19HelenC – CA Work Experience Program

Day 8

Today was a very bittersweet day, filled with goodbyes. However, before we get there, we still had many patients to see. There was a patient with an abnormal SPEP test, which basically measures the proteins in your blood. She had several antibodies that were being produced in excess, but this is never caused by cancer. She has rheumatoid arthritis, so it makes sense that she would have multiple proteins produced in excess. The case was pretty normal, but it was interesting because her primary doctor and Dr. Eisenbeis disagreed, so it was hard to convince the patient that she was in fact fine. Another sad case was that a man with breast cancer, which is pretty rare but possible, was in worse shape because he was barely eating or drinking any water. He could barely stand, and stayed in bed 24/7 for the past week. But, it wasn’t as severe as it looked, because it seemed like the problem was mainly coming from dehydration and lack of food, which were easy fixes and were good news because that meant that the cancer wasn’t getting worse and causing this.

I also got to see another bone marrow biopsy today, but there was more blood involved this time around. This lady’s bone was not as easy to reach, so many attempts were made. It made me a little queasy to see so many needles (BIG NEEDLES) being stuck in the same spot.

Overall, this experience has been amazing and so memorable, and it definitely furthered my interest in cancer. I think that cancer is such an unknown and always changing field, that maybe in 10 years, there may be a cure. But for now, a patient’s best shot is the treatment and care these doctors provide, and they are some of the kindest, most understanding, most helpful people you will ever meet. Doctors are real life heroes, and every day, they change lives.

Fun Facts – last one 🙁

Rheumatoid arthritis causes an overproduction if many antibodies in the body.
Everyone has had cancer sometime in their lifetime, or cancerous cells, but usually, our immune system can fight it off and we won’t know.
Pediatric oncology is a separate profession and is drastically different.
UNC Rex has some of the kindest, most welcoming, most inspirational nurses and doctors.

Day 7

Today was my last day at the hand center, and it was very event-filled. We saw a lady with a finger wasp sting, quite a few carpel tunnel syndrome patients, some shoulder injuries, and endless trigger fingers. Dr. Schricker showed me a picture of a surgery he performed a few days ago where he took out 62 pieces of bone and cartilage from a man’s elbow. 62! Some were the size of a peanut and some were upwards of 2-3 cm in diameter. It was crazy, and it was pretty rare for the doctors there as well. The x-ray was something I had definitely never seen before.

One sad moment today was when a older lady started crying because she didn’t want to lose the use of her hands she had been experiencing pain and no one knew why, and she started crying. Her husband was trying to cheer her up saying how she had perfect blood pressure, needed no medications and was in tip top shape. It was very cute! Made me realize how scary doctors offices can be, especially if the doctors don’t know what’s wrong either.

Another highlight was that one of Dr. Schricker’s patients made filipino egg rolls for the entire office staff, beef and veggie, and pork, and they were delicious! I need to find the recipe somehow because those were some of the best egg rolls I had ever eaten. At the end of the day, it was time to say goodbye and I was kinda sad because everyone was so nice and I really had a great experience with them. I hope to visit again someday, but hopefully not as a patient!

Fun Facts:

Dr. Schricker has climbed Mount Kilimanjaro.
Wasp stings take over a year to heal when in the finger.
Turmeric is shown to help arthritis.
A man was launched 21 feet in the air from his motorcycle, and swears he will never get one again. Motorcycles are scary.
The Raleigh Hand to Shoulder Center has the best nurses and doctors.

Day 6

Today, the patients and cases we saw were quite normal, but it was the conversations out of the exam rooms that made the day memorable. The nurses and doctors are all pretty close, and act very much like a family: bickering and teasing each other incessantly. There was often lots of free times between patients, but the nurses kept it very fun! They like to call their clinic “the fun one”. We discussed where we would move in the future, many arguing for Arizona or Florida, and we discussed Minnesota accents, which they claim that Dr. Eisenbeis has.

One patient that stood out was this woman with smoldering myeloma that is not treated because it is not malignant, but it is like a ticking time bomb and could go off at any time, with no trigger. She was very on edge and nervous at first, but once the doctor said she was still fine, she calmed down. She stated that it is quite difficult to forget about her disease, even though she’s had it for almost 10 years, because there’s always a cancer commercial or ad. She even said that only her immediate family knows, because she doesn’t ever want to talk to relatives or people about it at family gatherings. At first, I didn’t understand her anxiety, but afterwards, I realized just how scary it is to live every day not knowing when you could contract cancer. After hearing so much about cancer for the past week, it seems almost normal or not as severe to me, but it is still scary and y predictable. It just made me realize how strong and inspirational those patients are.

