The Immune System

Perhaps the denouement is behind us and we are finally on the down turn of coursework for the year. Getting out while the sun is still in the sky and having understandable lectures is a nice change for the new spring season.

Immune System

We have started our coursework in Immunity which at first seems a rather simple subject. It's not until you learn about the variability and diversity that exists when it becomes very complex. Sometimes I wonder why my immune system is just not performing so well. Does anyone know how to treat chronic rhinorrhea? Perhaps when school is out it will cure itself.

The immune system has many components that together provide a healing response to invasions. Having a good knowledge of individual parts will simplify the learning process of understanding how they interact to function efficiently. Although it is good fun learning how it all works, experiencing this process is anything but fun. Fortunately, vaccinations are available to help ward off possible infections.

Resistant or mutant strains of viral and bacterial organisms can prove to be chaotic. The common cold and flu are results of this phenomenon as well as more serious illnesses. Despite our best efforts to enhance the immune system with pharmaceuticals and exercise, it will still have the occasional bout of weakness leaving us in the proverbial pits.

Creative minds have made a variety of infectious agents available for purchase with an added sense of comfort and wit. Check out these giant microbes.

Clinical Corner

Antibiotics

Physicians prescribe antibiotics to eliminate infection. A growing concern is the resistance that develops when patients do not finish their prescribed antibiotic regimen or take it as prescribed. (Some of the bacteria that is not killed may not be susceptible to the specific antibiotic.) This leaves a window of opportunity for bacteria to alter its response to drugs creating a new strain that is more resilient. If this continues to occur in the general population, antibiotics may not work on general infections causing severe complications in public health. The moral of the story, take your antibiotics the way your doctor prescribed them.

Public Health

President Barack Obama addressed improvements that will be made in the public health sector, "...Americans can trust that there is a strong system in place to ensure that the medications we give our children will help them get better, not make them sick; and that a family dinner won’t end in a trip to the doctor’s office." [Full text] Our safety potentially lies in the hands of those who regulate our foods, vaccines and medications as well as the physicians who intervene locally.

Public Health

It is nice to see correlates between medical school and the real world from time to time. We recently started a course that looks at our current public health care, how to produce the greatest benefits for the community as a physician, and how to interpret the information researched by others.

Although the system is not perfect, public health policy has an agenda to provide a safe environment from illness through detecting, reporting and treating diseases that arise among the general population. By tracking the spread of illness and providing interventions such as vaccines or prophylactic support, physicians can impact individuals and communities alike. It is important that public health research be performed in an effort to educate health care providers concerning the diseases they fight.

Clinical Corner

Disease Prevention

There are cases highlighted around the world that reiterate the importance of contributing to the overall public health in our communities. Below are some valuable resources for both the aspiring and practicing physician (most can be downloaded in portable document format):

• Center for Disease Control and Prevention - Online health resource
  
• Guide to Clinical Preventive Services - USPSTF recommendations on screening, counseling, and preventive medication topics including clinical considerations
• Morbidity and Mortality Weekly Report - CDC reports available in text and podcast
• Immunization Scheduler - Children 0 to 6 years, provides personalized dates
  
• Child Immunization Schedule - 0 to 18 years of age
• Adult Immunization Schedule - 18 years and older

If you know of other helpful resources, please post them in the comment section. In the meantime, lets do our part to be educated and stop the spread of disease. Oh, and clean your stethoscope once in a while, it will do your patients' body good.

Tax Time

Just when things start to mellow out, I can feel Uncle Sam reaching deep into my already emptied pockets. It's that time of year again when W-2 forms show up in the mailbox, numbers get crunched, and taxes get paid.

Tax

Considering all the things that taxes are used for I guess they aren't too terrible, but they certainly don't help my situation financially as a student in plenty of debt. Once all the government documents arrive and get filed we get to file even more as students.

It wouldn't be possible to pay for school without a little help from the government. Therefore, completing the FAFSA and other scholarship opportunities permits my education to continue. Considering some of the tax breaks, the process a little more bearable (thank you new house). I certainly don't mind being able to file taxes for free.

Expenses

As the numbers become quite important, I thought a running total of expenses for Touro University Nevada's College of Osteopathic Medicine would be appropriate.

• Tuition - Roughly $37,000
  
• Books - $1000.45 (Used and new)
  
• Equipment - $1,550.65 (Laptop, lab coat and diagnostic tools)
  
• Clubs - $40
  
• Extra - $202.29 (Software, vaccines, etc)

Obviously these will vary from year to year and student to student, but it is in the right ballpark. Moving, housing and food expenses have not been included. With Valentine's Day around the corner, you can help curb some of these costs and get some fantastic deals, consider some of these great gift ideas.

