Healthcare Advocacy in D.C.

Well, I went to The Hill.
The Crohn’s and Colitis Foundation asked if I would, so I said, “OF COURSE!!!”

My professors were kind enough to let me get finals out of the way early so I could go make noise on Capitol Hill for a couple of bills:

1. The Medical Nutrition Equity Act H.R. 2501: Currently, health insurance in America will cover medical foods as long as they’re inserted through a nasogastric (NG) feeding tube, even if there’s no clinical indication for insertion of an NG tube. We need these medical foods covered orally! Medical foods are NOT groceries…that seems to be the consensus on The Hill, and I had to explain from the position as a future registered dietitian:
– Medical foods are broken down into single amino acids, digestible monosaccharides (single sugar components) and lipids, so the body can absorb them easier. These are especially important in patients who are malnourished.
-Medical foods are important, especially in pediatric patients, to prevent or prolong the need for more expensive/potent medications.

2. The Safe Step Act H.R. 2279: There are laws in 25 states currently that protect patients, but not in Oklahoma where I live. In Oklahoma and states like it in this respect, insurance requires patients to first fail a medication before they can then be prescribed a medication that would be helpful. However, there’s no burden of responsibility on the insurance companies to review the appeals process submitted by the doctor stating that the patient is failing a drug. This could mean up to 6 months time would pass before a patient finally receives permission from the insurance company to try a new drug. I experienced this firsthand in Oklahoma last year:
– My drug of 6 years, remicade, began failing me because my body developed antibodies to it since my doctor repeatedly forgot to write the order for it, delaying the time between infusions of remicade.
-I “failed” the drug, meaning I began to experience uncontrollable symptoms. I was told that it would take “several months” before insurance would approve another drug. I was missing work and knew I didn’t have “several months”. Literally, I was scared that I would die. I was violently losing blood 30 times daily, losing weight, and I couldn’t stay hydrated. I was hospitalized twice last year because of issues associated with failing remicade.
-I moved my care to Texas, which is a 6 hour round-trip ordeal for me to receive treatment. Because Texas has laws in place that protect patients, I was able to get my infusiong within 72 hours of finding my new GI doctor in Dallas. When insurance acknowledged that I was “failing” remicade, I was able to get on a new treatment within 48 hours of the doctor submitting an appeal to insurance.

The Safe Step Act would require insurance to make timely decisions so patients could receive the treatment they need as prescribed by their doctor, potentially avoiding missed time from work, loss of employment, surgery, hospitalizations, or even death (in extreme cases). The Safe Step Act saves healthcare dollars and lives!

A local GI doctor (George) and I spoke with the staffers for Senator Inhofe and Congresswoman Horn from Oklahoma, and then we met up with friends from New York and Kansas (Sarah and Tyler) to speak with Congresswoman Davids and Senator Roberts from Kansas (side note: Kansans are truly some of the kindest people I have ever met). Our goal was to get co-sponsors for these bills so we can make them into laws, bettering the lives of IBD patients and beyond. Most, but not all, of the legislators were receptive and even supportive! Contrary to what we see/hear in the media, Republicans and Democrats CAN agree on some things, and since these bills are bi-partisan, that made this whole, “please support these bills” requests much easier.

I saw Congresswoman Alexandria Ocasio-Cortez from New York from afar- SO exciting to see women MY AGE in Congress! I also saw Senator Ted Cruz from Texas about 127 times.

Between our meetings, we grabbed lunch underground at a cafeteria and waltzed over to the U.S. Botanical Gardens for some peace and quiet from the hustle and bustle. Shout out to Sarah from NY for knowing D.C. like the back of her hand, because I felt like we had a tour-guide, and this was a gem:

Since the 20 days that have passed since meeting with legislators, we have gained 22 co-sponsors for The Safe Step act. I sent another follow-up email to some staffers today, and we are actively seeking more support.

If you’re interested in these bills above and want to make noise where you are, email your representative and ask them to co-sponsor the above bills. Tell your story, and let them know how these bills would help you. These bills are currently both on the House of Representatives side, but we will have Senate call to action soon!

