MondayMorning: Nutrition in the Community. This contrasts with working in a hospital, and has been covering all the aspects of community practice that a dietitian might be involved in. My coeliac education session is part of this module. This week we were learning about tube feeding people living at home or out in the community, which involved a lot of calculations of energy and protein and fluid per kg body weight and timing delivery of the feed at ml per hour where bags contain 500, 1000 or 1500 ml at 1, 1.2 or 1.5 kcal/ml and 5.5 g protein/100 ml and can be delivered at 50-100 ml/h over 10-20 hours making sure that changing bags isn't at 2 am and people aren't getting too much or too little sodium and what if they get diarrhoea? I broke with tradition and sat at the back with some different, younger people, and I think I'll do it again. They are having just as bad a time as the rest of us but are somehow more pleasant to be with. Perhaps a change is as good as a rest.
Afternoon: An Occupational Health meeting and a meeting with my research project supervisor. It wasn't clear what the OH meeting was about, but I brought along all my vaccination records just in case. After waiting for 50 minutes sitting on the tiled floor in a corridor with all the other students who'd been summoned at the same time, the outcome was that I need to establish my vaccination status for measles and mumps. The meeting about my research project (The impact of visual impairment on food choices) resulted in some very good advice, but more work than I had hoped if I am to get it finished.
Evening: Badminton club night. I love badminton.
TuesdayMorning: Dietetic Practice. we had a visiting lecturer talking about paediatric dietetics: mostly infant feeding and weaning, protein, energy and fluid requirements. The very best part about this lecture was that it didn't last for four hours, only three and a half. Main thing learned: weaning isn't just about nutrition, it's also about muscle control of chewing, swallowing and hand-mouth coordination. Meh. Don't care.
Afternoon: Normally a module about the research we're doing, but they're combining it with some other useful things in anticipation of our clinical placements over the summer. We have to practice doing a one-to-one consultation with a patient, so we have a volunteer each and up to half an hour to talk to them about their diet. We are not being assessed on our interview skills, but on the accurate completion of a hospital record card, and a thoughtful reflection on the experience. Mine is scheduled for next week, so I had the afternoon 'off', which I spent on my research project proposal.
Evening: More research proposal. Mr A reports toothache.
WednesdayMorning: I visited the Rugby drop-in group of the Warwickshire Association for the Blind, where I met the person who's going to help me recruit volunteers for my research. Then I had a chat to some of the members of the Association who'd dropped in. I anticipate that the main problem I will have when I do the research is getting them to stick to the point. And to stop talking. Also received a message from our indefatigable student course representative, asking for feedback to take to the course management meeting. I am looking forward to this, even though it will take an enormous amount of effort to turn it into constructive criticism.
Afternoon: More on the research project, but seeing as I was at home for a change, I cooked the supper. Mr A went to the dentist, who diagnosed an infection and a need for root canal work, prescribed antibiotics and made an appointment for after Easter.
Evening: Research proposal finished, for now anyway. The exam timetable was published at the end of last week, so I spent an hour trying to plan all the coursework and revision that I'll need to do between now and then. It will all be over on 1 June, and none of us will die from the effort. It just isn't very pleasant at the moment. Mr A had to sleep sitting up because the pain stopped him sleeping lying down.
ThursdayMorning: Molecular Nutrition, all about how gene expression is affected by a diet containing fat, and the possible reasons why omega-3 polyunsaturated fatty acids (from oily fish) are better for you than saturated fats (from lard, meat and hard fats). It's not an easy subject, littered with many impenetrable terms such as SREBP1c and non-hormonal nuclear receptors and PPARs. I think I am now full, and anything more that goes into my brain displaces something else that has to fall out. I have lost some lecture notes, and I thought I'd lost my university card but found it in the car, and everything is in a muddle.
Afternoon: Dietetic Practice about paediatrics again. This time it was practical cooking: we had to team up in fours and cook up a meal for a 6-month-old and a 9-month-old child, with an allocated bag of ingredients. My group of 'those left over once everyone else had formed groups of four' consisted of me, one girl who promptly cut her thumb rather badly, and the only male in our year who got the time wrong and turned up half an hour late. I gave Late Male the bloodied vegetables to look after, and Bleeding Girl did the nutrient calculations and made up a bottle of formula milk. I did the rest of the cooking, and Late Male did the washing up. The two paediatric sessions this week only served to confirm that I'm really not very interested in paediatric dietetics. It was nice to work with different people again though.
Evening: Badminton match. True to form we lost overall, but with GG and me winning two out of our three rubbers. I had so much more fun in those 2½ hours than in all the time I spent at school this week. There's another match next week, but I've had to pull out because all my deadlines happen just afterwards and I will need every evening for last minute panicking. Mr A feels a bit better now the antibiotics are starting to kick in.
FridayMorning: Nutrition and the Health of Populations ('Nut & Pop'), with my favourite tutor/lecturer. I have discovered that I am not the only one in the room who has a soft spot for him, but he is my age not theirs and I will fight them if necessary. We are covering osteoporosis and nutrition of elderly people, particularly calcium and vitamin D and reasons for the high level of malnutrition found in the population of older people. The lecturer included the BBC report that dad drew my attention to earlier in the week, calling for better training in nutrition for doctors because malnutrition is still not picked up by GPs and hospital doctors. This is despite a seminal research finding 15 years ago highlighting that 40% of patients were malnourished on admission to hospital, and even more were malnourished on discharge.
Afternoon: I am supposed to be attending the last lecture in the Clinical Pharmacology module, about anti-obesity drugs. It is on a different campus, it is Friday afternoon, the lecture is only 18 slides long, there is now only one approved treatment for obesity since the only other one was withdrawn in the last few weeks, and we've been there and done that several times in different modules. So I didn't go. I celebrated by working on my essay for Nut & Pop, which is about the benefits and dangers of mandatory fortification of flour with folic acid in the UK. It is already done in the USA, Canada and Chile, but various European countries are still holding off. The UK Scientific Advisory Committee on Nutrition has recommended that we go ahead and fortify, but the Chief Medical Officer is still not convinced.
Evening: My evening off. Mr A's recovery stalled and he was in a bad way. He rattled when I shook him after taking two sorts of blood pressure pills, three sorts of painkillers plus the double dose of antibiotics for the root canal infection that the dentist advised. He was relieving the pain using iced water, and shunned the 'compress' that I manufactured by filling a finger of a vinyl glove with frozen peas. Eventually he managed to sleep with the aid of a piece of raw potato shaped in some way I can't quite understand but it kept his teeth apart or his mouth cool or something.
Saturday update: Mr A is much better and currently pain free. I am about to get started on a delightful weekend full of the pros and cons of folic acid fortification.