Blog 22: Senior Project Reflection

I. Positive Statement
What are you most proud of in your Block Presentation and/or your senior project? Why?

I was most proud of my second activity. For one part of it, I brought isolation robes for everyone in the room to wear. When I told the audience what they were and that they could wear it, the kind of, relief and cheering some people let out like, "Woah this is cool!" was really exciting to hear.

II. Questions to Consider

1. What assessment would you give yourself on your Block Presentation (self-assessment)?
• P+
2. What assessment would you give yourself on your overall senior project (self-assessment)?
• P+

III. What worked for you in your senior project?
Most certainly the information I learned throughout the year. In the beginning, i had focussed on Rabies but quickly changed to Coronary Artery Disease. Specifically for an Internist, who look at multiple systems, it is important to understand how the body works. I have gained a small, but useful base of information regarding the body, and equipment doctors use when doing procedures and tests.

IV. If you had a time machine, what would have you done differently to improve your senior project if you could go back in time?
I would most certainly have memorised the authors of the individual papers I referenced through my presentation. These are the actual doctors and researchers that took the time to find out this information. Knowing what the article about is important, but knowing about the author is equally so.

V. Finding Value
How has the senior project been helpful to you in your future endeavors? Be specific and use examples.

I most certainly know now that I want to have a career in the medical field. The start of my senior project had me doing mentorship at a hospital and leading to another mentorship with an actual internist. This has allowed me to experience just a small part of the vast amount of information that I should have a grasp on if I'm going to pursue a career in medicine.

I hadn't a clue what I was reading when going through the complicated articles and science papers in the beginning of the year. But slowly and constantly reading through more and more gave me an understanding of the definitions of the medical jargon as well as the procedures. The research checks every few Fridays seemed boring at first, but I got a deep appreciation of them in the long run.

The ESA component for Senior Project and even Model Assembly was really helpful. For a large majority of my academic life, particularly in primary school, using sketchy sources was a common occurrence. But ESA taught us how to find reliable sources and how to find out if the information is so. Sources are important particularly for the medical field. Papers from the National Centre for Biotechnology Information or the Journal of the American Medical Association have a ton of sources on each paper. That is because information is highly valued! These experiences at iPoly have helped me understand this.

Blog 21: Mentorship

Literal
Mentorship Log

Dr. Francisco B. Fuscaldo, MD.
North Broadway Medical Clinic and AEON Medical Equipment & Supplies, Inc.

Interpretive
What is the most important thing you gained from this experience? Why?

I think the most significant thing I gained from this mentorship experiences was the realisation that information is incredible. It's the common phrase that knowledge is the key, but numerous times I've seen my mentor, nurses (and even fictional characters) use the knowledge that they're acquired over the years into application. But it isn't just coming straight from the book. Their experiences have shaped them into the professionals they are today. That is who I strive to be. I've got to start somewhere and experience isn't easy to come by, so I'll start by getting as much knowledge as I can and working harder than I ever have before.


Applied
How has what you've done helped you to answer your EQ? Please explain.

Some of the equipment I saw (and used) were scalpels and sutures for closing up wounds. The technique for the knot isn't that effective when we're going micro and zooming in on the artery, but the idea is clear: stitch up the arteries that you graft during Coronary Artery Bypass Graft Surgery. There have been a lot of models regarding how balloon angioplasty works–and research for the iSearch Finding 2 (angioplasty) was brilliant. I learned the history of how angioplasty was developed and the hardships that came with it. As for the first answer, I think it was a reality check when i went to urgent care for angina (chest pain). Thankfully it wasn't heart related (I was just overreacting)–It was a skeletomuscular issue. But what made me eventually make it my answer–and best answer was something my mentor once said. "The one thing you have throughout your life is your body." 

Reversal of Vascular Ageing

Article Title: Antioxidant Reverses Vascular Aging In Mice
Info: http://www.iflscience.com/health-and-medicine/antioxidant-reverses-vascular-aging-mice

Mice are cool. Rats are cool. Kawaii too. Sometimes rats are cats. Unless they get rabies and die from sick. The article mentions a study published in the The Journal of Physiology where researchers have been able to identify an antioxidant that may be able to reverse some negative effects of ageing on arteries. 

Ageing is the primary risk factor for the development of cardiovascular disease. Nitric Oxide, a chemical involved in regulating blood flow, is a naturally created in our body. MitoQ, the antioxidant that the researchers have identified is able to increase the amount of Nitric Oxide in the body. MitoQ has been able to reverse the "related vascular endothelial dysfunction" in the arteries of mice. That's why this is so significant.

Blog 20: Exit Interview

What is your essential question and answers? What is your best answer and why?

What is the most effective treatment for a patient suffering from Coronary Artery Disease?

1. By making lifestyle changes regarding personal nutrition which focus on low sodium and cholesterol intake
2. Undergo an Angioplasty procedure by placing a stent in the narrowed artery to widen it
3. Undergo a Coronary Artery Bypass Grafting Surgery to graft a substitute blood vessel into your heart, re-routing blood flow around the clogged artery

Best answer is Answer 1, "By making lifestyle changes regarding personal nutrition which focus on low sodium and cholesterol intake" because I believe naturally, the latter two answers eventually fall back to the first. Coronary Artery Disease is chiefly caused by poor health habits (Consuming an excess amount of cholesterol/sodium) which answer one covers. Answers 2 and 3 are procedures that utilise non-natural equipment (meaning tools like scalpels and catheters).

