Category: Nishant P – Gastroenterlogy

I’ve had an incredible journey with Dr. Lawal, and to be frank, I’m not ready to let it go. Dr. Lawal has been absolutely genial to not only me but also his patients and faculty – no matter how busy he is, Dr. Lawal makes the constant sacrifice to help his own surroundings before helping himself, and there’s more than meets the eye. I could not be more grateful for this experience!

I’ve continued to develop strong relationships with Dr. Lawal’s patients, most of whom have been building acid reflux and colorectal cancers. Acid reflux is a very common chronic digestive disease that causes stomach acids/liquid bile to travel through the esophagus, otherwise known as the food pipe – chest pains and regurgitation of consumed substances occur directly from this abnormal movement.

Unfortunately, one common pattern I discovered among the patients is that they typically consume foods right before sleeping; in other words, they ‘snack’ prior to heading off to bed without the necessary digestion. Dr. Lawal explicated that substances should be decomposed within a 2-3 hour limit to alleviate reflux. The same instance can also be applied to the consumption of medication; taking medications prior to sleeping will result in colorectal damage, creating ulcers.

Dr. Lawal also lectured me on the plethora of gastric diseases that remain active in adulthood, most notably, diverticulosis. The diverticular disease pushes out the weaker portions of the colon to create small pouches, or ‘pockets,’ across the linning. Subsequently, small fragments of undigested food get stuck in these pockets, yielding gastric inflammation.

 

One other viral infection is hepatitis, which attacks the liver and also creates inflammation. Among five patients, one contracted Hepatitis-C (there are also A, B, D, and E), which leads to abdominal pain, internal bleeding, and fatigue. According to Dr. Lawal, 30% of men and 20% of women contract this disease.

I’m really excited (and a bit sad) for tomorrow! Looking forward to seeing Dr. Lawal and, hopefully, more patients to interact with. Gastroenterology may now be one of my favorite medical studies 🙂

– Nishant

 

 

I’m on Day 4 of shadowing and this experience keeps getting the better of me! Instead of being in the Physician’s Pavillion or the Surgical Center, I was relocated to a larger facility located in North Hills – larger offices, more patients, a surplus in technology, the usual.

Dr. Lawal had to make changes to his Friday schedule – instead of working with clients at the Pavillion, he had to continue medical procedures. Colonoscopies were way more prominent in today’s work than the first two days, which was not, shockingly, a surprise.

As I’ve analyzed more procedures, I’ve come to understand how prevalent gastric polyps are. I recall Dr. Lawal cutting out nine polyps in one colonoscopy, alternating between cold and hot snares. Most gastric polyps can be cancerous, which contributed to colon cancer for one particular patient. The cause of colorectal cancer is idiopathic and remains a mystery. Dr. Lawal had to perform a new surgical procedure, the colectomy, which is necessary to treat diseases and infections within the colon.

Colectomies are operations that extract all or parts of the colon to examine colorectal cancers or diverticulitis. Dr. Lawal performed a partial colectomy on the patient, which involves removing a segmental component of the colon (shown below). Dr. Lawal also defined hemi-and proctocolectomies, which require the removal of the right/left portion of the colon and the removal of the colon and rectum, respectively.

It’s been a blast getting to know Dr. Lawal for the first week in the Work Experience program. As we interact, Dr. Lawal and I begin to recognize our common interests, most notably,  swimming and playing in ensembles. He’s a huge fan of Marvel superheroes as well – he really likes Doctor Strange, which I respect. Speaking of Dr. Strange, I’m going to see Multiverse of Madness later today! 🙂

– Nishant

 

 

 

 

For today, I arrived at the Physician’s Office Pavillion, rather than the Surgical Center, which I attended the last two days. It’s quite pleasing to explore new locations and partially emphasizes that a doctor’s responsibilities are found extensive – impactful – to a broader roster of patients: physicians, including Dr. Lawal, commit to serving by all means, whether travelling to a hospital forty minutes away from their homes or having to be on-call over the holidays.

Dr. Lawal’s routine is quite fascinating and reminiscent of my father’s, who is also a G.I (they are both equally superior doctors): they both work Monday-Wednesday in their own practices, then work Thursday-Friday to communicate with patients in their offices. This idea, similarly, corroborates that doctors can be versatile (regardless of their medical field specialties). Serving for a large community is a rewarding experience, and I’m 120% game for it.

