The fourth week of our projects is coming and going so quickly I barely have time to catch my breath. I’m telling you, there are too few hours in the day to get everything done! But let’s review the week, shall we:
Just Your Average Monday
Not much new happened today. Another Monday meeting with few changes to report in regards to the studies. Then came a long session of scanning and more scanning. I almost broke the machine once...apparently, today was not my lucky day. Instead of getting to stand there mindlessly while it scanned away, the printer decided to keep getting jammed with my papers. Then it would finish scanning because I didn't put the papers in fast enough so I would have to start all over. Or, it would accidentally take two papers with it. Each of these files was, on average, 40 pages each, so how would you feel if everything was going great for the first 27 pages, but then skips just one page! Now you would understand my struggles. It was tear-able, just one big paper mess. Fortunately, I managed to get through it without becoming too frustrated. Below I paused to take a selfie (when no one was around) of the beloved printer when I thought I 'broke it'. I awkwardly walked away after that, and when I came back later it was working perfectly fine, so thank you printer gods!
However, the day perked up when I got to observe a patient go in for an MRI brain scan. This patient was part of the Structural and Functional Neuroimaging in Patients with Headache Disorders study. A brief refresher that this is the study that utilizes the thermode, the R2-D2-like machine that tests a patient’s threshold to heat pain. The thermode can test for both heat and cold pain, but the study only uses heat pain because of its increased accuracy in reporting pain.
Back to the MRI, after preliminary scans had been done, now is where the thermode comes back into the picture. A cord attached to the thermode is passed through a hole in the wall and attached to the patient's arm. Over a period of three 7-minute periods of heating then returning to body temperature then back up again, the MRI brain scan captures the activity in the brain throughout the duration. By doing this, we will be able to look at which areas of the brain are active when one is in pain/discomfort as well as the resting state.
Wow, Wednesday!
Dr. Chong told me either today or Thursday would be the day she would take me over to radiology to have one of the radiologists explain to me the process of analyzing an MRI brain scan. So of course, rather than sit around and wait in excitement, I did some more scanning to pass the time.
Finally, the time came and today was going to be the day! Not only that, but the radiologist to review the MRI brain scan with me would be none other than Dr. Chong’s husband...Dr. Chong! I think they met at Mayo. #HospitalRomance When I muster up the courage, I’ll ask for more details about how they met. I just didn’t think it would be appropriate to ask about their relationship when he was probably taking time out of his busy schedule to explain MRI things to some intern.
Finally, the time came and today was going to be the day! Not only that, but the radiologist to review the MRI brain scan with me would be none other than Dr. Chong’s husband...Dr. Chong! I think they met at Mayo. #HospitalRomance When I muster up the courage, I’ll ask for more details about how they met. I just didn’t think it would be appropriate to ask about their relationship when he was probably taking time out of his busy schedule to explain MRI things to some intern.
We walked into a room that was almost completely dark except for the light coming from multiple computer screens displaying various brain images. I’m sure I said wow in amazement about a million times...in my head, of course. I know I nodded a lot as he went through the thorough process of assessing a patient. The patient we were reviewing had a hemorrhage on the right side of the frontal lobe and previously suffered from severe headaches. The task for radiologists is to find the cause via a CT scan and various sequences of MRI brain scans, each of which focuses on a different aspect of the brain. I admit, I never realized the crazy amount of work that goes into finding the diagnosis for just one patient. When they say they look for all possible causes, they look at ALL possible causes. Medical history, family history, medications, lifestyle, occupation, basically anything related to one’s health they’ll look at. I found it super fascinating! And even after getting all this information, Dr. Chong (the radiologist) told me they still haven’t found the cause of her hemorrhage yet. Because of this, they’re going to wait three months and have her come back in for more scans of her recovery. Maybe then they’ll be able to discover what caused her hemorrhage.
And the brain scans were just as thorough! There was a coronal view (front of the brain to the back), sagittal view (left side of the brain to the back), and axial view (top of the brain to the beginning of the neck). A different scan showed all the arteries in the brain for Dr. Chong (the radiologist) said a possible cause could’ve been a rupture in one of the arteries in which the clot could’ve traveled up into the brain. There was a scan of the veins, too! Radiologists have to know the names of every single vein and artery should the situation arise where one would need to be removed, they know the exact aftereffects of this removal. I know this analysis doesn’t really have anything to do with gender-based concussions, but I’m guessing this is the process they go through to analyze any MRI brain scans. The overarching goal would be to find what is causing the problem in order to find a treatment.
