Day 6 – Page 4 – CA Work Experience Program

Day Six – EtBr Fun

Today I was back at the UNC Lineberger Cancer Center for some more adventures. I started off, like usual, talking to Dr. Bermek about the today’s experiments. There were many different new things she wanted to test because of some of the results from the experiments we had completed. The experiment we needed to get done first was using Ethidium Bromide (EtBr). We had tried to run the experiment using EtBr last week, but we discovered that EtBr only has a shelf life of about two years and the one Dr. Bermek was using had been in the lab for 13 years. When we analyzed the gel last week the results were not what they were supposed to be probably because of the expired EtBr, so today, we ran the same experiment with fresh EtBr. The reason we were using EtBr is to check for nicked DNA. Topoisomerase relaxes DNA (un-coils the supercoiled DNA strands) by creating an opening in the DNA, but based on a gel we had run last week with topoisomerase, we could not tell whether the nicked DNA got resealed or not which is what the EtBr would tell us.

Dr. Bermek had some samples being incubated so we spent the first hour talking and designing future experiments while we were waiting. There was lots and lots of math involved which threw me a bit of a curve ball, but I tried to keep up as best I could. The most interesting part was figuring out the calculations for reactions that needed the same final volume, but the samples were at different concentrations. There was a lot of dilutions involved. It fascinated me how fast and intuitive Dr. Bermek was when designing experiments. It was like she was creating a recipe. I am comfortable with carrying out a lot of the experiments we have done, but I will need much more experience in math and more practice to design my own experiments.

Once her samples had been incubated, we started on the EtBr experiment. Dr. Bermek prepared the samples because there were many ingredients while I prepared my first Agarose gel by myself. I measured out 0.5g of Agarose and added 150mL of TAE buffer. Then, I heated the mixture for 2 minutes and 30 seconds making sure to swirl the mixture every once in a while. Dr. Bermek taught me to run the Erlenmeyer flask (with my concoction) under cold water to cool the mixture faster. I also learned that we needed to add the EtBr to the gel and buffer instead of to the samples.

Once, I had finished making my first Agarose gel, I helped Dr. Bermek get the samples ready for loading by adding 4uL of 6x loading dye to each tube. Next, it was time for loading. I was a little more comfortable with loading Agarose gels, so I loaded the first lane and did pretty well; however, when I started loading the second lane, the tip of my pipette fell off and the sample went into the buffer. Luckily it was just the control, but after my mistake, Dr. Bermek loaded the rest of the samples because neither of us wanted to re-do the experiment for a third time. While we were completing the experiment, Dr. Bermek used a really cool heating mechanism that utilized little rocks instead of water, so people didn’t have to refill the container because rocks don’t evaporate like water. I thought it was a very clever idea.

Once the gel was running, Dr. Bermek checked some samples for their concentration of ATPase/phosphate. She used a really cool technique that I had never seen before. She used a plate with lots of different wells and added 180uL of water, 20uL of the samples, and 30uL of phosphate reagent. The samples and water were clear, but when she added the phosphate regent, the samples turned different colors. The shade of the bluish-green color of each sample indicated the amount of phosphate. I felt like I was experience a magic trick.

Towards the end of the afternoon after the samples had settled, we checked the concentration of the samples in a special machine. The machine gave us the exact concentration of each sample, but by that time, it was the end of the day. I’m excited to analyze the different concentrations as well as get the results of the gel we ran today when I come back tomorrow!

The magic color changing ingredient.

My first Agarose gel I prepared all by myself!

The clever heating mechanism.

The colored samples being loaded into the machine that checks their concentration of phosphate.

Day Six: (more) Debacles & Decorum

It seems that I can only go a few hours without making some sort of erreur fatale, as Madame Jones would say. This morning’s doozy was pulling into an employees only parking lot, and guess what? I needed one of those scan things to get in. If you assumed that I did not have one, as I am not a state government employee, you were correct. My only options were to go straight through the bar looming directly in front of me, or try my best to back out and reverse up the one-way street. The better option was to not immediately wreck my car, and taking a calculated risk, I decided to back out. This very, very, very nice lady helped guide me and my car (physically and spiritually) to safety, and to my job right on time.

On what actually happened today, this was for sure the most action packed days by far! It was the Advocacy Day for Occupational Therapists of NC, and my day from 9:00 am-3:00 pm was almost entirely spent on my feet. One of my main jobs was leading a gaggle of OT’S between buildings, up flights of stairs, and into elevator in order for them to met with their local representatives. We bounced from meeting to meeting, and if I tallied correctly, we attended seven total! That is definitely a lot for one day! I definitely was a busy gal all day, but it was interesting to see the fruition of the lobbying work that Ashley does. She isn’t anything like the money-hungry, devil-horned monster lobbyists of the NRA one imagines – her job consists of standing up for those who can’t. What she does is all for underrepresented people, and if someone meets her for even a minute, they’ll know that she truly cares for them and loves what she does.

