DBS

Well, I observed a Deep Brain Stimulation surgery today, and it was amazing. This is one of the relatively few procedures during which the patient is totally awake and aware, which was really neat because it was clear that she was immediately improved. Today was the first of a two part procedure; first, you implant the electrodes in the brain, then a few days or a week later you implant the impulse generator and tunnel the leads from the electrodes to connect to the generator. Today started with Dr. Johans and Patrick, a Medtronic rep (he travels all around the country to assist with this surgery, and handles the business end of things), dtermining their plan of attack using a computer - they were nice enough to explain to me what was going on, which is good, because this is going to be one of the research topics I will be tackling this year. Two different kinds of MRI scans (T1 and T2) were overlayed with a CT scan in order to produce a map of the brain. They then planned the approach to insert the electrodes into the target areas without damaging major structures or causing bleeding. The computer then calculated the angles and settings for this approach, which were then dialed into a frame that is positioned over the patient's head. This frame is used to guide the electrodes into the targeted spots in the brain (as you can imagine, precision is very important). So, to make a long story short, a bur hole is drilled into the skull and the electrode is placed on each side (one at a time). After the electrode is in place, it is connected to a power source to check the placement. The patient today suffers from essential tremor, and as soon as each electrode was turned on, she was given a basic motor exam to test for improvement. When she first tried to touch her nose as part of the exam, she immediately started crying. Her tremor was all but gone (after tweaking the voltage a bit, it disappeared completely). She was overcome with emotion; she's had this tremor for almost 20 years, and it's had a terrible impact on her life. The whole thing was very touching, and it was very cool to see such a positive outcome for someone who hadn't even left the OR yet. Most people are totally out of it until a while later, so this was a nice change. I'm hoping I will get to see the second operation to implant and connect the impulse generator, but I'm really hoping that I will get to see her post-op in clinic to see how she's doing. Very cool stuff.

Back to the Basics

Well, today was my first day of class at BSU. I totally felt like a freshman again, walking through the campus with my eyes searching desperately for the Multi-Purpose Classroom Facility, my mouth slightly open, and fear on my face. It really brought back some great memories from old KU. I've determined that I'm not entirely ready to be a student again. Other than a lifelong student, of course. Whatever the hell that even means. So, I found the building (it was right where I thought it would be) and sat through the obligatory syllabus/schedule first class of the semester. The only snafu was that I'm not on the roster for some reason - it's odd because I'm definitely enrolled in the class... I'm sure it won't become a huge hassle. Nothing like this ever does. Oh, and there will be weekly problem sets in my Cell Biology class, which marks the first time I will do homework since...

Well, tomorrow I'm going to observe a Deep Brain Stimulation surgery. Should be pretty sweet, though I'm not sure how much I will actually be able to see. Tim and his PA, Brian (who's a super nice guy) explained to me the nuts and bolts of the surgery today - as you might expect, it's pretty fascinating stuff.

By the way, one of the most annoying things in the world - my aunt and uncle have their dogs trained to poop in a certain area of the yard, but they have to be monitored to ensure that they don't go rogue and poop everywhere (the sidewalk, people's beds, etc.). So, it's pretty frustrating when they insist upon sniffing every square inch of the poop area and spinning in circles about 750 times before they do their business. But you can't really rush them. All they know is "No!" and "Come here!" - neither of which is helpful in this instance. It makes it almost worthwhile, though, to see the guilty, ashamed look on their faces as they defecate; you dog owners know what I'm talking about. I like to watch them while they do it, even talk to them so they know I'm there. They should be ashamed of themselves. Learn to use a toilet like the rest of us, seriously.

One last bit, I finished my latest powerpoint lecture yesterday. This one is about CSF fistulas; CSF is cerebrospinal fluid, which, according to Wikipedia (the world's most reliable resource), is a clear bodily fluid that occupies the subarachnoid space and the ventricular system around and inside the brain. A fistula is basically an abnormal connection between two vessels or between a vessel and the outside (like a leak), so a CSF fistula is just where CSF is leaking somewhere it shouldn't be. By the way, I might sound smart (and I am learning a lot), but I'm not. I still like playing video games and coloring.

A little embarrasing

So we went for another bike ride today, and we went on a new "little" loop that ended up being both very long and very intense. My uncle and I were both totally sucking wind as we were nearing the end of the climb, and right as I pulled over to catch my breath for a second (and let my uncle catch up - shit yeah), this extremely nice man passed me. He was at least 70. Now, you need to understand, I'm starting to get used to getting annihilated in the foothills by the female cyclists of Boise, but to get creamed by an old man who was not even breathing hard (and I could see the concern in his eye, like he was worried I wasn't going to make it to the top and he would have to race down the mountain and call Lifeflight to get me), smiling his huge, dentured smile at me... it hurt bad. But he was very nice, and clearly having a great time, enjoying the afternoon. I still kind of wanted him to fall. A little.