Clinical Corner

Epistaxis (Nose bleed)

Research says that about 90% of nose bleeds occur as a result of damage to Kiesselbach's area. It is found in the front part of the nose and has a rich blood supply. The predominant reoccurring trauma is caused by fingers that are doing too much scratching. A smaller percentage comes from the back of the nose that cannot be reached by fingers which often requires medical help. Stopping a nose bleed may take time, and is good knowledge to have if you ever need it.

Influenza

In the midst of the holiday season all I can think about is vacation. My body has officially decompressed and made the attempt to relax. In so doing, my stress compromised immune system leaves me vulnerable to illness.


Illness

With the visiting family gone, repeated meals of overeating, and very little fresh air, one of us were bound to get sick. Unfortunately, a few of us have and are doing our best to relish the remainder of our days off to return to normalcy. I do not fully understand all the bubbly noises and queasy feelings my abdomen has, nor do I understand the common sore throats and nasal congestion some of my family have to endure.

It makes me wonder what I would have done if I was completed with medical school and considered a physician in the eyes of those close to me. Would I suggest they see their family doctor or would I attempt to diagnose their symptoms? There is so much more to learn. In the meantime, I am watching Google's latest gadget - FluTrends - which is provided with help from the Center for Disease Control (CDC).

Using their time-tested search technology Google has honed in on specific search terms and put them to good use in identifying the spread of influenza. The CDC recognizes that Google FluTrends is able to show flu spread more readily than reported cases could.

Clinical Corner

Influenza

This viral beast can be the cause of much misery. Fortunately, there is an annual vaccine that attempts to fight the most common strain of the flu to help ward off potential illness. The CDC informational website regarding all things influenza.. In the meantime:

• Keep an eye on the FluTrends in your area (Historically February has the most cases)
• Reduce exposure to those who are infected
• Wash your hands regularly

The Science of Healthy Living for Success

It is not astonishing that some of the brightest minds in our world's history have researched the human body to some extent. Complex beyond belief, mankind has been studied by millions who have compiled literature on healthy habits, proper body function and medicinal remedies to heal the broken body. This type of knowledge relates to the field of health science, which applies scientific study to improving healthcare and the treatment of the body.

Physical Exam
In preparation for matriculation, I had my physical exam this week. I was fascinated by the numerous 'tests' used to assess for optimal health. From head to toe, the body is put through rigorous strain which can be expressed by various ailments and yet history has discovered ways to unmask some those that may be hidden from first glance.

I have yet to hear of anyone who is excited about hernial, prostate, rectal, or other intrusive exams. Nonetheless, it is amazing that we have learned the bodies reactions to abnormalities and can thus identify problems through simple tests. Need an exam? My recommendation is to find someone you know well to conduct your physical exam. They are much more likely to use prudent judgment when it comes to the nitty-gritty.

The physician that performed my exam is a good friend that I work with on a regular basis. He reminisced about the days when he was in school learning the techniques himself. We laughed as he explained that neighboring classmates were used to practice techniques pertinent to the eye, ear, mouth and other exams. It was great until the dreaded time came to practice the more personal exams. All he could think was, "how will I ever face my classmates for the next three years after doing those?!" Fortunately, the school hired individuals to participate where the students probably should not. Despite the trepidation that may arise, it is exciting to know I too will one day have the skills needed to adequately assess physical health.

Immunizations
Can you remember when you received that shot for Hepatitis A? How about the measles? I certainly can not recall them with certitude. If we are going to heal the sick, we have a really good chance of contracting various illnesses if not properly protected. Medical schools, similar to entering high school or an undergraduate university, require vaccinations and their documentation. As I do not have a copy of all my immunizations, I had to rely on other sources to obtain the necessary information. Each of the suggestions listed below will send you a copy for a couple dollars if not for free.

1. Contact your current and former county health departments. Use a search option to find 'local health department' or 'county health department' to find the contact information.
   
2. Contact your high school.
3. Contact your college or university.
4. Some employers such as health providing institutions will offer immunizations. Be sure to contact them for applicable information.

Physical and Mental Health
Whatever it takes to keep your head on your shoulders is worth doing. Life is going to get crazy really fast in medical school. New terms, people, activities and routines are just the beginning. Maintaining healthy habits are crucial. Every aspect is vital to scholastic success; nutrition, exercise, and leisure are just as important as the long hours studying bio-molecular pathways. A healthy balance will invigorate the mind and keep your physical state up to speed with the demands on your mental state of being. Currently, I am on vacation as there is no homework, test or quiz in the immediate future. Does that mean I am in a vegetative state...perhaps, but I am convinced it is good for my physical and mental health.