I’m learning that advocacy is so, so important. If you’re affected poorly by the systems in place, we can make a change…but we need to tell our stories. Lawmakers need to know how we can change our world, and advocacy is the perfect space to not only let people in positions of power see how we need change, but also to offer a solution through these bi-partisan bills.

Keep moving forward!

Not pictured: coffee shops, crab cakes with my friend Hope, riding bikes through a thunder storm, touristy monuments, and a cocktail reception with new friends

P.S. If YOU want to support medical research directly, please consider donating to my fundraiser here!


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Where I’m headed in Nutrition

Where I’m headed in Nutrition

WUFF LAWDAMERCY School has been BUSY lately!

How have yall been?

Something on my mind lately- to be honest, it’s a little existential. When I first started my master’s program in nutrition to become a registered dietitian nutritionist (RDN), believe it or not…I had no desire to become a healthcare provider in the realm of GI. At all. No gastrointestinal grossness for me, please and thanks, especially with being a patient and all. NOPE. Hard pass.

But then.

I kept getting mad, honestly. I was mad that IBD and IBS were constantly categorized as one and the same- it would be like telling someone with type 1 diabetes that it was just like type 2. And then I got mad once I realized that we constantly fail our patients by giving them micronutrient infusions but then not ensuring they’re accessible….aka, “medically necessary” by insurance companies…aka Susan needs an iron infusion, and now she’s slapped with a big ass bill, because her insurance company isn’t covering it since it’s not a “medically necessary” pharmaceutical, so Susan stops her iron infusions short, and now we struggle to get her healed timely and optimally. I feel like as healthcare professionals we are stopping the care short by not ensuring that it’s extended and accessible for healing. ugh. Makes me…mad.

And then.

I started learning about energy nutrients (aka biochemistry for food, which sounds boring and disgusting, but meet mega-nerd Stacey. She loves this shit). I learned about all the different parts of the GI tract, where food is absorbed, how we can enhance bio-availability of certain nutrients by pairing them with others. And oh no- I liked it all.

What I’m saying is…I have decided to write my thesis over nutrition in Inflammatory Bowel Diseases (IBD), and I want to work with medically complex cases- GI diseases and the like… in the worst way. I need to think really hard, and GI diseases are tough to treat. They’re fascinating (I say this as a patient!) and terrible (see? still a patient!), and nutrition support is so, so crucial.



I also still want to write nutrition articles for endurance athletes for magazines. Ever since Andi Anderson on How to Lose a Guy in Ten Days, I can’t seem to shake the dream of working for a magazine, and I refuse to let my adult self out-grow that junior high school daydream. And I also want to consult for MLB teams, and I don’t care who you are; I can out-baseball talk you any day. Unless you’re a Yankees fan, in which case I doubt you’re a real fan of the game and would venture to guess that you’re only a fan of winning, and I can’t say that I blame ya…but boy, bye.
xoxo love ya forever, Houston Astros.

But that’s the cool magic of the nutrition field. I’m going to be able to piece-meal my career together so it doesn’t fit a conventional, boring mold.

All this has me thinking…oh boy.
In October 2012 when I was handed my diagnosis of moderate to severe ulcerative colitis, it’s like a new life began for me. My thought process shifted, and I became more tender, softer, empathetic, stronger, thicker, resilient, and driven. I 100% do not believe everything happens for a reason, but I’m oddly thankful for an unfortunate diagnosis forcing me to be a vulnerable patient in a flawed heath care system. If I can’t change it, I deeply hope I can bring some light to it (I’m not entirely naive here; I’ve worked in healthcare- just hopeful).

And in the meantime, I’ll write a boring thesis that asks thoughtful questions and has a few hopeful answers for the future of GI diseases.
I’m excited.

And I’ll be rooting for the ‘Stros.

And for you!

-Stacey







^Post Hurricane Harvey at Houston Methodist Hospital

P.S. Posting pictures of Houston like I know where I’m headed…but I HAVE NO IDEA where I’m headed. Just along for the ride!

Alcohol for Health?

Alcohol for Health?

