The Art of Suturing

I would like to share with you all an opportunity I had today as part of my journey through medical school. One of our surgeon faculty members came to our class to teach us how to properly suture an open wound.

First, we learned the technique to tie the knots, which is an essential part of each suture. This alone took about two hours. It is very important to master this technique, as a poorly tied knot can come loose in the patient and potentially cause infection in the wound or scarring. There are special kits we used to learn this technique with normal string first around a makeshift “wound.” Afterwards, we were given the actual suture string, which proved to be a bit harder.

Finally, after much struggle and learning, we moved on to the pig’s foot. Each person was given one pig’s foot, which was subsequently cut with a blade. We now had a real wound to work with on this real flesh. Pigskin is very similar to human skin. It makes for a great teaching model.

We learned four different knots that surgeons commonly use:

Horizontal mattress

Vertical mattress

Running suture

Simple interrupted

For those of you who are interested in learning these different knots, there are many videos that you can find online to teach you.

Practicing on the pigskin afforded me an incredible opportunity to learn a skill that I might one-day use in practice. Thank you Dr. Safoui for your time and dedication.

One Proven Way to Prevent Cancer

With cancer on the rise, it is important to stay up to date with the most recent cancer research. Although there is currently no cure, scientists are researching things that might be linked to cancer risk or treatments that might increase survival. One such thing under heavy research is:

Vitamin D has been proven to help aid with certain diseases including rickets and other bone diseases. In addition, studies have shown that residents of northern geographical areas that do not get much sun have increased incidences of cancer. As you may or may not know, the sun is the most efficient and effective way to get your daily Vitamin D needs. Therefore, physicians suspected that the increased incidence might be due to a lack of sunshine, and thus lack of Vitamin D. This has ignited Vitamin D research with regards to cancer.
After a careful literature review on recent articles, here is what I have concluded:

• ™Vitamin D does have anti-cancer properties
• ™Animal studies have been consistent and promising.
• ™Several studies have consistently demonstrated an inverse relationship between serum vitamin D and cancer.
• –Some studies have proven otherwise, but for various reason.
• ™Cellular and animal models saying one thing, but clinical trials are yet to undoubtedly verify it.
• ™Vitamin D deficiency has been linked to increased risk of cancer.

For those reasons, I believe it is important to continue researching this, and possibly increasing the sample sizes for the clinical trials.

In the meantime, be sure that you are maintaining sufficient levels of Vitamin D in your body. One convenient way to do this is through the smart phone app "D Minder." Sunshine is the most beneficial way to take in Vitamin D.

However, if you live in an area with little sunshine, you can look into taking Vitamin D3 supplements, but be sure to talk to your primary care physician before doing so.

References:
Kennel, K. A., & Drake, M. T. (2013). Vitamin D in the cancer patient. Curr Opin Support Palliat Care, 7(3), 272-277. doi: 10.1097/SPC.0b013e3283640f74
Teleni, L., Baker, J., Koczwara, B., Kimlin, M. G., Walpole, E., Tsai, K., & Isenring, E. A. (2013). Clinical outcomes of vitamin D deficiency and supplementation in cancer patients. Nutr Rev, 71(9), 611-621. doi: 10.1111/nure.12047
Walentowicz-Sadlecka, M., Sadlecki, P., Walentowicz, P., & Grabiec, M. (2013). [The role of vitamin D in the carcinogenesis of breast and ovarian cancer]. Ginekol Pol, 84(4), 305-308.
http://acuarios-self-help-health-wellness.blogspot.com/2012/11/vitamin-d.html
http://www.vitamindwiki.com/Vitamin+D+proven+to+treat+or+prevent+many+cancers+in+animals%2C+but+only+breast+cancer+in+humans+so+far+%E2%80%93+Jan+2014
http://www.huffingtonpost.com/2014/04/29/vitamin-d-deficiency-signs-symptoms_n_5200408.html
http://www.vitamindwiki.com/tiki-index.php?page_id=774

Research on Breast Cancer

After researching for a year as part of my Master of Science program, I made and presented a poster with my research findings under the supervision of Dr. Raj Kandpal and his lab at Western University of Health Sciences. Here is my final poster:





























Throughout this experience, I learned the importance of research, not only for medical advancements, but also for educational purposes. I was able to take a topic that I learned in the classroom, and apply it in great detail in the lab. This hands on research has taught me much more than I could have possibly learned in the classroom. I highly encourage everyone to look for an opportunity to research something, anything, that might interest them. It can be anything from cancer research to behavioral or psychological research. Do what interests you, and you will find the experience very rewarding as well.

