· Date: 12/17/08

· Visit Location: UNC Hospital

· Visit Time (Start to Finish) in Hours to the nearest 15 minutes: 2:20

· Who Did You Meet With: Dr. Zdanski

· Purpose of Visit (Explain.): Originally Z had planned on me observing a cocular implant. The surgery was however canceled. So instead I shadowed him during patient visits.

· Did You Take Any Pictures or Video: No, wouldn’t have been appropriate.

· Explain What You Did in Your Visit (Explain, Elaborate): Dr. Zdanski was very very bust that day. I shadowed him through 10+ patient visits. Some of the cases ranged from mild ear infections to serious head traumas and abnormalities. There were a lot of eye opening cases. For a lot of people Z was the last resort specialist they had to turn to.

· What Was the Most Intriguing Part of Your Visit to You? Explain. The most intriguing part was examining a baby with voice box paralysis. Z examined his voice box with a fiber optic camera which went down the babies throat, and the feedback was displayed on a screen so that Z could walk us through what was going on.

My first choice… if its available would be to work with Dr. Zdanski.

      He is a ENT surgeon, I work well with him, and I think I would really get a lot from working with him.

My second would be to work with Dr. Zane Atkins

     Getting so see a live cardiovascular surgery would be a real eye-opener. That’s about as serious as it gets in terms of surgery and there is much to be learned from someone who has earned the right to perform an open heart surgery.

My third choice would  be to work with Dr. Duncan Phillips.

     If it’s not possible to obtain my first two choices I would like with Dr. Phillips due to fact that he is a surgeon working with children. There has got to be a lot of pressure when performing surgery on kids, and I’m sure there is a great deal to learn from him. 

Hello Dr. Gordon,

First of all, I thank you for devoting time from your field of medicine to help broaden my scope of medicine as a whole and to learn more about ophthalmology specifically. This Wednesday I am eager to begin my HIPAA training at UNC.

My name is James Link Jr. I am a Junior attending Cary Academy. I have taken the regular mandatory biology and chemistry courses here at Cary Academy. I don’t really have much expertise in medicine through classes, or summer camps. I got involved with the CA AMTP course because I have always had a liking and general curiousity with medicine, especially in surgery. I did not take the course as a filler course, but due to my desire to pursue medicine/surgery in the future. Medicine/surgery appeals to me because it involves problem solving and that sense of pressure I like and perform so well under. The basic “problem solving” part I see as the diagnosis of the patient and how to treat him/her. The “pressure” I consider the effects of the treatment and surgery. I think if I was to pursue some type of career in medicine, it would most likely be in surgery.

I am very eager to get out in the field with you and begin learning what I can from you. I hope to learn a lot about diagnosing patients, ophthalmology in general, and surgery.

Regards,

James Link Jr.

I would have to say the most interesting aspect of the dissection was seeing how the trachea, lungs, heart, and all the other parts fit together as a collective unit. It gave me a better sense of how they all function together in the body. The dissection of the sheep heart was at this point, relatively routine for me. Seeing how the heart exists within the paracardium, nesteled inbetween the lungs, and surrounded by fat, demonstrated more of how a real-life operation would be, as opposed to a already removed pigs heart. Dissecting the lungs was a totally new and eye-opening experience for me. Coming into the dissection I did not know what to expect of the lungs. The most interesting aspect of dissecting the lungs was seeing the bronchial tubes and the pulmonary veins within the lungs.

Lung transplants and resections are given as a last resort treatment option to patients that suffer from irreversible lung failure resulting from a variety of diseases. These diseases include emphysema, pulmonary fibrosis, cystic fibrosis, and pulmonary hypertension.

Sources:“Lung Transplants Fact Sheet.”Diseases A – Z. Disease – L. 2004.

