The Final Week of the Final Frontier

Welcome to the last week of the rest of your lives!!!

Well, the last week of my project that is. I know week after week you all have been waking up every day and longing to read each new installment of this ten part series that is my blog. Not every week was as exciting to read about as some of the more action packed weeks, but I have tried to make each post interesting and fun to read. I have honestly really enjoyed writing them and dramatizing everything that I do. No one wants to read about some guy putting some data into a computer. The people want to read about a young man finding himself by endlessly punching in names after names after names and prescriptions after prescriptions after prescriptions into a small, square laptop that takes FOREVER to load (I mean seriously its 2017 get faster wi-fi) while simultaneously considering the fact that this really should be illegal or be breaking some existing laws like I am looking at a lot of medical information right now.

Anyways, this week in the office consisted of exactly what I did last week which included printing off the results from the five standard tests that are used to check for diabetes. Soo not really anything new happened. I got tighter with Sarah and shes a pretty cool person. Maybe if my project was longer then we could have been as tight as the OG power duo: Carol and I. Alas, I think it is time to move on. I had a lot of great experiences at this doctor's office and it has definitely helped me have a clearer image of what I want my career to look like. I have decided that I don't really want to be a doctor but do something in the field of medicine. I don't know exactly what that is but I am hoping to find out in college (right now I am planning on doing biomedical engineering but we will see).

Outside of the office this week, I finished the rough draft of my power point! The senior project is coming to a close and fast. I can feel it and it feels great. I think my presentation will be pretty good. I mean it will be on a topic that I have been doing research on and participating in for the past ten weeks so I don't think it will be very difficult to talk about. Still not entirely sure exactly what day my final presentation will be on. It's gonna be sometime in May. I can tell you that much. I don't think this is the last post that we are supposed to do. I think I make another one after this, but I could be wrong. Anyways, I had a good last week. I said goodbye to Sarah and Heather and everyone that I have grown to know and love at the office. I wish peace to the world and to everyone reading this post for my last week! Bye bye SRP!

Almost There

Hello avid readers and welcome to the penultimate week of my project!

I'm almost done with the 10 weeks of my senior project! wooooohooooo. These past 2 months have been an emotional roller coaster. There were some good times and there were some bad times. I learned a lot and grew emotionally, spiritually, and geopolitically. Even though Dr. Lalani's office has been a great source of training and knowledge, I think ten weeks is the perfect amount of time for a research project. This way I can become accustomed to and knowledgeable about something and leave before my on-site mentor runs out of things for me to do.

This week in the office went very similar to last week where I would print off the different files of patients that are needed by Heather and various companies that need to check that Lalani's office has followed the standard operating procedure for treating certain conditions. Once again, along with progress notes I printed out what those companies needed, the results from past tests. This week Heather explained to me what the results I was printing out were actually for, which made my life more interesting. Apparently, when a patient has newly diagnosed diabetes, they go through five tests to confirm that they have diabetes, so the doctors have more specific data about the patient's individual case of diabetes.

The five tests are called the Doppler, Nerve Conduction, Smart Skan, Thyroid Biopsy, and a Retinal Scan. I am not sure on the specifics of these tests or how they work, but I know that in a typical diabetes screening all five are utilized.  Similar to last week, I had to look for these five tests that were performed in the year 2016 in the files of the patients in addition to any progress notes that needed to be printed out. Why only 2016? I don't know but I'm sure companies have their reasons. Or maybe they don't have their reasons and they want these files as a joke, in which case this isn't a very funny prank. Anyways even though what I did in the office was not related to the PGX study, I still got to learn a bit about diabetes and continue helping Heather and the other office people with stuff that needs to be done and no one wants to do. Seriously, this one woman treats me like a saint every time I come in, because if I didn't print out this stuff then she would have to do it.

Outside of the office, I have slowly been putting together my power point for the final presentation. I will put the date of the presentation in my next post, because I am drawing a blank on when it is while I'm writing this post. I hope it goes well. It shouldn't be too hard. At least I don't think so. I mean even if it doesn't go well, what are they gonna do? Make me not graduate? On second thought, maybe that's how it works. Welp, we will find out. I gotta go now. I'll see you all next week!

New Person, Same Old Medicine

Hello internet users!

Feeling good? Yes? That's good. I am glad to hear it. It always makes me feel warm inside when I know that each and every one of my dedicated viewers is having a good time. If at any point in your life you are not having a good time, I want you to know that you can come to me and we can talk it out. I feel like we have gotten to know each other pretty well.

