Christmas Vacation

I'm officially on Christmas Vacation!  Whoop Whoop!

Today was my first day of Christmas Vacation since Public Health is closed from Dec 22nd to January 2nd.  It's actually awesome because it means I get to go home for Christmas without missing any days of work.  They have Mandatory Leave with Pay days up here which means you're not allowed to work but you still get paid as if you were.  So technically I got paid to ski today!  Have I mentioned that I love the North?

Getting Paid to Ski :)

Meg and I headed out to the Hay River Ski Club to hit the trails.  It was more of a social ski than a workout since Meg was on classic skis and I was on skate skis but it was still fun.  I am anxious to get out and actually get better and get a good workout in though.  I guess I just need to find someone roughly my speed...aka not very fast!  I'm still learning so it's tough but I love that it's an activity that allows me to spend hours outdoors in the middle of winter.  I bailed pretty hard on one of the hills but other than that I managed to stay upright.  Unfortunately we had a pretty rough windstorm a few days ago and haven't had any new snow since then so the trail was covered in a lot of debris so I spent most of the ski terrified that by the time I was done the basses of my skis would be destroyed.  There are a few scratched on 'em but I'm hoping they'll brush out.  Fingers Crossed!

Last night we celebrated being on vacation by having a big bonfire out in Old Town at a friend's place.  I'm still really bad at whipping out my camera all the time in fear that I'll look like a huge looser so I only have a couple of blurry, dark pictures.  It was fun though!  We roasted hot dogs and marshmallows on the fire and had a nice low-key night.

Bonfire Night!

Acclimatization

I think I’m finally starting to become acclimatized to the North.  When I first got here I was bundling up in 12 layers every time I left the house.  Now I don’t wear my ski pants unless is colder than -25, I’ve switched from a hat to ear muffs for temps warmer than -15 and I don’t wear my big huge gortex mittens unless it’s -25 and instead just wear a pair of knitted red Olympic Mittens that I didn’t deem warm enough when I first got here.  I also started out by wearing huge clunky Sorrel boots every time I left the house but since it’s so cold here, and stays cold, I really didn’t need the waterproofing of those boots and now I just wear a pair of Ugg knock-offs which I’m pretty sure were about 7$ at Walmart.  I had never ever wanted a pair of real Uggs because in PEI girls would walk around in them but have wet feet all day since the puddles were unavoidable, even in the dead of winter.  The dead of winter in PEI means a lot of snow, but even more slush, which is definitely not conducive to wearing fabric boots. They seemed like the silliest invention ever considering they were winter boots but not waterproof.  Now  that I’m here and realize that not all winters require waterproof boots, I am beginning to see the appeal of a warm pair of boots that are light weight and easy to walk in.  I might have to invest in a pair of legit mukluks before the end of winter.

Other than how to dress appropriately for the weather, I feel like I’ve learned a lot up here!

1.)    “Down South” means Edmonton, not Florida. This is important since it’s used in conversation all the time and I was under the impression for my first week here that everyone went to Florida regularly and had family there.

2.)    Eating polar bear liver will kill you because it has toxic levels of Vitamin A in it.

3.)    Tuberculosis is still very prevalent up here.  About 80% of people test positive for the Mantoux test indicating that they have had exposure to TB and are carriers of it.  If I make it out of here without exposure to TB I will be considered lucky, especially since I am working in Public Health and in the Hospital.

4.)    My coworker is Stompin’ Tom’s cousin and was also in the show “North of 60”.

5.)    It is commonly believed that rabbit is a Canada’s Food Guide Serving of Vegetables (not meat and alternatives) since rabbits eat vegetables exclusively before being eaten themselves

6.)    You can wear real fur without fear of having red paint thrown on you by some Peta supporter. In fact, it’s encouraged because it’s soo much warmer than synthetic.  I’ve seen fur lined hoods (like in my Canada Goose Coat), I’ve seen fur lined coats and I’ve even seen a full seal skin coat and mittens ensemble.  No one looks twice or judges you for wearing it either.

7.)    Out at the ski club (aka a mere 15km from town) there are wolves and lynx and black bears.  I figured there would be wolves, but LYNX!!  How unreal is that?  I hear they are incredible rare to spot, but we saw lynx tracks along the ski trails last week.  So rad. Pictures of them remind me of our old cat Sid for some reason. The ski trails are lit at night (which is almost always) and these cats are primarily nocturnal.  I wonder if any late night snowshoers have ever gone missing from the trails…

Evidence Based Practice

This week at work has been incredibly quiet. By quiet I mean boring.  I’ve only had one client and was caught up on my charting and all my work at the end of last week so I didn’t really leave myself much to do this week.  I’ve been passing the time reading journal articles and catching up on the most current nutrition research.  I’m sure this time next month I’ll be wishing for an afternoon to read and catch up so I’m trying to take advantage of the office being slow while I can.