Tis the Season for the Sneezin'

This is a review of an article taken from WebMD, answering 10 questions that many patients suffering from allergies might have. This is in no way meant to treat or diagnose allergies. If you believe you are suffering from serious allergy symptoms, I recommend seeing your primary care physician.

http://www.utahpeoplespost.com/2014/03/most-challenging-places-to-live-with-spring-allergies-here-is-the-list/

I've tried to simplify their answers in this post. Questions include:
How do I know what I'm allergic to?
Simply, you cannot know exactly. You can have your primary care physician or allergist give you an allergy test which will determine if it's a type of mold, grass pollen, or weed.
How can I manage my allergies using over-the-counter medication?
Start with your daily antihistamine. If symptoms (nasal congestion, water eyes, itchy throat) continue, talk to your doctor about adding a corticosteroid nasal spray. You can also try lozenges or antihistamine eye drops to relieve symptoms. If getting an over-the-counter nasal spray, be very careful not to get one that could be addicting. Yes, the rumors are true, and this is possible. How do you know if a specific one can be addicting? Usually the label will say, "Do not use for more than 3 days at a time." Pay attention to this.
Beyond medication, what can I do to manage my allergies?
The most important thing to do is shower after you come home from being outside for a while, and wash your pajamas, beddings, and clothes as often as possible. Allergens are all over you when you get home. The worst thing you can can do is change out of those clothes, fold them back up, put on your pajamas, and get in bed with those allergens for 8 hours. Of course you will wake up congested and miserable.
What about the natural and alternative remedies I hear about: Do any work?
Start by talking to your doctor before trying anything alternative. However, a simple home remedy can be to mix 8 ounces of water with half a teaspoon of table salt in a spray bottle. You now have a saltwater nose spray!

http://childrens411.wordpress.com/2012/06/08/living-with-allergies/

Are antihistamines addictive too?
Experts have shown that antihistamines are in no way addictive.
I love the outdoors. How can I enjoy the warm weather with my allergies?
Simply take your antihistamines about 30 minutes before starting your day. Also, have decongestants and eyedrops on "standby."
When do I need prescription allergy medication?
After exhausting every option mentioned thus far, and your symptoms are not improving whatsoever, it may be time to see your primary care physician. He or she will prescribe drugs according to your specific degree of allergic reaction.
Do I need allergy shots?
Same answer as the previous question. After exhausting everything, including prescription medications, you can talk to your physician about this next step.
Is there hope on the horizon for those with spring allergies?
There is a new therapy under clinical trials called sublingual immunotherapy, which may replace allergy shots. However, it may be a couple years before we see it here in the US.
If I have allergies, will my kids have them too?
Unfortunately, if you have allergies, there is a 33% chance your kids will have them. If you and your spouse have allergies, the percentage jumps to 67%. Not much we can do about that.

Again, for more information, please visit the original article at WebMD, or talk to your primary care physician.

Life is Precious: A Tribute to Tyler Parr

I would like to dedicate this post to a close childhood friend of mine, Tyler Parr.
Tyler and I are neighbors, and we grew up playing on our street together almost every day. Just a few days ago, he passed away at the age of 23 due to a battle with brain cancer that he had been fighting for about 14 months.

https://www.facebook.com/photo.php?fbid=10151061940271246&set=t.1246806646&type=3&theater

However, Tyler was still able to teach us a valuable lesson before passing:

Life is Precious.

He may not have done this intentionally, but this is how I coped with the loss. He managed to live life to the fullest, cherishing every moment. He maintained a positive attitude, and enjoyed his time with family, friends, and loved ones throughout this time.

https://www.facebook.com/photo.php?fbid=10203306189037524&set=t.1582609879&type=3&theater

Tyler was one of the nicest and most caring guys I knew. I could not help but ask, "Why?" He was loved by everyone that knew him. He was brilliant and successful in school. He was a great all-around athlete. He was the best son, brother, and friend that anyone could ask for. In short, he will be missed dearly by us all!

Tyler, you will live on forever in the many incredible memories that you have made with us all. In addition, I will cherish every moment like it's my last, not taking anything for granted. Please watch over us all, and may God rest your soul in peace.

Love,

Karim

The Best Way to Get Your Daily Exercise

Do you have physical limitations? Do you hate running or going to the gym? Has your physician told you multiple times that you need to exercise daily? Do want to lose weight or lead a healthier lifestyle?
If you answered yes to any of these questions, then you should highly consider swimming!

http://www.hearos.com/earplugblog/best-swimming-ear-plugs-silcone-waterproof/

I am normally active whether playing sports, going on hikes, or walking my dog. Recently, I found less time for exercise, and began gaining weight. I have a lot to study, and an entire trip to the gym can total 3 hours. I simply did not have that amount of time. When I was young, my parents forced me to swim daily as part of a club. I took lessons and competed, but I just hated getting in the water on a cold day.

http://www.telegraph.co.uk/earth/earthnews/9198125/Water-company-boss-says-dont-swim-after-heavy-rain-to-avoid-sewage-overflows.html

Thankfully, I do not have to deal with that at the gym. So, I decided to get back into swimming. I know it's an incredible full body exercise. I can burn calories, increase my heart's health, and feel better each day with many more health benefits. To be honest, I hate running and sports can take up too much time. Whereas, I can go to the gym for 20-30 minutes of intense swimming each day, and reap the incredible benefits.

