Kayvan’s AMTP Blog

1. ENT doctor at UNC – i would enjoy going to this as a field placement because it would be good to learn about this area and i would like to learn more about it and see what the job of an  ENT doctor entails.

2. Dr. Keith Mankin – I would like to learn more about orthopedics as we are covering this this trimester and it would be good to learn more about bones, muscles and stuff like that

3. Dr. Zane Atkins – i would also enjoy going back to the durham VA and learning more about surgery, see another surgery and learn more.

Reading: http://www.pbs.org/wnet/redgold/basics/index.html

1.) Of the approximately 5 liters of blood in your body, what are the blood components (Hint: There are 3 main components. Explain what the function of each of these components is.

The First Main Component are Red Cells, they make up 40-50% of the blood volume and transport oxygen from the lungs to the tissue around the body and also carry out the carbon dioxide. The second Main Component are White cells, these make up about 1% of blood volume (in normal people.) They seek and destroy foreign bacteria, cells and fungi they also get rid of dead blood cells and other foreign matter. Finally there are platelets, these are what clots the blood and stops the bleeding when you get a cut.

(http://anthro.palomar.edu/blood/blood_components.htm)
2.) Plasma contains what essential components?

Plasma includes water, sugar, fat, protein, salt and it carries the white cells, red cells and platelets.

(http://anthro.palomar.edu/blood/blood_components.htm)
3.) Explain three functions of blood.

it delivers necessary substances to the body’s cells (nutrients and oxygen) and transports waste away from the same cells, also it regulates core body temperature and also it is a major part of our immune systems.

(http://en.wikipedia.org/wiki/Blood#Functions)
4.) Name and describe three blood diseases

LEUKEMIA – a group of cancers of the blood forming tissues

HEMOPHILIA – When the blood clotting mechanisms are dysfunctional so when you bleed it does not scab over like in normal people

DVT – when a blood clot forms in a vein deep in the body, when the clot breaks off it can cause PE

(http://www.nhlbi.nih.gov/health/dci/Diseases/Dvt/DVT_WhatIs.html)

(http://en.wikipedia.org/wiki/Blood#General_medical_disorders)

I think that the hardest part about the dissection knew deep to cut, at first I didn’t cut deep enough and I didn’t really know how to, but after a while I got used to it and it became a lot easier. I thought it was a very good experience and I was very glad that we got to dissect a heart. As the dissection progressed I realized it was quite hard to be precise with the incisions and I think I was lucky to not make many mistakes as I was dissecting.

After the dissection I had someone come to me and tell me I “killed a pig” morally I don’t see it as a big deal… I mean I didn’t kill the pig and by dissecting it it’s enabling me with the knowledge to potentially save human lives in the future so on that basis I have no problem with dissecting something that is already dead.

Like I said before I think that the hardest part of the making the incisions was the precision needed to not damage the inside. I think as a surgeon the biggest problem I would have operating on a heart would be cutting the bones and pulling them back to actually get to the heart. I won’t know though not unless I get to see it and observe my reaction… who knows I could have a problem with a number of things or I could be completely fine with it all. I think that if it was a live specimen we were working on…well it depends, if the heart was beating we would obviously have problems with precise incisions due to the movement and also with the blood, however if it was on a heart lung machine I think that it would make the experiment much more serious as we would be dealing with a life and would be much more focused on doing it right.

I think that the most interesting part of Dr. Murphy’s presentation was when he was describing to us how the valves are repaired; I think it was interesting to hear about the different methods to fixing different problems. I learnt a lot from this mainly on how the valves in the heart are repaired (for example cutting out part of the valve, repairing the chordate tendonae and then repairing the hole) and also the different problems with the valve you can have.

In my opinion I think that harvesting pig valves for human transplants isn’t always bad. I think that if the pigs are being bred especially for the purpose of saving lives it is fine, I don’t think that an animal’s life is any less important than a humans, I just think that if it was bred to help people it should be used instead of letting people die when they could be saved.

Rheumatic fever is “An inflammatory illness that may follow streptococcal infection and damage the heart valves.” (www.worldcolleges.info/18_r.php) “Symptoms of rheumatic fever generally appear within five weeks after an untreated streptococcal (strep) throat infection. Most cases of strep throat don’t lead to rheumatic fever. In fact, even in untreated cases, only a small percentage of people with strep throat develop rheumatic fever. In many cases, rheumatic fever may affect the heart valves (rheumatic carditis) and interfere with normal blood flow through the heart. There’s no cure for rheumatic fever. But it can be prevented by prompt and thorough treatment of a strep throat infection with antibiotics.” (http://www.cnn.com/HEALTH/library/DS/00250.html) The Exact Causes of Rheumatic fever are not defined. “It seems that when the body fights a strep throat infection, other parts of the body develop inflammation. For example, the heart valves aren’t necessarily infected with the streptococcal bacteria, but they can be injured or inflamed as the body fights strep throat. Medical research has focused on an abnormal immune system response to the antigens produced by specific types of streptococcal bacteria. One possible cause for this is the similarities between streptococcal antigens and heart valve proteins and heart muscle cells. In addition, researchers are studying whether some people have a greater genetic disposition for an abnormal immune system response to streptococcal antigens.” Rheumatic fever is not as common in the US anymore due to the widespread use of antibiotic penicillin to treat Strep-throat now, however it is still common in developing countries.