Here to talk to you about happy hour today!
One of my favorite macronutrients (second to carbs): alcohol. I was shocked to find out that alcohol is considered a macro, along with protein, carbs, and fat, NOT because it’s nutritious (spoiler: it’s not), but because it’s consumed in large amounts. oops.

What is moderation?

Moderate drinking is 1 drink/day for women, and 2 drinks/day for men, not because the laws of drinking are sexist, but because men typically have more lean body mass, which makes the alcohol easier to metabolize.

It has suddenly occurred to me how remarkably basic I am, struck by the realization of HOW MANY PRETTY DRINK PHOTOS I have taken over the years…cheers?!

What’s considered “a drink”?

I didn’t make the rules, Sandy; The CDC did, and they say that a drink is:
– 12 oz of beer with 5% alcohol content, or
– 8 oz of malt liquor
– 5 oz wine
-1.5 oz of 80 proof distilled spirits or liquor, like whiskey, gin, rum, or vodka

What’s heavy drinking?
-more than 8 drinks/week for women
-more than 15 drinks/week for men
^that seems unfair, right? But I digress.

What’s binge drinking?
-more than 4 drinks in a single occasion for women
-more than 5 drinks in a single occasion for me

I was also mildly taken aback when I read THAT ^ was what was considered binge drinking. In my earlier twenties, I spent so much time technically binge drinking on patios, at the beach, while studying, etc. Also- if you think you’re being easy on your liver by binge drinking, but not heavy drinking over time- that is incorrect! When we get drunk, we activate a secondary system in our liver called the MEOS pathway to metabolize alcohol- this takes a LOT of energy, and our bodies preferentially metabolize alcohol over pain meds, etc to remove it from our body as efficiently as possible. This will enable meds to remain in your body longer since your body is a little preoccupied with getting rid of the alcohol, so be vigilant! Know if your meds are metabolized by your liver before drinking. Does your RX bottle warn you about drinking? Part of drinking is being responsible, and that includes knowing how your medications work in your body.

I have since slowed down substantially on drinking; it disagrees with my ulcerative colitis situation on many occasions (alcohol kills GI cells!), and I’m at point where I’d rather be pain-free than buzzed. Plus, as it turns out, combating depression and anxiety with alcohol is maybe not the best idea.
*laughs nervously*



But I thought red wine was good for you?


Not untrue! This study mentions resveratrol and potentially other polyphenols in wine that have anti-inflammatory benefits. However, there is no evidence that you should start drinking if you don’t- you can achieve health with a mostly healthy, consistent diet alone, without help from alcohol. Similar results were found in this study– where the good parts of wine alone weren’t helpful in improving longevity, cancer outcomes, or inflammation with a Western (aka mostly American) diet. Bottom line: red wine, in combination with a healthy overall diet, like the Mediterranean diet that is rich in fruits, vegetables, and whole grains, is beneficial for overall and cardiovascular health, but not wine by itself.

red wine + healthy diet with fruits, veggies, whole grains = healthy
red wine + cheeseburgers + fries + rarely if ever fruits, veggies, whole grains = not ideal for health
-we can’t rely on red wine alone to save our diets and remove our risk factors for diseases, sadly.

And if there’s a takeaway from this post- it’s everything in moderation. I even defined moderation for you! Technically, the CDC did, but you can reference it here. 🙂

Unfortunately, I haven’t found any studies about the health effects of margaritas. But when I do, you’ll be the first to know. Who knows, maybe margaritas are the next superfoods smoothie?!
Here’s to wishful thinking.

Cheers!

For more info about alcohol from the CDC









More Cowbell

More Cowbell

I’ve got a fever…

If you don’t understand my humor, circa 2000 SNL…can we be friends?
Can we?

I hear people say “fruits and veggies don’t make me feel full.”
Here to tell ya…they’re not supposed to, sister!!!

Fruits and veggies are full of fiber, which can HELP us feel full and satiated, but fruits and veggies are carbs (hi- please keep carbs in your diet xoxo). One macronutrient alone won’t fill you up…not for very long, anyway.