We had fried chicken tonight for Megan's last night - it was awesome. My aunt does pretty darned good work, but I definitely miss my mom's creative, one-time-only concoctions (and pasta of any kind). My aunt and Megan leave tomorrow early, and then my uncle leaves Thursday evening; after that, the kids and I have the place all to ourselves until Sunday. That's right - kegger. $5 gets you all the Keystone you can drink. I guess I should say that I'm kidding so my brother doesn't buy a plane ticket.

Btw, I just heard today that Hugo Chavez, in addition to moving towards abolishing Venezuela's presidential term limit, is going to move his country's clocks forward a half an hour starting January 1, 2008. I read this in a short article on hotair.com (a pretty awesome website) called "Evil Clown's Megalomania Turns Stupid."

Oh, and I am now officially enrolled at BSU. I'm going to be taking Cell Biology MWF from 8:40-9:30. It will be cool, but I'm not exactly thrilled to be "back in school," because as we all know, I'm "too cool for school."

fine

Well, at my brother's encouraging, I've changed my picture to one that's a little more recent, and a lot less homo-erotic. I'm really tired - today was pretty much an 11 hour day. My uncle gave the first presentation for the nursing staff today, and it went off with only a few minor snags (fortunately, I was prepared with a back-up, a plan B if you will, and potential crisis yet again led to perhaps my finest hour [btw, I peaked in high school]). Then he had clinic all day, which was pretty neat. We were in his new office today, and while it's not quite finished yet, it's a really nice, comfortable environment.

Today was the first day since I've been following him that my uncle saw a patient he really couldn't help. She has terrible, crippling back pain, but not from any problem that is surgically correctable. She has unfortunately already exhausted pretty much all of her other options, including some pretty radical solutions. The only option that remains is a fusion procedure which has a much higher probability of making her worse than of helping her. Since my uncle isn't willing to subject her to the risk, she might go and try to find a surgeon desperate (or greedy) enough to try it. It was very frustrating for all involved; as a doctor, my uncle naturally wants to help everyone who comes in to see him, but there are still many things which are beyond the scope of neurosurgery today. There are many problems for which there are just no good solutions yet, and this was one of those. All that can be done is to try and help the patient manage their pain, and that's not terribly satisfying for anyone involved.

On a lighter note, my uncle told me today that my signature is hesitant and 3rd grade-ish. He's blunt.

So tomorrow is my cousin Megan's last day in town before she leaves for school in Portland. We're having fried chicken and champagne. Just kidding. About the champagne. My aunt is driving out there with her on Wednesday, and my uncle will fly out to meet them on Thursday. They're all going to see the Body Works exhibit there, and I'm way jealous. That is all.

Speaking of Dancing...

See below for afore-mentioned talk of dancing, but here's how it's really done; you may know this guy from this clip, but here's a longer clip of David Elsewhere dancing. He's pretty awesome.

Who's Bad?

Well, my uncle is giving the first presentation that I "created" tomorrow morning. I'm going to be on-hand as the resident tech-expert (ha) and so he can point at someone if something goes wrong. Should be sweet. One bit of great news - though I left Kansas with a newly acquired badass wardrobe, I have now graduated to wearing scrubs pretty much every day. It's awesome. Literally like wearing pajamas to work.

My uncle and I had a pretty awesome mountain bike ride today - we're both getting much better and are moving a lot faster. This is both good and terrifying; you really do just have to not think about all of the bad things that could happen and just sort of go. It's a lot of fun, though, and great exercise.

Oh, and last night, my cousins Molly and Amy showed me some dance moves - so watch out world. It should be noted, however, that most of them are Michael Jackson inspired (btw, we watched a few of his music videos from back in the day, and "Bad" is officially the least "bad" a person has ever looked [ note the included picture]). Check this out to see MJ in his real prime. And here's another little tidbit to help people like me make it into/through medical school.

One last bit- Here's the quote of the day: "Oh wow, I'm really surprised she sent you to that place. She got really sick the last time she ate there." - my uncle when he heard that my cousin Megan recommended I eat at a local Chinese food place. I was pissed when I heard that, but it was a few days ago and I'm not sick yet. I've had enough fun with Chinese cuisine in my days...

btw

If you're bored, and haven't heard about it yet, this is a pretty interesting read. Scientists are smart. If you haven't heard the background, click on their link "big data bug" in the first line. It's pretty ridiculous and it really puts the whole global warming thing in a new perspective.