Despite the quiet, I did have one cool project this week!  We have a mom of a premature baby who is in the process of switching from breast milk with added human milk fortifier to formula and wanted to know how long she should keep her baby on specialized formula for preemies.  There are a ton of different formula products out there formulated specifically for different conditions and stages of infancy.  The formulas designed for premature babies are higher in calories (22-24 kcal/fl oz versus 20 kcal/fl oz for full term formulas) and are higher in protein, vitamins and minerals. I didn’t know the answer to this question off hand; my initial assumption was to keep the baby on preemie formula while tracking growth very regularly and once the baby has achieved healthy growth patterns they could be switched to regular formula.  However, I didn’t really want to give a recommendation without knowing exactly what the research and official recommendations were.  As Registered Dietitians we use Evidenced Based Practice, which means we use the latest research to make recommendations to clients and to develop all of our interventions. We had an Evidence Based Practice course at UPEI where our project was to pick a random nutrition related question and answer it in a paper using evidence from our own research.  The point of the class was to learn how to evaluate research papers to determine if the research itself was strong enough to base recommendations off.  Anyways, it was time consuming and a huge pain, especially considering the paper took all semester to write and was only a max of 4 pages.  But I did learn a lot from that class. I really liked going through research articles and finding the limitations to the studies and flaws in their methods and having to decide if it was applicable to the population of my question.

Since I had a lot of free time this week for reading, I decided to tackle the question of the preemie baby formula in the same way.  I didn’t realize I was doing it until I was perusing through the Cochrane Library via the UPEI library website and had a flash back of 4^th year university.  It made me happy that I was actually using skills and methods I learned in University to solve real life Dietitian problems.  There were a lot of classes in University that I have never once used and that I am fairly confident I will never ever use in either my practice or my real life.  I loved UPEI and am so glad I chose to do my undergrad there and using this process made me realize just how awesome my program was and how lucky I was to have gone through a University program that actually prepared me to join the work force.  There are not a ton of programs that do that anymore.

Based on the research, there is no strong evidence that giving a premature baby specialized premature formula after hospital discharge impacts growth or development.  Babies are smart, and the evidence shows that preemies who aren’t on specialized formulas simply take in more of the regular formula to make up the different in the calories, vitamins and minerals. There is some evidence that these formulas can result in greater growth if provided for at least 6 months, but this was only evident in very small birth weight infants weighing < 1000-1250 g, which the baby in question is not.  So long story short is that this baby is following a normal growth curve and is currently doing well.  While providing him with specialized formula will likely do no harm, it hasn’t been shown to provide benefit either.  This answer seems really fluffy…it doesn’t actually contain a concrete recommendation for what mom should do, but based on the evidence it’s all I can really tell her.  I used to be really frustrated by the fact that often the evidence isn’t available for us to make definite recommendations and felt like we weren’t really answering the questions asked of us as Dietitians.  However, I am glad that we can tell people what the most current research is saying and allow them to make their own decisions based on fact.

Today is my last day of work until the new year! I’m getting antsy to get home. I’ve never travelled this close to Christmas though and am slightly terrified of what the airports are going to be like on the 23^rd of December.

First Ski of the Season!

Before I moved up here I had googled the town to figure out what facilities they have here in terms of sports or clubs that I could join once I got here.  I saw that there was a nordic ski and biathelon club and have been wanting to make it out there since I arrived.  It's only 15km from town but I don't have a car so it's been tough to get out there.  One of the nurses at the hospital hooked me up with a couple who are on the ski exec and they took me out to the club on Saturday.  I even got a 40 minute or so lesson before we headed out for our ski which was much appreciated since I'm not exactly a super star and haven't really done a ton of skate skiing before. Our actual ski ended up being primarily social.  They have some bird feeders set up about 20 minutes from the club that they wanted to refill and one of the other members of the club was out with his super hard ore camera gear and wanted to tag along.  His gear was heavy so we ended up pulling it in one of those baby buggies.  I posted one of his pictures in this post. When we got out to the feeders there were boreal chickadees everywhere!  Before we filled the feeders we put peanuts in our hands and they came and ate right out of our hands! Other notable parts about the ski included seeing a bear scratch tree, lynx and wolf tracks.  Skiing with these guys was awesome because I was constantly being coached by Bob while Adam and Sue knew the names of every type of bird and tree we saw and pointed out a lot of cool stuff I wouldn't have noticed before like the animal tracks.  I also got introduced to a bunch of other club members who I can hopefully hitch rides with!

