root veg
  • sauteed brussels sprouts
  • roasted sweet potatoes and apples
  • sauteed carrots
  • mashed butternut squash

It helped.

Another celebration- it was like 65 degrees outside a few days after Christmas! I met up with my auntie and we took a magical walk along the C+O Canal towpath.


Then we had a graduation celebration lunch of delicious sushi.


On my aunt’s delicious porch!


We have finally reached the last celebration- my family’s annual post-Christmas open house! This year it was held on New Year’s Day, and we had a smaller crowd than usual. Were people hungover? Were they preparing to return to work the next day? Were they watching the Redskins?

Anyway, it meant more cheese for the rest of us ūüėÄ


Here is the main table, midway through the party. Abundance, as you can see! Our usual mega roasted turkey and ham are in the background.


Additional yumminess:

  • crudite
  • various breads and crackers
  • labneh (from the Greek store)
  • taramasalata (from the Greek store)
  • baba ghanoush (made by my mom)
  • artichoke dip (made by me)
  • butternut cheddar dip (made by me)
  • green pea and pesto dip (made by my sister)


Annnnnnd a closeup of even more cheese. My mom went nuts (in the best possible way) at Costco this year. A raspberry on the brie so it looked womanly ūüėČ


And of course the cookie department.


  • macarons, purchased at Costco
  • rugelach, purchased at Costco
  • thumbprint cookies from Oh She Glows, made by me (gluten free and vegan)
  • chocolate crinkle cookies from Iowa Girl Eats, made by me (gluten free)<< people LOVED these
  • my aunt’s fruitcake (my grandma’s recipe)
  • my mom’s baklava
  • my mom also made the Dorie Greenspan recipe for sugar cookies (I decorated the purple one, as a tribute to Prince and the other wonderful people we lost in 2016)


sometimes i cook things

I’m not a new years resolution girl. However, the end of the holiday season is a natural time to change one’s routine. Going from “holiday mode” (eating 5,000 cookies and four pounds of cheese each day) to “normal mode” (trying to include actual vegetables in my diet).

Truthfully, my healthy eating suffered before the holidays. I had a whacky schedule and life for the previous seven months of my life, once I was done with coursework and started internships. Going from Wilmington to Winston Salem with various Carrboro interludes meant living out of a car to a certain degree. Also, I moved during the nomadic period, but never really had sustained time at home to settle in. So my new place in Carrboro was more of a place I crashed and ordered pizza on the weekend than a home.

So my goal is to make it more of one, and the best way to do that of course is breaking in the kitchen.

I have done a few little projects that were good enough to share:


Hippie brunch of whole wheat french toast and sauteed tempeh.


YUMMY greens that were actually vegan!

I used the saute function on my crockpot and put in a bunch of olive oil, 1/2 a sweet onion (minced), two cloves garlic (minced), a bunch of red pepper flakes, and some cumin. I sauteed that til it was aromatic and golden. Then I switched it to slow cook mode and added two cans of fire roasted tomatoes (plus their juices) and a large bunch of collard greens, chopped up. I slow cooked that for about two hours (could’ve gone longer) and seasoned it with apple cider vinegar, maple syrup, and quite a bit of salt.




Again, served it hippie-fied with tempeh. And on a base of cheesy polenta, mmmm.


Something easy but tasty: my stepmother gave me some Korean kimchi-flavored noodles (the package says”for vegetarian”, but other than that I have no idea what is in it, except for of course a great deal of sodium). She said it was good with eggs.

Well, I ran with that and made a big bowl using 1/2 the noodles and 1/3 of the flavor packet (so as to not give myself instantaneous hypertension from all the salt) and topped it with an over easy fried egg. I broke the yolk and stirred it in and it made for the most heavenly rich, tangy broth.


Another yummy meal, very simple: I had my friends and their little kiddo over. I took a premade soup (cashew carrot ginger), and added:

  • roasted carrots
  • more cashews, toasted dry in a hot pan
  • homemade broth
  • a little bit of wine I think?
  • spices

And cooked it til it was delicous. Semi-homemade, eh?

