Dietitian Legislation & how it affects people with Celiac

PLEASE support Licensure for Dietitians in Virginia! (I don’t usually get political on my blog so please bear with me) There is a bill in the VA House of Delegates HB 345 (O’Bannon) regarding licensure of dietitians, and it is important to me that it passes.

Why?

Well, services for Celiac clients are up to each insurance company. Anthem has stated they won’t cover RDs in Virginia because we’re not licensed in Virginia (they cover in other states). That’s not fair, and clients with Anthem can’t get the support they deserve on a gluten-free diet. I’m all for people getting the support they need, & making it financially accessible.

I like the idea of greater regulation, because it means we’re held accountable. If an RD is reprimanded for malpractice  in DC or MD,  they’d have to stop working as an RD in those states, or can just move to VA & work here. That just doesn’t make sense

There are many groups fighting this bill, and I think it’s because they don’t understand what it’s intended to do.  It’s only intended to give RDs a scope of practice and regulate our actiosn.  It is designed NOT to restrict on anyone who is not an RD (aside from someone who isn’t an RD can’t say they are). It doesn’t keep anyone from teaching about nutrition, coaching, or selling supplements, or doing what they do. It simply insures that RDs practicing in VA have not received sanctions from the state, or any other state.  And it may help us get services covered by more insurance companies.

Health coaches, teachers, Weight watchers, etc.  are not affected by this law (see below)

And, because I’ve gotten questions, here’s the text:

§ 54.1-2956.16. Exceptions to requirements for licensure as a dietitian.
108 The licensure requirements for dietitians established pursuant to this chapter shall not apply to and a
109 license as a dietitian shall not be required for:
110 1. Any student performing activities related to an accredited educational program under the
111 supervision of a licensed dietitian or any person completing the supervised practice required for
112 licensure;
113 2. A registered dietetic technician working under the supervision and direction of a licensed
114 dietitian;
115 3. A government employee or a person under contract to the government acting within the scope of
116 such employment or contract;
117 4. Any health professional licensed or certified under this title engaged in the profession for which
118 he is licensed;
119 5. A certified teacher employed by or under contract to any public or private elementary or
120 secondary school or institution of higher learning;
3 of 3
121 6. Any person with management responsibility for food service department policies, procedures, or
122 outcomes in any food service department in any program or facility licensed by the Commonwealth;
123 7. A dietitian who is serving in the armed forces or the public health service of the United States or
124 is employed by the U.S. Department of Veterans Affairs and who engages in the practice of dietetics
125 provided such practice is related to such service or employment;
126 8. Any person or retailer who does not hold himself out to be a dietitian who furnishes general,
127 nonmedical nutrition information on food, food materials, or dietary supplements or on the marketing of
128 food, food materials, or dietary supplements; and
129 9. A person providing weight control services through a program that has been reviewed and
130 approved by and when consultation is available from a licensed dietitian, a dietician licensed in another
131 state that has licensure requirements at least as stringent as the requirements for licensure pursuant to
132 this chapter, a dietitian registered by the Commission on Dietetic Registration of the Academy of
133 Nutrition and Dietetics, or a successor organization thereof, or a physician licensed in the
134 Commonwealth. Program changes may not be initiated without prior approval of the program approver.

Sounds kinda reasonable, doesn’t it?

If you live in VA, you can find your district representative here: Click here to the Who’s My Legislator feature.  Enter your name and mailing address then click Lookup.  You will be directed to a form where you can send a message to both your Delegate and Senator simultaneously.

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Banana ‘Scream with a Kick

Life has been busy—issues with construction, permits, fire hazards and the like.  And our oven broke.  So lately it’s been all about the quick and easy.

And what’s quicker and easier than Banana ‘Scream?  It takes about 2 minutes from start to finish, simple, and totally customizable to pretty much any diet (except a banana allergy).  We tend to have browning bananas go to freezer heaven, and the lucky ones are found and made into dessert before they become a mass of ice crystals.

1 banana, frozen, chopped into 5-6 chunks
1 TBSP liquor (chocolate liquor, Frangelico, whatever)
OR 1 TBSP “milk”, juice or water
1 pinch vanilla beans, cacao nibs, cinnamon, chocolate shavings or whatever other topping suits your fancy.

Blend until smooth in the food processor.

See?  Couldn’t be simpler.  I get my husband to eat fruit and he counts it as dessert.  That works for me!

I’m submitting this to Ricki’s Wellness Weekends, because it’s a great way to liberate dessert from the necessity of sugar, gluten and such.

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Embracing Courage

I love the Brene Brown’s blog and I was taken by the most recent entry on choosing a word, a theme of sorts for 2012.  And before conscious my brain could kick in, immediately the word “courage” popped into my mind.

