Monday (Feb. 6th)
I was about as excited as one could possibly be considering it was a Monday. I arrived at her office (with 5 minutes to spare) and just in time for the Department of Neurology’s weekly meetings. During this hour-long conference, a group of about ten people sat around to chat about the latest gossip (not THAT kind of gossip). Each of them is conducting their own studies, and they are responsible for giving status updates about where they currently stand on their projects. Most of them appeared to be in the preliminary stages, whether it be a matter of getting contracts signed or finding ways to increase enrollment. I found this consultation extremely helpful, not only for bringing me into the world of protocols and patients, but it also showed me the value of communication, especially in a constantly moving environment such as Mayo.
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| My on-site mentor Dr. Chong (RIGHT) and her colleague Dr. Schwedt (LEFT) and that empty chair is mine |
Wednesday (Feb. 8th)
I was looking forward to this day because we would be getting our first patient for a study comparing healthy controls, subjects with chronic migraine (CM), and those with post-traumatic headache (PTH). The patient this day was a PTH patient, a 63-year-old female. I sat in on her evaluation. During this time, the coordinator of this study reviewed with the patient the consent form, a summary of what she would be signing up for. Then for the next 45 minutes, the participant had to answer many questionnaires, including: headache history, symptom evaluation, a neurological assessment, a sensitivity questionnaire, and several more (post in the comments if you would like to know the rest, I just didn’t know how in-depth you wanted me to go). From there, the patient was taken to radiology for an MRI. Those who participated in the study got a free brain scan (sign me up)!
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| Brain MRI Scan |
Thursday (Feb. 9th)
Sad, but relieved that I’ve made it to the last day of my first week. Today I learned how to score questionnaires then input the scores into a spreadsheet. Easy, yet tedious work. Though I’ll admit, I got pretty skilled at typing numbers, tab, typing numbers, tab. We had another patient today for a different study comparing cluster headache patients, episodic migraine patients, and healthy controls. This study will look at the similarities between the MRIs of these subjects in addition to sensory testing. The sensory testing consists of this giant machine called a thermode attached to a cord that connects to various parts of the body to test one’s sensitivity to heat pain.
And so, there was my week in a nutshell. I enjoyed every moment of it. I can’t way to see how these studies progress, and I’m so glad that I have a front row seat to watch. Dr. Chong is a lovely mentor and a joy to shadow with. Though I haven’t yet found how these studies will connect to gender-based differences, I look forward to finding that out in the next few months!
P.S. I’m thinking of posting more than once a week so that I can go into greater detail about the studies that Dr. Chong is performing. What do you all think? Comment below!
Yay! I'm the first comment :) Please do post more than once a week! Your blog is such a lovely read, and I find your little anecdotes super cute and relatable (I was always lost in the Scottsdale campus over the summer-I'm lucky if I can navigate BASIS and my house properly lol). You're such a big kid (adult?) using that staff entrance now :) Besides sitting in on the evaluations, do you get to interact with the patients much? Like actually talk to them? Sorry, I was just wondering how much people interaction you get to do. Anyways, awesome 'week 1' post (I love the pictures!), and I can't wait to hear more (hopefully with a lot more posts ;))!
ReplyDeleteHi, Saleena! Thanks for being my first comment, and I'm glad I'm not the only one who has trouble getting from one place to another. I feel like such a grown up getting to walk among grown ups, it's very surreal. My interactions with patients have been a bit minimal because I don't really want to interrupt the questionnaire process by asking, "Hey, what do you do for living?" Though, by just sitting there, I do get to learn a little about their personality and medical history. In addition, my experience from Wednesday's patient showed me that radiology is usually behind schedule with their MRIs, so that waiting time is a great opportunity to get to know the patient better. Maybe as time goes on, I'll improve my socialization skills. :P
DeleteWow Kiri! I didn't know I knew such a professional. I should call you Ms. Carlson now, being that you've done so much amazing things already. And we all know that I'm also really bad at directions, so navigating the Mayo Clinic would be very horrible for me as well.
ReplyDeleteAs for my question, I wanted to know a little bit more about the thermode, the sensory testing thing. Why is testing a body's sensitivity to heat pain necessary in helping a patient that suffers from migraines and headaches? It seems really interesting.Also, if you have any pictures, it would be really cool to see what it looks like if possible. But I also understand if you can't.
Really cool first week post Kiri! I'll make sure to look for more in the future.
Haha, my professionalism must've been hiding deep, deep down, Robert, which is probably why you're so surprised. And yes, I am well aware of your slightly lacking GPS skills, but who doesn't love a good detour.
DeleteI actually had the same exact question...I guess great minds think alike. So technically, it won't help the patient directly, but it does help us researchers to test their threshold to heat pain. What makes it useful is the thermode's ability to be used during an MRI scan. If we know which parts of the brain are activated when receiving heat pain, we might be able to better predict whether someone is suffering from cluster headache or a migraine. This could then lead to more accurate treatments. Unfortunately, I couldn't take a picture of it, but I would say to picture it looking a bit like R2-D2 (but that could be a completely inaccurate comparison since I've never seen Star Wars).