If your snack looks like the above, you need more cowbell.

Image not mine- took from google images. Not sure if this disclaimer protects me from copyright infringement. 

YASSSSSSSS
More cowbell:

Fiber, fats, proteins, carbs = all the macros + fiber = more cowbell
Fiber, fats, proteins, carbs = high-octane fuel for that fine machine that is your body
Fiber, fats, proteins, carbs = the secret to keep you feelin’ full + fine longer

Pictured above
Fiber: pears, cucumber
Protein: chicken
Carbs: pears, cucumber
Fats: crunch PB

“But it’s just a snack”. But isn’t a snack supposed to be a pick-me-up? Wouldn’t you like to stay fuller longer so you don’t pick up a snack that you’re not enthusiastic to snack on that’s going to make you hungry in .2 seconds?

Yes. And the only cure…is more cowbell.

So…You Want to Be a Registered Dietitian Nutritionist?

So…You Want to Be a Registered Dietitian Nutritionist?

Happy National Nutrition Month! MARCH! Can it feel like Spring, already? To commence National Nutrition Month, I’m sharing some things about a profession I’m pretty stoked about: nutrition! Scroll down for more.

H O W

How to become a Registered Dietitian Nutritionists (RDN)? What is an RDN?

An RDN is a food and nutrition expert who has successfully completed:
– a bachelor’s degree
– prerequisite coursework for a DPD or CP
– 1200 hours of supervised practice (dietetic internship)
– a national credentialing exam

There are a number of routes to becoming an RDN, but here’s the route I took/ am currently taking:
bachelor’s degree: check! B.A. in Sociology- note: the bachelor’s does NOT have to be in the field of nutrition, because beginning in 2024, a master’s will be required to sit for the credentialing exam.
– I worked full-time and took the prerequisites simultaneously, because I could not afford to up and quit my job. I took biochemistry, organic chemistry, chemistry 2 with the lab component, and nutrition through the lifespan one.semester.at.a.time. It took 5-ever, but I am told that it will be worth it. Plus, I didn’t accumulate additional debt from paying on a course or two at a time. Bonus: If you work for a hospital, a lot of them will pay for the prerequisites!  Look into their tuition-reimbursement programs and see!
-I enrolled in a Didactic Program in Dietetics (DPD). A DPD is ONLY the coursework component to become a dietitian- not the internship. Think of the DPD as step 2 in the process after completion of prerequisites. I FULLY planned on working and going to school simultaneously like I had been doing, and then I was planning to apply for a dietetic internship (DI) later. Thankfully, I moved to a town with a Coordinated Program (CP) that combines the internship with the classwork.
-I’m currently completing the CP, and when it’s all done, I’ll have all my supervised practice AND some graduate degrees under my belt. Once I graduate, then I am eligible to sit for the CDR credentialing exam. Some states require additional licensure to be a licensed dietitian to practice (LD).

I wanted to be credentialed- that was important to me, because in order to work for the World Health Organization, hospitals, and community programs like WIC, even NASA…they require that RDN credential. Without the credential, the future seemed uncertain and volatile to me. If credentialing isn’t important, I suggest checking out programs in integrative nutrition. However, I don’t know if “nutritionist” will always be an option without pursuing the credential. Many people are advocating for the “nutritionist” title to be protected through the RDN credential, which can only be attained via the steps I listed at the top of this post. What I’m saying is, all dietitians are nutritionists, but not all nutritionists are dietitians…make sense?

What does an RDN do?
Where are they?

Glad you asked! They work anywhere and everywhere! In gyms, hospitals, schools, corporate wellness, for NFL, the NHL, MLB teams, the Olympics, collegiate sports teams, community programs, in education/academia, for the NIH, the WHO, for THEMSELVES in private practice, in the media, and beyond. RDNs provide individualized, evidence-based nutritional counseling and medical nutrition therapy (MNT). RDNs take a scientific approach to health maintenance and prevention. RDNs can even join practice groups (DPG) and gain field-specific knowledge in areas like pediatrics, diabetes, integrative and functional medicine, culinary arts, and environmental hunger. Dietitians can even become board certified in sports nutrition, pediatrics, clinical nutrition, oncology, diabetes, and more!

