Rock Music and Leukemia

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“When you live your life with an appreciation of coincidences and their meanings, you connect with the underlying field of infinite possibilities” — Deepak Chopra

“Coincidence” has been a major theme these past four months in med school. It seems as though when ever I learn about a disease or illness, I start seeing or hearing it mentioned everywhere. Myasthenia gravis and Guillain-Barre syndrome being the ones most frequently come across by both Lauren and myself. But this past weekend was the most poignant coincidence thus far.

I’ve had a much needed Thanksgiving break having just finished up the extremely arduous units called Hematology/Oncology and Immunology. Basically, we spent the month of November learning everything about RBCs, Leukemias, WBCs, blood types (of which there are hundreds), antibodies, antigens and on and on and on…. Don’t get me wrong, these units were my favorite so far, but I’m sure no one would like to take a stressful exam on these subjects.

OK, sorry for the rambling, back to the story.

So to relax a bit from school, my sister and I went to a concert in Philly to see the band Andrew McMahon in the Wilderness (they’re the ones behind song “Cecilia and the Satellite” in case you’ve heard it before). I didn’t know this before going to the concert, but the lead singer, Andrew McMahon, was diagnosed with Acute Lymphoblastic Leukemia (ALL) ten years ago when he was just 22 years old. As a med student, I was instantly intrigued seeing as I had just learned about ALL a few days prior. At one point during the show, he shared his inspiring story with the crowd and, in particular, pointed out how lucky he was to have a family member that could donate stem cells in order to treat and cure the leukemia. However, he also brought up a crucial point: not everyone has a close relative that is a bone marrow match. So what did his band do? They brought along the Love Hope Strength Foundation for their entire tour in which reps signed up concert-goers for the national bone marrow registry. I would have signed up right then and there, but I had–coincidentally–just received my swab kit from Be the Match the week before.

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My buccal swab kit from bethematch.org

These coincidences this past weekend really made me think about the seemingly small things in medicine. As first year med students, we learn all about terrible diseases, but we really haven’t seen how they affect the patients that have them. As lay people, we hear about or know people with illnesses, like ALL. We express our sympathies, but we don’t really know what more to do. But we can do something. We can sign up for great programs like the National Bone Marrow Registry or donate blood through the American Red Cross. These seem like such small things, but they really do save lives!

Please check out the linked pages above and consider signing up. It’s a very fast process (you literally fill out a 5-minute online health history and swab your mouth with a couple of giant Q-tips) and it’s such a wonderful thing to do. FYI: there’s a fairly low chance that you will actually be asked to donate after signing up  (about 1:540)– there are simply so many antigens to cross-match between donor and recipient to ensure that the stem cell transplant will have the best chance of success. Don’t let this stop you from registering though! You never know, you could be the exact match for someone who desperately needs a donation!

So sorry for the long post guys– I’m definitely not the most concise blogger, especially when I get to writing about something I’m particularly excited/passionate about!

Anyhoo, until next time,

Theresa ❤

Birth Control By Pharmacists?

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Hi Readers!

Happy “Belated” Thanksgiving!

I stumbled across an interesting read from the American Pharmacists Association newsletter a few weeks ago about how certain states are rallying for their pharmacists to have prescribing power for birth control. Pharmacists in California and Oregon are pioneering these efforts; within the next few months, women will be able to come to pharmacies in these states and get birth control without a prescription from a doctor.

How will this be possible? Instead of going to the doctor, women will instead come to the pharmacy and be asked to fill out a health questionnaire in place of bringing in a doctor’s prescription. Pharmacists will then process these questionnaires and fill the patient’s birth control method of choice (which will still be covered by insurance, of course).

What do I think about this? I have mixed feelings. On the one hand, I think it’s a great option – its convenient, potentially less expensive for the patient, and could save the patient time from seeing a doctor. In theory, they say that these kinds of efforts could help prevent more unintended pregnancies than ever. On the other hand, if patients are not seeing a doctor to obtain their birth control prescriptions, patients are no longer getting any preventative screenings for cancer or assessed for other life threatening side effects of contraception such as blood clots. When patients are asked to fill out the health questionnaire in the pharmacy for a new prescription, they are simply self-assessing their current health; a lot of women may not recognize when something is wrong. Women often think that something is just a common side effect, when in reality, they could be exhibiting signs of a much more serious issue.

