Tag: Medicine

Day Two – Cary Family Dental and UNC-Chapel Hill Dental School

Today, after jaywalking at least four times, we drove down to UNC Chapel-Hill to see the Adams School of Dentistry. We met with the dean of the dental school, and he answered our questions about the school’s application process and learning environment.

Fun fact: the Adams School of Dentistry gets around 1400 applications every year, but the school only excepts less than 100 students every term!

picture: the outside of the dental school

We then met with an orthodontist who works with  the school, and she taught us about the inner workings of braces and how they connect with the health of the overall head. After an introduction to the terminology of braces, she taught us how to take off and add O-rings (rubber bands) to teeth that had fake brackets on them.

top picture: the orthodontist’s slideshow that explained the debonding procedure in dentistry

middle picture: me in my “scrubs”

bottom picture: my completed o-ring set that I almost lost a finger on 😀

We then had lunch with two students, Elizabeth and Harper, and they shared their experiences with the UNC dental program. We also met one of their professors during lunch, and he told us about the teaching regimen and the free dental care opportunities the school provides for the community. Elizabeth and Harper then took us on a tour of the campus, where we got to see the clinics where the students tend to patients. (we weren’t allowed to take pictures of the clinic)

top picture: the inside of the Adams School of Dentistry

bottom picture: me and Priyanka because I panicked and thought I forgot to take pictures

After the tour ended, I went back to the office, where I got to shadow a periodontist, Dr. Van Scoyoc. He was treating a woman who’s gums grew around her dental implant – so, Dr. Van Scoyoc underwent the surgery to cut open her gums, remove the implant, and insert a screw port to prevent the gums form growing around the space again. Today was super exciting!

 

Day One – Cary Family Dental

Today I started shadowing Dr. Allan Acton and his team during their day at the office.

First, I was stationed with the lovely sanitation hygienist, where I learned about the procedures for hygiene trays, the meaning sanitization-wise for the color coding system, and the uses of the tools and machinery that are cleaned or used for cleaning.

Fun fact: the sterilizing agent, Cavicide, is so potent that it can’t be used without gloves because it can cause cancer over time!

top picture: sanitization machines and tray dismantling station

bottom picture: sterile trays labeled for each hygienist (over 45 made per day; one per patient)

Next, I followed Dr. Acton to some of his patients. While I (obviously) could not assist with the appointments, I was lucky enough to witness 3 incredible procedures: the insertion of a temporary tooth, the filling of an interproximal cavity (a cavity found between the teeth), and an emergency composite filling for a cracked tooth. (Due to HIPPA laws, I can’t take pictures of patients having their procedures.)

My favorite part was seeing the Itero machine, which is technology that was coined by Invisalign to help doctors scan full 3D models of the patients teeth through camera, which are then sent to the Invisalign company for dentures and retainers.

picture: Itero machine being used to scan a patient’s teeth 

Finally, I met with Dr. Acton privately where we looked over before and after photos of transformed smiles, where I learned about the different types of crown, veneers, the structure of a tooth, and how acidity affects overall oral health.

picture: before photo of decay/what I believe to be gingival hyperplasia (overgrowth of the gums) and after photo from treatment and veneers

I concluded my day by walking through the tornado warning and slipping in a nice, cold puddle in front of the practice’s door – can’t wait for tomorrow!

WakeMed Clinic

Today was the first day at the wake med clinic where I shadowed a urgologist throughout the whole day and watched him visit patients.

I met several patients, and even met one who drove all the way from Maryland just for his appointment!

I saw several different procedures including a prostate biopsy, vasectomy, and several others. The patients were all very nice and welcomed me very well.

All the doctors helped explain everything thoroughly and it gave me a very good experience of what it’s like to be a doctor. Overall it was a great day and I am very excited for tomorrow.

 

Maris James – Cary Family Dental

Hi!

Starting this upcoming Monday, I will be shadowing Dr. Acton and his team at Cary Family Dental, a dental practice that has been operating in Cary NC for almost 20 years. I am beyond ecstatic to work alongside this team for the next two weeks – counting down the hours until the week starts! 😁

Day 4 in the Emergency Department

Today I got to follow Dr. Best around for the day. Being a Sunday morning & afternoon, the ED was a bit slower than the previous shifts but I still got to experience a lot and had more time to talk to the doctors, residents, and PA student about their jobs, medical school, and more.

The day began with a meeting in the hallway including all the doctors and nurses, and then sign-out as usual. Dr. Best did rounds in the CEU (observation unit), including a patient he said came for the “Duke miracle,” which happens often, meaning someone comes from a more rural or smaller hospital thinking their inconclusive diagnosis or lack thereof is due to incompetency- but that’s just how medicine is sometimes.

One of the patients today was a familiar face who Dr. Best had seen for 15 years in the ED for alcohol and drug abuse. Today he came in for attempted overdose but was known for stealing and drinking the hand sanitizer outside each room in the ED because it is alcohol-based.