Today, Dr. Lawal has communicated with various patients to explore their bowel movements – to put it simply, poop! The reason for communicating with patients is to schedule their endoscopies and colonoscopies ahead of time. What I noticed is that the majority of his patients developed liquidy (rather than solid, or somewhere in between) stools in the result of inflammatory bowel disease, chronic inflammation of the G.I tract (small and large intestines); the cause of IBD remains unknown, otherwise (and scientifically) known as “idiopathic.” The majority of these patients contracted “ulcerative colitis,” which causes ulcers in the lining of your large bowel; Chron’s Disease, on the other hand, only damages the small bowel.

One specific patient not only built this mystifying disease, but has also contracted osteoarthritis, the most common form of arthritis. Unlike IBD, ostearthritis has a primary cause: the breakdown of defensive cartilage found within ligaments. This joint disease is most commonly found in the elderly – best ways to treat it are to take certain medications and participate in physical therapy/various exercises.

Interacting with patients has been a blast, but I limit myself to very little conversation to not alter their relationships with Dr. Lawal. Nonetheless, he does the magic, and I’m there to support him as much as possible.

Also had lunch with Harrison! Went to Bojangles for the first time. Harrison can vouch : D

 

 

 

 

 

 

 

Toodles,

– N

 

I’m on day 2 of this awesome experience. I’ve continued shadowing Dr. Lawal and recently witnessed a third colonoscopy where he attempted cleaning liquid poop and bile off the large bowel (large intestine) – funny enough, I haven’t been grossed out at all.

Dr. Lawal continued the procedure by extracting three polyps from the large intestine and, subsequently, cleansed the affected muscle tissues and blood vessels with water to heal the damaged wounds.

I’ve had the pleasure to interact with 2 patients in the pre-operative room, and they were extremely kind! Coincidentally, both patients believed I was in medical school given I’m not only wearing scrubs but also have the “physique of a med student,” which found pretty hilarious; even Dr. Lawal agreed with those patients.

I’m on my lunch break and intend to examine more procedures. These facilities are awesome, and I mean, Chickfila Wednesdays, for free???? 

 

Now, after lunch, I witnessed an endoscopy. The patient Dr. Lawal studied consistently developed gastric polyps, leading to vomiting; nausea became present from the large clumps of bile combined with gastric acids present within the stomach.

Dr. Lawal had to use a gastroscope to travel through the esophagus and to the stomach. After cleansing the peripheries of the stomach, he collected a small sample of the organ tissue for a biopsy report.

That’s all for now – peace.

– N

Today was the first day of interning at the WakeMed hospitals with Dr. Lawal! After being briefly introduced to gastroenterologist Lawal, along with his peers, I quickly transitioned to witnessing two intricate colonoscopies and an endoscopy.

Prior to those procedures, the patients are transferred to a pre-operative room; physicians begin to examine the primary organs of the human anatomy – heart, lung, and intestines – to determine if they are unaffected by risk factors, including the use of tobacco products. If the patients consume alcohol or tobacco products, they cannot undergo procedures.

In the intra-operative room, both colonoscopies were performed on the patients who developed liquid bile on the peripheries of the colon (which comprises the long intestine),  which, fun fact, contributes to the colour of human by-product waste – crazy, am I right.

Dr. Lawal and his peers used a mechanism, the colonoscope, a tubular device that goes inside the colon and cleanses out the bile, extracted into a large container; the machine, most notably, uses a cold/hot snare to rip colon polyps (shown below) that could build cancer. It is best to have the polyps removed at an early age as opposed to when the patient is older, given their polyps will be harder to treat over time.

The patient, however, is not actively conscious given he/she is placed under anesthesia, a treatment that prevents the patient from feeling pain during procedures, including colonoscopies or surgeries; doctors assign patients to wear masks during the procedure in order to effectively anesthetize them.

An endoscopy was performed on a patient who contracted liver disease as a result of consuming large quantities of alcohol. Dr. Lawal used a gastroscope that was placed through the patient’s esophagus, to the stomach, and to the liver. Polyps, once again, were removed to alleviate the spread of liver disease and extract the cancerous infection.

In the post-operative room, the patients recovered from the anesthesia. Dr. Lawal and his fellow physicians reviewed the colonoscopies/endoscopy with the patients to deliver the news. The patient who underwent an endoscopy shortly went to IHop after; even though he wanted a margarita, he was simply denied that request, hehe.

Look forward to seeing more procedures!

– N

 

 

For the next two weeks, I will have the amazing opportunity to shadow Dr. Adeyemi Lawal – gastroenterologist at WakeMed Raleigh and C.A. alumni parent! Dr. Lawal will be my supervising physician in facilitating various medical curriculums concerning gastroenterology. I am strongly looking forward to this shadowing experience!