The above pro-con list is only from the patient’s point of view. From a pharmacist’s point of view — How will pharmacists be able to incorporate this into their already hectic days? Anyone who has worked in retail pharmacy knows this is a near impossible task – how can a pharmacy with a single pharmacist be able to: take all prescription transfers, give all the flu/shingles/pneumonia shots, verify all outgoing prescriptions, counsel patients on prescriptions AND now potentially write new scripts for birth control after trying to assess a woman’s health state from only a health questionnaire?

Is it great that pharmacists’ roles are expanding every day? Absolutely. Can pharmacists adequately balance all the tasks they are expected to do in a day? Questionable. But possible, I suppose.

What do you all think? Is this a good idea? Do the benefits outweigh the risks? I’d love to hear your input!

:)Lauren

PhotoCred: http://www.newkidscenter.com/images/1HT03550/pill.jpg

What They Don’t Tell You About Pharmacy School: Semester 1

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Hi guys!

I am halfway through my finals at this point. Only three more to go next week! As my semester is winding down, I thought I’d share the things that they don’t tell you to expect when you come to pharmacy school (at least during the first semester). I’ll be honest – a lot of the things that I’ve experienced, I did not expect to be doing. Maybe this insight will help someone to prepare a little better than I did coming in to professional school!

  • Let’s start with the very beginning of the semester. Pharmacy school is not cheap. You’ve seen how much tuition is, you know about how much money you need to live for 4 months, but none of it really sinks in until you actually sign the loan papers. I can’t exactly describe the nausea that accompanies signing these loans, but it feels like a combination of the following: going to the doctor and they tell you that you need to get 7 immunizations before you leave + that feeling you get when you are going up the incline of a roller coaster and you decide you no longer want to ride anymore + when you are excited that you only have to get one textbook for the semester, but that book only comes in hard cover and it totals around $450. Anyways, you get the picture — its nauseating.
  • No one bothered to mention that every single test was going to be taken on computer. Using a special software. That uses very extreme measure to ensure that cheating is not an option, ever.
  • Part of a pharmacist’s job is to counsel patients on medication use. We see this, occasionally, in our local drug stores. But when you are in pharmacy school, the professors somehow convince you that every single patient needs to be counseled for every single medication that they pick up (even if said patient has been taking this medication for 20+ years). Yes, its good to develop counseling skills, but we hardly ever see counseling in the frequency that they tell us its going to happen. Either way, when I arrived to pharmacy school, I was unaware that we were going to have to counsel. In really authentic, creepy, sterile fake doctor’s examination rooms. In front of your professors. To a fake patient. Who knows more about the medication than you do. And asks questions that they know you can’t answer. All while being video taped for your viewing pleasure later on. And yes this is all for a grade. No pressure. Get used to the awkward and nauseating experience that is a counseling assessment.
  • I have now used placebo versions of every single inhaler known to man. Please, do not bother to ask me how to use any of these. I have already forgotten.
  • Yes you still need to buy a stethoscope even though you aren’t in medical school. And yes you have to take people’s blood pressure and take their pulse and take entire physical examination courses, because, why not? And no, I did not sign up for this! I don’t want to have to touch people!
  • Little did I know, that during our one hour lunch breaks, we are still expected to sit in on professional lecture series almost every single day. Yes, it is too much to ask to just eat lunch in peace at a table in the cafeteria every once in a while. Instead, we have classes for 5-6 hours every day, then they essentially want us to sit in an “unofficial” class for our only break of the day.
  • Our class is not very big. But, even so, when we want to contribute something in class, we have to hit a microphone button that is at our seat so our voice is projected over the loud speaker. If this wasn’t bad enough, a camera at the front of the room zooms in on your face for the entire duration that you are talking. I don’t participate in class very much.
  • And the last, most important thing that they don’t tell you about coming to pharmacy school is: abandon all your old study habits. They hardly every work. I was a Chemistry major in my undergraduate college. I foolishly thought I had mastered the fine art of studying. I couldn’t have been more wrong. I had to find a new way to study, and fast. My grades couldn’t keep taking hits from the bad exam scores I was getting. I can say that, at this point, I have found something that works. But it is very time consuming. I will not go in to my future semesters assuming this technique will work. But I can say I am more prepared to try and adapt to each of my classes now.