In resuscitation, there were multiple trauma patients. One was level 2, an older patient who fell while on blood thinners and broke 4 ribs. Nurses drew blood and stabilized his neck first. A level 3 patient was transferred from another hospital; he had been assaulted and had injuries to the head and face. A critically ill 92 year old was brought in by EMS for pneumonia, but her long list of medical history and problems made it more complicated. Later in the day EMS brought in someone with hypoxia likely brought on by drug use, as a PA student told me that opiods are respiratory repressors. The police actually had to come because illegal substances were found when getting the patient into his hospital gown.

Image result for pneumonia x ray

Example of a chest x-ray showing pneumonia

https://www.med-ed.virginia.edu/courses/rad/cxr/pathology3chest.html

 

Last Day at Waverly Hematology-Oncology

June 6th, 2019

I can’t believe today was my last day at Dr. Graham’s clinic. I had become close to many people in Dr. Graham’s clinic including the man himself. I’m going to miss the look on Vanessa’s face and the puff of air followed by a slight nod whenever I asked her if Dr. Graham was behind on his schedule. I’m going to miss the long conversations I had about the NBA finals and Drake with Konan, Dr. Graham’s newest scribe. I’m going to miss learning about fencing and the Mormons living in Utah from Dakota. I’m going to miss all the cool procedures Ms. Susan performed and let me watch. I’m going to miss seeing the long lines of staff members waiting patiently for Dr. Graham to finish his patient visit and step out of the room. I’m going to miss the conversations I had with various staff members while I used to eat my lunch in the break room. I’m going to miss the constant air conditioning I felt as I waited for him in his room. In short, I’m going to miss so many things that made this clinic so unique which was the people. It was a delight to meet so many new faces and hearing about their stories and learning about how Dr. Graham had impacted their life as they are on the way to recovery. I’m going to miss Dr. Graham interrupting my lunch break so that I never missed out on seeing any of his patients. I’m going to miss the smiles he brought to the faces of countless faces and the pure joy they felt when he said, “I went to sleep well last night after reading your report. I’m going to miss Dr. Graham’s most famous catch-phrase: “I kid you not”. But what I’m truly going to miss the most is the knowledge I was able to gain while shadowing him for the past two weeks. I hope that one day I will be able to make good use of all Dr. Graham’s teachings with hopefully get to learn so much more from him.

Dr. Graham and me

Day 7 – Final Day at WakeMed

The schedule on my final day at WakeMed allowed for a good amount of time to visit patients. The morning was procedure focused until around 11:00 before transitioning to a hospital visit day.

For the most part, the procedures were fairly typical colonoscopies / EGDs that were screenings done due to patient age. However, I was able to watch my first EGD that involved removal of a foreign object. This patient, due to psychiatric disorders or otherwise, had stuck 4 unraveled paper clips into his abdomen. Two of these paperclips had penetrated and become stuck within his stomach. So, a procedure had to be completed to remove these paperclips since they were causing considerable discomfort. A different set of forceps than the one normally used for biopsies was used to grab onto the paperclips.

Afterwards, we visited Dr. Lawal’s new patients in the hospital. Today was a rare case. He had 4 patients at one time who were afflicted with colon cancer. The first was a younger patient who had colon cancer than had spread to the liver. First, a colonoscopy must be done to view the nodule/mass before using chemotherapy. The rest of the patients were much older and also had colon masses that had metastasized elsewhere. One of the patients, although they acted quite normally and were quite active, had a tumor in the brain in addition to the colon. A colonoscopy needed to be conducted before evaluating the tumor. Although I definitely feel for the patient and the difficult stage they are going through, I was also conflicted by my interest in seeing new things.

Overall, this week was a great learning experience for me. I certainly know more about the colon and GI tract now than I did before and this has certainly shaped my future intentions to work in medicine.

The above image is of a CT scan of one of the patients. You can see that the large white nodule on the right side of the scan is a colon mass. This mass is cancerous.

Here is an image of a colon mass. This was taken during a colonoscopy procedure.

 

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 8/ Last Day– Duke Work Experience

Today was day 2 of the GMP FACT inspection. My day started out rather slow because the inspector was not there when I arrived. Thus, I was able to shadow a coordinator whose job was to keep parents of potential clinical trial participants updated. I watched as she answered emails with questions from the parents. Much of the work was repetitive, often involving repeating the same information back to recipients. Many of the people who contacted the coordinator were very well informed. I learned that there are websites as well as facebook groups that are created to inform the public about these trials. Because Duke has a policy where they cannot voluntarily reach out to patients, the people interested in these studies have to proactively seek out such opportunities.

In the afternoon, I shadowed Dr. K as she and her team received the results of the GMP inspection. Though I had heard from others that this particular inspector was very thorough, I can only agree with the others. The inspector had caught onto every detail. They even went as far as to examine the labels of storage bins, saying that they needed to be dated and timed. Afterward, I observed as Dr. K  ordered a prescription for a patient. This particular patient needed an antibiotic for an infection. Based on the patient’s weight and age, Dr. K calculated the dosage needed. I ended my day by helping sort through old patient files. Most of these files were from past clinical trials and needed to be sorted as a backup.

Overall, these past days were very enlightening. I was able to see the whole process of caring for a patient and am inspired to learn more about the medical field.

This was an interesting bit that I noticed in Dr. K’s office. Because she travels a lot, she collects the name tags that she receives from all over the world.
This is their logo.

 

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