Saturday, January 3, 2015

Blog 11: Holiday Project Update

1.  It is important to consistently work on your senior project, whether it is break or we are in school.  What did you do over the break with your senior project?


Mentorship
I did more clinical observation.


Independent Component

            Cath Lab
            Did more volunteering like I did in the summer for my summer mentorship.

            Cardio-Pulmonary Physical Therapy Rehab
            I observed what goes on in the physical therapy room. I helped out by cleaning the machines. I learned how to take blood pressure. I learned a little about EKGs (Echocardiograms).

            Cases (surgeries)
            I was able to observe two different surgeries by two different doctors.

Miscellaneous
I looked up things for medical school.






2.  What was the most important thing you learned from what you did, and why?  What was the source of what you learned?


Mentorship

Throughout my mentorship, I continuously noticed how much the patients loved my mentor, Dr. Muthiah. Every time I told the patient that I was a student of Dr. Muthiah’s, they would tell me that I was lucky to have gotten the best doctor around here. Even back at the Pomona Hospital, even the nurses and staff tell me that he is the best cardiologist around. The reason is because he is gentle with his patients and also really knows his stuff. He has good bedside manners and good character as well. After shadowing him, I can indeed see that all of this is true about Dr. Muthiah. One patient told me that there were many doctors trying to figure out his problem, but none succeeded. But when Dr. Muthiah checked him, he immediately knew what the problem was and recommended a dual bypass surgery. After observing all this, it occurred to me that having the qualities of good character and really knowing your stuff leads to effective patient care. I have only seen about two to four patients that actually needed a surgery after their checkup with Dr. Muthiah. For majority of all patients, Dr. Muthiah just tells them to change their lifestyle and diet and they will be good to go. He also tells them that it is risky to get surgery and it is much better to just change your lifestyle. Another thing I noticed about Dr. Muthiah is that he really cares about his patients’ wellbeing. Dr. Muthiah usually asks his patients rhetorical questions to make them think. Things Dr. Muthiah tends to say are, “So…you like smoking more than your heart?”, “I cannot change you, your wife cannot change you, but you can change yourself.”, “You have to lose the weight.” Dr. Muthiah makes them think so that they can see the importance of their situation and the fact that they have to change if they want good results. Dr. Muthiah is direct and straight-forward with his patients’ when it comes to this.

Me and Dr. Muthusamy Muthiah


Independent Component

            Cath Lab
            I helped do a little bit of paperwork and I discharged three patients. Once again, I saw the importance of a volunteer because even though these are little things, it really means a lot to the nurses because they can’t afford to give up that time.

            Cardio-Pulmonary Physical Therapy Rehab Center
            The cardio-pulmonary physical therapy rehab room is designed for patients that underwent heart surgery. It basically looks like a regular small gym though. I was able to observe what the workers do as well. I learned that there is a whole process for patient treatment even after surgery and that surgery is not enough for complete treatment. While getting advice from Cecilia, the therapist and Gloria, the nurse, they helped me narrow down my Senior Topic of Cardiology. I will be focusing my EQ on open-heart surgery and post-surgery treatments. I hope that this is specific enough though. While shadowing Dr. Muthiah, I noticed that majority of his patients have undergone heart surgery, so this fits right along for my new EQ.  After seeing what goes on in the physical rehab room, I might incorporate many elements of it for my activity in the Final Senior Presentation. I also noticed how family-oriented it was inside the physical therapy room. The workers would occasionally talk with the patients and vice-versa. The patients would talk with other patients easily as well. It was a small group and everyone was happy and this in turn was leading to more effective patient care as well. I also gained a new connection: the nurse Kathy. She is a nurse for patients that are about to undergo open heart surgery. I will be shadowing her for a few hours to see what it is like for patients before open-heart surgery because it pertains to my new and narrowed down Essential Question.