At first, I was surprised.  I have more than enough courage when it comes to the pushing, type A, hard driving/yang/masculine side—the staring down the lion courage, or the courage of a mouse eating a leopard’s dinner (seriously).  I struggle with the soft/yin/feminine side of courage—the courage to be vulnerable, the courage to accept reality exactly as it is and accept my own imperfections without trying to fix or hide them.

Or, as put so eloquently:

“Courage doesn’t always roar. Sometimes courage is the quiet voice at the end of the day saying, “I will try again tomorrow.”

~ Mary Anne Radmacher

The hardest thing is always exploring the parts that aren’t quite comfortable and don’t come naturally, but it’s always the most rewarding, too.

What’s your word for 2012?

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Sanity Recap and Winner

I hope everyone had a wonderful, sane holiday (or wonderfully sane?)  One way or another.  I’m glad so many people opted to join the Sanity challenge and posted or commented.  Here are a bunch:

We were joined by:

JT of Faux Foodie Girl

TPOT of http://nourishingyourself.blogspot.com/

Jonathan of the Canary Files

and his updates, too

I, for one, enjoyed having one more little nudge to slow down, be mindful and focus on what’s most important.

As for 2012, I have 2 resolutions:

  • More kindness.  Kindness to myself, my body, the people I love and the people I don’t.
  • Savoring life.  There are so many beautiful aspects of life already here each day.  I want to marinate longer in them.

And….drumroll please…our Sanity winner is Jonathan of the Canary Files!  Congrats, Jonathan, and I’ll be in touch this week.  And give yourself a gift and stop by Jonathan’s wonderful blog.

Posted in December Sanity Challenge | 4 Comments

Review: Gluten Free Makeovers

Better late than never, yes?  I got a copy of Beth Hillson’s Gluten Free Makeovers

I think it was in late October—right before our annual huge baking binge…er…party.  And so I was not really up to cooking!  And then my camera died, and then construction and then…so yes, it’s taken a while.

I was eager to review it, because Beth has such a great reputation.  As usual, I made two recipes: one for royal icing, which you can see decorating the NinjaBread Men, and the other was Quinoa Sesame Wonder Bread.

The Royal Icing was awesome because this was a super easy recipe, and the icing was very easy to work with and stayed firm.  I wouldn’t hesitate to use it again, although I’d totally cut the amount in half.

The Wonder Bread intrigued me because I have a recipe with quinoa, sesame seeds AND one of my co-workers named it wonderbread!  However the similarities stopped there with ingredients, and Beth’s is a much simpler recipe (mine is much higher fiber and I will have to post it sooner or later!)

I struggled to follow Beth’s directions because I’m so set in my ways.  I.e., in my brain, you just always proof yeast and use parchment and….so on.  But since I was supposed to be reviewing, I did my best to follow as written, and indeed, it worked as promised!  I did use parchment anyhow because I’m so lazy about clean up.

The bread rose beautifully, kept well and the recipe was a keeper.  A friend has half in her freezer and I will do my best to update this post when she updates me!

Regarding the book overall:
pros:  The recipes I made were great, I wouldn’t hesitate to make either/both of them again, and many looked wonderful.  I think the Challah will have to be high on my to-make list!  There are also quite a few dairy free subs, which I think is a fantastic plus.

Cons: many of the recipes have very specific flour combos.  I.e. there’s a basic blend, a cake blend, 2 bread blends….since I’m someone who doesn’t cook anymore, I’d hate to make those up each time.  HOWEVER, I have no doubt that those blends are just an extension of the fact that Beth is a great baker!  I do wish, however, there was one blend and some sort of conversion between the two (i.e. add extra cornstarch for the cake flour, or whatever).

I wouldn’t hesitate to recommend this book and it’ll have a happy place on my bookshelf!

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Sanity Goals: Week 2

Tales from the front lines…

So the December Sanity Challenge is chugging along and I’m loving reading all of the posts/comments!  Our Sanity hostess this week is Valerie of City Life Eats.  She has been doing wonderfully with her exercise goal and has decided that cutting back on blogging was needed as a temporary step.  She also pointed out that I first emailed the Sanity crew on Black Friday.  I’d forgotten that, but it figures.  I was already finding myself pulled into buying things I didn’t need!

This week has been a challenging one for me.  I generally do food gifts, and it’s almost expected.  So I tried to make a batch of toffee and it burnt to a crisp.  Thinking it was because I decided to veganize it, I tried again.  Smoking stinky stenchy goo.  What in the heck was going on?  I tried another recipe.  Same thing.  And then I knocked over the bowl of chopped nuts  that were supposed to go in the toffee, and *poof*, my kitchen was covered in a layer of ground hazelnuts, almonds and cashews.

