The NICU employs eight doctors, two fellows, a fluid (but moderately high) number of nurse practitioners (NNP), and over 150 nurses. The doctors, fellows, and NNPs all know why I’m always in the unit, but it is difficult to keep all of the nurses informed because there are so many. So, Dr. Knight had me make a poster with all of the information. I decided to make it super colorful and I had a lot of fun with it. Felt like art class.
Archived entries for Dr. Gail Knight
My brain seemed to have a lot of it floating around today. What an unexpectedly great birthday!
When I was younger, I used to have the best birthday parties. Always themed (i.e., shells, clowns strawberries, bird houses, Roald Dahl), my mom would cultivate parties that involved crafts, delicious food, backyard games, and copious usage of my playground and hammock. I also remember tons of lemonade and well-decorated cakes. I think my favorite was my clown birthday party, where my aunts all teamed up to paint the faces of the party guests in their preferred clown get-up. The craft involved making these snow globes using jars and these really fun, miniature clown statues. This is certainly a retrospective favorite because I don’t actually remember this party; I just watch the home video at least twice a year.
But my 21st was so great, too! Even though it would have been nice to see my family, my host family and my work friends made the day truly special.
7:30 a.m. – On my way down to the stairs to leave for work, notice a wonderful birthday balloon bouquet (BBB) from Jay and Penny. Yes!
8:30 a.m. – Found out that the IRB approved the study, and received a bunch of e-mails from NSI employees wishing me a happy day. Cute!
10:30 a.m. – Got TB test, but the nurse missed the first time (read: she stuck me with the needle, went to inject the fluid and it went all over my arm.) Ouch!
11:00 a.m. – Returned to Dr. Knight’s office to meet with Carol, a nurse practitioner involved with the study to find the office decked out with birthday decorations, an extraordinary cake (click “extraordinary” for onset of jealousy), a book I have been yearning to own but unable to afford, and a generous gift from the my coworkers at RCHSD! Amazing!
12:00 p.m. – Had lunch at NSI with Ani, John, and two women who are interested in starting a chapter of Dancing for Parkison’s in San Diego. Inspiring!
1:00 p.m. – Entered my NSI office to find a nice birthday message (on a beautiful postcard, no less) from Ani and a Putumayo CD called “From Mali to Memphis: An African-American Odyssey.” Thoughtful!
1:30 p.m. – Stopped by the office of Debbie Honeycutt, a member of the NSI Development Staff, who baked me the most delicious brownies I have ever eaten in my entire life. Chewy!
2:00 p.m. – Continued to amass and categorize articles about the effect of stress on neonatal brain development, how music can effect neonates, etc. etc. Knowledge!
4:30 p.m. – Tripped on the way out of NSI and opted to fall on my left knee instead of drop the brownie tray. Split my pants and my knee cap, but luckily there was a non-emergency-bound ambulance at the gas station so I could clean myself up. (Cute) EMTs!
6:30 p.m. – Ate delicious carne asada tacos at a Mexican restaurant with my host family and some family friends. Delicioso!
Overall, I realized today more than any other day how happy I am to be in San Diego doing exactly what I’m doing. In other news, Haverford physics professor and avid jazz saxophone player Stephon Alexander is joining Ani, John, Dr. Gall, and I for lunch tomorrow! Exciting!
(To update you on my sunburn, it has certainly faded to a tan and a pretty deep one at that. It impedes my wardrobe selection and I look like a fool in my gym shirts.)
Dr. Knight was talking to me about a generic electrocardiogram (EKG) print out, and I wasn’t following her as much as I would have liked, so we decided that I should learn about it. I am currently trying to teach myself how to read one so I can understand what is actually going on in the heart when looking at a monitor. I wrote down some notes on it, but I figured it would be good to have it all in one place for myself, complete with some pictures that are much clearer than my drawings. The process of learning this involved regurgitating my knowledge of the heart, which has waxed and waned over the past five or so years, but it is amazing what the brain can remember.
Anyway, I first researched how EKGs function: the electrodes placed on the body detect electrical changes on the skin that happen when the heart muscle depolarizes and repolarizes. These changes are very tiny so the EKG must amplify them in order to extract anything meaningful from it. Using the following two images and some great information from Wikipedia, I’m starting to understand more of the physiological intricacies.
The P wave represents the depolarization that spreads from the sinoatrial (SA) node throughout the atria. There is a brief zero volage period, also referred to as the isoelectric period, after the P wave. This represents the time during which th eimpulse is traveling within the atrioventricular (AV) node and the bundle of His, the collection of cells specialized for electrical conduction.
The QRS complex represents ventricular depolarization, and the T wave represents ventricular repolarization, which takes longer than depolarization. The P-R interval is the period of time from th eonset of the P wave to the begining of the QRS complex, which is essentially the time between onset of atrial depolarization and ventricular depolarization. Finally, the ST segment is the isoelectric (remember, zero voltage) period following QRS where the entire ventricle is depolarized.