Day 6 – Carolina Ear and Hearing Clinic

Today was the last day with Dr. McElveen. We were at The Duke Raleigh Hospital observing him perform ear surgery. In the first surgery, he replaced the stapes bone with a prosthetic. Dr. McElveen performed this by going in through the ear canal and peeling back the ear drum to replace the bone. This surgery only took about an hour. In the second surgery we saw, Dr. McElveen placed another prosthetic by cutting behind the ear and accessing the inner ear that way. We then returned to the clinic and learned about Audiology, Hearing aids, cochlear implants, and various hearing tests. Below is a picture of the inner ear and the small prosthesis that was placed.

Day 6 – Team Meetings

Today Tommy and I started off the morning with meetings. First was a tech tip meeting led by Precious, where we learned how to use Keller Williams’ form of MLS. Specifically Tommy and I learned how to add contacts to keep your sphere of influence up to date. We also learned how important it is to keep your leads and clients up to date on your business so they have you on their mind. Agents can do this through thee Keller Williams’ MLS site with welcome or listing emails automatically formed for you to send to your client or lead. After the tech tip meeting we had an office meeting where we discussed mortgage, law, and coworkers successes and challenges. Tommy and I then got lunch and headed out to another model home where we took lots of pictures and spoke to some agents about the communities.

Day 6 – So Many Articles

Another busy day! We began with a bit of free time, in which we decided to start the 2 supplementary tasks we were assigned. In one, Dr. Lara Lorenzetti, who is researching ways (specifically “savings groups”) to get those in developing countries to adhere to their HIV medicine. She asked for our help in looking through all of the literature to determine which pieces would be useful to her research. In the other, Dr. Rebecca Callahan did research and asked for help in beginning to develop a Powerpoint for her to present her findings. We decided to split it up, with RJ and I working on the former and Chiara and Krishan working on the latter. RJ and I read SO many articles (hence the blog title), but we actually became pretty fast and worked together well. It felt great to know that this small task we were doing would be used for something way bigger than ourselves.

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^^ click to see how many articles we sorted through today

We also talked to a couple of people today. First, Dr. Jennifer Ayres discussed her role in the CTID. She had a really interesting perspective because she was one of the only chemists at FHI 360. To tell you the truth, I had been waiting to meet with her since I learned about her chemistry background a couple of days into the job. While talking to her, we learned even more about contraceptives and how they work, specifically as it relates to drugs and dosages.

After we took an hour to explore main street and eat lunch, we headed back to talk to Chris Harmon. He discussed his work with the CTID, which was incredibly different from the others’ in that he was mainly focusing on the technology aspect at the moment. Basically, he was working on compiling a couple of different databases. One was to compile all of the contraceptive technologies that were being worked on, one was a database of the main chemicals that were in contraceptives, and one was a system to determine if using two drugs at once would give negative side effects. I thought the third was the most interesting, as it has to be a pretty complicated system for you to be able to go through all the different pairings and get an answer.

Finally, we met with Holly Burke. She was also a scientist, but she worked for the Reproductive, Maternal, Newborn, and Child Health division (RMNCH). She talked to us about the research aspect of her job, including the studies she had done with injectables and the results that she had gotten. She also talked to us about her career and her journey as a whole.

All in all, a great day! Can’t wait for tomorrow, where we will have 4 (!!) back-to-back meetings and will hear MANY perspectives!

Day 6: Proofing a Patent and Meetings!

Today was another day at the KDB office in Durham. When I arrived at around 8:30 this morning, I was told I was going to be participating in a meeting with Mr. Kavinsky and some Facebook executives. Although I can’t legally say what we discussed, I can say that it was very, very interesting. The meeting lasted about one hour and afterwards I met with Ms. Courtney White where she walked me through how to proof a patent using the USPTO website and various other patent tools. It was actually quite interesting seeing all the hard work that goes into making sure a patent application is properly filed and sent off. I then shadowed Ms. Moye as she sent out a patent to an IP attorney on its deadline. There are a lot of steps that go into this process and the entire process took around 45 minuets to complete. I then got to do some proofing myself as I was assigned 10 patents to proof. Those took me about 3 hours in total to do. Overall the day was pretty eventful and riveting.