After saying a few choice words, I sat amidst the nuts and had a good laugh.  Because seriously, what else is there to do in times like those?  I didn’t NEED to make treats, I wanted to.   And of course, I figured out the problem.  My candy thermometer was about 30 degrees off.  That’ll do it!

So overall, the amended goals are doing pretty well.

  • Exercising 3-4 times a week.  Ideally, Mondays, Thurs and Saturdays, and doing my fun PT exercises daily.  Going strong (yippie!)
  • Waiting at least 2 hours before making Internet purchases.  Hopefully by then I’ve figured out that I don’t need whatever wonderous toy they’re selling. I think I’ve done it…still waiting on a shawl to see if I really need it…
  • Meditation twice daily. Yes, and going back to longer meditations, which really helps me.
  • 6 desserts in December.  That’s it. Um, yeah.  that one got totally blown out of the water.  It’s officially amended to only making things when I will enjoy it. 
  • Writing a schedule Tues. I think I’m not really a schedule and list person.  That one hasn’t taken.
  • Heading off on a silent retreat this weekend!  Way to get off to a good start. Completed week one. I can’t do that every week, unfortunately.

And everyone else?

Carrie of Ginger Lemon Girl is our next hostess, so watch for her post!  She also has her goals up here.

Posted in cheryl's musings, December Sanity Challenge | 2 Comments

Menu Plan Monday: Citrus

Having a crazy holiday season?  this is a plug for the December Sanity Challenge!  Find a goal to keep yourself sane, blog about it, and even report back.  Iris of the Daily Dietribe is hosting this week, so go give her some love.

I think it’s helped me stay saner, except for right now when I should be heading to bed, so I need to make this snappy, and I’ll add more tomorrow.

Fun stuff: An article on Immune Boosting foods in the Washingtonian Blog

and my holiday newsletter, too!  It’s got wonderful tips and gobs of recipe goodness, including a slew of naturally gluten-free recipes (or should I say, Gluten Free Easily?  Although the recipe list goes back more years than I’ve known Shirley!)

Fun tasty stuff: Candy Cane Marshmallows, dipped in chocolate.  Mr. Dude risked serious injury when he mentioned last night that he ate a bunch and hoped I didn’t plan to give them to many people.  And yet he is alive and well, and sanity prevails.  If the Christmas treats get eaten early, that’s it.  I’m making what I’m making, and that’s it.

That leads me today’s ingredient: citrus! For the schedule and our new Menu Plan Mama, please see Heather of Celiac Family.  Want to join in on the fun? I’m sure she’d love to hear from you.

If anyone is keeping track, I rarely eat citrus because it doesn’t agree with me (and if you’re keeping track, congrats.)Every year I make Choco covered orange slices because they’re Mr. E’s faves, and I’ll post a recipe this week.

Monday:
Chicken with Celery in Chestnut Sauce

Tues:
Quinoa Italiana, I hope!  I think I have more olives

Weds:
Halibut with Kale Pesto

Thurs:
Classic Beef stew

Friday:
Leftovers!

Sounds like Citrus is popular all around!

Wendy at Celiacs in the House is having an abundance of citrus in the form of Clementines and grapefruits.  She’s got a great lineup including a white bean Cassolet.  Also, don’t miss out on her 4 book giveaway to celebrate her blogniversary!

Heather of Celiac Family has a very cute logo.  And the theme will inspire her to use up the citrus that been around and also to drink more water.  She’s got cilantro lime shrimp on the menu, too.

Renee of Beyond Rice and Tofu intrigues with an Indian Spiced Squash soup.  She generally eats citrus in its native form rather than baking or cooking with it.

Angela of Angela’s Kitchen stops by with a Bison and Sweet Potato Stew and what looks like a very busy week of shuttling around kids to various places!  Hopefully she can find inspiration from other blogs for other yummy meals, too.

I’ve just “met” Samantha of So Simply Good, but anyone who is laundry phobic is clearly a long-lost soulmate of mine.  She’s got a nice paleo menu, and not only that, her grandfather GROWS oranges!  How cool is that.

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Dec Sanity–Update Week 1

I just saw Iris’ Dec Sanity Goal, and it’s terrific!  Go check out her plan.  Simple yet elegant.  Heather of Celiac Family posted hers, too.  Anyone whose goal is to get more hugs is a winner in my book.

And I wanted to check in on my goals…ya know, the whole accountability thing–and see how things were rolling along.

