Tag: Day 4

Day 4 – A New Day, A New Doctor

Day 4 of my work experience was slightly different than the past few days. For starters, Dr. Bloom wasn’t in the office, so Mrs. Bridges and I were paired with Dr. Gavankar, another primary care doctor. It was also a “dress-down” day, meaning that I was able to wear jeans! My day also started 30 minutes later than usual, at 9:00am, due to a faculty meeting in the morning. My day then ended 2 hours earlier than usual, at 2:30pm, due to a doctor’s appointment that Mrs. Bridges had. The following are some of the patients I visited with…

  • 9:45am patient (53 year old male): This patient came to the office for an urgent visit, regarding pain in his right hand. His pain initiated around 3 months ago when he started lifting weights. It hurts more severely in the mornings, and the pain is centered around his ring finger, palm, and top of hand. He has not been trying many home remedies to ease the pain, other than stretching. Upon Dr. Gavankar’s entry into the room, he pressed along the patient’s palm, which was the source of the most pain. He also asked the patient to make a fist and bend his fingers in certain positions. When the patient would bend his fingers, they curved at an angle. Dr. Gavankar predicted that the patient has a flexor tendon nodule, which becomes more irritated when the patient bends his fingers (this leads to rubbing against the nodule). He also thought that the patient likely has arthritis in a joint in his ring finger. Dr. Gavankar ordered for the patient to receive an x-ray of his hand. After receiving the x-ray, Dr. Gavankar explained to me how the patient’s metatarsals in his ring finger are not symmetric, which could be the reason the finger bends at an odd angle. He also clarified that this was where the patient’s arthritis was. When Dr. Gavankar returned to the patient’s room, he reiterated the patient’s condition of a flexor tendon nodule. He also explained that the patient was in the beginning stages of trigger finger, which is a condition in which a patient’s finger locks up when they make a fist. The patient was able to make repetitive fists without his finger completely locking up; however, he sometimes experiences stiffness. Dr. Gavankar recommended the patient to ice and take a prescribed anti-inflammatory as needed. The patient should also wear a glove during lifting and should avoid excessive gripping. Before the patient left, Dr. Gavankar allowed me to feel the patient’s hand; the nodule was a very solid and obvious bump in his palm. 
  • 10:45am patient (34 year old male): This patient was here for an office visit, concerning pain in his right foot. He has been having paint intermittently for the last 3 months. His pain is concentrated around his heel and the back of his heel. He thinks the likely cause is from a cricket game that he played with unsupportive shoes. He has not been doing any home exercises, taking anti-inflammatories, wearing a night splint, or icing. Most of his pain occurs in the morning, but he also has a consistent “tingling” sensation throughout the day. After walking for a while, the patient’s pain wanes; however, after resting, the pain accelerates again. Mrs. Bridges explained to me that the likely has plantar fasciitis. The plantar  fascia connects the heel bone to the toes and is often indicated by intensive pain in the morning. It can also be caused from a tight calf. When Dr. Gavankar entered the room, he felt along the bottom of the patient’s foot and heel, which was the source of his pain. He agreed with Mrs. Bridges that the patient has plantar fasciitis, but also ordered him to receive an x-ray to see if he also has a bone spur in his heel. Upon reviewing the x-ray, Dr. Gavankar pointed out to me where a bone spur would be located and how this patient did not have one. He recommended that the patient perform physical therapy exercises for the next month, ear silicon heel cups which help to alleviate some of the pressure on his foot, and avoid walking barefoot (especially on hard surfaces, for this causes microtears in the fascia). He also suggested the patient to take prescription-strength anti-inflammatories, but the patient was not willing to. Dr. Gavankar stressed the importance of the patient performing his home exercises, for that is the only way he will get better.     
  • 1:30pm patient (10 year old male): This patient was here for an office visit, regarding a check up on his shoulder. Last visit, he was diagnosed with an interior subluxation, which means that his shoulder popped out of its socket and then back in. Upon his arrival, the patient explained that he is currently pain free and came out of his sling on Monday. He also happened to be scheduled for physical therapy after his check-up. When Dr. Gavankar entered the room, he had the patient demonstrate his exercises from physical therapy. The patient then took his shirt off and Dr. Gavankar tested his movement and strength with various stretches. He recommended that the patient continues with physical therapy and has a follow-up appointment in 3 weeks, which is when he should be cleared.
  • 2:15pm patient (41 year old male): This patient was here for an office visit, regarding a stitch removal. Last visit, he had two sebaceous cysts removed from his head. Mrs. Bridges explained to me that a cyst is a fluid-filled sac that can be moved around. In order to remove it, one must make a thin incision without puncturing the sac and then remove the sac completely, otherwise it will just be refilled with the liquid. Suturing then takes place to sew up the cut. The patient had two different cysts removed: one on the top of his head and one at the base of his neck. They had 2 and 3 stitches respectively. After Dr. Gavankar approved the removal, Mrs. Bridges snipped each stitch before pulling it out from beneath the patient’s skin. She explained to me that these stitches slid out easily because they were tied loose enough to be removed, but still tight enough to close the incision.