Day Six – Tuesday is the New Monday

Today was a somewhat slow day again for Devivo and Sams Policy Partners. However, it began in opposite fashion as early in the morning we had a short meeting regarding our car-clients from last week. Then we had a short meeting with some more new clients. They were chiropractors who needed some sort of representation within the legislature, but I couldn’t glean any more than this. Afterwards our day consisted of several short meetings with different lobbyists and representatives regarding a car-software bill set to be voted on this week by both houses of the legislature. In between these meetings we killed a lot of time in various hallways, in the building’s cafeteria, and with two very sweet old ladies in the building’s telephone center. Our day ended with a short meeting with Representative William Brawley.

“I don’t have any photos for my blog today”
“OK, just take one here”

I’m posting photos of Paco to appease my bosses

Paco Doesn’t Like It when I talk to his Girlfriends

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^Paco does like food but not when his girlfriends are stealing it

Day 6 – Trigger Point Injections, A Wrist Fracture, and More

Day 6 was off to a late start, for I didn’t have to come into the office until 10:45am; there was an off-campus faculty meeting in the morning. Upon my arrival, the day went as usual, with the following patient visits…

Follow-up on the 46 year old female from yesterday: This patient, who was seen in the office a couple of times in the past week due to poison ivy and likely an allergic reaction to prednisone, portaled Dr. Bloom this morning with an update concerning her condition. Yesterday, Dr. Bloom had prescribed her Medrol dosepack (tablet) and Clobestasol ointment to be put on her neck twice a day. This morning, she messaged him with an update saying that she has seen some slight improvement from yesterday. A couple of new poison ivy spots have formed; however, they are not blistering. She also said that her old spots are becoming darker and disappearing, which Mrs. Bridges confirmed as healing.
11:45am patient (45 year old female): This patient came to the office for an urgent visit, concerning eye pressure/pain. She was last seen in the office at the end of May for a physical, where she had some abnormal thyroid labs (blood test). Thus, she was referred to an endocrinologist, who found a nodule on her thyroid. Today, she came to the office regarding pressure behind her eyes and “enlarged lymph nodes.” She explained to Dr. Bloom that she feels pressure behind her eyes during yoga, specifically the downward dog pose or other positions where she is upside-down (blood rushes to her head). The pressure was initially just behind her right eye, but it moved towards the center. She feels no pressure when she is standing up-right or during any other times. Dr. Bloom went through a neurological exam with her, checking her coordination and balance and then feeling around her lymph nodes in her neck and armpit. He assured her that everything looks normal. The patient questioned about her enlarged lymph nodes, to which Dr. Bloom said were actually normal. She also mentioned that her ophthalmologist thought the eye pressure could be from her vision, which is strained in her right eye. Dr. Bloom agreed with this possibility and ordered the patient to wear her new prescribed glasses. He also said that if symptoms worsen, then keep him updated. He added that the patient is likely noticing a bunch of small tweaks in her body that usually go unnoticed, which means there is nothing to worry about.
2:15pm patient (36 year old male): This patient was here for an office visit, regarding trigger point injections. He was in a car accident in December, in which a car rear-ended him at a stop sign. He has been doing physical therapy since then and has been receiving dry needling for the past 2 months. Dr. Bloom assessed his pain by pressing on various areas in his back and testing his motion and strength. The patient’s pain is centered all around both of his shoulder blades. Dr. Bloom then gave him 5 trigger point injections. He explained to me that the injections work by stimulating a flare up (cells flood to the area of injection), which then leads to pain relief. The needle and injection themselves are not what cause relief, but rather the rush of cells to the area. Dr. Bloom cleaned the patient’s back thoroughly with alcohol pads. He then sprayed a freezing liquid on the area of injection. Dr. Bloom inserted the needle into the trigger point and moved it around 360 degrees, slowly injecting some of the Marcaine. Dr. Bloom repeated this process 4 more times, after feeling which spots were the source of the most pain. Some spots began to bleed after the injection, so Dr. Bloom massaged the area before covering it with a band aid. He recommended that the patient really focus on good posture for the next few weeks, perform aerobic exercises to raise his heart rate, and practice his high yield physical therapy exercises. Dr. Bloom also said for the patient to portal him at the end of a month with an update on his pain.
3:00pm patient (47 year old female): This patient came to the office for an urgent visit, concerning a wrist fracture. She had slipped on some rocks by a creek and hit her hand when she landed. Dr. Bloom ordered for her to have a short-arm, water proof cast for the next 10 days. In 10 days, she will then be switched to a plaster cast. To make the cast, first a layer of soft material was put along 2/3 of the patient’s forearm. Ms. Kristen explained how you should make it half an inch too long on each end for it to be folded over. A sticky layer then covered the cushioned material, followed by 2 more wet layers. The final layer was black, as requested by the patient. Dr. Bloom noted to Ms. Kristen that in the future, a short-arm cast is actually slightly longer (just below the elbow), but that this cast will work this time. The patient’s recovery will take about 6 weeks in total.

