Week 1: The start of summer immersion

     This week I shadowed Dr. Crystal on two patients' visiting. The first is an A1AT (Alpha-1 antitrypsin deficiency) patient. A1AT is an autosomal co-dominant disorder. It is correlated with the mutations of the SERPINA1 gene and causes pulmonary or liver malfunction. This antitrypsin protein can help prevent the body's tissues from being damaged by the enzymatic digestion of infection-fighting agents. Without the antitrypsin, the lung's protease-antiprotease balance will be disturbed, and its matrix and structure will be destroyed. This is a relatively rare disease that impacts around 100000 Americans and occurs in European descent with a large chance. The M version of the SERPINA1 gene results in a normal level of the alpha 1 antitrypsin while the S and Z alleles of the gene are detrimental. S allele produces a moderate amount of antitrypsin while the Z allele is more serious and causes a higher risk of lung/ liver diseases. The patient had severe asthma before the pandemic began. However, during the pandemic when she could spend most of the time at home and wear masks, which decrease her exposure to the pollutants in the air, she gradually recovered from getting frequent asthma. The reason is that she has a SS combination and obtains a relatively normal antitrypsin level. After some assessment, there might be no need for her to take the treatment.     

Comments

Post a Comment

Popular posts from this blog

Week 8 - Our final week and an ending with watching a major surgery.

 Week 8! This week was our final week of immersion and it was bitter sweat. Looking back, I have learned so many different things and it saddens me to leave the OR and clinic behind. However, I have made new connections with the thoracic surgeon teams. I may even decide to integrate lung cancer into my Ph.D. and expand off of the summer project. This week in the OR was extremely exciting. I saw Dr. Alorki do an Esophagectomy - a major surgery which removes the esophagus. The esophagus runs from the throat, though the chest and into the abdominal cavity, and thus the surgery has three parts to it. The surgery took the entire day and in all probably about 6 hours. First Dr. Altorki made incisions on the chest and used a laparoscopic and minimally invasive approach. The esophagus is located in the mediastinum, this means that he had to first peel off the layers of the mediastinum to get to the esophagus. He detached the esophagus from the surrounding tissue and made sure that the...
Read more

Week 7: The COVID Testing Set-Up

I absolutely cannot believe that we are starting our last week of summer immersion. It has been weird seeing consultation cases, knowing that I will not be able to see their follow-up surgeries. I also enjoyed being able to see summer students visiting from other schools and learn more about how the medical school functions. In the clinic, I saw a former mastectomy patient on their yearly post-op appointment, who was healing well with a little rippling on the breast. Another patient came for a tummy tuck consultation, where I learned that after giving birth people often develop hernias. One of the fibula patients returned for their 2-month post-op appointment and was doing much better, especially with improved speech. They had a wound on their chin that the team worked to clean up and the patient had their lip sutures finally removed. This was the patient who I first saw during my second week here, and it has been remarkable to witness their recovery. Most of the swelling in their to...
Read more

Week 7

 This is Ruoxin. I observed a liver transplantation. The patient got liver cirrhosis where the liver was scarred and permanently damaged. The damaged liver was taken out of the patient while the fresh liver from donor was being processed. All the main veins of the donor liver would be tied up with threads, which were non-degradable, before being connected to the main veins of the patient's body. The whole process took over 6 hours. This experience was so amazing and meaningful. 
Read more