BTW, I just came across this picture of my fam whitewater rafting this summer. It's kind of small, so you'll have to look closely, but see if you can tell why I think this picture is hugely funny.

note: a tech-guru I know pointed out to me that you can actually make the picture bigger by clicking on it. Technology. What will they think of next.

Stress

Well, I just finished my first powerpoint presentation for my uncle. For those of you not in the know, that's what my uncle "hired" me to do; he gives weekly lectures to the nursing staff at one of his hospitals, and they wanted to start doing it electronically. My uncle is comedically tech-challenged (to the point where everyone makes fun of him at work - he literally has voice mails on his cell phone from months ago because he doesn't know how to check them. This amuses me because he's a brilliant neurosurgeon who uses the most advanced and complicated devices in imaging and surgery, but can't check his email. But I digress.) So, I've been charged with creating these powerpoint presentations, which works out well for everyone. My uncle can avoid wasting hours trying to figure out computers, and I get to buff my resume a bit.

I spent the better part of yesterday trying to learn the program and make a template (and get a little more comfortable with macs [sorry this link is a little bit crass, but it's way true]) but now I've got a template for future presentations, and I'm rolling. The one I just finished is about carpal tunnel syndrome which, contrary to popular belief, is something a neurosurgeon is trained to deal with. This is especially true of doctors like my uncle who are trained specifically in peripheral nerve problems. It's all pretty interesting stuff, and I'm excited to get working on the next one.

The rest of my time the last few days has been devoted to the AMCAS medical school application. It pretty much sucks. A lot. I had to hand-type every single class I've ever taken including class number, number of credits, grade, etc., even though they're going to get my transcripts anyway. Seems like a waste of time. Especially since I took about 150 different classes in my time at KU, for a grand total of 8,000 credit hours (give or take). Oh well.

So, I'm trying to keep my cool in the face of stress. Things are good here in Idaho, and I'm going to see my fam in November and December), and things are pretty good. But, there's a lot to do. I should probably get to it.

My Life is Way More Important than Yours. Here's Proof.

Well, I've been in Idaho for about 9 weeks now, I think, and I'm going to take this opportunity to catch people up on exactly what it is that I've been doing. Because people care. And they really ought to. First, I should point out that I haven't started this "blog" until now because there really wasn't anything to report; I would lie awake at night imagining what my blog would look like, and every would-be post consisted of, "Today I studied. Then I ate and studied more. Then I went to sleep." I decided to spare my unquestionably massive audience and wait until something interesting happened. With that said, here's pretty much what I've been up to:

I'm in Boise, ID, living with family. I took the MCAT on the 24th of July (still waiting patiently for the scores), and I left feeling utterly dominated in every way. I don't want to talk about it. I'm living with my aunt and uncle, and their three girls, aged 16, 17 and 18. For those of you who are like I was and have never really lived with teenaged girls, let me tell you, it's an experience. More on that in the future, I would imagine. My uncle is a Neurosurgeon here in Boise, and I'm going to be following him around and working for him for the next year or so. I've just started all of this in earnest over the last week (today was my first day in scrubs, and yes, I did look amazing, thanks for asking). In the few short days I've been following him around, I've literally learned more than in a whole year of "music education" classes at KU. Shocking.

I have also, it seems, taken an interest in mountain biking, and am rapidly progressing towards novice status. It's terrifying. And I'm terrible. I guess I like the rush of knowing that I have trusted my life not only to a bike I've only just met, but also to my decidedly lacking abilities in maneuvering said bike. It's really fun, and I just got a new mountain bike, which makes me feel a little less close to death all the time.

Also worth mentioning is the fact that my grandparents live in Boise, as well, though they spend most of the summer at their cabin in McCall. I have been able to go up and visit pretty regularly, which is great (I've included a picture purely as a means of bragging).

I think that should pretty much cover it. So I should point out the purpose of this blog - I guess I want to let people kind of know what I'm doing (you're welcome, mom), but I also am going to use this as a way for me to remember the cool/interesting/important things I do and see whilst here in Idaho. As a result, this may get somewhat technical (see: boring). Sorry about that in advance. I also may periodically seize the opportunity to opine if the mood strikes me. So, thanks for reading (mom) - and get ready for a really wild ride! I just threw up in my mouth a little.