Citations

“Rheumatic fever.” 25 Aug 2008 <http://www.cnn.com/HEALTH/library/DS/00250.html>.

“Rheumatic fever.” glossary of medical terms 25 Aug 2008 <www.worldcolleges.info/18_r.php>.

·       Date: Wednesday October 1st

·       Visit Location: Durham VA center

·       Visit Time (Start to Finish) in Hours to the nearest 15 minutes: 1. 30 minutes

·       Who Did You Meet With: One of Dr. Atkins’s colleagues

·       Purpose of Visit (Explain.): We visited to learn more about cardiovascular surgery and cardiology in general

·       Did You Take Any Pictures or Video (You Must Complete One Interview): no

·       Explain What You Did in Your Visit (Explain, Elaborate): first we witnessed an angioplasty where they put a catheter through the guys and fed a balloon through the artery, blew the balloon up to ease the blockage and then inserted a metal stent into the artery where the balloon was, which holds open the blocked artery, eliminating the blockage at least for a while. secondly we witnessed a pre-op speech to a patient and finally we watched a heart echo (sonogram) which checks for backflow throught the valves in the heart and such.

·       What Was the Most Intriguing Part of Your Visit to You? Explain. : I thought the pre-op speech was the most interesting part, because it gave a huge insight into how patients take news, how they listen to the advice and also how doctors and patients do interact.

1.  What is a VAD and when is it used?  Explain.  What does it mean when it is said that drugs are “no longer working”?

A VAD (ventricular assist device) is a mechanical device that helps a weak heart pump blood around the body, it is mostly used when a ventricle is weak (to help pump the blood.) When it is said that drugs are no longer working it means that due to a long exposure to the drugs or a change in condition that they are not effective anymore in the way they were.

2.  Find a picture of a VAD and create a MLA citation for it  Explain how it works.

A VAD works with the patients heart pump sufficient blood around the body. “A left ventricular assist device (LVAD) receives blood from the left ventricle and delivers it to the aorta — the large artery that carries the blood from the heart to the rest of the body. A right ventricular assist device (RVAD) receives blood from the right ventricle and delivers it to the pulmonary artery – the artery that carries blood from the heart to the lungs.”

3.  How does someone become an organ donor?  What organs can be donated?  Find a site that describes how one becomes an organ donor and cite it using MLA citations.

The first step to become an organ donor is to register with your state donor registry, secondly you would need to designate your drivers liscence and finally you would need to sign a donor card. You can donate heart, kidneys, pancreas, lungs, liver and intestines. Tissue that can be donated include, eyes, skin, bone, heart valves, veins and tendons. Also Bone Marrow and the Middle ear can be taken.

http://www.organdonor.gov/donor/index.htm

http://www.thetransplantnetwork.com/Organs%20I%20Can%20Donate.htm

4.  Would you or would you not want to be an organ donor?  Why or why not?  Explain.

I would want to be an organ donor, because i like to help people and so if thats all i could do to help people even after i was declared clinically dead, then i would do it willingly. Also because after im declared dead.. im really not going to be using them so why not donate them.

• Date: 10th September 2008
• Visit Location: Durham VA hospital
• Visit Time (Start to Finish) in Hours to the nearest 15 minutes: 2:15 – 4:30
• Who Did You Meet With: Dr. Jean and Dr. Zane Atkins
  
• Purpose of Visit (Explain.): Get the security stuff done and tour the hospital, meet the people we will be shadowing and get our bearings in the hospital
• Did You Take Any Pictures or Video (You Must Complete One Interview): No
• Explain What You Did in Your Visit (Explain, Elaborate): First we met up with Dr. Jean as Dr. Atkins was busy taking the patient from surgery to the ICU. So first off we needed to go fill out some forms HIPAA and volunteer worker stuff. next we had to go get volunteer badges (which if we dont have we can’t stay in the hospital) so Dr. Jean took us to the security bit and we got that done. Next she gave us a tour of the clinics in the hospital and some parts of the hospital. Then She took us upstairs and handed us over to Dr. Atkins. Dr. Atkins took us around the cardiology department, down to radiology and explained some stuff about heart problems and diagnosing them, first he took us through the ICU and we saw Vets. hooked up to EKG’s and other machines. After that we walked down to radiology (after not being able to visit the OR due to lack of scrubs) and he showed us what they do to check for blockages in the heart (veins/arteries) he explained that and showed us some CAT scans and MRI scans of the heart and body. Also he showed us the x ray videos of the heart test that they do. After this he took us back up to his office and explained some more things to us showed us some more scans and then we left.
• What Was the Most Intriguing Part of Your Visit to You? Explain ; I think that the most intriguing part of the visit was when we went down to radiology and we like saw the process of checking the heart for blockages and like i think just seeing the way they diagnose was really interesting.
• What Part of this Visit Could You use In Your Final Multimedia Project? Pictures of the different parts of the hospital, different wings, units and stuff.