Anyways enough about you, let's talk about what you really want to read about: me. After the tragic loss of Carol last week, I had to look to new horizons to finish off my senior project in these final three weeks. My mom is friends with Dr. Lalani and she asked if there was something else I could do in his office. He gave me the number of a physician's assistant named Heather. I left Heather a voice mail pleading for some sort of structure in this chaotic spiral I was slowly descending into. She texted me and informed me of a new possible on-site mentor. Her name is Sarah and she is the professional and spiritual successor to Carol.

I may not have the same, witty rapport with Sarah that I had established with Carol, but her position in Dr. Lalani's office is essentially the same as Carol's was which means that I do relatively the same kind of tasks that I have become accustomed to. The only problem with coming into the office now is that all the work on the PGX study that needed to be done in the office was completed by me during my first four weeks of my project. So Sarah and Heather had to find new tasks for me to do. However, even though what I did this week in the office was not related to the PGX study, I still developed valuable skills in learning how to look at patients charts electronically and help Heather with tasks that make her life easier.

To explain what I did this week, first you have to understand that when a doctor visits a patient many of the important notes that they take are hand-written and then later scanned into the patients electronic charts to be kept on file. Now when these patients come back for a follow-up visit with Heather, the problem is that many times Heather does not have these hand-written notes (labelled as "progress notes") on hand. So, it was my job this week to take all the patients that she will see in the next few weeks and print out their progress notes and then attach these progress notes to their physical, paper charts, which Heather actually has. This way Heather has all of the information that she needs before she meets with her patients. If I didn't do this, then either Sarah or Heather would need to do it themselves and they don't got time for that. They have more important stuff to do. Or at least I would hope that they do. Also, I learned that insurance companies like to know what kind of tests have been performed on the patients, so in addition to the progress notes, I also had to print out a series of results of tests that were done on Heather's diabetes patients to then fax to the insurance companies.

All in all, it felt good to be back in an office, feel productive, and feel like I was actually helping someone with something, hopefully making their life easier. I printed out sooooo many progress notes. Lemme tell you, Heather is stacked with progress notes. She has all of the progress notes she could ever need. Well I hope you had a good time reading this. Catch ya next week!

Mourning the Loss of a Great Mentor

Hello everyone. Today is a sad blog post.

I know you all have gathered here today to be entertained by another one of Jack's amazingly comedic blog posts, but alas this one will be dreadfully serious. Today, we sit here at our individual computers and contemplate the loss of Jack's greatest mentor and friend, Carol. On Monday March 20th, 2017, Carol resigned from her position at Dr. Lalani's office to have a better life somewhere else. Although I know that somewhere deep down she would love to still work in the field of medicine, the petty, verbal kerfuffles between the coworkers she oh so despised finally got the best of her. She couldn't take it anymore. Years of being underappreciated finally beat her down and won a long war of attrition. The conflict ultimately climaxed when she finally had an epiphany at the end of her vacation and decided that she would not be returning to work on Monday.

In many ways, Carol quitting her job made my life harder. On one hand, I lost my on-site mentor, but more importantly I lost a friend. On the other hand, I learned a lot from Carol's actions. She told me before she left that in America it doesn't really matter how long you have worked somewhere or how good you are at your job, because if you do not have the proper credentials (i.e. college degrees) then you will not go very far in life. I think that this is a very important lesson to learn especially for people in high school, because you always hear about how important college is but not usually from someone who actually wishes that they had gone to school for longer. So, in the end, am I upset that Carol left? In the same way that you are upset when your dog is terminally ill and in pain and you have to put him/her down. You wish you did not have to live through the whole situation, but it's for the best. I know that Carol will be in a better place. She told me that her husband is some master tennis court builder or something so she is gonna try to get in on some of that action.

So since Carol was in-charge of everything I was working on in the office, I didn't get the opportunity to come in this week, but I'm working on being able to shadow a physician's assistant named Heather for the remaining 3 weeks which would be awesome. I would get to do more hands on stuff and see if interacting with patients is something that I would like to do as a part of my future profession. Instead of going in this week, I continued to do research on enzymes and their processes in the body. Apparently there are some medications like Humira which are not metabolized by the cytochrome p450 enzymes so they are just not tested for in the PGX study. I thought this was interesting, because it shows a shortcoming of the experiment.

Anyways, I just hope Heather is as much of a bro as Carol was. I hope to see you all next week with some interesting stories! LONG. LIVE. C@ROL.

Research as a Lone Wolf

I'M BACK. Hope you all missed me, because you know I missed sharing my life with you all. My spring break was pretty fun. I'm sure all of your spring breaks were pretty fun too. Honestly with nothing to do though sometimes I get a little crazy, so it feels good to be back.

