Victory!

I've passed all the classes of my first semester of med school, except Anatomy (which has the final in two weeks)!

Time to celebrate!

Finals Week

Today I just took my final Biochemistry exam and am officially done with my first med school course!

Tomorrow I will finish out Integrated Problems and Thursday will end Human Behavior in Medicine. Another two weeks of Head and Neck Anatomy and then my first term is over!

I cannot believe all I have learned in the past few months. It has been an incredible adventure.

I've got some great photos and stories to put up...as soon as I get through finals =).

Trina 2, Anatomy 0

I passed my second Anatomy test!

It covered the thorax, abdomen and pelvis and it was a lot of material. But, I loved it! Learning about all the organs is just so cool.

Today we got the syllabus for the final (and most intense) section, head and neck. It is all so interesting, but I'll admit today it was, as I said to Ron "baptism by drowning."

Ooooh, also, I got my stethoscope today! I'll take a picture when I get home and put it up for you. It's like I'm really going to be a doctor!

A year ago today

I was interviewing (and falling in love with) Boston University School of Medicine.

First line of defense

In class our professor said, you have a patient with high blood pressure. You need to bring it down ASAP. What do you do?

"Beta blockers? ACE inhibitors?" We say, feeling smart that we know the terms.

"Nope. How could we have corrupted you so early? He says. The first thing you do is get him exercising, modifying his eating habits and give his body a chance to do what it does best. If his risk is too high, he might need a pharmacological agent to help in the short term. But, that's what it is supposed to be...a crutch until his body can make the necessary modifications to help itself. Any time you put someone on blood pressure medicine, it is with a lifestyle change plan. And, it's with the expressed expectation that they are weaning off in the not so distant future.

Of course drugs have side effects. Our bodies are amazing, really complicated machines. If you stick a butter knife in your computer fan because the noise is bugging you, how's that going to go long term? Drugs are the backup. They're for when you've done all you can do by eating healthy food, exercising regularly, sleeping well, investing in friendships to keep stress low and you're still having a problem. They aren't permission to behave badly. When used that way, they will backfire. And, really, is it their fault?"

The good, the bad and the magic pill

You eat. Let's say eggs. Eggs and bacon. And, some toast.

The fat and cholesterol get zapped by some pancreas juice and broken into smaller pieces. They float into your intestine, get packaged up with a phospholipid shirt and a protein hat. A clever little huckster convinces the package to give up it's fat in exchange for...nothing. The clever cheat shoves the fat in a nearby cell and floats away. The remaining shrively package gets sent to headquarters...the liver. HQ can take the cholesterol that's left in the package, puff it up, repackage it and send it back out there. With a fresh shirt and three hats, it ends up selling a couple hats for snacks and end up chock full of cholesterol. He looks like a fat guy in a little coat. His protein hat is tiny and his cholesterol belly is enormous, hanging out. That's LDL. Low density lipoprotein (lots of lightweight fat, not much heavy protein). He's the bad guy.

He can prowl around looking for a home indefinitely. If he's out on the streets all night long, he might find some kindhearted cell to take him in, but he might run into a gang and get oxidized. If he's oxidized, he loses his mind, starts foaming and ends up lodging in an atherosclerotic lesion. Enough LDL's on the street, getting oxidized, lodging in lesions...some artery gets blocked with the nasty foamyness. Then, that's real trouble.

Fortunately for you, there are good guys to counteract this evil. A fit, muscular superhero with a large protein cape and just enough fat to not look scrawny roams the streets collecting bloated LDLs from the kindly neighbors who might have taken them in, and returns them to the liver to be dealt with by a higher authority. That's HDL. High density lipoprotein. He's the good guy. He actually chases down the slacker bad guy, hauls him off and gets him help.

As you can imagine, it's important to have a good ratio of superheroes to bad guys, or the whole happily ever after thing gets kind of screwed up. As if this wasn't enough, your body actually makes it's own cholesterol - you need it for making hormones, membranes, etc. So, there's LDL, parading his cholesterol-filled self all over the place, and your own cells are churning out cholesterol. Our whole town is threatened to be overrun.

There's a magic little pill to keep us in fairy tale land. Magic pill puts a wrench in the pipe that makes bodily cholesterol. Now, your neighborhood is panicking...where are they going to get the supplies they need to make doors, messengers, etc.? They start taking in bloated LDLs they find on the street like nobody's business...and sacrificing them (ok, so my story breaks down a little here...creepy neighbors, but go with it). They pull out the cholesterol inside LDL, use it for making doors, messengers and if they have any extras, superhero HDL will be by tonight to take it away. That's a statin. And it has saved millions and millions of happily ever afters.

Of course, the best possible solution is to stop throwing away the neighborhood by inviting so many bad guys into your city. But, it's pretty impressive that even if you make a few mistakes, you might still have a happy ending.

The End.

Abundance

Have you ever thought about why your body stores energy as fat? You've probably heard that fat has 9 calories/gram whereas protein and carbohydrates have just 4.

So, if you could choose between a 3lb battery for your boombox that played for 10 hours, or a 6lb one that played for 9 hours, which would you pick? The 3lb one, of course! And, that's why your body picks fat. Energy dense storage to minimize how much you have to carry around.

The bummer is that while our bodies were smart for millions of years, in the past hundred or so, they're sabotaging us.

In the entire history of humankind, did you know that it's only in the last few (50-100) years that we've had access to more food than we could eat?

Less than 100 years ago the development of fertilizer, pesticides and herbicides meant we could stop sharing our food with the weeds and bugs. Add to that vast improvements in preservation and distribution channels and...voila...a truly unique experience in all of human history.

Our clever bodies worked hard over the years to be sure that when we planted and worked our field for months and a swarm of pests came through a week before harvest and destroyed 70% of the crop, we'd be ok. Our bodies learned to efficiently store fuel to tide us over when we ran out.

Now that we have the problem of too much food, we are seriously fighting our instincts and natural body systems to maintain a healthy weight.