Rain, Rain Go Away :/

To be very honest, I do not really remember what happened yesterday at school. I got there early, as usual, and we went into the lab to process samples. The techs in the lab have gotten used to us hanging around and are always pulling samples aside for us to look at! They pulled a urine sample aside and waited for us to make a wet prep out of it. What was inside?! A little creature, swimming along while waiving back at us - they're so fun to see in the urine...well, fun for us.This is Mr. Trichomonas.... aka STD. Both men and women can be infected, and its not too much fun. Well, what STD really is? They're super cute to watch under the microscope until you realize what it means to the patient when you report it out.... The whispy flagella are their motor system, and they move across your microscope slide :) You get to follow them around and see where they go. Ah, the joys of being a nerd.

Our practical went really well. I think I finally understand how to function in a clinical hematology laboratory! After our practical, we took a little break and headed back to the lab. We started working on what's called the Iris IQ.This is the Iris. You put samples on the right side, and the machine measures color, turbidity, clarity, specific gravity, as well as a whole slew of chemistry tests, such as glucose, ketones, pH, etc. This helps us know what's wrong if anything. There are quite a few methods that are applied within the testing for urine samples. Lets say that you have a positive protein result on your urinalysis - you don't just report it out; you get to do the SSA confirmatory test. So, its not as easy as just pushing "GO" but almost :)

The techs yesterday also pulled aside a urine sample for us to observe - a waxy cast was found on the urine wet prep. A waxy cast... hm...how to explain! Waxy casts are indicative of renal failure, renal meaning kidney. We don't like to see these:

The IRIS is a really cool instrument. It takes 500 pictures per minute, classifies the elements in the urine, and then shoots those pictures over to the analyzer. I never really understood how you could automate urinalysis, but I guess this is how. The analyzer measures and inspects the contents of the elements as it photographs them - then you review the pictues to make sure it called bacteria bacteria and not mucus strands. Because of this set-up, we can attach pictures to our report, giving the physician a clear picture of what contents are really in the urine!!

FUN STUFF:
So, now onto real life :) I took a beautiful 2 hour nap yesterday after leaving school! Wonderful! I woke up, took a shower, and Ty finally came home from work. We decided to hit up Rumbi's - which I definitely recommend - for dinner! Then, we went to a concert in Brigham Young Park, just east of Temple Square - for FREE!


They had chairs set up and everything - so we pickniced in the park with our yummy dinners! The show lasted almost an hour and a half and it was so fun! The weather was spectacular! The performers were from a barbershop-chorus, and featured a female quartet that took 8th in their novice division after having only been together for 9 weeks :) Im not necessarily biased, but I perfer men over women's barbershop any day, even though both groups performed so well!
Our favorite part was the tribute to the armed forces : they brought out the flags for the Army, Navy, Coast Guard, Marines, and Air Force (in that order) and placed the American flag in the middle. They started with a medly of "America the Beautiful" and then branched out, singing one anthem at a time - when they sang the Army anthem, all of those in the audience that had served were to stand up! Did I mention that we were the youngest couple in the park by nearly 40-50 years? As each song was sung, everyone would turn around and look at who had served - the Air Force swept the audience with those who stood! It was so emotional, I had to try the entire time not to tear up. I had just been thinking about how our generation knows nothing of the sacrifice of an entire World War. Sure, we know all about the war in Iraq - I sent a marine to that fight in 2003 - trust me. But we don't know war in our own country, on our own people - 9/11 was the first taste our genereation had. Today, we feel like we deserve something for sacrificing. Those men and women who served during the World Wars came home and simply said that they sacrificed because it was their duty and their honor. I feel honored to have those gentlemen in my own family. It was a wonderful experience.

The concerts are every Friday and Tuesday in the park - everyone is welcome :) Check out the schedule - this Tuesday, Broadway tunes will be the theme!

Tyler and I were going to go running today (trying to fit into my wedding dress = needed exercise) but its pouring....rain, rain - go away! haha

Hope you're having a great weekend!

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!!!!

