Hello all! This week was a truly amazing week on site, and the first week we gave the surveys!. We saw upwards of 15 patients with my time on site, all a variety of cases, ranging from diabetes, to Kallmann’s Syndrome. We also had some establishment of care visits, which is the term for appointments with first-time patients of Dr. Barker. Busy week!
The first type of common visit we saw was diabetes management. Fasting glucose level (where you do not eat for 8 hours before having blood drawn), often called your “sugars”, is another factor in health influenced by both lifestyle and genetics. This should be under 100. 101-129 is pre-diabetic, and above 130 is diabetic.
We explained this information to patients, and other warning signs of diabetes, such as high A1C levels or imbalanced levels of insulin. (A1C is another blood test done, with healthy values being under 5.7, prediabetic levels ranging 5.7 to 6.4, and diabetic levels being about 6.5). In general, diabetes patients require more frequent visits to the doctor to manage their condition, so reading their survey responses should be interesting!
A fascinating case of female Kallmann’s Syndrome was something new I was introduced to this week. Kallmann’s Syndrome is type of hypogonadotropic hypogonadism. In layman’s terms, this is a low level of activity of the gonads (sex organs), creating a lack of sex hormones, specifically estrogen and progesterone. It prevents the completion of puberty, requiring hormone supplements that in females can be provided by the oral contraceptive pill. This condition also brings another interesting symptom: anosmia, or the lack of smell. Hearing can be damaged as well.
The connection between these and the lack of hormones is unclear, but it is theorized that the genes responsible for stimulating the hypothalamus (which would in turn stimulate the gonads) are related to those responsible for some sensation.
However, the best part of my week was not related to either of these. It was confirming that a young couple was pregnant with their first child. Seeing how happy they were when they found out more than made my day. This experience has actually stirred interest for me in the OB field, as these happy couples and little newborns would be amazing to work with.
All in all, it was a great week, full of fantastic experiences. I started collecting the surveys, and have only skimmed through them. Thorough analysis will begin once I have more of them completed. Until next time, thanks for reading!
Hey Julia!
ReplyDeleteLooks like this week was even better than the last. You mentioned interest in the OB field. Would you consider specializing in this field even though it is still a developing field? Would you consider becoming a surgeon in this field?
The information about diabetes was very interesting. I didn't know diabetic patients need to visit their doctors more often then others, so thank you for including that.
I look forward to reading your blog next week and good luck with the rest of the surveys!
Shivalee Nigam
Hi Shiavlee!I am definitely considering this field! Most OBs are surgeons as well, so that they can deliver babies via c-section if needed/chosen. Additionally, High-Risk OB is an even more specialized field out there, where even more surgeries tend to be performed (as High Risk patients more often need emergency c-sections and more).
DeleteGlad you learned; thanks for reading!
Hi Julia!
ReplyDeleteI loved reading about the all of the different patients that you got to meet this week, in particular, it was amazing to hear about how great it was to confirm that a young couple was pregnant with their first child.
I wanted to ask, now that you have a sparked interest in the OB field, what do you think your next steps will be to learn more about pursuing that interest?
I am looking forward to reading your entries in the coming weeks, until next time, good luck!
Connor Williamson
Hi Connor! I thought so too; it was too cute! My next steps would be shadowing an OB, something to do in undergrad or even early medical school. I would also get to experience OB during clinicals in medical school. Thanks!
DeleteHey Julia! This was yet another wonderful post :) The young couple anecdote was so cute and lovely. In terms of the symptoms of Kallmann’s Syndrome, is anosmia the most common symptom or a rare (and very sad) symptom? Can't wait to hear more in Week 3 :D Good luck!
ReplyDeleteHi Saleena! For Kallmann's anosmia is actually pretty common. Another slightly less common symptom is hyperosmia, where your sense of smell is incredibly heightened and sensitive! Both ways are relatively common and frequently associated with Kallmann's. Thanks for reading!
DeleteHi Julia!
ReplyDeleteYour story about the soon-to-be parents was really sweet. I think going into the OB field could be a very fulfilling practice for you. Also, do you think you would like to further study Kallmann's Syndrome to discover connections between the loss of senses and a lack of sex hormones? I look forward to reading about your survey results next week!
Best,
Gabby W.
Hi Gabby! Kallmann's is probably something I won't see much of again, and as such won't study too much. However, the patient with Kallmann's did fill out my survey, so it should be interesting to see her thoughts! Thanks for reading!
DeleteSounds like an interesting week! Out of curiosity, what is covered during an establishment of care visit with a DO? Does this differ at all from a similar visit with an MD?
ReplyDeleteHi Ms. Mitrovich! It is pretty standard as compared to a visit with an MD. We went over previous medical history, medications, lifestyle choices, ordered some labs, and got to know the patient personally just a touch. We met some really amazing people! Thanks for reading!
