Blog 14: Independent Comp. 1

Content:

LITERAL
(a) Statement saying: “I,Cynthia Garcia, affirm that I completed my independent component which represents 30 hours of work.”
(b) Odette Van Der Ed
(626) 851-6063
 *specify MOHS Night
(c) Independent Component 1 Log
(d) During MOHS night, I would observe the doctors and the medical assistants perform the Mohs techinque for skin cancer. For the Mohs technique, the doctor would surgically extract the skin cancer from where the tumor is located, and the tumor is then taken to the pathologist so he/she could examine it. After the pathologist studies the cancerous cells, the doctor either has to take out more, or he/she can sew the skin back in place. Depending on how much the doctor has to take out, and where the tumor is located, the doctor may have to do reconstructive surgery. Not only would I observe, but I would also "assist" them by getting the items they needed such sutures, gauzes  and tape! I also got the opportunity to take a picture of the patient before the procedure.
INTERPRETIVE

The hours that I have done demonstrates 30 hours of work because although it seems like a quick procedure, it is not! It ultimately depends on the tumor location, size, and whether the tumor has progressed to other tissues in the face. During the procedure, I saw the doctor remove the tumor, which takes about 20-30 minutes. Then, the pathologist examines it, which takes about 30 minutes. However, since 2 doctors perform the Mohs procedure on 2-3 patients, it's going to take more time to have the pathologist examine the cells. Once the cells have been examined and the results come back positive, the doctor is ready to end the procedure  If the results have come back negative, the doctor still has to extract more cells,and the process is repeated until there is no more cancer. For example, on my first night of Mohs, I saw the doctor extract basal cell carcinoma from the right tip of the ear of a patient, however since the cancer had spread, the M.D had to cut even more of the ear. Eventually, once the doctor was done, there was a gap in the patient's ear. Once the results came back positive, the doctor was able to sew back the tumor site. Since the patient did not have a normal appearance of the ear, the doctor, having a done a fellowship on plastic surgery, had to do reconstructive surgery on the ear. The end result was amazing! Although there was a slight difference in the ear size, the ear looked totally normal and had a great appearance  Due to confidentiality reasons, I could not take pictures of the actual procedure, but I did take pictures of the handouts that are given to the patients explaining Mohs, and the Head and Neck Surgery department logo, where they do Mohs Night.
APPLIED
 This component helped me understand the foundation of my essential question because it provided information towards the first answer of my essential question. Being that skin cancer is classified under head and neck cancer, it gave me first hand knowledge about the Mohs procedure and what the doctors do to cure the patient of the tumor. From this experience I have learned about the 2 main types of skin cancer, basal and squamous cell carcinoma, and how the doctor helps the patient through the procedure. Through out the procedure, the doctor asks the patient if he/she is feeling alright, and makes easy conversation with the patient to lessen the nerves and stress. Although the Mohs procedure is not a major one, it helped me understand how beneficial surgery is, and the effectiveness of the treatment. Since the cancerous cells are being examined during the procedure and not after, the doctor doesn't have to estimate where to take out more cancer. I also got to view Mohs from the pathologist perspective because she helped me understand what they are looking for in the slide, and from what region the doctor's can cut from. For example, the pathologist told me that they based the drawing the doctor drew as a clock. The pathologist would then write "between 3:00 and 6:00pm", meaning that the doctor had to extract more cells based on the clock and the drawing that he/she did. This illustrated the importance of accuracy and observation so the patient could have the best outcome from the surgery.

Blog 13: Rough Draft of 30 Minute Presentation

30 Min. Presentation Lesson Plan

Blog 12: Third Interview Questions

1.What is the best way to treat head and neck cancer in adults?
2.What are the most common types of head and cancers?
3.How would the doctor go about diagnosing head and neck cancer?
4.What symptoms do patients experience when dealing with a head and neck cancer?
5.What are the  physical and mental effects patients experience when they have cancer?
6.What encompasses head and neck cancer?
7.What factors affect a patients prognosis?
8.What is the prognosis of a patient if they do not decide to have treatment?
9. How do other health problems or conditions affect the patient with head and neck cancer (ex. pregnant)?
10. How would the physician or physician assistant help the patient cope with the cancer?

Blog 11: Mentorship 10 Hours Check

Content:

1.   Where are you doing your mentorship?
I am currently doing my mentorship at Kaiser Permamente Baldwin Park, specifically at the Head and Neck Surgery department.
2.   Who is your contact?
My contact is Odette VanDerEb, clercial administrator at Head and Neck Surgery
3.   How many total hours have you done?
The total hours that I have done are 128.5.
4.   Summarize the 10 hours of service you did.
The 10 hours of service that I completed at the beginning of my mentorship were concentrated on concierge service, since at the time, I was not able to go into a specific department. During my concierge work, I guided patients to the departments that they needed to go, such as the Laboratory, Cardiology, or OB/GYN. Once I moved to the Head and Neck Surgery department,  I help the M.A's restock the exam rooms with supplies that are needed, make copies, and prepare surgery packets.

