A Partial Move

From now on, this blog will focus on health narratives and other science-related topics for a general audience. Any topics dealing with specific issues regarding the IT field or higher education are moving to another location. If you want the new location, leave me a comment and let me know.

Second Opinion

I went to see a Nurse Practitioner for a second opinion about hypothyroidism (when your thyroid produces too little thyroid hormone). I believed she would have different conclusions, that perhaps my regular doctor was just overreacting or mistaken. I kept resisting taking this thyroid medication, mostly because I did not like the way it made me feel. When I first tried the generic version of Synthroid, about a year ago, I felt terrible. It's difficult to continue taking a medicine when it makes you feel worse, not better. The attitudes I got from doctors were all similar: are you sure? most people have no problems taking synthroid. Is it possible you're just being emotional?

I did not appreciate this mentality of just take this medicine because I say so.

When I went to see a Nurse Practitioner recently, I was surprised and thrilled when she showed an interest in educating me about why I should take the thyroid hormone. Below is a picture she drew for me, showing how your pituitary gland acts like a thermostat, sending TSH (thyroid stimulating hormone) to your thyroid to tell it to make thyroid hormones (T3 and T4).

The effects of hypothyroidism, as shown below, include swelling, slow reflexes, hair loss, dry skin, high cholesterol (and therefore greater risk for heart attack and stroke), miscarriage, and more.



When I was there, the Nurse Practitioner recommended I have a test I hadn't had before, to measure the level of antithyroid antibodies in my blood. She explained that if this was abnormal, it indicates an autoimmune issue: your body is attacking your thyroid and it is only a matter of time until the thyroid quits working.

Below are my test results:

I was stunned. I really expected the antithyroid antibody test to come back normal. When I got these results, I had this feeling like I'd been sentenced and no matter what I do, I can't fix this issue. However, I have started seeing a certified ayurvedic practitioner whose response to this was "what goes largely unrecognized [in our culture] is that you can do alot with diet and exercise." This statement gave me alot of hope. I have been working with her to develop a new eating plan, consisting of little meat and lots of grains, beans, fruits, and vegetables. Also, I've incorporated some herbal treatments and after much thought, I took the Nurse Practitioner's advice and filled the prescription for Synthroid. I have been taking the lowest dosage (25 mcg) for about two weeks now and so far so good.

Sacrifices from Pigs

Would you be scared if you read this about a medication you were taking???

As with any medication, Armour Thyroid can also cause allergic reactions. In fact, it may have a higher risk for allergic reactions, since it contains ground-up pig thyroid glands. Seek medical attention immediately if you develop signs of an allergic reaction, including:

•An unexplained rash
•Hives
•Itching
•Wheezing or difficulty breathing
•Unexplained swelling (especially of the lips, mouth, or throat).

It is the comment about the pig thyroids that REALLY freaks me out. Poor pigs. Wtf? I have been taking this medication for about two months and the last few days I have been feeling so itchy and my skin feels abnormally dry and tight. I looked up "Armour Thyroid" side effects on the web and saw the above statement. (Side note: I tried taking synthetic thyroid, Synthroid, last summer and had a bad reaction to it...)

I have an appointment with a nurse practitioner next week, who was recommended to me as being open to holistic medicine, among other things, by an ayurvedic practitioner I recently saw. So I’m going to get someone elses opinion on this whole hypothyroidism thing. In the meantime, I will try and keep taking the medication since pigs were slaughtered and their thyroids were ground up for it. I’d hate to have had them die in vain. How horrifying.