Anyways, Carol is actually on vacation this week so if I went into the office there would not be anything for me to do, because she is in charge of all the PGX study stuff. So, I took this week to stay at home and research the different genetic and enzymatic processes behind the study so that I could better understand it and be able to explain it to others in the future.

So, to start my research (and I began to explain it in my Week 4 blog post if you want to refer to that), I looked at Cytochrome p450 which is a group of enzymes responsible for the metabolizing of a myriad of the most common drugs prescribed by doctors. Now it is important to understand these enzymes for the obvious reason that they deal with exactly what the PGX study hopes to accomplish which is to investigate which drugs metabolize well in the patient. Enzymes included in Cytochrome p450 are ones that start with the letters CYP. This is integral to know since half of the genes that are tested for in the PGX study start with the letters CYP and those genes code for the enzymes that start with the letters CYP.

In my Week 4 post I mentioned the CYP2C9 gene which codes for the enzyme of the same name. As it just so happens, some common drugs act as CYP2C9 enzyme inhibitors and if a patient is already a poor metabolizer of the drugs that are broken down by the CYP2C9 enzyme then they will experience adverse effects from those drugs. Looking at CYP2C9 as an example, we can understand more broadly how the study operates. By looking at the genetic code of a patient, we can see whether that patient is a poor, normal, or rapid metabolizer of 12 specific genes and then we can recommend the drugs that do not inhibit the production of the enzymes that the patient naturally does not produce very well.

Well, I can't divulge all of the information that I researched, because then this blog post would become more like a biochemistry paper instead of a blog post. However, learning about all of these biological mechanisms will make it much easier to explain everything when I inevitably have to present what I did over ten weeks in a power point. But I am glad I did the research, because it was actually pretty interesting. Soooooooooooo i'm done here I guess. See ya'll next week. Quick shout out to Dalton for leaving a dope comment. This gif is for you!

Get Schwifty!!!!!!

Why Are You Looking At My Blog?

IT'S SPRAAAAAAAAAAAAANG BREAK!!!!!!

Enzymes Are Pretty Cool

GOOOOOOOOOD MORNING VIETNAM!!! and hello there blog readers. 

How has your week been dear viewer? Oh, it's been not terrible? That's always nice to hear. You think this conversation is kind of one sided? Yeah, it is. Well, since you are here let me tell you what you want to hear: what happened in my life this week. In all honesty, not a terrible amount happened but nevertheless I will tell you all about it. 

Since I am essentially the only one in the office who knows really how to input the data from the PGX study (Carol forgot since I have been doing it for the past four weeks and she isn't too good with computers), Carol was going to have me train someone from the office on how to input the PGX data. BUT, apparently some people are too good to be trained by some kid in high school (or they were too busy but I wanted it to be more dramatic). So, I didn't end up training anyone which would have been cool, because I would have been able to showcase my expertise at looking at papers and then typing what is on the papers into a computer. 

Since no one wanted to be trained this week and their was no more data to input, I decided to learn why exactly these twelve genes were chosen and how exactly the tests work. 

If you take a look at this picture which I included in my last post, then you will see that 6 out of the 12 genes that are being tested for begin with the letters CYP. Now, why is that? That is exactly what I was trying to figure out this week by doing my own investigative research. It turns out that all of the genes listed in this study correspond to enzymes that have the same name. So, the CYP2C9 gene codes for the CYP2C9 enzyme. Super cool! Apparently, the CYP genes are all part of a family of genes called the cytochromes P450. These enzymes are produced in the liver, like many enzymes, and are responsible for the breaking down of over 100 different commonly used drugs. It all makes sense now!

As I got deeper and deeper into my research I realized how much chemistry and biology are related. For instance, the CYP enzymes are all proteins that need a cofactor called Heme to function. Heme has a very specific shape of four five-membered rings containing a nitrogen atom all connected by methine bridges (=CH-). Lower levels of Heme can result in a patient not being able to metabolize some drugs as effectively, because then the CYP enzymes will not function at the normal rate. 

Moving forward I am planning on doing more research into the biochemical properties of enzymes and how they relate to genes and their ability to metabolize common drugs. Hopefully doing this research will allow me to accurately explain the complicated science behind the PGX test. Next week I am taking my spring break so I will have a week off of my project. It should be fun. I am planning on relaxing pretty hard. I hope you all have a good time on spring break too! WOOOOOOOO SPRAAAANG BREAAAAAK