^Texas Medical Center in Houston

What excites me about the field of nutrition?

I think there’s room for entrepreneurship and growth in the nutrition field. People are more interested in nutrition and disease prevention than ever, and the job growth for this field is exciting. I like the idea of piece-mealing a career that’s rooted in science, helpful for others in areas like counseling and education, and practical. There’s constantly new research being published to keep up with, and the science nerd in me loves that. I like that the field doesn’t have to be rigidly structured and black and white- there’s room for flexibility in nutrition…and I’m excited to see what that looks like in my own life as a professional.


Friendly Reminder about Healing

Friendly Reminder about Healing

Healing is.not.linear.

I have learned this with ups and downs of life with a chronic disease.
But this is especially difficult for me to remember with my mental health.

I struggle with anxiety and depression, and I’m currently wading through it with help from a number of healthcare professionals, people who support me, and the #1 role-player…myself!

I woke up a couple of days this week in a fog, sad, heavy…which is counter to my normal, healthy, chipper self. But I’m not apologizing for these bad days, and I’m taking them in stride, going to therapy, journaling, soul-searching, moving my body when I need to, being still when I need to, feeling all the feels, and not feeling bad for the bad days.

Growing up, I carried such guilt when I had a bad day, and my coping mechanism was pretending that everything was finnnnnne and grrrrrreat. I now know that I don’t owe anyone an apology for a bad day, not even myself.

I guess what I’m saying is- give yourself grace, because I’m working on giving myself grace:
-when I KNOW I’ve done everything to feel better; given myself the right amount of sleep, food, #self-care, and I still don’t feel better
-in the thick of it, in my lowest low, feeling like it will never pass. spoiler alert: it will- it’ll wash over
-when I’m panicked for no reason/ when I’m panicked for a real reason
-when I’m tired, weary, and downright depleated
-when I don’t accomplish everything…or anything on my to-do list

Healing is the ups, the downs, the peaks, valleys, rough parts, ins, outs, and all the in-between. But it’s the good stuff, too. I’d like to think the lowest lows help us feel the highest highs with even more intensity and gratitude.

I want to be a sure, steady shoreline that can take on storms, and allow them to wash over. I watch the tide take the storms away, and when they come back, I’m still the shoreline, only this time- I can stand in the storm from a different vantage point from before, because I’m still the shore.
Is that cheesy?
I’m a cheese-ball, yall. I don’t care- this works for me, okay?

And remember- you’re never alone. People are healing all around you, including me.



Chocolate Cherry Smoothie

Chocolate Cherry Smoothie

My smoothie game has been wicked strong lately.
But I promise not to bore you with all the reasons why
Make this, and thank me later.

1/2 C almond milk (malk brand)

1/2 C H2O

5 frozen wild cherries 

3 ice cubes

1 C frozen broccoli

1 heaping tbsp PB

2 tsp wild honey 

B L E N D

Note: You don’t need to add honey, or any sweetener for that matter, to smoothies when fruit is added. The fructose in the fruit is sufficient enough! But this honey was local, fresh, and delicious, and you better believe I enjoyed every last drop of it.

This smoothie has all the goods to keep you feelin’ full and fine:
Protein (PB + chia topping)
Fat (PB + Milk)
Fiber (broccoli + cherries)
Carbs (broccoli + cherries)

If you’re using this as a post-workout snack, your body needs carbs AND protein to recover optimally. Don’t fear those carbs, Sandra.

Also- I know people are on this whole “fruit is bad for you” craze, and that is BANANAS. Those aren’t your people. Fruit is SO SO rich in phytochemicals, antioxidants, vitamins, and minerals that are all GOOD for your body. As Americans, TRUST me when I say that fruit is the least of our problems. Added sugar? shoot, yeah. We could do a better job here…but don’t demonize fruit, I beg you.


Let me know what cha think of this recipe if you give it a shot!

P.S. THIS study talks about how tart cherry helps accelerate muscle recovery after exercise!