A Day in the Life

- For one of my classes this summer, I have to keep a reflective journal of what I'm learning.... I decided that I'll just post updates online each day (for 6 weeks) so you guys know what I'm doing too. I'll try and not be too scientific, and post links to what I'm talking about. So, here's to a day in the life!
Currently I'm doing my clinical rotations through ARUP, an enormous reference laboratory. Apparently, they're in the same league as the Mayo Health Clinic; before I moved to Utah, I'd never heard of ARUP, but my mom used to diagnose us out of the Mayo Health Clinic book! haha So, here's a summer filled with diagnosing...in a different way then you'd think. I think of myself as a Medical Researcher. For a moment, think of a doctor as a consultant - you present to the Dr., tell him what's wrong, and he deicdes to order a battery of tests. The nurse comes in and draws the necessary sample. The doctor peaces out and the nurse sends the samples off. Where do your lab tests go? Right to me. A good friend of mine once quoted a famous surgeon, saying "If you want to change one life at a time, become a Dr. If you want to change thousands of lives, become a researcher." My role is to figure out why you're sick, how sick you really are, how you got that way (in a sense), and what will make you all better. When the medical field/staff are working correctly, we should all confer together - lab, dr, nursing staff. This ensures best treatment for the patient. And, here's a look at what I do allllllll day long!
This month, I'm rotating through the University of Utah Hospital's laboratories. This includes the University Hospital and the Hunstman Cancer Institute. Since both of my parents have had cancer, its really interesting to see the clinical viewpoint, having been on the patient end. I'm in hematology this month - that's the study of blood. And, its way more interesting then you'll ever know!

Today, we trekked over to ARUP labs to investigate hemoglobin electrophoresis. Hemoglobin is what comprises your red blood cells. We receive samples from all over the world, and this is where it gets interesting. There's a fancy machine abbreviated HPLC (high pressure liquid chromatography) that separates hemoglobin content out by charge, dependent upon pH, etc.
HPLC machine!

There are over 900 hemoglobin variants - when we say that people are unique, we're not kidding. Each hemoglobin molecule is compsed differently, and this can be dependent upon race. You may have a certain composition and I may have another - and you and I are totally normal. Some people aren't - disorders and diseases can arise from deletions in the genome (and I'm getting really scientific here, aren't I?!) and make life miserable. So anyway, back to HPLC. We run the blood through this machine, and it prints out super cool graphs - which we have to interpret. Peaks come off the machine at certain times. Peak correlations with time tell us what hemoglobin variants make up your blood. HbF (hemoglobin F), for instance, is called Fetal Hemoglobin. You have a ton of this as a baby, yet by the time you reach adulthood, you've only got 2% left and your bone marrow has switched to making HbA.

Some people inherit blood disorders because of their ethnicity - so when you fill out that medical questionaire, don't think about race in a negative sense - you're giving us vital info! For instance, if you're of African descent, you have a high probability of inheriting HbS. This stands for Sickle Cell Anemia. Remember reading about that in biology?

See the regular, round red blood cells? They carry oxygen to your tissues, etc. The sickle shape, or cresent, has some issues. They can congregate in your capilaries and cause "vaso-occlusive crisis" which is extremely painful. Its like cutting off an arm...well, maybe not that bad, but its no picnic either.

So, we look at those peaks, and lets say you have a peak in the S window, indicating to us that we've got to do another test for Sickle Cell. We do a fun, simple test called sickle sol, which stands for solubilty. You add some buffer to a tube with come chemicals in it, add 50 lambda of your patient sample, mix and wha-la! Compare. If you can read through the tube, you don't have sickle cell! Congrats! If you're like the tube on the right, you're a pretty good looking candidate for having Sickle Cell.

Electrophoresis (running a sample through a gel mechanism) follows as well. Its like the confimatory test, and we run an acid and an alkaline gel - different hemoglobins migrate differently. And they can be tricky! HbS, D, G, & LePore all migrate the same on an Alkaine gel...so how do you know which one you have? Run an acid, and they'll separate. The HbD and G will migrate towards the A region...and you've got 'em caught.

