Today I welcomed back Dr. Chong from her Spring Break in Utah. She said it was very enjoyable and snowy. And yet here in Arizona, it's the first day of spring and it already feels like the beginning of summer! I began scoring a few of the COMPASS 31’s from the patient files using the program I helped to create last week. It worked like a charm, and I’m super proud of my work. Then for the rest of the day, I finished up the second case study Dr. Chong had made up for me. This time it was “A 60-yo male who came to the ER with ‘the worst headache of his life.’ He had dizziness, vomiting, and blurred vision. However, no fever was reported. Two weeks previous, he experienced a similar headache, but he had not gone to the ER. His medical history comes up as normal.” So, what happened? Below is a screenshot of the spreadsheet that I created for this case. The colors don’t mean anything, I just wanted to be able to distinguish the different diseases that I had listed, except the purple boxes, which are the definitions of terms I didn’t know or needed a refresher of. For my second case study, I’ve now ranked the diseases from least likely to most likely. My research has shown that this patient might be suffering from one of the following: Dehydration, A concussion, A stroke, A migraine, or A Brain Aneurysm.
Then on Wednesday, I showed Dr. Chong what I had found. She was also thinking this patient was suffering from a brain aneurysm, the "ballooning" of a blood vessel in the brain. After I shared my research, she went into a little more detail about each of my 'diseases', mainly how these are diagnosed as well as the surgery required for the more dangerous conditions (stroke and brain aneurysm). With a stroke, surgeons can provide medications (such as TPA) to dissolve the blood clot, resuming blood flow to the brain, or perform a carotid endarterectomy, removal of the arterial plaque that runs along each side of the neck to the brain. Another possibility is the use of angioplasty and stents, which is the insertion of a balloon into the carotid artery to expand a narrowed artery and supported by a stent. Unfortunately, the medication will only work if the signs of stroke are caught within a certain period of time. If not, surgery will have to be involved to regain blood flow to the brain.
With a brain aneurysm, they can use a cerebral angiogram, the less invasive option, where a catheter is inserted into the groin to navigate to the enlarged blood vessel. Once there, it will eject tiny detachable coils into the area, blocking blood flow and allowing a blood clot to form. However, if the blood vessel has already begun to burst, they'll have to use surgical clipping, the invasive option, in which they will enter through the skull to clamp the base of an aneurysm and stop blood flow to it.
On Thursday, there wasn't much to report. I started out by scoring some straggler patient files from the Structural and Functional Neuroimaging in Patients with Headache Disorders study. Although, Dr. Chong was able to show me, on a small scale, the beginning process of analyzing this collected data.
My expectations going into this part of the study was that there would be a lot of statistics involved (fortunately I can still remember some of the stats terms I learned in AP stats like z scores and t tests). Not sure if that vocab will come in handy, but we'll see. For this analysis, Dr. Chong used a program called the SPSS Statistics Viewer, which is some sort of tool used to statistically analyze sets of data. We compared the ages, pain thresholds, and sensitivities to light and sound between those with cluster headache, migraine, and the healthy controls. We found the mean age to be highest in cluster headache patients, and the pain threshold to be highest in migraine patients. It has also been observed that migraineurs are most sensitive to light than those with cluster headache. Researchers aren't really sure why this is yet, but they're hoping these studies will provide some answers.
That was all for this week! Hope you enjoyed my post, and I thank you all for your continued support and thoughtful comments over the past weeks!!
Hey Kiri! Amazing post as usual :D I don't know... sounds like a pretty eventful, action packed week to me! Quick question, for the different medicines for a stroke, which one is the treatment option most often used and why? Also, on a side note, have you decided or had any ideas for your final product? Thanks a bunch, and I can't wait to hear more from you next week :D
ReplyDeleteHi, Saleena! I think you might have misread. I said that I had an uneventful WEEKEND. I never said anything about my week. :D I think TPA is the most popular medication because it is most effective in dissolving the clot and preventing stroke, as long as the symptoms are caught in time. I do actually have an idea for my Final Product! Unfortunately, I couldn't use any of your thoughtful ideas because sadly my project has changed again. :( I'll let you know what those changes are in my following post. I apologize for wasting your time coming up with ideas. Hopefully my idea is final (pun intended), and that I can begin. Thanks for commenting! :)
DeleteHi Kiri! It sounds really cool that you got to do more practice case studies. Now that all the data has been collected from the concussion study, what is the next step?
ReplyDeleteHave fun!
As you know, Serena, practice makes perfect. ;) The next step for me, in terms of my project, will be to focus on just one of Dr. Chong's studies and use a sample of the data to analyze. From there, it will answer my original research question, which has now changed (sadly). I will discuss the changes in further detail in my next post. Hope you have a great Week 8!
DeleteHi Kiri! I'm glad you're allowed to hone your AP Statistics skills along the way. BASIS doesn't teach us this stuff for nothing. I just wanted to know more about these machines used to help support th eblod flow of the body. Like what is this cerebral angiogram and why is the less invasive option a catheter? Thank you!
