Thursday, June 18, 2009
Tomorrow we have a practical exam on this analyzer - Its called an Advia Centuar. We process all of the incoming hematology samples according to what the doctor orders. Its a really interesting instrument - ours looks a little different. Its a bench-top analyzer and has a series of almost blue-LED looking lights and a series of clear "veins" that you can watch your sample get processed through, etc. It lines up the sample with reagent and then pipes the cells from your blood through a very fine laser - this allows the cells to by analyzed one by one, giving an increadibly accurate reading/composition. The granulocytes, or white blood cells, get stained. Why? Well, inside their cytoplasm are certain granules that tell you a lot about the stage of a cell (dealing with maturation) which can give you a clue as to a disease state or even if the cell itself is infected due to a serious viral infection, etc. These granules have a distinct composition, so the machine dyes them, for lack of a better term, and then when they react, the machine knows what they are. There are some cells that the analyzer doesn't pick up; it has a hard time differentiating the different stages of neutrophilic maturation, so that's where we come in. Remember how I have to classify all of those cells? That's why. It helps the physician make a diagnosis - also, the resident pathologist gets called in on the really weird stuff.... This is the most artistic part of our trade. Its making a definite decision - and its never definite because no two people are the same. That's why we sit at microscopes for hours :) I love it!
What I do not love, however, is this picture above. I have a love-hate relationship with my hemocytometer. You use what's called the Unopette system. In essence, you add a specific amount of blood from an EDTA tube to a unopette - it contains a solution (ammonium oxalate) which lyses, or "kills" the red blood cells in the sample. In turn, it leaves the WBC (white blood cells) and the platelets. You perform a series of incubation steps and the horrid "charging" step, which is where you load your sample onto a hemocytometer. That's the hemocytometer down below. You count that square thing (picture above) and you load your sample through a very small tube, capillary tube, into those triangle thingies.
Its such a small area! We count the WBCs and platelets; WBCs we count all of the squares, while with the platelets we count the middle square, which contains 25 smaller squares. They are extremely tiny and they're refractile, meaning they refract light; and they wiggle. That's how you know they're platelets.
This is a picture of what it looks like - all of those circles are WBCs - and that would be an extremely elevated count! I've never seen that many in one field. When you finish counting them, you perform calculations and get a result - you compare it to the analyzer's printout of the sample to see if that's really what's going on :) Its fun....but today.....
Today, I got so car sick. You are looking for tiny platelets, which look like specs of dirt, quickly. You move so fast and try and focus up and down, your eyes are focusing, straining, etc. I was going to lose the lunch I hadn't even eaten at that point. Luckily, you don't have to do this all day everyday in hematology, so that's wonderful news!
Having an elevated WBC count can mean infection, etc; having a decreasd platelet count can infer that you may be clotting somewhere and we need to find out why in both cases. Its extremely useful information - especially if you're experiencing a decrease in RBC, WBC, platelets, etc - that could be an indicaiton of a leukemia or bone-marrow anemia, etc.
In fun news, today we took a tour of the Huntsman Cancer Institute. To the left is the patient care center - where all of the patient rooms are. Its a magnificent facility with marble floors, glass everything - its like staing in the Hilton in NYC. Grand. Anyway, to the right is the research center and The Point. The research center is where we all hang out: the lab geeks (haha), drs, pathologists, and fellows. Its really neat. On the very, very tippy top to the right, where that big point is = The Point. Its a fancy-schmancy resturant and our teaching specialist treated us to a drink and we sat right out there on the top floor and looked over the valley. Grand indeed. I love the Huntsman. This week at church we met a really amazing patient who is currently in the Huntsman with a terminal illness. So sad. And the patient has an amazing attitude; so humble. It really puts life in perspective. Every day that I go to school, I try to think of those patients and what I can do to make a difference. Not many people know what our profession does - if they did, I think a lot more respect would come our way. How can people give respect if they never see the faces behind their diagnosis? Well, luckily we don't do it for the respect. We do it for the love of the game. Its freakin rad.
I have an exam tomorrow and 2 finals on Monday - keep your fingers crossed for me!!!!
Posted by Krista & Tyler at 8:09 PM