This week we've also spent countless hours looking through a microscope, looking at blood smears from cancer patients.This is a picture of a patient's blood smear - we count all of those purple things, called neutrophils, and we have to classify 100 cells. Then we look at those fleshy-red looking cells, or the red blood cells, and classify their morphology. This is extremely informative. For instance, the arrow there is pointing to a BAND neutrophil. That's not good to see in someone; well, if you only have 1, not a big deal. Bands usually accompany other immautre cells, like "blasts" which mean -CANCER- like a leukemia, etc. They're really interesting to see, but as excited as you get, you also feel a pang of sadness for the patient.

INTERESTING: Today, we were processing samples in the hematology area of the lab when we received a notice for a intrauterine transfusion hematocrit. What the heck is that? Well, "intrauterine" deals with the fetus that's still present in the mom... transfusion? They're going to infuse blood into the fetus to prevent distress, HDN, etc. Hematocrit? This deals with the amount of RBC inside the fetus. We measure all of these things in order to ensure welfare of the baby. Today, the nurse ran down with the sample in her hand, and it was a STAT test because the mom was still up in the Operating Room, with a needle stuck in her belly...scary enough for me to run that sample soooo fast. Everything turned out to be ok! Hooray! Way to go baby!

Anyway, hope you enjoy today's day in the life.... Hopefully, tomorow will bring another exciting event! I'll keep you posted!!! Any comments would be great (espeically since I have to hand this in! haha)!!!!!!

giggles-listen closely!!

OBSESSED

I know its not a new season of America's Next Top Model, but I am beyond OBSESSED with the boy of my summer...

http://link.brightcove.com/services/player/bcpid4020141001?bctid=19604590001

Check out Eric Hutchinson....this is the perfect touch to your summer.... Feel free to dance around when you're jammin' out to it!!!!!!

ENJOY!

Marseilles Dress SHABBY APPLE GUEST GIVEAWAY!!!!

Marseilles Dress SHABBY APPLE GUEST GIVEAWAY!!!!

Editorrial Confessions

One of our many wedding pictures. I've never posted any of my professionals. Why, you might ask? Well, that's what my confession is alllll about. Click on this picture. Enlarge it till it fills your screen. I must confess that while I love my wedding pictures, I don't feel like my photog put any effort or thought, etc, into taking them. I'm missing essential shots - and lets be honest - you can't re-create that day. The pictures are beautiful, no doubt, yet...there's just a little something that's been found wanting...

Many of you know my personality. I'm not one to keep things to myself when I feel that justice needs to be served. But guess what? I've kept quiet about this since November, and since my emotions are almost under control, I figured I'd be ok. I sought some good advice from a photog friend and finally emailed my photog today. I gave this person 2 options...and a week to decide.

Either way, I might be in the market for someone who loves to edit photos, another photog, etc. I'm not trying to be silly - I'm merely interested in greener grass :) I'll post my prof wedding photos for you all to see; let me know if you think I'm going bonkers...at least Ty supports my habits! haha

A Word to the Wise

Last week, Tyler and I took our car to my Uncle's mechanic shop and left to go on Vacay! It was so much fun and we saw so many people-thanks to everyone who made time to see us! We returned safe and sound, just in time for me to get the worst cold of a lifetime. Anyway, last night we went to Bountiful to pick up our car and my Uncle shared something with me that I would like to share with all of you:

Apparently, many mechanics are "inventing" or "fixing" problems on cars that aren't even there, or letting something slip loose so that you'll have to come back and pay more, etc. At this point, many consumers are massaging our older cars and trying to get as much out of them as possible! But are things really being fixed? I would be very careful if you have to go get a tune-up, etc, and if you get something fixed/replaced, ask to see your old part (which is such an old standard; ask your dad-he'll tell you the same thing) which ensures that it actually got fixed. Ask around and really search for a safe place to get your car fixed/oil changed, etc. I have a few great places around the SLC area for anyone in need! I wouldn't have imagined that something like this was really happening, but believe it or not, I'm more naive that I thought I was - so keep your eyes peeled! Just a word to the wise.

Hope your summers are going great!

Stick to the beat

SIMPLE:

Today I discovered how to stick to the beat. It wasn't anything profound, just a little something that I needed to learn.