And homemade soup must always be served with grilled cheese!

The presentation was nicer when I served it to my friends, but here’s a picture of the leftovers. You get the idea.


And finally, a recipe-ish using leftovers from my (to be chronicled) family post-Christmas open house.

Tortilla soup!


I sauteed onion, carrot, celery, and pepper (all diced) in some olive oil, and added spices (cumin, chili powder, seasoned salt). Once they were aromatic and turning golden, I added some leftover roasted turkey and water and let that all hang out. Meanwhile, I broiled some red and green pepper slices and some cloves of garlic (also topped with cumin, chili powder, a bit of cayenne) til they got blistery and lovely. And whirred up the broiled veggies with some cherry tomatoes in the blender. I added the veggie mixture to the turkey mixture and seasoned to taste (the more cumin the better! Some apple cider vinegar was also nice). And because it was a little too virtuous, I added some cheddar cheese ūüôā

All done! Quick and easy. And delicious topped with avocado and sour cream.


Displayed on the beautiful tablecloth my mom got in Mexico!


The next photos are not of beautiful cooking but do manage to capture an entire day of food! This was a highly inactive day, being the day I drove back to NC from my mama’s house in VA. I also had a limited appetite given the aforementioned holiday mode (a cookie and cheese based diet).

I wasn’t feeling breakfast- just had a cup of tea and frantically got ready to leave (after some unimpressive sleep).

Lunch was picked up at my favorite stop for cheap gas- South Hill, VA. Unfortunately the most appealing option there was McDonalds¬†ūüėĀ

So I did my best and got oatmeal with fruit. And a coffee, of course.


After unloading my car I was wiped so I had a nice afternoon snack in bed- I’m a big fan of these cashews, they are truly spicy! And¬†their spiciness makes you eat them a big more mindfully (unlike sugary or cocoa-y nuts- I can probably¬†put away 8 ounces of those guys at a time, eesh).


I have yet to restock my fridge so dinner was a freezer endeavor: fish nuggets from Trader Joe’s and brussels sprouts, sauteed in a bit of olive oil with a new¬†Zanzibar seasoning mix.


And evening snack- I stole some exquisite Costco kiwis from my mom’s house. They are huge and fat and juicy and sweet. Picture this times two!


That was not a¬†normal day of eating, but it involved a level of mindfulness (and limited added sugar and dairy fat) that had been missing in my diet for quite awhile. I’m going to attempt to capture more of the things I make and eat in the hopes that it will help me get back in a healthier mode.

Have you tried any yummy recipes I should be making?


Sheila hopes your Christmas was merry and bright.


It started with a road trip to my family in VA (Lola stayed at my auntie’s in NC so as to prevent the stress of her sitting in a car for four hours. And also to prevent her from trying to murder Sheila, as she has attempted so many times).

I stopped in Richmond where my classmate/fellow recent graduate (!) Claire lives. Gotta do the Ted Cruz smile any time we’re together.


My sister arrived in VA too, along with her boyf and their pets. Malindi does odd stuff like throwing avocado peels off the deck (her interpretation of environmentalism) but I gotta say she had the last laugh because this little squirrel loved it.


Christmas Eve was at my aunt Dena and uncle Louie’s house. They recreated the annual chicken curry dinner my grandmother always made.


Buttt honestly I was most excited about the Hannukah table.


I could eat 10,000 latkes a day. And I always do both sour cream and applesauce because why should I have to choose?!


There was also smoked salmon and shmear. Mmm mm so good.


Mearl, Malindi’s cat¬†greeted us when we got home to my mom’s last night. He eagerly looked for Santa’s sleigh.


Christmas morning! The Hannukah love continued with my inspired gift from Malindi’s boyfriend.