Social Media Revolution

Why You Shouldn't Let Students Sabotage Your Lecture

I am finishing up my second semester of Anatomy & Physiology and one of the most surprising things has been the lack of student engagement. The lecture hall holds about 70 students, stadium-style seating, and students talk through entire lecture periods. It is so loud, obvious, and distracting, that I've moved around the room numerous times to try and escape the chatter. I finally found the best option in the front row, although I can still plainly hear various conversations. Not once--until yesterday--has the instructor, a 25-year veteran faculty member, called the students on this behavior. She didn't acknowledge the behavior in class, but rather sent this email rant right after class:

"I thought it was especially bad today. The GFR control mechanisms can be difficult to explain…what with afferents and efferents and glomerular pressure up and down and sideways with GFR going up and down. I know who was talking because I had time to be distracted and look…I would not be showing up on my doorstep being confused about this topic right before your lecture final exam since you gabbed all the way through lecture…much to the chagrin I am sure of your fellow students. I am beginning to feel like a stand up comic with a bunch of drunks heckling me…but I don’t get to take an exam and get a grade on my performance, do I? For you who tried to hear me above the din, thank you so much for being mature and listening…I don’t know what to do about the gabbers…it only gives them their 15 seconds in the spotlight if I yell at them in class…and they will just do it next time as well. How sad. "

I wonder if she acknowledges that she plays a role in this lack of student engagement? Don't get me wrong--students should not be talking, Facebook-ing, texting, or gaming during her lecture, all of which happens on a regular basis. But if I learned anything in my little experience teaching it's that you have to call students on their behavior, immediately when it is happening, or they will keep doing it.

Students would also leave all the time right in the middle of her lecture. She would be droning on about skeletal muscle contractions or the instrinsic conduction system of the heart, and several students would just leave, on a daily basis. One day after class she sent the following email:

"Is there some reason why people are constantly leaving the classroom suddenly this semester? In my 25 years teaching Human Anatomy and Physiology, I have never had this happen so routinely or so abruptly. Anyway, it is starting to make my mouth draw into a tight little line, so that must mean that it is irritating and distracting me. Was wondering if there was a reason for it that was known…or if not, could you please sit nearer the front of the room? It’s like people just suddenly bolt from their seats for no reason. Will try to be more tolerant, but it’s starting to strike me as being rude…which is not a good thing for my attitude while lecturing. Sorry to complain, but what in the world is going on with this? Probably some perfectly normal explanation."

I think this is really sad, that you get to a point where you are either opposed or unwilling to update your approaches in order to engage your audience. This class could be so interesting, with all the anatomy & physiology material available online that is interactive, all the ways that she could relate the topics to current health issues, and yet she lectures straight from the textbook, displays dense amounts of text under a document camera, and uses hand-drawn diagrams when she could be playing video clips or animation or any various multimedia available online. She even shows SCREEN CAPTURES of the obviously dated computer simulations that she assigns outside of class, rather than demonstrating the simulation in real-time on the computer.

Most confounding to me is her lengthy discussions of her circa 1980 published research about horses, given that this is a teaching university, not a research university, and she clearly hasn't updated her teaching practices in about 20 years. Not to mention that this is a human anatomy & physiology course.

Now, I've only had three college level science courses in the past year, but so far I have a bad impression. Science should be interactive, engaging, thought-provoking, and hands-on. So far all I know is that I will show up to a lecture and absolutely nothing will be expected of me other than to sit there passively and listen.

"It's real lullaby material," one student said to me on the way out of class one day. "Puts me right to sleep."
"It's so sad," I replied.
"I'm used to it," she said. "I'm a science major."

Thyroid Hormone, Thyroid Stimulating Hormone, and More...

I am particularly interested in the thyroid gland, since I have been diagnosed with hypothyroidism, which means my body is not making enough thyroid hormone. In Anatomy & Physiology, we have identified the thyroid gland on various models in lab, and we have also learned about the physiology of the thyroid gland. I am surprised to find out that many people I talk to are either being treated for hypothyroidism, or think they have it, so I thought I would share what I know here.

The first picture is a model of the larynx. The thyroid gland is the big yellow blob in the lower left corner of the picture. The second picture is the neck and chest of a torso model. The thyroid gland is the big yellow blob attached to the larynx!