For me, this felt like a lot, so I’ve decided to talk about Thursday in a second post so that I don’t break my word on having more than one post a week. Plus, I’ll be starting the new topic of Dr. Chong and the rest of the department’s new office space with pictures provided. So stay tuned! My kitty thanks you for following along!! :D
Good luck with the printer!
ReplyDeleteAlso, I was a little confused, how is pain threshold related to the headache disorders? Is it looking into how pain can cause the headache?
Thanks for posting!
Thank you, I'm honestly just glad she only asked my to scan things and not anything particularly complicated. So technically, sensory testing doesn't help the patient directly, but it does help researchers to test their threshold to heat pain. What makes it useful is the thermode's ability to be used during an MRI scan. An idea has been hypothesized that there exists various types of headache disorders because pain is being distributed in different areas of the brain. If we know which parts of the brain are activated when receiving heat pain in a cluster headache patient versus a migraine patient, we might be able to better predict which one suffers from. This could then lead to more accurate treatments. Thanks for your great question!
DeleteOMG Kiri! I am so jealous of your experiences this week. I loved your #HospitalRomance haha. It's always a delight to read your personality-filled posts when I don't get to see you at school (except I kinda see you on snapchat, I guess). Everything in this whole post was so so interesting :D Which was your favorite part to learn about? Are you considering going into this field after the insight your internship is providing you? Can't wait to read more next week <3
ReplyDeleteThanks, Saleena, I'm glad we both love each other's blogs! xD I hope to keep you entertained for the rest of the project. Aside from Snapchat, we really do need to hang out one of these days...I would have to say my favorite part that I learned about were all the different tests and scans they do on the brain. Also, I found it very impressive that they have to know the name of every artery and vein (if that's not memory being put to the test, then I don't know what is). As for your other question, I don't think I could be a research scientist. Conducting various studies and writing papers about those studies looks seems very interesting, but maybe not something I could do every day. And even though this may not be the path I choose career-wise, my internship is still a wonderful learning experience that I'm grateful to be a part of. Have a great Week 5! :)
DeleteHi Kiri! Did you use any of things you learned in Post-AP Anatomy & Physiology to help you label some parts of the brain? Just kidding. That's not my question, but it would've been fun if you knew some stuff along the way, right? For my question, I was wondering if he told you or you knew why the cause of the hemorrhage was not detected? I understand it's most likely difficult to locate every individual vein and artery in the brain, but are there other factors that can make detecting the root cause difficult? (Sorry for the very weird question again. I'm running out of ideas. :P) Just kidding.
ReplyDeleteAwesome post Kiri! Keep up the great work!
(P.S. The selfie is on the point by the way.)
Yes, taking Anatomy and AP Psych proved to be very helpful, Robert! Because of this, I was familiar with the lobes of the brain (frontal, parietal, occipital, etc.), so it was nice to see some familiar information. To address your 'real question', the patient we were looking at is a current patient at Mayo, and as of now, they don't have an answer to what caused her hemorrhage. Dr. Chong (the radiologist) analyzed more than the MRIs (including scans of the arteries and veins). He also looked at medical background, family history, and even her occupation. He was sure to be very thorough in examining all factors that could've caused the hemorrhage, yet to know avail. Thanks again for commenting! I thought my selfie was "on the point" as well!! :P
DeleteHi Kiri! As you have spent more time in the lab I'm curious if there are any experiences from your classes here at BASIS that you have drawn upon or that you've found helpful?
ReplyDeleteGood question, Ms. Wilson! Interning at Mayo, I'm very thankful for having taken AP Psych and Post-AP Anatomy & Physiology as a junior (so shoutout to Ms. Das and Mr. Carey!). Taking their classes was very helpful when it came to labeling the brain. It was a bit different labeling a black and white image of a brain as opposed to labeling one in a textbook or a real brain for that matter, but I still thoroughly enjoyed it. When we went over the brain functions, it was mostly review. It's awesome to be able to take what I've learned in the classroom and be able to apply it to a real world experience. I look forward to using other knowledge that I've learned in school!
DeleteHi Kiri! Sounds like you had an exciting week! A concussion is different than a hemmorage, right (sorry I know nothing)? Does a concussion show up with an MRI and if so what does it look like? Can't wait for next weeks post they are always so funny and entertaining!
ReplyDeleteThat's okay, Sarah, I know it might be a bit confusing since my research is on concussions, but my post talked about hemorrhages, so I'm sorry for that. So a hemorrhage is an escape of blood from a ruptured blood vessel, while a concussion is brain injury that affects brain function. Concussions actually don't show up on MRIs, however it's good to get an MRI after a concussion in case there are signs of a more serious injury that the MRI does pick up. Anyway, hope you're having a good Week 5! :)
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