Here’s one of the gifts I got my sister ūüėÄ


Fun story: I accidentally sent it to my aunt’s house! I ordered it off of Amazon and Amazon had Dena and Louie’s address as my most recent shipping address (because they were wonderful enough to foster my kittens and I’d been sending kitty litter/kitten food/etc. to them). So they got this tshirt in a box from Amazon with no context whatsoever! They thought it was for their granddaughter and “felt it was inappropriate”.

Which of course is false because ovaries are a beautiful thing to be celebrated at all ages.

Anyway, hilarity and joy and deliciousness continued at my aunt Kathy and uncle Tom’s house for Christmas Day brunch.


Bountiful table as ever. Baked brie with figs, billions of other cheeses, biscuits, two kinds of bread-y, egg-y stratas


This magnificent deli platter from the Italian store.

There was more, too, but I really tried to exercise some self control because (as you’ll see) as a child of divorce I always attend two major Christmas meals and it often results in me eating so much I feel like I’m going to die, and I really wanted to not feel that way this year.

So I ate these incredible stratas, and had some fancy meats. And some unpictured veggies and dip. But believe it or not that is actually quite restrained for me.


Oh and I had a mimosa and a bite or two of this pumpkin cheesecake


My mom brought these sugar cookies- Dorie Greenspan’s recipe- but it was only 1/4th of the abundant dough and I know I’d get to have it in the coming days.


Then we did our usual gift exchange, which is followed, as usual, by violent and aggressive throwing of wrapping paper-based projectiles. Crazy relatives.

Honestly, the best treat of Christmas Eve and Christmas Day was this delicious baby. He is the offspring of Dena and Louie’s nephew Keith and he is an A+ baby. High quality. You hold him and he’s like “Oh hey new best friend I don’t mind in the slighest being held by strangers! I’ll just continue to make adorable faces!”

me and baby

So that was Family Time Part 1.

Then it was off to see Jasper and Alice the scotties (and my aunt Jeanie and Uncle Tim, their humans) to celebrate Christmas with my dad’s side of the family.


I made this salad, a recreation of one I had at a restaurant in NC. It contained:

  • arugula
  • goat cheese
  • craisins
  • blistered peanuts
  • roasted butternut squash
  • a honey-based dressing


Delish! Though sadly slightly overdressed, but what can you do.

A highlight of the meal for me was this combo of oatcakes, smoked salmon, creme fraiche, and capers. YES.


Also there was a goose! Quite lean from the active goose lifestyle.


And ham, and roasties.


My plate.

As for dessert, my auntie made an English trifle just like my English grandmother used to make. Sponge cake and sherry and custard and jam and fruit and whipped cream and nuts. SO GOOD!


Unpictured: I made gingerbread with lemon sauce as an additional dessert. It was good.

All in all it was a delicious, indulgent Christmas with the people I love.

Now, please enjoy this giraffe angel ornament.


your girl has a masters degree!

Behold, my posse from the past 2.5 years of getting educated!


For some reason they opted to hold my graduation ceremony in the most poorly-lit area ever, so there are virtually no good pictures. Fortunately, there are lots of excellent memories, hahaha, so this will be a tell-don’t-show post, for the most part. (Can you spot me? I’m center-left, striped dress, head down).

OK, yes, let’s address the fact that I had high hopes of blogging eagerly through my NICU internship but I just… didn’t? It wasn’t like I was crazy busy- my days had a fairly consistent pattern of work-gym-Netflix (Monday-Thursday), then Friday-Sunday I was back in Carrboro doing Carrboro things (and working from home on Friday on data analysis which WHOO IS JUST A TREAT).

But anyway, I didn’t, and that’s the long and short of it. But now I’m in a brain space where I’d like to reflect on the fact that WHOA GUYS I HAVE A MASTERS DEGREE. (And I did a lot to get it, which will be my next post).

Here’s the moment in which I crossed the (again, poorly lit) stage to be¬†pinned, by my lovely professor Amanda. The pin has the seal of the Academy of Nutrition and Dietetics which has like 10,000 symbols on it, all of which symbolize something important about my new profession.