Hormones made by the Thyroid Gland
Calcitonin works with Parathyroid Hormone (which is made by the Parathyroid Glands) to regulate calcium in the bloodstream and calcium in the bones. Calcitonin stimulates osteoblasts (causing bone formation by increasing calcium in the bone matrix and removing calcium from the bloodstream). In other words, irregular levels of these hormones could lead to osteoporosis.

What about other hormones made by the thyroid gland?
At the microscopic level, the thyroid gland has Thyroid Follicles surrounded by Follicular Cells. The Follicular Cells make Triiodothyronine (T3) and Tetraiodothyronine, also known as Thyroxine (T4). Together these 2 hormones are referred to as “Thyroid Hormone”.

These thyroid hormones are mainly regulated by Thyroid Stimulating Hormone (TSH), which is produced at the Anterior Pituitary Gland. In my case, my TSH was recently at 6.69, which is considered elevated. According to Medline, normal TSH values are .4 to 4.0. If your TSH is high, it means your thyroid hormones are low. Your doctor may prescribe a synthetic thyroid hormone known as Synthroid, which I had a bad reaction to, or a natural (but less used) thyroid hormone known as Armour Thyroid.

What do increases in “Thyroid Hormone” cause?
1. Nervous System – Increases activity and necessary also for proper fetal development of the nervous system (also necessary after birth for normal nervous system)

2. Skeletal System – Promotes normal bone growth while growing in height AND promotes remodeling of bone after a fracture or as a result of change in weight, etc.

3. Cardiovascular System - Increases Heart Rate, Force of contraction of cardiac muscle and blood pressure

4. Respiratory System – Increases respiratory rate and depth of respiration

5. Increases Metabolic Rate – Increases heat production AND Increases rate of catabolism of carbohydrates, proteins and lipids

Patent Foramen Ovale & Fetal Circulation

When my mom was in the hospital for four months, after having an ischemic stroke that blocked blood flow to the right side of her brain, I kept hearing doctors say things about the reasons for my mom’s stroke—things like, “she has a PFO.” I had no idea what this term meant, but I later found out that PFO stands for “patent foramen ovale.” It’s a hole between the right and left atrium in the heart, which allows blood to bypass the lungs during fetal development. The foramen ovale is supposed to close on its own at birth, when the baby begins to breathe on her own, but in 20% of the population, the hole never closes, resulting in a patent foramen ovale, a hole between the atria of the heart. Since it can be hereditary, doctors recommended that my sisters and I be evaluated for a PFO. A transthoracic echocardiogram with a bubble study confirmed that I do have a PFO, and neither of my sisters do. There is no treatment and usually no symptoms, although doctors suspect that a PFO can allow blood to pool and form clots, and therefore increase the risk of stroke.

Our method of studying this in A&P involved text and a couple heart models in lab (our class is pretty much devoid of technology), but as I suspected, a search of “fetal circulation” on YouTube reveals many creative approaches to understanding fetal circulation and the changes that occur at birth. The foramen ovale is supposed to close at birth and be replaced by a flap of tissue called the fossa ovalis. And there are several other unique characteristics of fetal circulation similar to the foramen ovale, such as the ductus arteriosus, which allows blood to bypass the lungs by shunting blood from the pulmonary trunk to the aorta, and on to systemic circulation. When the ductus arteriosus closes at birth, it becomes the ligamentum arteriosum. These videos also discuss the umbilical vein, ductus venosus, and the umbilical arteries.

The following YouTube clips show fetal circulation in a creative and interesting way. I think it also says a lot for how audio and images can be paired with text to demonstrate a process or complex concepts in ways that are easy to understand. These are relatively simple projects that involve still images and audio, and no actual video footage. It’s exciting to see that some educators are taking advantage of technology-based assignments that students will enjoy much more than sitting idly in a lab and identifying numbers on plastic models. These projects would also help students learn about processes and how different parts of anatomy are related, rather than just focusing on identification and rote memorization. Do you think my A&P teacher would be offended if I sent her links to these YouTube videos?! Probably.