  • Exercising 3-4 times a week.  Ideally, Mondays, Weds, Thurs and Saturdays, and doing my fun PT exercises daily. *yay!*  Did M, Th, Sat…forgot all about planning to do Weds.  Hmmm.  I still feel like I did a good job, and 3 is pretty decent.
  • Waiting at least 2 hours before making Internet purchases.  Hopefully by then I’ve figured out that I don’t need whatever wonderous toy they’re selling Even better–didn’t buy anything!
  • Meditation twice daily. Om…..
  • 6 desserts in December.  That’s it. Yeah, about that.  I’ve made less than 6, but I’m up to 3 with 3 weeks to go.  This does not bode well!
  • Writing a schedule Tues. I didn’t specify which Tues….I will write it by SOME Tues, does that count? And I have kept up with work, so I should get points back for that!
  • Heading off on a silent retreat this weekend!  Way to get off to a good start. Even saw an Owl.   The more I google, the less certain I am of the kind–it looked a little like a barn owl and a little like a barred owl.  The one I saw seems bigger than any of the pics I’m seeing on line.  Maybe I should split the difference and cal it a barned owl?  Either way, it’s the first one I’ve  not on a leash in the zoo.  Very cool!

And everyone else?

For more about the Dec Sanity Challenge and how to join, see the initial post.

Posted in cheryl's musings | 8 Comments

Medicare Covers Obesity Counseling (sort of)

I generally post on food and my thoughts on health, but I feel like this is important enough to make an exception!  Medicare has decided that only physicians, nurses and physician assistants are qualified to provide people who are very overweight with nutrition counseling services.

Let me start off by saying I don’t really have a horse in the race.  I don’t accept Medicare and obesity has never been my primary area of interest or practice.  But no matter how you look at it, this is a huge problem.

Most doctors receive little to no nutrition education–1/2 a day, tops.  Nurses receive about 20 hours.

That’s it.

Is that who we want supporting weight loss and behavior change?

I’ve had the pleasure to know many fantastic doctors and nurses, and despite their huge among of knowledge and skill in their field, they rarely have the training or experience for intensive, long term nutrition counseling.  Unlike RDs, they didn’t get training for 5 (or more) years on nutrition and behavior change.

And think about it.  How long do you have to wait to see your primary care doc?  Can you see them being available sessions for weekly sessions for weight loss clients?  I’m afraid this just doesn’t compute for me.

To the best of my knowledge, nurses and doctors that accept Medicare are increasingly squeezed and overworked.  So not only do they lack the knowledge, they also lack the time to give quality services or learn more so that they’re able to.

Lots of people stand to lose here.  As far as I see it, the only people who benefit are those selling surgery or diet pills/shakes, and there’s been some question of conflict of interest among those who made this decision.

And this isn’t even a matter of debate over RDs vs CNS vs other nutrition or coaching degrees.  At the end of the day, if the people who can provide this service according to Medicare don’t have the time or training to actually do it, people simply miss out on this benefit.  Or, people will only get support if they can afford to pay for it out of pocket.  It also makes it more likely that people wanting to lose the weight will fail, because they won’t have the support the need.

And this affects pretty much everyone, because either the hundreds of dollars that could go for nutrition counseling will now be tens of thousands for surgery, or increased medical expenses.  So, if you’re so inspired, you can call your government representatives
http://www.usa.gov/Contact/Elected.shtml.

And now, we return you to your regularly scheduled program of munchies and stress relief.

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My Goals–Dec Sanity Challenge

I am so glad that the December Sanity Challenge is underway!  Since it first came to mind a week or so ago, life has become increasingly INsane.  I left my job at Kaplan Center on Tuesday, which was very sad, but the drive became too long and it was a huge physical drain.  Instead, the plan has been to work at home, and I’ve started working on some nutrition education webinars AND now it seems, am very close to committing to write for a nutrition magazine, too (details to come…) Somehow, just like that, I forgot about my plan to take more time to relax.  How does that happen so quickly??!!?? Also, I was nominated by NDVDA as Emerging RD leader for VA so I’ve been working on pulling together my application and letters and such.

The new things are delightful, but they also require TIME MANAGEMENT, which is not traditionally one of my strengths.  I’m like one of the cats, I get distracted by whatever flits by. (Or for anyone who watches the Daily Show or has seen the movie Up, SQUIRREL!)  So I will need to seriously build some structure in order to meet these deadlines and take care of myself, too.

So my sanity goals this month:

  • Exercising 3-4 times a week.  Ideally, Mondays, Weds, Thurs and Saturdays, and doing my fun PT exercises daily.
  • Waiting at least 2 hours before making Internet purchases.  Hopefully by then I’ve figured out that I don’t need whatever wonderous toy they’re selling
  • Meditation twice daily.
  • 6 desserts in December.  That’s it.
  • Writing a schedule next Tues.
  • Heading off on a silent retreat this weekend!  Way to get off to a good start.

Anyone else?

Posted in cheryl's musings, contest | Tagged | 8 Comments