Fun Facts:

According to nurse Melanie, you can have five wives in Utah and there are penguins in Alaska.
A phlebotomy is a procedure that removes blood to treat high iron levels or blood counts.
The UNC Rex Hemonc Clinic in Cary is the fun office
For one patient, his wellbeing is gaged on how often and how well he plays golf.

Day 5

It may be Monday, but the clinic was still as busy as ever. Starting off with many new patients, most were there just for abnormal blood counts, which mainly resulted in anemia or iron deficiency. We then went and saw some follow up patients, and saw a young lady of 24 years who had just had a pancreas transplant for pancreatitis. She is also diabetic and has stomach issues. Her doctors sent her to the clinic because they were worried she might be anemic. I was surprised how many patients came into the clinic and did not have an issue at all. The checkups were quick and easy.

The main excitement of the day was a bone marrow biopsy I got to see. Now, I’ve never been one to get queasy at the sight of blood or needles, but this procedure kinda got me. The doctor first started off with some numbing medicine, but the needle was so deep that it was tapping on the pelvic bones. She let me feel the place where the biopsy would be taken, the flat bones in the lower back, and she then proceeded to take out a ginormous hollow needle to take the biopsy with. The needle was twisted into the bone, going all the way through to the marrow in the middle, and then was aspirated to retrieve the liquid marrow. At the end, she also took out the piece of bone she went through, and it basically looked like a little tube of bone. I was shocked at how easily she was able to go through the bone, because I always thought there had to be drills or hard tools involved. It was definitely an experience I won’t forget.

Fun Facts:

You know if a biopsy sample is good if there are sand-like particles in the blood.
Sometimes when people age, their bones become like Swiss cheese with holes and the biopsy needle just crunches the bone when going through.
According to the nurses, men always faint at the clinic, but women never do.
Radiation is dangerous because the radiation affects anything behind, in front of, or around the targeted area, resulting in organ damage sometimes.

Day 4

Today, I was still at the UNC Hematology and Oncology Clinic, which they nickname Rex Hemonc for short. Today was pretty normal, nothing out of the ordinary, but I did see a woman with blood clots in her calf. Most other patients were just new hematology patients, or just follow ups before they went for their treatment.

One case that stood out was this man with cancer who didn’t speak any English. We had to get a Chinese interpreter on the phone to translate for us. I speak a little mandarin, but definitely not enough to help translate! It was pretty cool to see how the doctors are so willing and ready to help all their patients, no matter their language or age. They also don’t discriminate based on the patient’s ability to pay, and they even have programs that help patients cover treatment costs.

Other than that, most patients were just referrals from their primary doctors who had an abnormal blood count, and the doctors just wanted to rule out cancer as a suspect. I’ve realized how scary the word “cancer” is in society, and I am guilty of this as well, but with modern medicine and technology, I’ve realized throughout this week that cancer is not always very severe. Many cancers have upwards of 90% cure rates, which is pretty amazing considering how complicated and different each cancer case is.

Fun Facts:

Women who take estrogen-containing birth control are 4 times more likely to get blood clots
Pet scans use radioactive liquid to show where tumors may lie in the body.
The kidney, brain, and bladder all light up a lot on pet scans.
Alex Trebek is in remission from Stage IV pancreatic cancer (yay!)

Day 3

Today, we returned back to the UNC Rex Hematology and Oncology Clinic. I actually got locked out of the office, because I took the back entrance, but thankfully, Clare, a nurse practitioner, helped let me in. Clare is Dr. Eisenbeis’s nurse practitioner and she just returned from her two days at the hospital working in the in-patient clinic. She told us a funny story about this one lady, who she was trying to prescribe medicine to, who was allergic to EVERY antibiotic medicine. No joke, when Clare pulled up this lady’s list of allergies, the screen was just a jumble of letters from the countless medicines that were listed. It was something else that’s for sure.

However, other than that story, the day was pretty normal. Nothing out of the ordinary and there were some times where Dr. Eisenbeis, Clare, and I were just sitting in the fishbowl waiting and talking. Those moments were honestly some of the best of the day. We talked about everything from college to the Appalachian machete killer to sports. We even talked about this 41-year-old nurse who ran a sub 2:30 marathon, fast enough to qualify for the US Olympic Trials. Crazy! Needless to say, I feel like I got a lot more comfortable with the doctors there and was still able to learn a lot. They were talking to me about how important iron is for one’s health and how hard it is to maintain normal iron levels. For example, iron deficiency is extremely common because our bodies cannot absorb iron very well, but we also saw some patients who had a genetic mutation that caused them to have too much iron levels because their body absorbs too much. I feel like, after today, I have a greater understanding and appreciation for hematology because I knew a good amount about oncology, but I never realized how much information you can retrieve from just a small sample of blood.

