Blog 16: 2-Hour Meeting Answer #2

Content:

1.  What is your essential question?
My essential question is "What is the best way to treat head and neck cancer in adults?"
2.  What is your second answer to your essential question (write your second answer in a complete sentence)? My second answer to my essential question is that the patient receive follow-up care after they have completed treatment.
3.  What are three details to support or justify your second answer (details are examples or facts)?
Follow-up care is extremely important after a procedure,  especially if the patient experiences head and neck cancer.

• Follow-up care is important because it helps to identify changes in health. The purpose of follow-up care is to check for recurrence (the return of cancer in the primary site) or metastasis (the spread of cancer to another part of the body).  www.cancer.gov
• Follow-up care visits are also important to help in the prevention or early detection of other types of cancer, address ongoing problems due to cancer or its treatment, and check for physical and psychosocial effects that may develop months to years after treatment ends. www.cancer.gov
• The frequency and nature of follow-up care is individualized based on the type of cancer, the type of treatment received, and the person’s overall health, including possible treatment-related problems. In general, people return to the doctor for follow-up appointments every 3 to 4 months during the first 2 to 3 years after treatment, and once or twice a year after that.   www.cancer.gov

4.  What source helped you prove this answer is justified for your essential question?
The source that helped me prove this answer was one of my research articles, number 38, which is "Esophageal pathology in patients after treatment for head and neck cancer", by the journal Otolaryngology- Head and Neck Surgery. This article illustrated the importance of having follow-up care because of the fact that some patients could develop serious medical conditions after they receive treatment for cancer. In this article, the majority of patients had oropharyngeal cancer, and after undergoing treatment, they developed esophageal problems.  The authors recommended that the patients needed to be diagnosed quickly after the treatment because the physician has to take into consideration how the patient feels when performing simple acts, such as swallowing. The physician has to perform tests to check if everything is functioning normally after a major procedure. The authors also highlighted that the results must not be based on patient symptoms alone; it is necessary for the doctor to perform routine examinations so the problem could be detected early, and there are no other complications with the patient.

5.  What do you plan to study next with your second answer and why?
What I plan to study next with my second answer is how doctors can provide the best follow-up care for the patient, depending on the type of cancer and the treatment that they have. By doing research about my second answer, I can see if follow-up care is one of the ways that the patient can receive the best treatment. I also want to learn the different ways that can follow-up care can have an impact on the patients. For example, if the patient were to develop psychosocial effects, how would the physician outline the care needed for the patient.

Blog 15: Independent Component 2 Approval

CONTENT:
(1) Write a description of what you plan on doing for your independent study component.
For my second Independent Component, I plan on continuing to go to Mohs Night, at the Head and Neck Surgery department at Kaiser Permanente Baldwin Park. Before, in my first independent component, I studied how the doctors practiced the Mohs technique and what were the procedures that the nurses followed during the procedure. Now, I want to examine how the doctors interact with the patients because that is an important step in the and well being of the patient during and after the procedure. I am also going to volunteer more and have the opportunity to take a college class at Cal Poly Pomona. The class that I am going to be taking is Biology of Cancer on Mondays and Wednesdays from 4:00-6:00pm (starting 4/2/2013).
(2) Describe in detail how you think your plan will meet the 30 hours work requirement.
My plan will meet the 30 hours work requirement because I will go every Monday or Thursday for 3 or 4 hours for several weeks to observe the doctors and medical assistants. On some occasions, they conduct Mohs on Wednesdays, so there is a possibility that I might attend that day so I can complete the 30 hours requirement. I am also going to go more often to volunteer and attend classes regularly.
(3) How does your independent study component relate to your working EQ?
My independent  component relates to my essential question, which is, What is the best way to treat head and neck cancer in adults, because from this experience I did not only get knowledge about the Mohs procedure, but I will also see how each of the different doctors interact with each patient and the methods they use to ensure that both the surgery and the patient are well. This relates to my EQ because treating a patient does not only involve the best treatment for them, but also the follow-up care they receive and what the outcome is for the patient. The Bio of Cancer class will also aid my understanding  about how patients acquire cancer and the effects that the tumor cells have on the body.

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.