Friday, July 19, 2013

Experience is Knowledge

I planned to go to the gym this morning but decided to sleep in instead. I ended up sleeping for a bit too long and was a bit late to breakfast. Today was the day that we get to go to CELA (Center for Experiential Learning and Assessment) and diagnose and counsel 'patients'. Everyone was asked to wear clinic attire so they can look the part. I decided to be smart and packed the cloth into my backpack to change into during lunch since the session is after lunch. With the hot Nashville weather I did not want to walk around in black slacks and a shirt that doesn't air too well. 

Our morning class had one guest lecturer named Dr. Michael Fowler. He is an endocrinologist and he talked to us about diabetes today. Diabetes means "sweet urine", so if your body is not using glucose then it goes out with your pee. The cause of diabetes depends solely on what type it is. Type 1 diabetes is idiophatic, meaning that doctors don't know what triggers it. Your body just doesn't produce the needed insulins. Type 2 is the most common form of diabetes (95%) and it's when your body makes insulins but does not use it, also known as insulin resistance. There is also gestational diabetes which is diabetes that pregnant women get due to the hormones and they become insulin resistance. You can also get diabetes if you have a disease or injury pertaining to your pancreas. Genetics also plays a factor in whether or not someone might become diabetic. Diabetes can cause blindness and numbness in the feet, which may result in amputation. Diabetes is a health risk factor and having it can lead to more risk factors. There are plenty of things you can do to prevent type 2 diabetes, such as eating healthy and exercising regularly, while the others are a bit more unpredictable. Having to hear about diabetes all week it was really nice to be able to go more in depth into it.

After the lecture, we got to learn how to make stitches. We used a thick yard to practice with at first then after a while we starts to use real suture. We learned how to knot with two hands and then we learned the one handed knot. They planned for another speaker but that person never came so we spend the rest of the class suturing instead. It was difficult to get at first but after a try or two I could stitch almost like a pro. I have had suturing experience before but then I used synthetic skin, needle and needle holder. While doing this current suture I wondered how I would work it into a real patient's skin.

The afternoon class was held at CELA so that we could see 'patients'. We were put into teams of two and we get to have 25 minutes with a trained/paid actor who plays a patient. They all have a storyline that they followed but some parts are real information about themselves so I am under the HIPAA rules. My partner was Jenna, a fellow Med School 101 student. Before the session with our patient, we got together to discuss the attack plan. We talked about what we would say, how we would introduce ourselves and we practiced a bit. We were given information about the patient ahead of time so that we can talk to them about their health problems. Before the session Mary told us that we wouldn't focus on the physical exam part but rather the history and counseling part. She wants us to learn to interact with our patient and talk to them about their health. While standing outside the patient's room preparing to go in, I noticed there were medical students there as well. I later found out that they were there to learn how to give bad news to patients. I could hear yelling coming from a room close by and I thought that those students are really getting the experience.

So our session began and we prepared to go in. I knocked on the door before entering while Jenna sanitized her hands like she should. I introduced myself, as a Med School 101 student, and then washed my hands while Jenna introduced herself. It was extremely awkward! Our patient was a middle aged man so it was so strange to have him talked to us like we were real doctors. So we learned that we should establish trust with our patient by sitting down, so we did. Things felt really nerve wrecking for a bit before we dived into the talking and it eases up a bit. The patient was overweight so we talked to him about his diet and exercise. I used what I learned from my shadowing last week and applied it to the situation. Since he ate fast food 5 out of 7 days a week, I suggested that he should do every other day and maybe order healthier choices. I also recommend that he prepares dinner for several days when he has time and then freeze it. I know that it is healthier to eat frozen home cook food than to eat McDonald's. His job involved a lot of walking around so exercising wasn't really the issue. I learned that it was really difficult to keep track of the conversation. I had a list formed in my mind that I wanted to follow but at the dame time I wanted to address whatever issues that the patient brought up so the conversation went all over the map. One minute I was asking about his medical history the next I would be telling him about how to eat better. There were a few awkward silence but they were deflected by Jenna before it got too bad. We ended the session five minutes ahead of schedule because we didn't have anything else to say. Thinking back to the experience I noticed how similar it was to a debate round. I had to prepare some things to say and be prepared to say things off script when needed. I had to convince my opponent that what I said is the better option just like how I had to convince the patient that planning to eat healthy would benefit him better. This session not only gave me a lot of experience but it also proves how being in Forensic will better shape my future. While we waited for the other half of the group to have their session, Mary taught us about laboratory tests. I knew most of the information since on eof my Health Academy field trip was to the Jonh Muir Lab and I got to learn all about laboratory.

Since today is Friday, we had to do our Arete showcase. I really enjoyed my self-defense class this week and I know it might save my life in the future. The showcase went really well and I really enjoyed everyone's performances. The day ended with an abundance of small activities around the Hank Ingram's house and I attended some. Today's experience is one that will really change my life forever. I went into that room expecting to assess a patient's complaint but ended up counseling him with my Jenna. Playing doctor has never been this important and I was really glad I got such a golden chance to try it.

It's the weekend tomorrow, so it means that I get to sleep in for one extra hour. We have a busy Saturday planned out tomorrow and I can't wait.

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