What process did you take to arrive at this answer?
I arrived at this answer through research. My findings about the causes of Coronary Artery Disease came down to the effectiveness of taking care of your body. As my mentor has said, "Your body is the one thing you have for the rest of your life." Answers 2 and 3 ultimately end with the doctor telling the patient to eat well, exercise, and to just live healthier; they are also short-term solutions compared to eating healthier, which It was this realisation that led the way for Answer 1 to be my best answer.

What problems did you face? How did you resolve them?
At first when I researched, I hadn't a clue what I was reading. Studies with abstracts, results and whatnot seemed overly complicated. Words like paclitaxel and percutaneous popped up with little to no context–these are the types of words that I knew I had to familiarise myself with so I could fully understand the article. Focussing on this, Google is a really handy tool. Whenever an obscure word popped up, I simply searched for it. But this impacted my research in more ways than one. Now, I'm able to read these journal articles with a better understanding than I had before. Repetition of particular words and phrases stuck with me. In addition to that, when I search up a word, I [fortunately] do not stop at the definition. I'll use Wikipedia as an example. For complicated jargon that's widely used in the medical field, Wikipedia does have a fairly simple summary as to what it is. But that is all it is: a summary. I have found myself at times grasping for more information either by clicking through more articles or more recently, scrolling through the numerous references at the bottom of the page.

What are the two most significant sources you used to answer your essential question and why?
My two most significant sources are the National Centre for Biotechnology Information (NCBI) and my Mentor. The NCBI has given me a load of information. While at first I looked at definitions and explanations on WebMD and similar sites, I eventually moved on to more academia-focussed archives (like NCBI). Similar sites such as The Journal of the American Medical Association (JAMA) and The New England Journal of Medicine (NEJM) were popular archives for medical journals that I frequent. 

But a problem I faced many times (as reiterated in my iSearch Paper) was the fact that many articles, particularly more recent studies cost money. $33 for a single pdf file isn't worth it from my position. I'm not doing a full-fledged study, so spending money is not my preference. Fortunately, sites like Reddit have smaller forums called subreddits where users sometimes give out these articles for free through file sharing websites. I believe it's a small duty of resourcefulness that I find these links.

My mentor has helped me out as well. He is a board certified internist with many years of experience. I will admit people may not be as thorough as articles devoted to the topic, but my mentor, as a trained professional knows an incredible amount of information. He can literally go on for hours on his clinical studies on Diabetes. I've come to him for answers and his influence and knowledge led me to my EQ and subsequent answers.

Blog 19: Independent Component 2

Literal

1. I, Alfonso Esquivel, affirm that I completed my independent component which represents 30 hours of work
2. My mentor, Dr. Francisco Fuscaldo, equipment technicians, and nurses helped me complete Independent Component 1.
3. Independent Component Log 2
   Total Mentorship Log
4. I learned much more about the heart than I ever did before. I have a more complete understanding of the different parts of the heart and not an elementary memory of the parts of it. I've come to understand that the body is far more complex than I could ever imagine. How the lungs effect the heart, how the lumen determines blood pressure; the importance of Systole and Diastole. I reused an ultrasound machine and looked at someone's heart and how they beat. You're even able to see individual vessels!

Interpretive

Pulmonary Exam

Cardiovascular Exam

Outside the American Red Cross in Irvine

Helping out with the CPR session

Applied

1. I learned a lot during Independent Component 2. I learned about the importance of keeping up to date with research. It's mind-boggling how fast research is being done and what's coming out of it. I'll put it into reference with the Pacemaker. It took over half a century to come up with an incredibly efficient and useable Pacemaker, but this was happening all in different parts of the world. It was an incredible breakthrough and its effects were phenomenal. I've been trained in CPR for less than a year, but when I helped with the training, I also got to talk to the trainer who was a former Paramedic. Fast pace and fast thinking were needed to do his job. I understood the fragility of the human body. I want to improve my research as soon as possible.

Egyptian Princess

Article Title: Egyptian princess was first person with diagnosed coronary artery disease
Info: http://esciencenews.com/articles/2011/05/17/egyptian.princess.was.first.person.with.diagnosed.coronary.artery.disease

Well, the article title is a bit misleading. Very misleading, in fact, when you say it slowly. Surely had been diagnosed before a corpse, no? Well, yes. It's a sensational title–more accurately poorly worded, but essentially meaning Princess Ahmose-Meryet-Amon was the earliest person who we can confirm has Coronary Artery Disease.

But what was interesting was that since she was an Egyptian, her diet must have consisted of vegetables, fruits, some meat and barley. Yet she still developed Coronary Artery Disease.

Dr Thomas and his co-principal investigator Dr Adel Allam of Al Azhar University, Cairo, suggest three possibilities:

1. Our understanding of Coronary Artery Disease is limited–our understanding is not complete
2. Genetic inheritence
3. Inflammatory response due to parasites common to Ancient Egypt

Else, another possibility is that because she was a Princess–royal her diet was not similar to a normal Egyptian. Surely her status grants her the ability to indulge in luxury foods like butter and cheese. Meats were stored using salts, another determinant of high cholesterol. It's incredible what we can infer from CT Scans of mummies!

Ah, the Old Switch-a-roo

I'll probably switch what I planned as my answer three to become my answer two. Just a (physically) mental note. No problem!