During my lunch break, I was able to have a mini-interview with Dr. Bloom to learn about his process of becoming a Primary Care Doctor…

He attended Dartmouth University for his undergraduate degree and was a history major
At Dartmouth, he studied abroad in Kenya for 4 months
He took the MCAT his senior year and applied to multiple medical schools
He attended Tulane University for medical school
He explained to me that the process was 4 and 4: 4 years of actual schooling and then 4 years of residency (Dr. Bloom did 3 years of family practioning and 1 year of sports medicine)
He has been working at the Carolina Family Practice & Sports Medicine for 15 years now

More driving, more meetings, more models!

A kitchen I would be (less) willing to learn to cook in :/

Apparently, my wicked good looks and on the spot smarts make me look like an actual agent because EVERY SINGLE PLACE I went today someone asked what agency I worked for. I’m 17 guys, not that hard. Today started at 10, a bit earlier than usual, with a tech tips meeting. We pretty much learned how to use the KWMLS (Keller Williams Multiple Listings Service) and how we can put leads into a database. In real estate, leads are the biggest help because they help agents gain listings and therefore gain business (and money)! Afterwards, I re-parked my car because anyone that has seen me drive knows that is a necessary endeavor, which made Natalie and I almost late to the team meeting. In the conference room, we met with Kristi, Sarah, Ed, and all of the other agents to catch up on how everything is going. The team members shared leads and listings, a mortgage agent answered any questions, an attorney helped brief everyone on what to do, and everybody thanked each other for all the hard work. Naturally, Natalie and I headed out after to go check out even more new construction. I’m not going to lie, at this point every house looks the same. We went to one development near CA that was nice, albeit cookie cutter, that gave us good insights into the difference between Cary and Durham’s new developments. Afterwards, we headed out to check out another model, learning a lot more about what is takes to both stage and sell a model home. Finally, we headed to another development near downtown Cary and while there was no model, the agent on duty was more than happy to brief us on both the neighborhood and the industry as a whole. I have to admit, with each day of work, my interest in real estate just intensifies!

Day 6: Archives

In the morning, Grace, Dr. Malarkey, and I traveled to another National Institute of Environmental Health Sciences building, known as the National Toxicology Program Archive. At the NTP Archive, we joined some of the staff there on a tour of all the different storage units there. First, we visited a fire and vacuum sealed room containing all the NTP project files, dating from 1980 to present. Next, we visited the room that contains all the histopathology slides from projects; government policy requires that all slides must be archived. The NTP archive staff is currently in the process of scanning all histopathology slides to put on a public atlas for easy access; it is currently in a pre-release phase only accessible by NIEHS scientists. Later, we toured the wet tissue archives, which houses all the tissue that has been studied in previous projects. Each tissue is preserved in chemicals and vacuum sealed into a plastic container. Finally, we had the opportunity to travel into the massive freezer warehouse, which houses dozens of minus eighty degrees Celsius refrigerators, and for extreme cooling, roughly twenty liquid nitrogen tanks for samples. Grace and I also, briefly, walked into the minus twenty degrees Celsius freezer about the size of a school bus.

After our tour, we sat down with Dr. Malarkey at a microscope to review some of the archived slides from the GSM and CDMA Modulated Cell Phone Radio Frequency Radiation study. We went through a couple of different histopathology slides from male rats and attempted to identify what lesions if any, the radiation caused on the tissue. We identified a particularly interesting malignant oligodendroglioma in the brain of one mouse, which is indicatory of an adverse effect from radiation. The challenge, though, is determining if an unusual brain tumor in one rat out of ninety is enough to justify cell phone radiation as a carcinogen. Further studies are required and are currently in planning at the NTP, as present data is inconclusive. We also found some cataracts in the lens of the eye, a tumor in the liver, and extramedullary hematopoiesis (the creation of blood cells outside of bone).

During lunch, Dr. Malarkey challenged Grace and me to take our food up to one of the conference rooms where he would be reviewing tumors and lesions with veterinary pathology students. I tried my best to stay focused on the screen while eating, but some of them made me look away while trying to stomach my meal! Nevertheless, I learned a lot and had another great day.