Thanks for reading and commenting!
Hi Kiri! I'm excited to know that the rooms doctors do MRIs in look like how they do in the TV shows! When you were scoring the questionnaires, what were the most influential factors per each patient? I can't wait to find out how these different factors contribute to gender based differences!
ReplyDeleteThanks, Nikita! I can't say that I watch very many medical-related TV shows (but give me Friends, Doctor Who, or Sherlock? I'll be there!), so I'll take your word for it. Great question! Depending on whether the patient was in the healthy control group, the cluster headache group, or the migraine group, each had different distinguishing features. Of course, the healthy control group remained neutral throughout most of the questionnaires, since they're the baseline for comparison. However, the cluster headache group showed that they had higher sensitivity to light when experiencing a headache. Migraineurs, though sensitive, don't appear to have as intense reactions, according to the scoring from the questionnaires. *Sidenote: From the data that I've recorded so far, most of the subjects seem to be right handed (not that it has anything to do with the study, I just thought it was interesting).
DeleteI'll be sure to keep you posted on the gender-based differences! ;D
Wonderful writing, Kiri! The transition between college and "real life" can be a difficult but wonderful experience. I think this internship is giving you a little taste of that "real life" and that is so cool! I really appreciate the pictures as well as the Snoopy cartoon :') Yes to more posts per week!
ReplyDeleteI love how you get a "front seat" at these evaluations! In your opinion, what is the most interesting thing about sitting there during these studies?
Looking forward to your next posts!
You are so right, Lorena! I am very grateful to have this opportunity to preview the real world before having to dive right into it. It's a very eye-opening experience for learning about professionalism as well as becoming more independent.
DeleteI think that the best part of the studies is getting to sit in with the patients. It may be a bit repetitive in seeing each patient go through the same questionnaires, but I also view it as a chance to learn about someone else's life by how he or she acts and what he/she shares about his/her life. I get to hear how they got a concussion or how they cope with migraines or cluster headaches. I'm fortunate enough to be headache and migraine free, so it makes me appreciate not having to go through that kind of pain.
Thanks again for commenting (I'll be sure to post more and find pics to please)!
Hi Kiri! I'm glad your first week was so much fun! How did the first patient's scoring in the questionnaire influence your predictions in this study, and how many more patients will you be working with before you hope to be able to compare the gender differences?
ReplyDeleteYes, Rachel, I'm glad that my first week went by without hitch, too! I guess I would have to say that my proposal was my prediction, that I would find gender-based differences in sports-related concussions. The studies had already started by the time I got to take a look at the questionnaires, so it was a bit late to take any guesses. The healthy control group scored average, which was to be expected since they are not affected by headaches or migraines. Then the migraineurs and cluster headache subjects seemed more sensitive to things such as pain and light during a migraine or headache.
DeleteAs for your second question, it's not the number of patients (though I say the more, the merrier), it's more of the particular study that I'll be looking at. Fortunately, you're in luck, for on Wednesday, Dr. Chong gets her first patient for a study comparing male and female recovery times post-concussion. I'm very excited for that, and I look forward to sharing my findings with you all.
Until then, keep the questions coming!
Hey Kiri! It sounds like you've jumped right in and the research that is being conducted seems really fascinating. The first day of my internship was pretty overwhelming as well with parking and navigation. Anyway, I was wondering if you could expand on the differences between the types of headache or migraines, etc. you are testing. You mentioned chronic migraines, post-traumatic headaches, and cluster headaches, but what are the differences between all of these exactly? I look forward to hearing more about your project!
ReplyDeleteAs you probably read from my comment on your blog, I absolutely loved your Week 1 post, Sarah! So entertaining, yet informative. Sure, I'd love to explain. I apologize for not including it in the post, that probably would've been helpful...anyway, a chronic migraine, officially, is when a person has more than 15 days of headaches per month over a three month period. PTH is when one starts having symptoms of or actual headaches following a post-traumatic injury (in Layman's terms, after receiving a concussion). Lastly, cluster headaches are headaches that take place during some time of the year, for a certain period, but then the person is headache free the rest of the time. Again, I apologize for not clarifying those terms in the beginning, and I hope you can forgive me.
DeleteEnjoy my next post, which will hopefully be fully defined (as needed)!
Thanks Sarah for asking this question, as I was equally curious about the difference between the two!
DeleteKiri - what would you say is the most common cause of concussions in the patients you have seen so far? Is it car accidents, falling, some other type of injury?
I am so amazed by all of the experiences you have already had while at Mayo. What an incredible opportunity! I can't wait to see more of your posts in the following weeks.
Yes, it was quite interesting to learn about the different types of headaches and migraines. I would say the most common cause of concussion is falling. The patients I've sat in on have mostly been middle-age or older, which explains the cause. I, too, was very surprised that I managed to fit in so many new experiences in the first week, and I look forward to what the next few months bring. Thanks for your comment, Ms. Conner!
DeleteHi Kiri! Your blog has been an amazing read. It's always a pleasure. It sounds like you had a great first week, and I hope your second week is just as good. It's very interesting that there are different kinds of migraines and headaches.