For those of you looking to get your daily exercise, but haven't figured out just how to do that, I strongly encourage you to go to your neighborhood pool or local gym and try a simple 20-30 minutes swim. You will feel great, and absolutely not regret it. After all, who doesn't love to get in the pool for a swim? It can often be therapeutic and soothing as well. Each day, challenge yourself to swim more and more laps without taking breaks. Before you know it, you'll be swimming for 20 straight minutes. Running for 20 minutes would not have nearly as many benefits.

Let the laps begin!

Health Education IS Health Prevention

The fact is, a physician and team of healthcare experts can only do so much. In fact, they are more often tasked with treating illness and disease, not necessarily preventing them. No one goes to a physician and says, "Hey Doc, I'm healthy. I just want to know what I can do to make sure I stay healthy."
For that reason, we resort to health education -- teaching the world about illness and disease in hopes that they can be better patients to themselves. Hopefully, we can nearly eradicate certain diseases by teaching people exactly how to prevent them.
Ergo, Health Education IS Health Prevention.
The more we work to educate the world about illness, the more we can prevent illness from happening.
Here is my general concern about the future: it seems that physicians are having less and less time with each individual patient. There is only so much a physician can do in that little time. Most importantly, of course, is to treat and address the chief complaint. Less time = less education = less prevention = more illness. More illness leads to even less time with a patient as there are more patients who now need care. This is a vicious cycle, so what can we do about it?
1. Increase the amount of physicians we graduate each year. Clearly we need more physicians, and we have more and more competitive applicants each year, so why not simply accept more? Ultimately, the government would need to open more residency spots to accommodate the increasing amounts of graduating students, but I believe it a feasible option.
2. Increase our resources for health education. Everyone should be constantly striving to educate the people and communities around us. This can eve be done through the media or internet.
3. Increase the amount of time we spend with each patient. Unfortunately, this is probably the least feasible option. Hospitals are mandating physicians see a certain amount of patients in a given time, so there is very little a physician can do in this aspect. It would have to start from the top down.

At this time, we can only work to increase our health education and hope for more prevention.

Patient-Family Centered Care

Patient-centered care is a widely understood term for health professionals dictating that patients are the sole focus of our healthcare -- not bills, treatments, colleagues, supervisors, etc.
There is little dispute of this type of care as of course the patient should be the center of their own healthcare. It is also implied that the family is included in patient-centered care. However, too often the family is left out of critical decisions and patient health updates. This can be crucial because often times family members are the best source of information about the patient -- particularly if providers are dealing with younger or older patients.
The phrase then should be altered to include "family." Patient-Family Centered Care sends a stronger message that the family needs to be heavily involved in not only the decision-making, but also the investigation of the patient's illness. Family members stay right beside the patient in the hospital more than any other health care provider. They carefully observe every nurse, physician, student, and chaplain that comes in and out of the room. They watch every step of the treatment with extreme scrutiny. They may even know better than the patient themselves exactly what is going on. For these reasons, it would be wise to heed the advice that a close family member might give to the medical providers. In fact, even when advice is not given, they should be consulted frequently. Health care providers must remember that the patient is not the only person affected by their treatment or outcome. There may be several other people that will be heavily affected by the decisions made -- whether good or bad. Therefore, we ought to include them in the Patient-Family Centered Care.

The Cure of the 21st Century

I would like to start my first blog by describing the reason behind my title.
This blog is in no way meant to cure anyone of anything - sorry. Rather, that is the exact thing I am trying to combat. In this day and age, everyone is looking for a cure - The Cure. Not just the cure to a disease, but people want the cure to stress, the cure to poverty, the cure to obesity, the cure to your annoying little sibling, etc. Well, there is no all-encompassing cure.
A cure is often seen as the easy way out. Simply do this and you will be cured! Of course, this can be very attractive. Unfortunately, that's not always the case. More times than not, there is not one simple cure to a problem. To cure is to prevent.
Prevention is The Cure.
Prevention is surely less attractive, however. Prevention comes with long, arduous tasks that seem daunting and endless. Well, what options do you have? If there is no cure, then I suppose you ought to give prevention a fair shot.
Science has come very far, and it is true that many diseases have an evidence-based cure, but this is minute in comparison to all the things that we are trying to cure.
We cannot cure stress, but we can work to prevent it by finding out its underlying cause.
Likewise, we cannot cure poverty, obesity, annoying siblings, etc, but we can certainly prevent them. This will not come easy, but diligently struggling to prevent these things can in itself be The Cure.

I challenge everyone to think deeply about those things that they most want cured. Create a list of actions that you might be able to do to prevent those things. Now, instead of waiting for the cure to come on a silver platter, start working honestly and diligently to prevent those unwanted things. I am sure you will see reward.

Welcome to The Cure.