In the back you can see the title of my master’s paper. People did all kinds of cool things for their masters papers including:

  • a media content analysis of lead poisoning in Flint, MI
  • a study of nutrition education (or rather, the lack thereof) in medical schools and how to improve this in the future so doctors can better aid their patients in improving their nutrition and thus lowering their nutrition-related disease outcomes
  • a case study of hepatocyte autophagy (basically, liver cells eating themselves out of starvation) in a patient with anorexia
  • an analysis of the nutrition environment in the Dominican Republic (my badass classmate Taylor is actually moving there this year to start a nutrition program for Kids Alive, a nonprofit for which she’s been volunteering for years)
  • a literature review of artificial sweeteners in patients with diabetes

As for little old me, I helped my preceptor create a manuscript for a study she did. Basically, we looked at very low birth weight infants (VLBW= less than 1500 grams at birth, or about 3.3 lbs) and wanted to see whether getting breast milk improved their brain development.

We looked at the proportion of human milk they got in their feedings (in other words, babies could get 0% human milk- babies who were fully formula fed- or 100% human milk- babies whose moms were absolute heroes and managed to pump enough that their NICU babies got all maternal breast milk- or somewhere between those two things.

Past studies have looked at volume of human milk babies got (in milliliters [well actually in mL/kg/day but that is not meaningful to yall so lets just say milliliters]), but the problem with that is that teeny teeny tiny babies (like 23 weekers, some of which we had in our hospitals) obviously get teeny teeny tiny feedings (we start them as low as 1 mL every three hours. 8 mL a day. To give you some context, 30 mL is an ounce. 6 mL is a teaspoon). And teeny teeny babies tend to have a tougher time of it and are more likely to have adverse outcomes. And unfortunately are also more likely to have impaired brain development as a result.

So our study looked to see whether even babies who got teeny teeny amounts of feedings showed a difference in brain development if they got human milk for those feedings.

And the babies got tested using something called the Bayley Scales of Infant Development when they were between 1 1/2 and 2 years old. And that showed their mental and physical development.

And long and short of it the answer to whether human milk affected development was:

  • maybe?
  • but it may be more likely to be affected by other things related to moms who give human milk (moms who give breast milk are more educated, less likely to be on Medicaid, more likely to be white with all the social privilege that entails, etc. etc.) which also help improve brain development (educated moms may put more into their infants’ education, wealthier families have more time/money to devote to helping their babies’ mental development, etc.)
  • and it may also be related to the babies’ gestational age- in other words, were they born at 24 weeks? 34 weeks? BIG DIFFERENCE in terms of brain growth.
  • and our sample size was really small, unfortunately, so true differences were tough to tell
  • but an interesting tangent is that when you excluded babies who from the moment of birth showed that they already might have had some brain impairments (they had a low Apgar score, they had a brain bleed), or babies who got really sick in the NICU (they got necrotizing enterocolitis, or a brain bleed, or chronic lung disease) that human milk makes more of a difference. In other words, while moms of the smallest and sickest babies get beat over their heads that their milk is liquid gold and they should do everything they can to get as much of it as they can into their babies, IN FACT it may be just as important, and in fact more important, for moms whose babies look healthier on the outside to get that human milk. Because those are the babies in which it can make a big difference in their brain development.

Anyway, more on the NICU to come.

First, let’s discuss my graduation party, which was SO NICE! I especially lovvvvved that card at left from my aunt Kathy and uncle Tom. In the front of the table you can see my fancy pin. And see that Carolina blue book? This was PRECIOUS- my friend Sam, who’s a returned Peace Corps volunteer, told us that she and her Peace Corps buddies had created their own yearbook to commemorate their experiences. She suggested we all do the same for grad school and of course we loved that idea! So we did pics, and superlatives, and it was all very silly and fun.


