Hi all! This week is my first week on site researching, and not just shadowing. I have been coming to the practice a couple times a month to observe since September, but now I will be here twice a week.
This week I saw around 15 patients, with a lot of them being endocrinology appointments. We spent a lot of time going through lab work with the patients, so that they could understand what exactly their current state of health was and how to improve it.
For example, a lot of the patients at this practice have thyroid imbalances, even to the extent of Hashimoto’s disease (hypoactive thyroid) or Grave’s disease (hyperactive thyroid). We sat down and read through full thyroid and hormonal panels to examine their T3, T4, and TSH levels. These show level of thyroid function and level of management of said function by the brain. An underproduction of T3 and T4 is often seen alongside an overproduction of TSH, and vice versa. Low levels of T3 and T4 stimulate the brain to release TSH, to stimulate production of more T3 and T4 in the thyroid. We explained this mechanism to each of the patients, rather than just stating that the person was hypo or hyperactive.
We also did this for different labs, like lipid panels. For these patients, we explained HDL (good cholesterol), LDL (bad cholesterol), the combination and ratio of the two, and triglyceride content in the blood. For those of you who don’t know (and I didn’t until this week), HDL levels should be at least 40 but ideally above 60, in order for good cholesterol levels to actively protect against heart attack and stroke. LDL should be below 130, and total cholesterol should be around 200 or less. If these numbers are met, a patient is considered low risk for heart attack and stroke.
Low HDL is easily fixable with lifestyle changes, such as eating more avocado and olive oil. High LDL however, is usually managed with statin-therapy. We would talk to the patients about their risk factors for cardiovascular problems, and prescribe statin drugs, some of which you may have heard of or used (like Crestor).
This week was a great chance to see how doctors (and osteopaths specifically) manage prescriptions and long-term afflictions. Not only did I learn about specific drug pathways and functions, but how patients feel about them as well. Can’t wait to be on site next week! Thanks for reading!
Hey Julia! Sounds like you had a great first week and learned so much! You did a great job explaining your research in a simple enough way for people like me to understand. I also did not know about the ideal levels of HDL and LDL, so thanks for teaching me the ways of cholesterol! I have a small question, though: are the majority of thyroid imbalances caused by genetics or lifestyle choices? If that's a really horrible question, I'm sorry. I'll make up for it in your next post. Anyway, great job, and I can't wait to read more of your blog!
ReplyDeleteHi Korina! I'm so glad you got them; it's honestly hard to visualize so I'm glad this explanation did the trick! That's a great question! Thyroid imbalances are usually genetic, as the genes in your thyroid are insufficient. They either code for an inadequate amount of protein, or dysfunctional ones. Lifestyle choices can help manage symptoms of hypo or hyperactive thyroid, but only the symptoms. No worries! Thanks!
DeleteHi Julia!
ReplyDeleteLooks like you had a great first week observing the doctor you are working with. The first week is especially crucial when starting a new project and I am so happy you had an amazing one. I didn't know about the levels of cholesterol and what is considered healthy and unhealthy, so thank you for including that. You mentioned that you visited the institution before your research project started. Was the experience this week different from when you previously visited? Do you interact with the patients at all? If so, How is that experience? I can't wait to read next week's blog!
Shivalee Nigam
Hi Shivalee! I was so interested to learn about it so I could understand my own health, and wanted to share. I was on site shadowing less frequently before this week, and less hours a day. I also was not administering surveys like I will be starting Week 2! I do interact with the patients; I help read labs, take surveys, ask them about their medical history and current problems, and more. It's an amazing introduction to medicine, as I get to learn actual introductory medical skills, as well as how to interact with patients. Thanks for reading!
DeleteHey Julia! I'm so glad you have had such a wonderful first week, and have a great doctor to guide you throughout the project. The blood cholesterol levels information you provided was fascinating and really helpful (considering I had blood work done recently and didn't understand any of the numbers :)). This might be a silly question because I don't know much about this topic, but does genetics play a role in cholesterol levels or is it mostly about one's lifestyle? I don't know because what we eat basically affects cholesterol levels (I think?); so how on earth would genetics play a role? Like maybe what we crave? Haha I'm basically ranting now... anyways, awesome 'week 1' post and I can't wait to learn more next week :D
ReplyDeleteHi Saleena! I was in the same boat... but from the last few days at the office I've learned a lot about how to read labs! And that's a great question. Both genetics and lifestyle majorly impact cholesterol levels. Food does play a major role, as large amounts of unhealthy fats build up high levels of LDL in the blood vessels. But additionally, genetics influence how we process this cholesterol. A patients genetic code can predispose them to store excess cholesterol, or quickly clean out cholesterol. Everyone processes it at a different rate, a rate which is determined by the genes they have. Hope that answers your question! Thanks for reading!
DeleteThis comment has been removed by the author.
ReplyDeleteHi Julia! It is good that you began shadowing and you saw how the patient responded with Dr. Baker's explanation. Thank you for explaining the Cholesterol info! With the Osteopathy consultation, did the Patient seem more worried, or did it seem more reassuring since they fully understood the way that the drugs would affect them and their recovery? Thank you, I look forward to learning more from your blog entries!
ReplyDelete*Dr. Barker
DeleteHi Sri! In general, most of Dr. Barker's patients seem reassured once they understand their course of action. As with most medicine, hesitation is present, but having that in-depth understanding of their condition and possible courses of action really helps! Thanks for reading!