I think that the hardest part about the dissection knew deep to cut, at first I didn’t cut deep enough and I didn’t really know how to, but after a while I got used to it and it became a lot easier. I thought it was a very good experience and I was very glad that we got to dissect a heart. As the dissection progressed I realized it was quite hard to be precise with the incisions and I think I was lucky to not make many mistakes as I was dissecting.

After the dissection I had someone come to me and tell me I “killed a pig” morally I don’t see it as a big deal… I mean I didn’t kill the pig and by dissecting it it’s enabling me with the knowledge to potentially save human lives in the future so on that basis I have no problem with dissecting something that is already dead.

Like I said before I think that the hardest part of the making the incisions was the precision needed to not damage the inside. I think as a surgeon the biggest problem I would have operating on a heart would be cutting the bones and pulling them back to actually get to the heart. I won’t know though not unless I get to see it and observe my reaction… who knows I could have a problem with a number of things or I could be completely fine with it all. I think that if it was a live specimen we were working on…well it depends, if the heart was beating we would obviously have problems with precise incisions due to the movement and also with the blood, however if it was on a heart lung machine I think that it would make the experiment much more serious as we would be dealing with a life and would be much more focused on doing it right.

I think that the most interesting part of Dr. Murphy’s presentation was when he was describing to us how the valves are repaired; I think it was interesting to hear about the different methods to fixing different problems. I learnt a lot from this mainly on how the valves in the heart are repaired (for example cutting out part of the valve, repairing the chordate tendonae and then repairing the hole) and also the different problems with the valve you can have.

In my opinion I think that harvesting pig valves for human transplants isn’t always bad. I think that if the pigs are being bred especially for the purpose of saving lives it is fine, I don’t think that an animal’s life is any less important than a humans, I just think that if it was bred to help people it should be used instead of letting people die when they could be saved.

Rheumatic fever is “An inflammatory illness that may follow streptococcal infection and damage the heart valves.” (www.worldcolleges.info/18_r.php) “Symptoms of rheumatic fever generally appear within five weeks after an untreated streptococcal (strep) throat infection. Most cases of strep throat don’t lead to rheumatic fever. In fact, even in untreated cases, only a small percentage of people with strep throat develop rheumatic fever. In many cases, rheumatic fever may affect the heart valves (rheumatic carditis) and interfere with normal blood flow through the heart. There’s no cure for rheumatic fever. But it can be prevented by prompt and thorough treatment of a strep throat infection with antibiotics.” (http://www.cnn.com/HEALTH/library/DS/00250.html) The Exact Causes of Rheumatic fever are not defined. “It seems that when the body fights a strep throat infection, other parts of the body develop inflammation. For example, the heart valves aren’t necessarily infected with the streptococcal bacteria, but they can be injured or inflamed as the body fights strep throat. Medical research has focused on an abnormal immune system response to the antigens produced by specific types of streptococcal bacteria. One possible cause for this is the similarities between streptococcal antigens and heart valve proteins and heart muscle cells. In addition, researchers are studying whether some people have a greater genetic disposition for an abnormal immune system response to streptococcal antigens.” Rheumatic fever is not as common in the US anymore due to the widespread use of antibiotic penicillin to treat Strep-throat now, however it is still common in developing countries.

Citations

“Rheumatic fever.” 25 Aug 2008 <http://www.cnn.com/HEALTH/library/DS/00250.html>.

“Rheumatic fever.” glossary of medical terms 25 Aug 2008 <www.worldcolleges.info/18_r.php>.

Last year after helping people with issues and problems, I realized that I wanted to make a living of helping people and decided that the best way to do this would be through medicine. I have a big interest medicine and I want to be either a doctor or a surgeon. Eventually if I become a doctor I want to travel overseas and go somewhere that people need doctors (Africa or the Middle East.) I Decided to take this elective last year after I found out the anatomy and physiology would not be an elective again this year but instead this was replacing it. I took it because I think it could give me a pretty good knowledge of anatomy, physiology and other topics before college (I plan to take Pre-med.) I took biology in freshman year and that the only real prior experience I have had with that, health also in freshman year is the only other experience I have had with anatomy. I have two relatives on my dad’s side who had heart attacks, my granddad and my cousin Taghi. My Granddad died before I was born and my cousin died about 2 years ago.