As for the party itself, most of my school buddies had already skipped town, so it was mostly my friends from outside of the program, as well as¬†family! My mom came down for graduation, Malindi came, my aunt Michele came, and my cousin Sophia and her husband Mike and their sweet baby nugget came! All parties should have babies ūüėÄ

In the future, I definitely want my mom to come down to NC and cohost all of my parties because everything ran so beautifully with her help!

For awhile we were contemplating getting it catered but then I decided I just wanted all the tasty things from Trader Joe’s, so that’s what I did.


  • Lots of wine
  • Lots of cheese
  • Tempura shrimp
  • Mini samosas
  • mushroom tartlets
  • various dips
  • various carbs to dip into various dips

And of course the dessert department, which included these:


My godmother and dietitian mentor, Teresa, is the coolest. She was the one who taught me dietitians can and should eat like normal human beings (not restrictive psychos, as, alas, so many seem to be). And she introduced me to the greatest recipe for chocolate chip cookies in the land, which I can share for all who need it. Key components include ground up oatmeal for part of the flour, and an EXTREMELY high ratio of chocolate to batter.

Anyway, everyone enjoyed the cookies and it was just a lovely party. My friends brought their two year old who was clad in the most adorable little red velvet dress with white faux-fur trim and looked like a sweet Christmas elf. My other friend’s dad enthusiastically joined in our discussion of feral cats. My friend Shaylen who has an MPH of her own geeked out with me about the statistical drama of my paper.

And because I’m rubbish of taking pictures of people, I lack any of those from the graduation party. I can, however, recount some¬†delicious eats throughout the graduation weekend.

I was unfortunately recovering from a rather horrifying bout of food poisoning the night before my paper presentation (so fun right?!) so I didn’t have much booze, which was probably a blessing in disguise ūüėČ But I ate tasty food!

The night after our graduation ceremony, my mom treated me, sis, and sis’s boyf to an amazing meal at Glassshalffull. We just got small plates and shared (I’m having to describe this so I remember the meal, which I was too giddy and disoriented to photograph after the rush of the graduation ceremony):

  • COCA: crisp Spanish flatbread with caramelized onions, goat cheese, preserved figs, shallot, garlic, shiitake mushrooms, and arugula¬†
  • CARAMELIZED ENDIVE AND BUTTERNUT SQUASH SALAD: granny smith apples, feta cheese, toasted hazelnuts, and radicchio served over mixed greens with a maple shallot vinaigrette
  • MINI LOBSTER ROLLS: Maine lobster salad on three warm, herb buttered house-made rolls¬†¬†
  • ROASTED LOCAL ROOT VEGETABLE HASH with a Turkish spice blend, brown butter, preserved lemon, and sunflower shoots
  • SAVORY N.C. CORN CAKE served with a mixed pepper and corn chow chow, cilantro basil cr√®me fra√ģche, and a fris√©e radicchio salad

It was SO GOOD!

Then Malindi and I both got dessert, a sticky toffee pudding for her and a Mexican chocolate budino for me that was so rich, so intense, I wanted to weep with joy.

Saturday, the day after graduation and the day of my party I was rather nonchalant about things so my mom and I went to Hillsborough for a bit of fun Christmas shopping and I took her for a tasty lunch. I got a soup, and this salad which was so delicious I later recreated it for Christmas dinner (details forthcoming).


Then we went to Matthew’s Chocolates, and my mom got me this rather life-changing confection which had spices and sesame seeds and crystallized ginger and was just outrageously good.


So a final note is that throughout all these festivities I had my wonderful friend and classmate Camille staying with me on and off, and we had so much fun! Taking the bus to campus together for presentations, sitting around talking in our jammies.

On the last day of her visit, Sunday, we walked to my fave coffee shop together and then bought huevos rancheros from the dimey food truck operators outside. It was nice having a little detachment period where I got to reflect with a friend who’d just gone through the same stuff I did about what was coming next for us, and what was exciting, and what was scary. Also, it’s a real bummer that a sizeable chunk of my friend group has left town, so it was nice getting a few extra days with her before she took off too.


So that’s the celebrating. More posts to come about how I got there!