I couldn’t possibly list everything that came as a surprise to me in pharmacy school. I will be sure to share similar posts as each semester comes to a close.

That’s all for now!

:)Lauren

Med School by the “Numbers”

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Hey guys, Theresa here!

For my second blog post, I thought I’d try my hand at making an infographic (which are really fun to make, btw)! I decided to do a little summary on kind of the “numbers” med schools look for in applicants. I put numbers in quotation marks because these just include MCAT, GPA, etc. but in no way do these make up your entire application. When I was a pre-med, I used these figures to set goals in terms of my academic credentials. That being said, a good med school applicant is way more than a few numbers. I know many students who got into med school with a “below-average” MCAT or GPA. Conversely, I know many students as well that didn’t get in with an excellent MCAT score and a 4.0. Good “numbers” might get you an interview, but the rest of your app will get you admitted. Med schools (and every other health care professional school) looks for well-rounded individuals, of whom they can tell really want to go into this profession. Schools want students with vibrant experiences who show real passion for health care. Of course, each school looks for something different in applicants, so it is vital to do research on schools and see if you would be a good fit or, more importantly, if they are a good fit for you.

So don’t let these numbers scare you! Use it as a guide or motivation to keep going. I know being a pre-med is super stressful, but it is all worth it when you get that first acceptance!

For those already in med school reading this, I hope this infographic makes you feel proud! In 2014, only 41% of applicants actually got in. Med school can make you feel really dumb sometimes, but just remember you wouldn’t be in the 41% if you weren’t awesome and smart!

Theresa ❤

 

& With Finals, Comes Stress….

It’s that time of year – pharmacy school finals.

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As I try and prepare for the torture that is 7 finals in the next week, all I find myself thinking about is – when can I just lay in bed and binge watch Netflix again?

Managing the stress that comes with the end of the semester is a really tough thing to do. How you manage to “de-stress” is a really personal thing — not everything works for everyone, some things have the opposite effect and stress you out more… it takes a matter of time to find what really works and what doesn’t.

I will not regale you with stories of all the times my de-stressing failed, but instead, I will share a few things that have helped me to get through the tough times.

  1. Do not stay indoors for the entire duration of your study time. I cannot stress this enough. Fresh air really does wonders. Be sure to take time to clear your head, go outside for a bit, or at least leave your study space. We all know that staring at something for hours does not mean you know it any better – sometimes taking a break is crucial for your mind to process the information.
  2. Do call someone that cares. If there is one thing I have learned throughout my entire undergraduate career and my very short time in professional school, it is the importance of your support group. There is not a day that goes by where I have not called my mom, my boyfriend, or Theresa (sometimes all three in the same day). They may not fully understand what you are going through, but that doesn’t matter – just talking helps to de-stress and put things into perspective for you.
  3. Do not sacrifice sleep for study. I would never ever condone this behavior. I do not believe in staying up all night to study. As I stated before, sometimes your brain just needs time to process all the information; this can’t properly be done without giving your brain its proper rest! Giving your mind the time to recharge is important – don’t forget this!
  4. Do remember that there is a light at the end of the tunnel. At this point, you’ve finished all your classes and you are probably getting ready to go home. Just take one day (or one final) at a time, and think about all the good and happy things waiting for you once the week is over. If I can do it, you can do it! Also, remember that Netflix is at the end of this tunnel too.

Happy studying!