Day 4 – Projects Galore!

Back at Chesterfield today! Even though it’s Friday, everyone in the lab was working as hard as ever. Will and I started off the morning with a jam-packed session of activity as he explained to me the three main projects he is working on this summer. His first and most prominent project is working with PVA (Polyvinyl alcohol) a soft but sturdy material that has a widespread array of applications. He is currently developing a PVA material to be used in patients with arthritis, specifically with repairs in the joint between the toe and the foot. Overtime, the cartilage in these joints deteriorates, so Will is trying to develop a self-healing material that can act as cartilage for patients. The self-healing properties are extremely important because patients shouldn’t have to obtain replacement fixes again and again. The material is made of PVA, water, and melamine, a nitrogen-rich material used to strengthen the PVA through hydrogen bonding. The PVA samples are made by mixing solid PVA powder and water in a flask that’s placed in a hot oil bath. Overtime, the PVA will dissolve and turn the liquid into an amorphous structure.

The second project we dove into was the use of hydrogels. Will is helping Shelley Huang, a famous breast cancer surgeon and author, develop an injectable biomaterial for breast cancer tumor resection. The goal is to create a colored material that can be injected into the patient’s tissue while retaining its shape around the tumor so surgeons can more easily locate the tumor before surgical operations. In the lab, we tested this theory by injecting an arbitrary facial cream into a matrix of polyethylene glycol and seeing if it would hold its shape. (Refer to the photos for more detail). The polyethylene glycol (yellow jello-like substance) mimics a patients tissue and the facial cream acts as the injectable biomaterial. Ultimately, if it can be proven that something as generic as the facial cream can be injected while retaining its shape, commonly produced creams or gels can be dyed and up for consideration to use to enhance this medical procedure.

It was brought to my attention today that Dr. Ken Gall, the head professor of this lab, owns a startup company known for developing a new material called polycarbonate urethane (PCU). The plastic-like material is slightly malleable yet substantial, so it retains its shape well. Most importantly, it can be 3D printed easily. The astonishing thing is that few materials with the malleability and durability of PCU can be 3D printed on a mass scale. Dr. Gall is using this creation to develop tracheal support structures for patients that may need implants in their throats to breathe properly. The intrinsic qualities of PCU makes it a good material for this application because it will work effectively, last long, and its dimensions can be tailored for each respective patient. Furthermore, the use of such support structures is far more efficacious than simply cutting a hole in a patient’s trachea so they can breathe – it is a viable and cost-effective solution. In the lab, Will is currently testing the PCU using a laser cutters to determine its true durability, but there are already several cases at Duke Hospital in which the PCU tracheal support structures are up for consideration to be used!

In the afternoon, we carried out tests for each of the three projects. For project one, we poured the batch of PVA that will had prepared into dog bone molds so they could be frozen later for testing. For project two, we checked on the test tube we had injected with facial cream earlier to see how it retained its shape; it did fairly well. Finally, for project three, we spent a few hours at the laser cutter making dog bone samples of the PCU. This was hands down the most enjoyable part of the day since I single-handedly cut two dog bones with the laser cutter by myself! I have never worked with a machine so powerful and was happy that Will gave me the opportunity to do so. The dog bones I cut are going to be used for future strength testing to see just how viable PCU will be as a tracheal support material.