Sorry this entry was super drone. I need this information, and I could not think of any fun analogies to map onto the different waves. My inability to lighten up this content is definitely indicative of how little I am grasping, but you gotta start somewhere.
P.S. My heart has been beating for 21 years today. If my heart beat at an average of around 72 beats per minute for my entire life, it has given me a hefty 795,251,520 beats. You’ve done me good, heart.
My favorite part of an undergraduate education is doing research for papers. It is the thing I miss most in the summer, so I requested an off-campus VPN log-in so I can get my research fix whenever and wherever I want, as long as I have my laptop. That “Proud to Be a Nerd” moment aside, yesterday, my computer at NSI was set up with access to journal articles abound and I was able to dig for information about infant neural development, cortisol levels, stress in the NICU, infant perception of music, etc. etc. If only Rob Haley could see me now. He is Haverford’s Interlibrary Loan (ILL) librarian who has definitely written a poem or two to cope with how often I request articles.
Yesterday at Children’s, Dr. Knight gave me the task of perusing through the data input program to familiarize myself with its format to speed up the process of entering data when the study actually gets underway. After this task, Abbie, Dr. Knight’s assistant, gave me a PowerPoint document that included a lot of info about the NICU to help me get a better grasp about how RCHSD’s NICU is set up.
Finally, I gave myself the assignment of looking through all of the various heart conditions that plague infants, neatly described on this website for parents and Wikipedia. I’ve been keeping notes while at the hospital of little snippets of doctorspeak to look up when I get to a computer again in hopes of picking up some of their language. I’m finally getting there with some of the acronyms, as observed in native speakers with sentences like, “This one is SGA* with PDA** and needs ECMO*** stat.” (This sentence does not refer to any baby in particular, and I’m not even sure if ECMO would be needed for a patient with PDA, but I’m learning the nouns and adjectives first, okay? I’m getting there.)
*SGA – small for gestational age
**PDA – patent ductus arteriosis, a heart problem that results from a failure of the ductus arteriosus (a blood vessel connecting the aorta and the pulmonary arteries in fetuses) to close, resulting in a mixing of oxygen-rich and oxygen-poor blood and strain on the lung arteries and the heart
***ECMO – extracorporeal membrane oxygenation, essentially a heart-lung machine
What a week! Preparing for my departure has been a full-time job, especially considering the added neuroticism of an individual who has ne’er-before traveled by air. Yes, it’s hard to believe, but I’m about to embark on my first adventure in the sky. Here are some thematically-appropriate tunes, even though I already booked my flight and I’m not going over the sea.
I’ve been shopping to smarten up/California-ize my wardrobe and gathering all of the last minute necessities that have spent a little too long simmering on the back burner. I just finished packing my carry-on, which barely falls under the limit in both weight and size, and my personal item, a stuffed-to-the-brim backpack complete with airplane snacks and enough reading material for a time period equivalent to the length of my flight cubed.
Tomorrow, the Cherichello clan is getting up bright and early to have a family breakfast before Dad has to go to work and my brother (Johnny) has to set off to school. Mom is taking the day off to take me to the airport, which I greatly appreciate.
Anyway, on a note directly relevant to the project, I received an e-mail about a required Biomedical Ethics training course that I had to take online due to my involvement with this summer’s music therapy research with human subjects. This course, mandated by the UCSD Institutional Review Board (IRB), ended up taking me longer than expected because I became fascinated with the array of completely unethical studies throughout history that led to today’s cautionary procedures. One study that sticks out for quite a number of scientific errors intended to determine whether sleeping or being physically active allowed for more digestion. The researcher fed two prisoners a large amount of food, then sent one to bed and one to engage in vigorous physical activity. Going through the lessons and quizzes of this course brought me back to this semester’s Experimental Methods and Statistics (colloquially, “Psych Stat”) at Haverford, as they mark one of the many prerequisites to my first engagement with IRB-approved research as a role other than “participant.” Although I have conducted two group studies at school, both have been for lab classes and thus have not gone through the IRB. I feel so legit!
To further build on this legitimacy, I’m continuing my progress with Why Zebras Don’t Get Ulcers and Music Therapy for Premature Infants (I’ve yet to mention the second in any detail, but that post is soon to come). Both have incited in me countless a-ha moments, whether they regard my own experience as a stressed person, my (limited, but growing) knowledge of infant development, or the power of music. If I were already in SD, it would be merely 12:30 a.m. and my eyes would not be feeling the wee-hours-burn, so this post would include some of the content of these “a-has,” but for now, they must wait.
One last exiting update is that I meet Dr. Patel for the first time over lunch at the Neurosciences Institute (NSI) on Tuesday at noon, after which we are both heading over to Rady Children’s Hospital for the first meeting with Dr. Knight. I have training at the hospital during the next few mornings and will my afternoons at NSI.
In sum: sleep, family breakfast, Newark airport, California by 4:30 (7:30…), readreadread, acclimation. I can’t believe this thing that I’ve been talking about for so long and thinking about for even longer is happening. Wish me luck!
Note: Posts following this one should be full of photographs, pending the purchase of batteries for my camera.