:)Lauren

My First Patient

It has been three months since I started medical school and I only just now had my first patient. Now she wasn’t my first patient that I ever encountered (I don’t think I would have chosen medicine or even made it into med school without having some kind of patient interaction), but she was my first real patient in which I was one of her providers. I practically died of excitement when I saw my name listed as part of her medical team. The apathetic fourth year seeing the patient with us probably thought us first years were a little too happy to be seeing a new patient at 8 pm on a Tuesday night, but I did not care one bit. This was why I came to medical school. All I that I have done since starting med school in August was study and learn—not exactly what I want to be doing. I want to treat patients.

Let me give you a quick (uninteresting) background on how I came to see my first patient. Every Tuesday and Thursday, my medical school holds a free clinic for uninsured or underinsured patients. Along with other med students we work with social work students, pharmacy students, etc. to give the most well-rounded care possible. In fact, many patients that come to our clinic use it as their primary care office. Logistically, a fourth year heads the patient’s medical team with younger students contributing as much as they’ve learned. Afterwards, the team presents to the supervising attending who either confirms the team’s conclusions or asks that we get more information or run more tests. Overall, it’s an incredible learning opportunity on top of the added bonus of actually seeing a patient and having an excuse not to study for a couple hours.

FYI: I’m not going to divulge too much information about my patient, clinically given HIPAA laws and such.

So here it was. Three first year med students in our starch white coats, a confident MD/PhD student and an exhausted fourth year in wrinkled scrubs crammed into a tiny exam room with our patient and her husband. I can imagine how overwhelming our patient felt, especially when us first years began shooting unorganized, seemingly random questions about her history of present illness, family history and past medical history. She was a good sport though; although timid and shy, she answered all of our questions and didn’t make us feel awkward. I had to keep reminding myself that I had to be confident, though. She came to us expecting to be cared for. This was for real.

About an hour and a half later, we had finished her exam and made a preliminary plan for her care. Our attending was impressed (undoubtedly more so at the fourth year and MD/PhD student than us first years) and agreed with how we wanted to proceed. We then all went back to the tiny exam room and spoke to our patient about what we wanted to do. She seemed hesitant and I had a sinking feeling that compliance might be an issue. Like for many patients in an underserved area, going to a pharmacy to pick up your meds or returning to the clinic to get necessary bloodwork is a much lower priority than caring for young kids and/or your job that keeps food on the table. I won’t get the opportunity to follow-up with my patient in the next few weeks (first years are limited to the number of times they can help out in clinic) but I hope she makes the effort for her health and to set a good example for her children as well.

My first patient probably won’t remember my name or face. I’ll probably never even see her again. But she will always be the first person that I helped treat (albeit in a nearly imperceptible manner). I will always remember her because she was my first patient.

Theresa ❤

The Miracle Cancer Cure — (& Pharmacogenomics)

Hi everyone!

What an amazing day for medicine!

(Read me: http://www.huffingtonpost.com/entry/baby-with-incurable-leukemia-cured-with-designer-immune-cells_563bf870e4b0411d3070759a)

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This realm of medicine is highly experimental, relatively new, and absolutely positively one of my favorite emerging subspecialties in pharmacy. Individualized medicine is the new frontier. Even the most difficult of cases can sometimes miraculously be cured due to a personalized therapeutic approach. The field is new, but the potential is great. If the success rates of these experimental procedures keep going up, there is a great chance that some of the biggest challenges in medicine, such as cancer or autoimmune disorders, may see amazing new treatment options — treatments that were created specifically for you, by you (using your own genome!).

I love pharmacogenomics. Every person is different – why do we assume that standard treatment options are appropriate for everyone? We often see that this is not true in practice. Do you ever wonder why some cancer treatments are highly effective for some but fail miserably for others? Or why it is so hard for people who suffer from autoimmune disorders or chronic illnesses to get their symptoms and disease states under control? All of our genomes are different; we don’t all respond to the same therapies. Instead of always implementing the “standard” medicinal treatment for our patients, what we should be doing instead is setting the standard for gene therapy. By studying a patient-specific genome, we will already be able to tell what therapies won’t work, and save our patients from using up their precious time.

I personally think that this is an incredible advancement to medicine and pharmacy, alike. I can’t wait to see what pharmacogenomics will have in store for us in the future. What a time to be alive!

:)Lauren

Picture Credit:  www.genomicenterprise.com