Today was a short, but fun day. Looking back at this week, I have come a long way. I have learned about countless test procedures and several unparalleled projects that immediately captivated my interest. Lab work is definitely where a part of my passion lies, yet I am thankful for the weekend to come so I can take a quick break before going back to Chesterfield on Monday.

House Hunting (like the show!)

Construction at my future neighborhood (I mean Southpoint Trails)!
This was the worst house of the day….that says something!
If you need me between now and next Friday, you can find me at the Drake model home at Southpoint Trails!

Today was the most laid back day of the experience thus far. After our somewhat of a failure discovering the new developments yesterday, Kristi called the agents at both of the developments (Southpoint Trails and the Meadows at Southpoint) to let them know we were coming. We went to Trails first, where we toured two different model homes (1 and 3 Photos were at that development). The homes were awesome! I liked the first one best due to the light and airy feel, while Natalie preferred the darker, homier one we toured second. After we gained information surrounding Southpoint Trails, we continued down the road to the Meadows. The Meadows featured smaller, lower priced homes that we targeted much more to a starter home level. They, while still nice, were much less stylish than the other ones. We toured these homes in order to gain insight into what the neighborhoods were really about so that when new clients come to town, Kristi will know where to show them. Natalie and I were supposed to meet with a development expert today, however that was postponed until next week, so we got a great lunch at the mall. After lunch, we met Kristi at one of her listings where she showed us how to show a house. One thing that I found interesting was that in reality, it is better to not shove the information down the client’s throats, rather to let them wander and provide information when necessary. It was an awesome day today and I can’t wait for what next week holds!

Day 4

Today was our fourth day at Field2Base. Milen and I began our day by once again attending the development team’s daily stand-up meeting. Then, we talked to Mary and helped create a section of a form for a construction company. We had to use drop-down menus which pulled their options from an online excel file in order to determine the options, and then based on the user’s choice from the first selection, it would autofill another column with a matching response. Once we eventually figured out how to make this form work, we uploaded the form to Field2Base’s QA account and tested the form for any errors on a tablet. Then, we talked to Howard, who holds a similar position to Mary. Then, we started a project that Howard had created for us, using the knowledge we’ve amassed to create a form using more complex forms of all the regions and techniques that we have learned the past few days and this morning. After a few hours of working on this form using forms designer and all the reference materials on the website, we completed the assignment and got the form working in the test environment.

Day Four – Questions

My day began with two questions which would end up dominating my work day – 1. How was Kanye West able to yet again release the world’s greatest music? and 2. Who knew that you needed an ID to enter the state archives? 

Answers: 1. He’s Kanye, and 2. I didn’t.

Thus my day began by driving to the state archives, realizing that I didn’t have any sort of ID, driving back to my house, grabbing an ID, and then finally driving back to the state archives. At the archives fellow junior-lobbyist Ava and I researched the NC Department of Transportation. We learned all sorts of thrilling facts about the NCDOT. For example, did you know that the annual operating budget of the DOT is around 4.7 billion? Or that the DOT collects most of its money through a fuel tax and was founded in 1915? All of this information should help me with the one-day internship I have at the NCDOT on Monday. Can’t wait! 

I love to learn!
Black Beard -> Pirate -> Ship -> Transportation -> NC Department of Transportation

6/01/18 – Image Creation

Today we worked from home once again, for the same reason as yesterday. I spent most of the day working on a program that would create a PNG file that would display information on the patient’s CBC values so that it would be easier for people to understand what was being written because it is the shorthand way Clinicians report them. I’m currently becoming more versed in the way Clinicians report things and how to make python create images and then save them to the computer with a file name. It is somewhat similar to the programming languages that I am already familiar with, C++ and Java and so it has been somewhat easy for me to become well versed in the language.

Below is an example of what the PNG file would display, with the abbreviations replaced with various different numbers that the abbreviations represent:

Day 4 – It’s always the last box

The 4th day of my work experience started off like normal. I got in for the day and helped out around the IS department, helped Mr. Rokuskie box up charging cords, and also attempted to trace discrepancies in the tablet purchase sheets. This all was quite normal until it was realized after a count of the boxes that there was one more tablet somewhere in the wall of boxes that didn’t belong. We counted a few times all 240 tablets but the database had 239 registered. Someone might simply say “well, just register one more in the database”, but we needed the serial number and had to register the specific missing tablet. We spent a while opening boxes and checking for them in the database each one after the other came back as registered. After searching through almost 25 boxes of tablets I opened the last box and pulled out the first tablet. I read the serial number and was about to put it back in the box until i heard “Its not on the list!” and of course we found the tablet we were looking for in the very last box.