DeleteHi Julia!
ReplyDeleteIt sounds like you had a very fascinating week working with the doctors and patients on site! It’s great that you’ve been building up for your project since September! I loved how you explained what each component of the thyroid and hormonal panels are and what they do in relation with each other! This made it so much easier read and understand. What are some of the specific effects of either Hashimoto’s disease or Grave’s disease? It was also very interesting to learn about good and bad cholesterol! You said some sources of good cholesterol were avocado and olive oil. Both of these are often said to be good fats, so are fats and cholesterol directly related or do certain foods just coincidentally contain both healthy fats and good cholesterol? Those are all the questions I had for this week, but I look forward to next week!! Best of luck for your next week of research!
Bhumika K.
Hi Bhumika! I'm so glad you enjoyed it. Hashimoto's is hypo-active thyroid, so metabolic processes are slowed. Thus symptoms include weight gain, fatigue, muscle weakness, hair loss, and brittle nails. Grave's disease is the opposite: hyperactive thyroid. Thus the symptoms are the opposite: weight loss, excess sweating, rapid heart rate, anxiety, tremors, and irritability. On to cholesterol! Eating "good fats" helps raise you HDL (good cholesterol), as does exercise and a healthy life. Eating "bad fats" (trans fats) raises your LDL. It is a cause and effect type process, where making certain diet choices raise and lower your internal cholesterol levels. Hope that helped! Thanks for reading!
DeleteHi Julia!
ReplyDeleteI really enjoyed reading your blog! I found it extremely interesting that you shadowed the work place in September before actually working and participating. I was wondering if there were any specific causes for thyriod imbalances or if they are just common. Additionally, are thyroid imbalances more natural with older people or are all ages subject to thyroid imbalances? I look forward to see your blog next week! Good Luck!
Julie Loison
Hi Julie! Great to hear you are enjoying. Thyroid imbalances are usually just a genetically inherited condition. Although relatively common, they are not caused by anything other than the genes someone has. Thanks for reading!
DeleteHi Julia!
ReplyDeleteIt sounds like your project is off to a really great start! It's nice that you were able to visit on site before beginning your project. In regards to your research on the different thyroid imbalances, what exactly are the effects of an overproduction/underproduction of T3 and T4? Also, are Hashimoto's/Grave's disease genetic? I can't wait to see what you have in store for next week!
Sophia Vaidya
Hi Sophia! So an overproduction or underproduction of these is what causes Hashimoto's and Grave's disease. An overproduction of these can lead to an overly-active metabolism, and cause rapid heart rate, excessive sweating, bursts of energy, and weight loss. An underproduction will bring on Hashimoto's and an low-activity metabolism, causing weight gain, loss of energy, hair thinning, and more. And yes! Both are genetically predisposed and come straight from your genes. Thanks for reading!
DeleteHi Julia. Interesting project about osteopathy. What was really the main motive for choosing this type of science instead of another type? Any big motive? Thank you in advance.
ReplyDeleteRegards,
Harikrishna
Hi Harikrishna! I chose Osteopathy based on my summer programs and the fact that my on-site mentor and her colleagues in her private practice are Osteopaths. It is a truly amazing approach to medicine and I am really excited to do work with it for the next few months. Thanks!
DeleteHi Julia!
ReplyDeleteGreat research so far! I think it's cool how you were able to interact and explain to the patients what their condition entails and not just that they have a particular disease. From your description, I can see that being a doctor definitely requires a high level of social interaction as well as an ability to examine and diagnose patients. Also, I was curious as to why most of the appointments were endocrinological. Were prior visits to a traditional M.D. not effective for the patients?
Side question: Have you begun administering the surveys?
Best of luck on week 2!
Gabriela Wodka
Hi Gabby! It is interesting that a lot of patients this week were endocrinological. In general, Dr. Barker does a lot of this kind of work, so these patients happened to be clustered together this week. However, I do not have a definite answer (yet) as to why some of these patients see Dr. Barker. It could very well be that they did not feel as managed or healthy with an M.D.! And yes, we began giving them Wednesday. I'll post about this for Week 2! Thanks for reading!
DeleteHi Julia,
ReplyDeleteI want to start off by saying that I am so jealous that you get to experience what is is like to work at a doctor's office, I think that your project is giving me some ideas for what I will do once I'm a senior! I sounds like you are learning a lot from your internship and having the ability to learn so much about the medical and chemical fields. Good luck for next week!
Connor Williamson
Hi Connor! I'm so glad its had influence on you; it's a really amazing way to spend my time. I really am--thanks for reading!
DeleteLooking forward to hearing about how the surveys go, Julia. I'm glad you've had a good first week and am looking forward to seeing how your research progresses. I was also interested to hear exactly how Dr. Barker goes through the pathways for each of the prescription medications and how a patient's life-style can change the side-effects. As someone who likes to know everything, I find this aspect of the office particularly appealing.
ReplyDeleteHi Ms. Cooney! We just started giving them Wednesday--updates will come soon! I also appreciate her amazing thoroughness and attitude with the patients; it is one of the things that makes me like interning with her so much.
DeleteWow Julia! It's really interesting how thyroid production levels can influence the entire functioning of the body. I am extremely excited to see where this information takes you and how it'll influence the rest of your project!
ReplyDeleteThanks Jacob! It is definitely super fascinating to get to see so many cases like it. Thanks for reading!
ReplyDelete