Me attaching electrodes on to the monitors

A machine for exercise

Me observing Hoang Pham, a college graduate volunteer, recording a patient's results

(From left) Hoang, Cecilia, Gloria, Oliver, and Kathy


            Cases (surgeries)
            The first and foremost lesson from this is, “Just ask”. For both surgeries, had I not asked if I could watch them, I would not been able to because the doctors and nurses would never know that I had a desire to watch them. This was the most exciting part of my senior project so far. I learned tremendously from observing both cases. The first case was changing the battery of a pacemaker and Dr. Discepolo was directing it. Dr. Discepolo and his medical assistant, Maryiza, both work in the clinic that Dr. Muthiah works in and Maryiza was watching the case with me. I was able to see Dr. Discepolo cut open the patient’s chest and take out the pacemaker. He used interesting technologies such as this handheld object which was so hot at the tip of it that it could burn through many things; he used this to burn the skin to stop bleeding. The whole case took a little over an hour. From my observation, the thing that surprised me the most was Dr. Dicsepolo himself. Throughout the whole surgery, the atmosphere and vibe was really “un-serious”. It was such a chill and kickback atmosphere that it kind of even felt like a mini-party. Dr. Dicsepolo was able to explain to me what was going on half the time while also doing the surgery in such a cheerful way. He had a really good relationship with all of the workers inside the operating room. He had good humor as well and was making jokes and puns throughout the surgery. He was talking with everyone and had a really good personality. This surgery completely overturned my initial biases of how in the surgery room, it is always serious and everyone is focused. But Dr. Discepolo successfully did the surgery while also having fun. I really liked that about Dr. Discepolo; not only did he make himself feel good, he made his co-workers and me feel good and relaxed throughout the whole surgery. This made me realize how much more fun a surgery can be and how this can lead to a more successful and effective surgery because every worker is relaxed and will do their job properly without making mistakes. And Dr. Dicsepolo also said I could watch him anytime, so I am really glad and thankful for this opportunity.

            The second case I watched was an EP (Electro-Physiology) Study which was being directed by Dr. Merla and his anesthesiologist was Dr. Weller who invited me to watch the case after I asked him. In an EP Study, the doctor barely cuts open the patient just to insert a catheter (a tube with a camera) into the patient. The Dr. then moves around the catheter within the patient’s body to map out the inside and also to locate what the problem is where the problem is; the Dr. is seeing this all on a screen in front of him. Once Dr. Merla found out where the problem is, he conducted tests (hence EP “Study”) to determine the exact problem. And once he found out, he moved to phase two of the surgery: inserting a pacemaker. Each pacemaker is different depending on the patient’s needs. What I saw here was basically the same thing that Dr. Dicsepolo did. In this case, I had to wear a lead vest to protect myself from radiation. Atmosphere-wise, this actually met my initial biases of what a surgery is supposed to be like: all serious and focused. And thank God Dr. Merla also said I can watch him anytime in the future as well.

Me posing after observing my first case

The men's locker room



Scubs



A catheter (a tube that enters a patient's body)

That line with the swirl is the catheter inside the patient's body. This picture is what a doctor would see on the TV screen in front of him



Me in a lead vest after my second case


Miscellaneous

During the winter break, I had also researched how to properly shadow a doctor and how to take notes. So I have been trying to apply that. But I still need to write a page of my experiences in my journal after every mentorship. I also looked up the medical school personal statement prompt in which I basically have to answer, “Why me, why medicine?” I have been keeping this in mind while doing my senior project because I will need to be as passionate and true as possible when I write this. The exact prompt is: “Use the space provided to explain why you want to go to medical school.” And here are some of the links that I used for my additional research:








3.  If you were going to do a 10 question interview on questions related to answers for your EQ, who would you talk to and why?

Now that I have narrowed down my Essential Question to open-heart surgery and post-surgery treatments, I would ask 1 of 6 people: Dr. Kaiser (an open-heart surgeon), Dr. Jane (an open-heart surgeon), a patient that did or is about to undergo open-heart surgery, Kathy (a nurse), a worker at the Cardio-Pulmonary Physical Therapy Rehab Center, or Dr. Muthiah.

Dr. Kaiser or Dr. Jane because they are the ones doing the open-heart surgery, so they know all the protocols and procedures they need to do for themselves and for the patients. A patient because I can found out what requirements that patient had to undergo before going through open-heart surgery. I could also do a patient in physical therapy to ask about what s/he experience throughout the whole process of treatment from pre-surgery to open-heart surgery to post-treatment. I could do Kathy because she is the nurse for patients that are about to undergo open-heart surgery, so I could ask her how she takes care of her patients and keeps them in shape in preparation for the big surgery. I could a worker because they also have to take care of their patients for the post-surgery treatment. And I could do Dr. Muthiah because even though he doesn’t do open-heart surgery, he has the knowledge of it and he is also responsible for the post-surgery treatment of his patients because many of them came from surgery.

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