Boreal Chickadee

Trail Map

The club is awesome.  It's small and run completely by volunteers.  Members have the password and can come and go as they please.  The club is completely stocked with tons of snowshoes and ski wax that are free for members to use.  The majority of the trails are all lit at night so you can ski whenever you want.  There's a little kitchen thats stocked with coffee and tea and a couch and fire place making the clubhouse definitely somewhere you could hang out all day with intermittent ski loops and snowshoe trails. I really wish I had a car, I'd be out there all the time, it's gorgeous out there!  The best part is membership is only 55$ a year!  It costs that much just to go for one ski at home if you're renting gear for the day.

Ski Club

I didn't really take a ton of pictures (I had my phone on me) but I'm hoping to make it back to the ski club on a very regular basis between now and the end of April.  I hear the snow doesn't melt until May so it'll be an extra long ski season!

Candy Shrapnel

Happy Friday!

Today was pretty uneventful.  I only had 1 client come in to see me this morning and the office was dead quiet all day.  After aerobics I went to the grocery store and stumbled upon this on my way home:

It's hard to tell but it was the Hay River Santa Clause Parade!  There was a big to-do in the paper about it several weeks ago when I first arrived because the city had decided not to have a parade this year to the dismay of the residents. All of the local businesses got together to make it happen though.  I ended up having to wait on the side of the road for about 20 minutes while the parade went by before I could cross with my bag of groceries to get home.  I didn't mind though because otherwise I wouldn't have seen the parade at all!  Plus it was cold enough out to keep my groceries frozen.  My favorite part of the parade was all the little kids handing out candy from the floats.  It consisted of them hurling handfuls of candies at the crowd. Literally pelting the crowd with Hershey Kisses and little mints and caramels.  I'm fairly confident that there will be candy on the road for at least another month.  Actually, if you look in the bottom left hand corner of the above picture you can see shiny silver specks which are candies all over the road. This was the scene for the entire 2 km parade route. I managed to catch a few to nibble on while the parade went by but most of the candy hurled at me bounced off my head and rolled under the cars parked on the street.  The ravens will have a feast tomorrow with the left over candy!

Christmas Sunshine!

It's almost Friday!  This week has been way more exhausting than it needed to be.  We were pretty busy at work, and now that I finally have access to all of the computer programs I need, I have been doing a lot more work by myself.  Today was my last day of 'shadowing' slash working with the other Dietitian and starting tomorrow we'll each be responsible for our own workloads and will have different roles within the office.  We had out office pot-luck yesterday and our office cookie exchange today so I've spent every night this week baking or cooking.  For many of my coworkers, today was their last day in the office until the new year so we had all of our Christmas celebrations today. My apartment is slightly Christmas-y now since I have pretty Christmas cards to decorate with.  It was a busier than normal week, but not really that busy at all, but yet I'm still pooped.  To be honest it's probably just a sugar crash from all the holiday eating that's happened at work this week.

I believe that every single person has a talent.  It may be obscure and not very obvious, but every body has something that they excel at better than anyone else.  I used to think that my talent was functioning on very little sleep without being an exhausted zombie all day.  My productivity:sleep ratio used to be pretty impressive if I do say so myself. I say "used to" because I feel like I've been  a walking zombie since I got here!  One of my goals for the year was to try to get 8 hours of sleep a night, and I have been consistently getting more than that, but yet I still feel like I could fall asleep at any moment.  My mind feels hazy, as if I haven't slept in weeks and all I ever want to do is go home and nap.  