ReplyDeleteHaha, it's great to see my BASIS knowledge being applied to a real world situation. So, I'm sorry, I think I explained things poorly. The cerebral angiogram is not a machine rather it's a type of medical test used to detect arteriovenous malformations or aneurysms. Once identified, they use the inserted catheter, a small thin tube, to eject the coils to block blood flow. This is the less invasive option because surgeons are literally drilling a hole into your head. You may not be aware of this, but the brain is a delicate structure. A hole in the head not only risks exposure to countless infections, but any misstep in navigating the brain could lead to serious brain damage. You don't see brain surgeons just poking holes into patients' brains willy-nilly. C'mon, Robert, use your head! ;D
DeleteHey Kiri! Nice job using your stats skills!! I hope you're at the mock on Friday. What are you going to do now that you've gotten all the data from the study?
ReplyDeleteUnfortunately, Grayson, you won't be seeing me at the mock, but good luck! :P Now that the data has been collected, it's time to start answering my research question. Check out my latest post to read about the changes I've made to my project. At this point, I've decided to just focus on one of Dr. Chong's studies because talking about them all during my presentation would take too long. After choosing a study, I'll take a sample from that study and use it for analysis. I think I'm analyzing the data this week, so I'll tell you more in my Week 8 post! Stay tuned!! :)
DeleteHi Kiri! I bet that the case studies are really fun. Do migraine patients suffer from a migraine after exposure to different sources of light?
ReplyDeleteYou're right, Nikita, it's a nice activity to do when you need a break from scoring and scanning. They weren't really looking at the sources of light, but more along the lines of light intensity. Meaning that they've found migraineurs to be most affected by bright lights. I would assume it wouldn't matter where the bright light came from. But maybe that's something researchers could look into. The possibilities for research are endless!
DeleteHey Kiri! Glad your program worked like a charm. I find it so cool that you make these spreadsheets to determine the patient's disease. How much time does it take to finish a spreadsheet and do you spend a lot of time researching the symptoms and cross referencing them to different diseases?
ReplyDeleteThanks, Isabella, I'm glad it was a success, too! The spreadsheet usually takes me a couple hours, mind you I'm in no hurry, so I probably would complete them faster if say there was a deadline put on them. But fortunately, Dr. Chong is very easygoing and let's me research at my own pace. My method of searching is to first use the symptoms together to see what diseases I get, then I look up the symptoms individually for diseases I may have missed in my first search. I try to make sure the diseases I choose for my spreadsheet have all the symptoms, but I'll still include a disease, even if it only has one of the symptoms, if I can still make a case for it. So yeah, that's my basic process when I research for a case study. Thanks for your questions! :D
DeleteHey Kiri! Your program sounds like it's very useful. Why would you include migraine as a possible option? Did the paitent have a family history of migraines?
ReplyDeleteYes, I think Gina is hoping this scoring program for the COMPASS 31 can be used by others in their research. I'm just grateful that I got to play a small part in its creation. Since it's a hypothetical case, it's possible the patient could've had a family history of migraines, but Dr. Chong didn't mention it. You're probably right in questioning whether migraine should be an option since migraines usually begin at an early age. Since he only began to have these headaches recently at the age of 60, he probably does not have migraine, so thank you for catching my mistake. In the end, Dr. Chong was going for brain aneurysm, which is what I thought as well. Don't ever hesitate to question what I'm doing! ;D
DeleteHi Kiri! That is a beautiful spreadsheet is is so colorful it makes me happy. Anyway, you mentioned that if medicationw as not possible with a stroke a surgical option would have to be taken. What does that involve? Looking forward to your next post!
ReplyDeleteHaha, thanks, Sarah! Adding color to things always does seem to make things more fun. :D If it is too late for the patient to take the medication, the surgical route would be what I mentioned before: the carotid endarterectomy or the angioplasty and stents. I apologize for not making that clear before. Thanks for your question!
DeleteHey Kiri! Great job with the spreadsheet:) How did you determine what the most-likely causes were for the patient's symptoms? Can't wait for next week's update!
ReplyDeleteYou know, Reyna, this activity made me like spreadsheets even more! A spreadsheet is a wonderful organization tool. For the case study research, I just used the power of the internet to look up the symptoms, then find the diseases. Of course, it's always good double check that you're looking on reliable websites. I mainly used the Mayo Clinic website as my source. It was a great experience for basic learning on how to research and what to look for. I'm sure you're excited as I am to see how everyone's projects have turned out!
DeleteHi Kiri! The spreadsheet looks great! How did you decide the symptoms most likely lead to an aneurism instead of another head injury?
ReplyDeleteThat's a great question, Rachel! What I did was I used the categories that I made in the spreadsheet to see which ones the patient fell into, according to the disease. Brain aneurysm is the most likely because his symptoms exactly match those of a brain aneurysm, and his age (of 60-yo) definitely puts him at high risk for it. Because he fit the categories so well for a brain aneurysm, then that's probably what he had (hypothetically speaking). Hope this answered your question!
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