Image result for iron deficiency — Iron Deficiency Symptoms

Fun Facts:

Individuals of African American descent have lower white blood cell counts compared to other races.
A unit of blood of a person with hemochromatosis (surplus iron) has the same amount of iron as someone with normal iron levels.
Clare was a swimmer in high school who walked on to the University of Florida’s team.
Iron deficiency causes high platelet levels, low RBC count, and small RBC size.
Four new patients didn’t show up to their appointments today: Dr. Eisenbeis theorized that either they knew enough that they didn’t think the appointment was necessary, or they got scared because they saw the word “cancer” on the clinic’s name.
Pro tip: don’t google your diseases; WebMD is basically Wikipedia. A headache does not mean you have a brain tumor.

Day 2

Today, I ventured to the Raleigh Hand to Shoulder Center to shadow Dr. Schricker, a hand surgeon and specialist. We started off the day with a man with gout in his wrist, which is basically when small crystals form in your joints due to your uric acid being supersaturated (shoutout to Mr. Rushin). This excess acid, which should be disposed of in urine, hence the name ureic acid, spreads to various joints and crystallizes, so it basically feels like you have glass shards in your joints. Yes, it is as painful as it sounds. But, it was easy to treat: a simple cortisone shot was objected in the area and he was good to go.

As the day progressed, I was learning more and more about your hands and fingers. The nurses joked to me that after I go home, I’m going to get all these diseases and disorders now, but hopefully that isn’t true! The one most interesting thing I learned about was a trigger finger, which is very simple yet extremely painful. Dr. Schricker basically explained that your fingers are controlled by strings connected to muscles in your forearm, so there are no real muscles in your fingers. However, that string passes through these eyelets, just like a fishing pole. A trigger finger is caused when your strings get knots in them and can not get through the eyelet, so they essentially get stuck and make a popping sound when getting unstuck. For mild cases, a cortisone shot can be used to losses the knot, but we saw some very severe cases, where surgery was needed. In one case, the lady’s finger was completely stuck and even the doctor couldn’t get it to open!

Dr. Schricker and his team are all very nice and love to talk, which I truly appreciated. They seemed very close and made the day fly by because they were always moving. All the patients were extremely nice and seemed very grateful, even though they sometimes didn’t want to get the shot or the surgery, but both the patients and the doctors never failed to make me feel unwelcome.

Fun Facts:

Dr. Schricker’s 30th anniversary is coming up and he and his wife are going to Charleston to celebrate.
Arthritis is caused by spurs in the bones, but sometimes these spurs don’t cause any pain.
Arthritis is completely genetic, but there is no cure. There was a 30 year old woman with terrible arthritis, but this other 108 year old lady had no arthritis at all!
Hand surgeons require 14 years of school/education after high school.
Dr. Schricker has 3 little chickens, 2 big chickens, and 2 ducks (if I remember correctly)

Day 1

Today was definitely a day like no other. I shadowed Dr. Eisenbeis, a doctor at the UNC Rex Hematology and Oncology Clinic. At the clinic, patients can receive chemotherapy and immunotherapy treatments, as well as receive bloodwork and labs for various reasons. In fact, a majority of Dr. Eisenbeis’s patients don’t have cancer, they are just sent by their primary care doctor after observing abnormalities in their bloodwork or labs. The nurse practitioners are the ones who do most of the chemotherapy treatment and bloodwork, Dr. Eisenbeis mainly helps monitor patients’ wellbeing and helps diagnose different diseases as well.

An interesting thing I saw today was that there is actually a device, called a Dignicap, that helps cancer patients prevent hair loss during chemo treatment. It was quite interesting and is rather new, and in my opinion, is definitely a big game changer because many people are insecure about hair loss or they want to keep their cancer private, so this cap helps give them that choice. Dr. Eisenbeis explained that the cap basically uses cold water to help prevent the hair follicles from breaking, as chemo treatments cause a break in the hair, which is what causes the hair loss. I didn’t get to snap a picture, but it is basically the large yellow helmet that fits around a patient’s head during chemo treatment.

Overall, the day was very interesting and definitely widened my exposure and understanding of a career in oncology and just cancer in general. Treatment is very difficult because each person’s cancer is different and requires different attention and treatment. What really inspired me was how most of the patients are so well-spirited and gregarious, it made me feel like there’s no reason not to be happy and you can always find a reason to smile.