Tuesday, July 23, 2013

Week 2 at EVMS!

Monday(07/09)- It was a busy day but I loved it! My morning was spent with the certified diabetes educator meeting with diabetics who were having trouble managing their diabetes.  During the one on one meetings with the patients we discussed their blood sugars, eating habits, and lifestyle. For a diabetic, everything affects their diabetes and diabetes affects every aspect of their life. Eating a balanced diet with right sized portions can make managing diabetes much easier. For instance, when a diabetic eats something high in carbohydrates (cake,cookies,bread) if they pair it with a lean protein it will help balance their blood sugar. Therefore, they have fewer spikes in blood sugars. However, not only diabetics should eat like this. When a non-diabetic eats a lean protein with a carbohydrate in prolongs digestion and will keep them full longer.

In the afternoon, I went to maternal-fetal medicine to work with Dr. de Veciana. She was fantastic she taught me so much about how to communicate and learn from patients. She spoke to me about becoming a doctor and made me realize that maybe becoming a doctor rather than a nurse would be a better choice for me. I loved working with her because she was joyful and it allowed the patients to really loosen up and speak to her about their worries. I  enjoyed being able to hear so many stories some good and some bad. Although Dr. de Veciana taught me a lot, one thing she said that stood out to me is when she said that her patients teach her something everyday. This is so true, I feel as though I have learned more during these couple of weeks then I would have ever learned in a classroom. There is more to being successful than good grades it's being able to listen, understand and experience things from others. No one knows everything no matter how much education they have. "Anyone who stops learning is old, whether at twenty or eighty."- Henry Ford

Thursday(07/11)- It was such an amazing day! I had the opportunity to talk to diabetic patients about their struggle with diabetes. I met with a patient who was having a hard time because she went into the hospital healthy and came out ill with a lot of new information about how to maintain her health. We both shared the same view on health. For instance, realizing that health is not guaranteed. Diabetes has made me realize that I must live the best possible life now, with good diet and exercise, so that I can prevent illness in the future. Everyday that I feel good and I am in good health is a good day because you never know what tomorrow will bring. The patient was feeling down about her health but she said seeing me in great spirits about living with this illness made her hopeful for her future. Another patient I met was fairly new to diabetes. She was a type 1 and having a hard time coping. The patient told me that after seeing her family live with type 2 she made sure to live a healthy lifestyle to avoid diabetes. However, as many know type 1 cannot be prevented like type 2 diabetes. Therefore, despite her best efforts she was diagnosed with T1D. She, like majority of us diabetics, stressed about her A1C and blood sugars. The patient was having a hard time bringing her A1C down and just wanted to give up. Hearing her stress reminded me of a time when I too was having a difficult time stabilizing my blood sugar and just wanted to give up. I felt this way until recently after speaking to other T1D's who made me realize that the number on the glucometer is there to help guide me to better manage my diabetes; it is not telling me that I am failing at taking care of my diabetes.  The only way we can fail at checking our blood sugar is when we do not check at all because then I would not learn how to keep more stable blood sugars. Blood sugars do not have to be perfect 100% of the time. If our blood sugars were perfect, while it would be nice, we would not learn. Having the expectation of perfect blood sugars is unrealistic and will only cause more stress. If you're a diabetic then you know stress will only hurt you more than help you. This is because stress raises blood sugars for those who do not know. Therefore, sit back take a breather and think what can I do differently next time. It may not work next time either, but it just allows us diabetics to learn what not to do. I like to think of diabetics as scientist we are constantly experimenting with our blood sugar trying to figure out what method of treatment best suits our diabetes. Everyday living with T1D is different and brings new experiences and life lessons. "Don't be afraid to fail. Don't waste energy trying to cover up failure. Learn from your failures and go on to the next challenge. It's okay to fail. If you're not failing, you're not growing." - H. Stanley Judge While I don't like the word fail because I do not think bad blood sugars means we are failing I do like the underlying meaning to this quote. This quote can really help those who struggle with blood sugar relax and realize it's okay for their blood sugars to not be perfect. Meeting with patients and hearing such positive feedback made my day amazing. I had the best day and it made me realize just how much I want and would enjoy a career in diabetes education. Now I have the decision of becoming either a certified diabetes educator (CDE) or an endocrinologist.