Because I have sickness induced asthma most of my life this disease sparks some interest for me. Asthma in its simplest definition is the swelling and constriction of the bronchial tubes caused by
inflammation, bronchospasm, and hyperreactivity. This makes it difficult to impossible for the person to breathe. Asthma affects people in different ways and severity. Some people may have their asthma sparked when an allergen or some other irritant they are allergic to is in the air, and some may have their asthma sparked when they exercise. Due to the many different ways a person can flare up their asthma treatment varies from person to person. There are two general types of Asthma, extrinsic and intrinsic. Extrinsic asthma which is asthma induced by allergens or irritants is common in children, and generally goes into remission in early adulthood. Intrinsic asthma which is common mostly in adults, is not a result of allergies. It is generally harder to treat, and a year-round chronic disease. Some general symptoms of asthma are, weezing, shortness of breath, coughing, and chest tightness. Asthma is now the most common chronic illness in children, affecting
one in every 15.

“Asthma, Causes, Types, Symptoms, Treatment and Medication.”Diseases and Conditions. Asthma. 2004.

Personally, I thought that dissecting the pig heart was fairly easy. Once you knew which part Mrs. Todd wanted you to cut next, actually making the appropriate cut, without over cutting, was easy.

Dissecting a pig heart does not affect me morally in any way. For one, we were not randomley mutilating the pig. We were using the pigs organ to help us learn the anatomy of a heart. I feel that it is morally wrong to mutilate an animals organ for no reason, but if it is being done for a justifiable purpose, then its acceptable.

Making the cuts into the pigs heart really wasn’t that hard. The only slightly tricky part was making sure not to cut to deep past the walls of the heart, slicing the valves and cutting the chordae tendinae.

Obviously, dissecting a pigs heart provides much less stress and consequences. If a mistake was made on cutting the pigs heart no one was to be affected. If operating on a live patient, one slip could permanently damage the patient. In the situation of a live operation the stress level would be exponentially increased, not to mention the heart you were operating on would be enclosed in the chest cavity and not out lying on the table for easy access.

Dr. Murphy’s lecture was fascinating and provided much insight into what its like to be a cardiovascular surgeon. I think the most interesting part of Dr. Murphy’s lecture was when he was explaining how a heart machine works, and then the pictures of a heart actually hooked up to a heart machine. Dr. Murphy made reapairing heart valves seem incredibly staright forward, yet at the same time tricky and a delicate process. I was surprised to learn that they actually use the valves in a pigs heart to be substituted in a human heart. To me it’s a little unerving and I would rather opt. for the mechanical valve.

Rheumatic fever is a rare inflammatory disease due to untreated or under-treated strep throat. Although it can develop in adults it is most common in kids from the ages of 5-15. It can damage the brain, spinal cord, skin, joints, and most importantly the heart. It can damage the heart so that the valves in the heart need to be replaced. The only way to prevent Rheumatic fever is to treat strep throat quickly with antibiotics. In the United States people almost always are treated with antibiotics when diagnosed with Rheumatic fever, however, in developing countries, this is not always the case and thus there are higher rates of Rheumatic fever.

Mayo , Clinic. “Rheumatic fever.”Heart Disease. 1998.

      I have always had some general interest in medicine and health care. A career in medicine or health care has always been on the top of the list of options throughout the years. As for what specific field of medicine or health care I am still unsure. The idea of being a surgeon is the most appealing of all the different job types I can think of in the field. Pressure has never been an issue for me and I actually enjoy it. I think surgery would give a certain feel of pressure that I could enjoy as a career. But, I have always wanted to understand more about the complex system we call the human body in general. I am eager to learn as much as I can about the human body in this class.

      This elective seemed like a very hands-on type of class. That really appealed to me. This elective seems like a good way for me to decide if I want to make medicine or health care my profession in the future. I am not taking it to get out of a harder science class, but rather for the genuine interest in medicine and health care.

      My background in biology/anatomy/physiology is that of any normal junior at Cary Academy. I have not had much experience in the fields outside of the classroom.

     The only relative I have had that has suffered a heart attack or any heart issues would be my un-related Uncle Bob Dahle. He suffered a spontaneous heart attack in the middle of the night, and died in his sleep.