ReplyDeleteThanks, Grayson! I'm so glad that you liked my post (I aim to please). Hopefully the rest of my posts can continue to entertain and inform you. I, too, was very fascinated in knowing that there are different types of headaches and migraines. I look forward to finding the link that connects them to gender. Happy reading!
DeleteHey Kiri! Your writing once again is such a joy to read! It was interesting how the patient you met had PTH and I was just wondering how does this tie back to concussions? Did the patient have a concussion previously or are you analyzing how different genders may be under a circumstance of a concussion by analyzing data such as their medical history and MRIs? Sorry if you may have already mentioned this... I am just a bit confused. Looking forward for the next post!
ReplyDeleteNope, it's perfectly fine to be confused, Isabella. Please, always tell me when something is unclear because that...is not very good. To be frank with you, I don't really have it all sorted out either. I thought when I started, I would immediately be looking at a study that had to do with gender-based differences in sports-related concussions. Obviously that didn't happen. But not to worry, Dr. Chong has another study (yes, she has a lot of studies I can hardly keep track of them all) that has also just started with the goal of comparing male and female recovery times post-concussion. Her first patient comes Wednesday, so I'll be sure to report my findings from that.
DeleteFor your first question (sorry for answering your questions out of order), the patient did have a concussion a while back, not sports-related unfortunately. I'm learning that I might have to tweak my proposal a bit so that it's less focused on sports-related concussions specifically. I think it's been a bit difficult to find subjects that fit the criteria of a sports-related concussion, so they've generalized it to all concussions. I don't have everything figured out yet, my apologizes, but as of right now, the tentative ultimate goal is to find gender-based differences in concussions through symptom reporting, recovery time, and/or pain sensitivity. I will make sure to inform you all if anything changes.
I'm leaning toward writing more posts to provide more in-depth explanations, so keep an eye out for those. Again, I'm sorry for the confusion! Bare with me while I learn that I can't always have things my way! :D
I'm glad you are enjoying working at your site (even if it can be a little overwhelming!). I agree with Saleena, if you have the time, more frequent updates would be great so we can understand all the details of your project. I was wondering, how did they do the "neurological assessment" on the questionnaire?
ReplyDeleteCool project, and I'm looking forward to when you begin to see the differences between male and females with concussions.
Thanks, Serena, it's a bit overwhelming, but I think I'm getting used to it...I think. I agree with you two, too. I've been getting a couple comments about confusion, plus I was struggling with having to fit one week's work into one post (maybe if I hadn't procrastinated, it wouldn't have been as bad...). I'll try for two posts this week to alleviate the confusion. For the neurological assessment, it was divided into three sections: loss of consciousness (LOC), post-traumatic amnesia (PTA), and alteration of consciousness (AOC). So, when the patient had the concussion, he/she was asked if he/she experienced any of these things right after the concussion, for how long, and if there were any witnesses.
DeleteThis Wednesday, Dr. Chong gets her first patient for a study comparing male and female recovery times post-concussion. I'm very excited for that, and I look forward to sharing my findings with you all. Thanks again for the feedback!
Hi Kiri! I can't even imagine how intimidating an entire hospital must be compared to our little school. When you were working with the thermode, what exactly were you testing for in the patients? Can't wait for next week's update!
ReplyDeleteIt was a pretty dramatic change, Reyna, and I'm still getting lost, but I think I'll survive. So, the purpose of the thermode is to help researchers test the patient's threshold to heat pain. It is useful because of its ability to be used during an MRI scan. If we know which parts of the brain are activated when receiving heat pain, we might be able to better predict whether someone is suffering from cluster headache or a migraine. Thanks for the question!
DeleteHi Kiri-
ReplyDeleteI'm thrilled to hear you're loving the experience! Do you know how, in the lab, they go through the process of deciding which patients receive which assessments? If you come in with PTH do you automatically get a regular list of assessments?
If you've learned this much so far I'm sure that you'll have some more insight soon on your big research questions!
-Ms. Wilson
Thank you for your comment, Ms. Wilson! Dr. Chong is wonderful to work with and such a great mentor for someone new to the internship world like me. All the subjects receive the same questionnaires so that we can compare them across the groups, whether that be the healthy control, the chronic migraine, or the cluster headache group. I'm excited to begin to address those big questions and sharing my observations with you all!
DeleteHello Kiri, I'm Zand. I found your blog to be very interesting; I have a question nonetheless. What has been the most interesting piece of knowledge you have acquired from your case study regarding the 63 year old? Thank you for considering my question and keep up the amazing work. I know I'm not the only one who is tremendously excited to view your conclusion, so thank you for sharing your findings. Again, thanks, Zand.
ReplyDeleteWell, it's nice to meet you, Zand. Thank you so much for taking an interest in my blog! I'm happy to answer any questions you have now or in the future. Hmmm, my most interesting piece of knowledge...I would have to say learning the differences between PTH and migraine has been pretty eye-opening, for I didn't really know that one could have various types of headaches and different pain sensitivities for each. I feel the same as you, and I can't wait to share the rest of my experiences. Week 3 posts, coming soon!
DeleteI agree
ReplyDelete