I'm beginning to think that the lack of day light might be getting to me!  It's pitch black when I go to work and pitch black by the time I get home from work.  I have a window in my office but it's tinted heavily to protect patient confidentiality when I have clients in my office.  I don't normally get a chance to venture outside during the either, but I might need to start trying harder to do so.  I also need to start taking some Vitamin D!  You can't get enough Vitamin D from your diet and the rest normally comes from sun exposure.  The majority of North Americans are Vit D deficient, and up here it's actually impossible to get enough from the sun so we recommend 1000 IU of vitamin D daily to all of our clients.  Vitamin D deficiency is typically associated with bone health but current research has indicated that adequate levels of Vitamin D are also associated with decreased risks of cancer, increased risks of developing diabetes, hypertension and multiple sclerosis.  It's one of those super vitamins that no one really knows a lot about.  More and more research keeps coming out suggesting even more super powers the vitamin may have.  I guess it's time to start practising what I preach! On the bright side, the shortest day of the year is December 22 nd this year which is soon! By the time I get back up here in January the days will be getting longer and brighter and hopefully I'll be more awake throughout the day.

Enough about my exhaustion, it's probably mostly in my head anyways!  I'm so excited to get home for the holidays to temperatures that permit running outside during day light hours!  Plus I have 10 days off work and am not even missing a single day.  We have mandatory leave days up here from the 22nd to the 2nd, which is probably so people don't go crazy in the dark over the holidays.  This time next week I'll be all packed and pumped to get on a plane the following morning.

To get into the holiday spirit I'm spending the night watching my favorite Christmas specials.  Charlie Brown Christmas, and the claymation Rudolph.  It's not Christmas until I've seen them each at least once.

Diet Destruction

I have never actually been a real grown-up over the holidays before.  I've always been a student, cramming for exams.  My strategy for cramming for exams usually also involves cramming food into my mouth at a more abundant rate than is typical for any human being.  I somehow manage to find time to bake a lot more during exams that I do during the rest of the year.  Not to mention I somehow managed to wander my way into the kitchen every 5 minutes convinced that I was 'hungry' when actuality I was just bored out of my mind of biochemistry or stats or microbiology.


Turns out that there are very few things worse for healthy eating than working in an office over the holidays.  Instead of just having to deal with your own baking marathons, you have to weave your way through everyone in the office's baking sprees too!  There are countless parties, all of which include a potluck or buffet meal, office cookie exchanges and countless other delicious treats being brought into the office every day.  Don't get me wrong, I LOVE the holidays, including holiday baking, but I can only take so much of it!  It's still almost 2 weeks until Christmas and I have a potluck, cookie exchange and hospital christmas party/dinner to go over the next week.

Chocolate Covered Chocolate Chip Cookie Dough Balls

Today a co-worker brought in chocolate covered cookie dough balls.  Working in Public Health, there are a few of us who are slightly food safety conscious.  Raw cookie dough, as delicious as it is, is actually considered an unsafe food because it contains raw eggs, which have the potential to carry salmonella.  This normally doesn't stop me from licking the bowl and beaters clean when I'm baking cookies but it would definitely worry me if I was serving raw cookie dough to a group of people.  I'd be too afraid that someone would get sick to serve it!  Luckily this recipe didn't contain egg so we were in the clear.


However, according to a recent study investigating the cause of an e.coli outbreak that was traced back to raw cookie dough in 2009, raw egg may not be the ingredient to worry about!  This outbreak involved commercially available cookie dough, and in most commercially available products that contain eggs, the eggs are pasteurized which kills pathogens that could cause harm.  Actually, every single ingredient in the cookie dough underwent pasteurization, even the baking soda and margarine used in it's preparation, except for the flour.  When analyzing commercially available wheat flour, researchers found that 13% of samples were contaminated with salmonella.  Although the study was somewhat inconclusive, and researchers can't actually state that the flour was the definitive cause of the outbreak, they still recommend that raw cookie dough not be consumed, whether you buy it commercially or make it at home.


My favorite part of this study was the random stats on raw cookie dough consumption:

• A 2008 study of risky eating behaviors among college students found that 53 percent admitted to eating unbaked homemade cookie dough.
• In the new study, published in the latest issue of the journal Clinical Infectious Diseases, several of the people who were sickened bought the contaminated cookie dough with the sole intention of eating it raw. “They had no plans to actually bake cookies,” the authors reported.

My first thought was that only 53% admitted to eating unbaked cookie dough.  Guaranteed that way more people eat raw cookie dough than 53%.  The key word is 'admitted'.  I'm not convinced the will power to bake cookies without eating a bit of dough even exists.  I have to admit though, I'm not surprised that some of the dough was purchased with no intention of baking cookies.  

Even though I probably have more food safety knowledge than the majority of people given my Food and Nutritional Sciences degree, and I know that cookie dough may carry e. coli or salmonella when consumed raw, it never seems to go through my head when a bowl of cookie dough is sitting in front of me.