Friday(07/12)- Casual Friday! I got to wear jeans and sandals which is always nice. I worked with Jen and Sam the two girls who work in research. We started getting ready for RAM (Remote Area Medical) which is next weekend (very exciting!). For lunch we went out to a local restaurant called Bardo. They serve tapas so we  all ordered 2 or 3 things and shared. Luckily we are all vegetarian/vegan (what a coincidence!)  so sharing was easy.  Everything was very delicious and we had a great time relaxing away from the office. The waiter even told me as I was leaving, "I don't normally fraternize with customers but you are very cute." which is always a nice thing to hear!  Friday was a very fun and relaxing day before the weekend. :)

Wednesday, July 3, 2013

First week in Norfolk!

Hello everyone! 

My name is Adrian Cobiella and I am from Orlando, Fl. I was diagnosed with type 1 diabetes 10 years ago the day after Mother’s day when I was 11 years old. I am currently a student at the University of North Florida.

For the past ten years I have always known that I wanted to work in the diabetic community helping others. Therefore, this internship is going to be fantastic for my future career! My internship at Eastern Virginia Medical School (EVMS) will consist of

  •  Assisting with community diabetes screening events. 
  • Facilitating screening activity
  • Assist with patient recruitment and patient enrollment 
  •   Assist with data collection for the Wellpoint grant.
  • Working with the endocrinologist, Nurse Practitioners, CDE’s, and other doctors.

My internship’s journey began on Thursday when my mom and I started our 12 hour drive from Florida to Virginia! The drive was not as boring as I thought because we were able to stop at the famous tourist attraction “South of the Border” in South Carolina. The attraction was full of mexican inspired buildings and fun souvenirs.

 Friday- My mom and I were able to experience the horrible traffic that Norfolk has to offer. On our way to EVMS our 10 minute drive turned into a 2 hour drive. I now know to always leave plenty of time to get wherever I need to be! After being in traffic I moved into my new apartment.

Saturday- My mom and I explored the city of Norfolk. We had a great time seeing what life on the  Navy Battleship Wisconsin was like. I became very claustrophobic in the bottom of the ship and lets just say I will not be joining the Navy anytime soon! However, it was a lot of fun to see what life in the Navy was like on the ship!

  Going to the very bottom of the battleship!
 These are the bunk beds that the sailors slept in! Very small and cramped! 

 The dentist office on the ship. 

The chapel on Battleship Wisconsin. 

Monday- was my first day at EVMS! I first received my employee badge and then went on to learn all about EVMS and the great things that they have done for the community. For instance, December 1981: Elizabeth Carr, the nation’s first child conceived through vitro fertilization, was born in Norfolk General Hospital under the care of IVF innovators Drs. Howard and Georgenna Jones. Dr. Mason Andrews performs the delivery(EVMS.com, EVMS History) 
Tuesday-I had a lot of training to complete before I could begin to work. However, I had the chance to meet everyone in the office and they are all fantastic. I am very excited to start working with everyone.
WednesdayToday was great I was able to work with Dr. Aloi following him while he met with patients. Hearing everyones story about how they handle living with diabetes was very interesting and educational. I also learned how to check someones A1C and cholesterol levels for when we will begin to go out on study's.  The second half of the day I was able to follow a nurse practitioner while she met with her patients. I learned about how different people view having and caring for diabetes.   

Thursday- Independence day! 
Friday-  I went to Sentara Princess Anne Hospital in Virginia Beach to work with pregnant women with gestational diabetes mellitus(GDM). I had the opportunity to work with Phyllis Woodson an amazing Certified Diabetes Educator (CDE) and Certified Dietitian (CD). I learned so much about gestational diabetes and what the mother must do to manage it. For instance, if a pregnant woman can control her GDM by eating a strict diet  she may never have to go on insulin or pills to control her blood sugars. The women I met today who had GDM had either had it in a previous pregnancy or had a family history of type 2 diabetes. Educating those with GDM is very important because GDM increases the woman’s chance of developing type 2 diabetes later in life by 35-60%. Therefore, a CDE must educate the mother on how to not only have healthy eating habits now but also after she gives birth. The education process is mostly focused on the type of food and how much food the mother can consume while pregnant. Some major changes the mother must do:

  • No sugary sodas or juices. 
  • No milk and fruit together.
  • No milk or fruit for breakfast. 
  • Only 1 piece of fruit a day. 
  • Must eat protein with a carbohydrate. 
These changes in diet are also required for a pregnant woman with either type 1 or type 2 diabetes. 
View from the office.

I had such a great first week in Norfolk, Va and I cannot wait to see what the next 5 weeks have in store!