Senior Project Update

Content:

1. What are you currently doing in your independent component?
For my independent component,  I am currently going to the hospital on Thursdays, to shadow a doctor when he/she is surgically removing skin cancer from a patient. 

(2) What is a recent piece of research (article, interview, or audio-visual) that have you reviewed you would say was significant in helping you understand where to go next in your senior project?  The piece of research should be something you reviewed in November.  Please explain what you learned and where are you going next because of this piece of research.
The piece of research that has helped me in my understanding of my senior project would be an informal interview that I did with Dr. Jennifer Lee, an otolaryngologist who works at the Head and Neck department. On November 8th, while participating in Mohs Night, I  meet Dr. Lee who graciously answered my questions despite the fact that she was on her break, and she only had a few minutes to spare. I asked her about life while in medical school, and the "proper term" for an otolaryngologist. She told me that residency is hard since you have to dedicate all your time to the hospital (for crap pay!), but if you become chief resident, then starting a family is much easier, which is something that she did. She also told me that as a resident, you gain interesting experiences since you have to travel through the various departments in the hospital. I told her that I possibly wanted to go into the OB/GYN specialty  and she related her experiences while touring in that department, while a resident at USC. Because of this interview, I gained insightful knowledge about life as resident from the perspective of a doctor, and how she got to where she is now. I am considering that she become my official mentor for my senior project.

(3) Provide evidence from your independent component or the piece of research as something you recently did.  For example, a photo of something you working on for your independent component or your notes from the video you watched. 

The notes that I took while  in Mohs Night.

Science Fair Proposal* Revised

1. What is your topic?
My topic is Otolaryngology-Head and Neck Surgery

2.What is the driving problem behind your experiment and the quote by an expert to support the problem? (Expert citation must be in MLA format.)
The driving force behind my experiment is that through the research that I have collected, I have noticed that based on race you are more susceptible to a type of head and neck cancer than your other counterparts. For example, the book Cancer in Minorities by Lovell A. Jones, illustrates the that the black race is more susceptible to a  poorer prognosis for head and neck cancers then whites (non-Hispanic) or Hispanics. "Since 1950, the age-adjusted mortality rate per 100.000 population for buccal cavity and pharyngeal cancers has decreased from 6.6 to 4.7 for white males while increasing from 4.9 to 10.2 for black males." Contributing factors that led to a poor prognosis are tobacco usage, alcohol consumption,  and low socioeconomic status. "The study population included 103 cancer patients (38 women and 65 men), and 91 controls (39 women and 52 men). Individuals living in the most deprived areas (OR, 4.66; 95% CI, 1.79– 12.18) and those who were unemployed (OR, 2.27; 95% CI, 1.21– 4.26) had a significantly higher risk of cancer than people who had high levels of educational attainment (OR, 0.17; 95% CI, 0.05–0.58)."   Evidence-Based Dentistry 11, 57-58 (2010) | doi:10.1038/sj.ebd.6400726

3.What is your hypothesis? (Must be in If-Then form.)

• If a minority race (black, Hispanic, Asian, etc) has a higher prevalence of smoking and alcohol usage, then they are most likely to develop head and neck cancer.
• If a patient has a low socioeconomic status and is a minority race, then they are most likely to die from head and neck cancer head and neck cancer.*

* chosen hypothesis

4.Write a paragraph summary of how you will perform the experiment. Include the tools you plan on using.

I will perform the experiment by studying research and data that I get from various legitimate sites. For example, one piece of research that I found was by a journal titled "Evidence-based Dentistry", which examined the socioeconomic status of  103 patients who had malignant cancers of the oral cavity, including the oropharynx, hypopharynx, or the larynx.  I will also be going to Kaiser Permanente to ask the doctors at the Head and Neck Surgery Department if they have any information about the topic at hand. The tools that I will be using are graphs and raw data that I collect from the various websites that I will be examining. I will also call the Cancer Information Service to see if they can supply me with data. I will be using Excel or statistical tools (proportional hazards model) so I can make my data about the correlation of head and neck cancer and socioeconomic status.

5. Select one of the project categories  for your experiment:
Animal Biology & Physiology

Working EQ and Possible Answers

(1) What was the working EQ you used during your presentation?

• The working essential question that I used for my presentation was: "What do you have to know to be a successful  ENT  doctor."

(2) Did you decide to revise your working EQ after your presentation? If so, write your revised EQ here.  If not simple write "I am not going to revise my EQ at this time".

• I am not going to revise my EQ at this time.

(3) What are possible answers to your current working EQ?

• Some possible answers to my working EQ is that in order to be "successful" you need to be as good as your team. When doing my mentorship and independent component, I see that the doctors and nurses work extremely close with one another to provide the patient with the best care possible. Another possible answer would be that, although this might sound cliche, you have to have passion for what you do daily. Being an otolaryngologist encompasses the knowledge and the passion for head and neck anatomy, but if you didn't have that passion, then why spend 3-4 years of your life dedicated to a particular interest, when you could be focusing on another field, such as Pediatrics, or something that really catches your attention. Also, a possible answer would be in order to be a successful ENT doctor, you would need to know the various duties that your job entitles you to do.