DeleteHi Julia! Delivering the news to the young couple must have been heartwarming! The connection between the loss of senses and the decreased levels of sex hormones is intriguing. Do you know if Kallmann's syndrome is genetic or any lifestyle aspects that have been connected with it? Thank you, I look forward to hearing more on your project!
ReplyDeleteHi Sri! Kallmann's is 100% genetic. It happens when genes that code for hypothalamus function do not work correctly. Thanks!!
DeleteHi Julia!
ReplyDeleteLooks like you had an amazing time working with Dr. Barker this week! It was very interesting to learn about each level of sugar from normal to diabetic especially as my grandfather, unfortunately, has diabetes. In terms of Kallmann’s Syndrome, would you be interested in studying this syndrome more or would you prefer to study more along the lines of an OB since you had mentioned interest there as well? I never would've thought that hormone levels are linked to senses so that was also very interesting to learn about. I loved how interesting you make these blog post (especially with the gifs) so keep up the good work! I look forward to learning more about your experience with Dr. Barker! Good luck with the surveys!
Bhumika K.
Hi Bhumika! I am not super drawn to studying Kallmann's more, but I am leaning towards the OB field as a whole! I love babies so that field would make me very happy. Thanks for reading!
DeleteHi Julia,
ReplyDeleteReally excited to hear whats yet to come from your research project. Why is that disease only for women? Why not for men? Or if there is then is it called something else or does it have different symptoms? I am asking that because you mentioned that this only for women so that made me curious enough to ask about men's condition. Thank you very much in advance. I am very excited for your future blogs. Good Luck!
Hi! So it is not only in women; it's actually more common in men! I only specified Female Kallmann's as it is more rare, and has more acute symptoms. These include a total halt in the onset of puberty and gonad development. Hope that helped-- thanks for reading!
DeleteHi Julia! It’s so nice to see how well your project is coming along so far! I was really interested to hear about your studies regarding Kallmann’s disease. What exactly is the correlation between the lack of smell and the inability to produce a sufficient amount of gonads? I hope to hear more about your surveys in the next few weeks! Good luck!
ReplyDeleteSophia Vaidya
Hi Sophia! So the lack of gonad development is due to a failure in the hypothalamus, in the brain. Lack of gonad function, leads to lack of hormones. The theory is that the hypothalamus is right next to the olfactory bulb in the brain (which controls smell), so if the hypothalamus develops poorly, it can cause the olfactory bulb to do the same. It's all about what happens in the brain! Thanks for reading!
DeleteHi Julia! I'm so excited that your project is getting even more interesting as the weeks go on! I am also so happy you were able to tell a couple they were going to receive a child! Does lack of smell mean that people with this disease are unable to produce smell? Would that mean that people with Kallmann's disease are unable to produce pheremones either? Also, is there any testing for young children with Kallmann's disease?
ReplyDeleteGood Luck!
Julie Loison
Hi Julie! For people will Kallmann's, anomasia means they cannot smell their surroundings. The problem is with detection, rather than production. As far as I know, they still can produce pheromones. And testing actually is not done until pubescent years. The two signals that warrant genetic testing for Kallmann's is the delayed or all together halted onset of puberty, accompanied by anomasia. When both these occur, then someone is tested. Thanks for reading!
DeleteHi Julia! Your second week sounds absolutely amazing. It must be so much fun to work this closely with the patients for your project. I was just wondering, what exactly A1C is and how it can be used as a indicator/warning of diabetes? Also, you say you are interested in the OB field (which is great, I personally have always had in interest in this field of medicine), but what other professions are you considering? Like always, it's so much fun reading your blog and I can't wait for your next post!!
ReplyDeleteHi Korina! A1C is a test to measure someone's long term blood glucose levels. When these levels are constantly running high, it is an indicator that there is an excess of sugar not being broken down, and thus an indicator of diabetes. And OB is so cool! I am also considering emergency and pediatrics as my top choices. Thanks for reading!
DeleteHey Julia! It sounds like your project is going great so far! The information you got this week is very interesting, but how do diabetes and Kallmann’s Syndrome relate to Osteopathy? Also, how do you test people with theses diseases to see how they relate to the senses like smell and hearing? Keep up the good work!
ReplyDeleteHi Jacob! So Kallmann's is a disease managed by a primary care physician. Dr. Barker is a primary care physician, a family medicine doctor, who is also a D.O. Thus she is a D.O. who cares for these patients. As for the senses, they are typically noticed to be sub par by a patient, and then examined by a doctor to confirm they are from the Kallmann's, and not another temporary ailment. Thanks for reading!
DeleteI am looking forward to hearing about the initial results of your survey. Thank you for sharing some of your experiences at the office and telling us a little about what you are finding so great about the office. Can't wait to hear more about what your normal routine at the office is like.
ReplyDelete-Ms. Cooney
Hi Ms. Cooney! I'm so glad you're enjoying hearing about it. Can't wait to keep researching and keep sharing! I'll post a day-to-day view soon!
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