 

(the stack of boxes we searched through)

 

 

Day 4-People’s Court

At 9:00am Friday, I was immediately stationed in room 302 with Judge Chasse.  302 is People’s Court on Friday mornings.  I specify Friday mornings because the types of court sessions held in each room can vary by day.  That’s why it seems to take so long to get a court date: they have to find a specific day where your case will fit the theme.  What I mean by People’s Court is that it’s the courtroom you go to after you tell your neighbor “I’m pressing charges”, with an added twist.  This People’s Court was held in a criminal courtroom, which means that the person continuing charges believes a crime has happened, and that the defendant should be held criminally responsible.  From there, the District Attorney prosecutes the case and often calls the victim to the witness stand.

The Assistant DA goes out of the courtroom to talk to people involved, and I notice that she has a shadow.  Apparently, all of the DAs have Campbell Law students following them around for the summer.  Because they have some understanding of the law, they’re allowed to help out and actually do work.  I, on the other hand, am not allowed to do any work.  That would be so much of a liability, so it is understandable.  Early in the morning, one file came back with a green sticky: incarcerated.  The bailiff called the jail to request that the man be sent upstairs.  Apparently, there was a mistake, because the jail said they had released the man five days ago on bail.  In fact, the guy just hadn’t shown up on his court date.  Oops. They held him in contempt, so we all knew he would be back in the jail in no time.

People’s Court involved, once again, lots of discussion between the DA and the Public Defender.  Judge Chasse told me that most of the time he doesn’t even know what’s going on in his own courtroom because these negotiations are kept at a low decibel.  He really only learns of the situation after the lawyers are done discussing.  He also told me that in North Carolina, People’s Court charges can be filed online or with a form.  Because no officer or magistrate has to issue charges, there are presumably lots of people filing claims out of spite.  To keep this number in check, cases can easily be dismissed if the accusing party doesn’t show up to court.

In the afternoon, there was a Bar appointment scheduled in room 2A with Judge Davidian.  Judge Davidian made the new lawyer swear to protect the Constitution, and then the man signed some papers and was admitted to the NC Bar. Even though taking pictures in courtrooms is not allowed, Judge Davidian allowed the countless family members in attendance to have some pictures for safekeeping.  There wasn’t anything scheduled after the swearing-in, so we had a pretty relaxed afternoon session.

Day 4- RTI

Today was the day I had been waiting for: chemical inventory day!  I was so excited to spend hours sorting, organizing, and looking at endless chemical bottles.  I expected this to be the perfectly monotonous repetitive task I dreamed of doing every day.  I was wrong.  After hours of hand cramps, back aches, and blurry eyes from reading chemical names that contained more letters than I ever thought could be in a single word, I decided chemical inventory was just not for me.  It is a necessary part of having a successful chemical lab, but it was just painful.  Kiera and I tried our best to reorganize the chemicals when we put them back in the cabinet, but it seemed that our organization would be in vain, as the various people using this lab would likely not even notice our new organization system.

DAY 4

Today’s post is short, as I was only in for a couple of hours.

I started off the morning today with going to the office’s sort of “weekly wrap-up.”  In this wrap-up, usually several employees come in to the office manager’s office and discuss various issues that have arisen throughout the week.  In this case, it was an issue with a program called MedSuite not appropriately populating the correct categorization for patient need.  Though this was a seemingly simple issue, to me, I began to realize that it was actually very significant.  The classification for the needs of the patient is extremely important, and especially important when handling the patient’s medical records.

There was another, even more important meeting happening at the hospital today, so there wasn’t a whole lot for me to do.  I sat with one of the financial people for almost the entire morning, which was intriguing at first but began to get a bit mundane after about hour 3.  She worked on reconciliations, which I didn’t entirely understand but was still interesting to learn about.  Fridays aren’t usually a particularly busy day, so there wasn’t too much she could show me.

I’m looking forward to next week!

Skip to toolbar