Tyler and I gave the Sunday School lesson today on Prayer and Faith. This is where most people, once you announce the topic, simply turn off and wait for it to be over. Why, you might ask? Well, probably because its something simple. I've noticed that the simple things are the ones that we struggle with the most. They're usually the ones to drop from our habits, our daily schedule, and eventually, from our conscience. Once its out of your thought pattern, there's no way your actions will convey those simple traits that could make the world better. Funniest thing - the simple things are usually the ones that hold the most important keys to happiness. Isn't that crazy? Think about it for a minute, and I'll come back to that.

Today = day from H.E. double-hockey sticks. Remember the time that I had to play the organ in church? Not a very cool incident. I can do anything in front of lots of people, no problem = sing, talk, entertain; you name it, you got it. When you add an instrument, I panic. My harp recital = almost perfect. Loved it. When you mess up on the harp, not so bad. The organ is louder than the shot heard round the world, because I'm pretty sure the chapel in the hospital is less than 20 square feet. Ok, not that small, but amazingly close. And what happens when the organ is set to transpose the song 3 keys higher? To even reach an A, people are pretending to be eunuchs. Awesome. NOT. After the meeting was over, people said I played great, and they were really impressed that they could sing the base-line. Everyone had a cold, so they attributed not being able to sing the high notes on that. Either way, I walked back to my Aunt, Uncle, and Ty's parents and cursed that organ to hell and oblivion. Whoops. But seriously, its all in the bible-that organ belongs with Cain.

Now back to the rest. Simple things of life. What made my day? Someone's smile, a kind comment, and a laugh with me at how high the organ was set. What could make your day better? Why not being the initiator? Simply extend a hand to help, even if you don't know much. Say something that's simply kind. You'll feel better inevitably - don't you remember that Friend's episode where Joey and Phoebe have a competition to see who can do acts of service without feeling good afterwards? haha Love that one. Why not invite that into your life? It doesn't have to be anything grand; just keep it simple.

My favorite story about how simple being a friend can be:
A little girl was supposed to arrive at home after school, and was a little tardy. Her mom was upset, and questioned the little girl about why she was late. The little girl related the story; her friend had fallen off of her bike and it looked broken. The mother informed the little girl, "You don't know anything about broken bikes!" The daughter replied in all earnesty, "I know. I just stopped to help her cry."

SIMPLE.

Monday, Monday

In honor of tomorrow being Monday, I decided to post a quick re-cap of what our last week has been! I don't remember most of it, minus the fact that we played in the sunshine for 3 hours one day and then the week of weather took a turn for the worse. It started to rain, which isn't all that horrid, but that quickly turned into snow. So sad.

In other news, Saturday was a busy, busy day! I got to meet my best-friend-in-law's parents, and since Ty was at work that morning, Eric and his family took me out for breakfast! haha Loved it! Thanks Eric!

Saturday night Salt Lake hosted the SuperCross (dirt-bike thingy) at the U of U stadium. Tyler and I were on our way to a breakin competition when I looked in the sky and saw this!!!!!!I totally felt as though I had stepped out of real life and into a Harry Potter novel!!! It was soooo dark at first, this haunting black ring in the sky-just like the Dark Mark. It was sooooo creepy.

In honor of the break dancing 2-on-2 competition, we decided to just have fun and go wild. Well, since Ty had to cut his hair for Sunday services, we did this instead!

hahahaha I loved every minute of it. I wanted both sides to go symmetrically, but Ty said he didn't care since he would be wearing a hat most of the night. love it. especially since he came home and cut his hair, which is lucky he did because today at church we got a big surprise!

So, right now, this is where we have church. Not in some gargantuian building, but in the University of Utah hospital. We're still on assignment here in the Medical Branch, and every week another amazing experience lies in front of us.
Last week we had the opportunity to visit the rehab ward and talk with some of the patients there. The elderly people there are so funny-they'll beat us to Sacrament meeting most of the time, then tell you when you come back around to visit their neighbour that someone needs the elders, or so and so needs to take the sacrament, and it didn't ever really matter if you were already going there :) So fun. One person in particular was just the sweetest person in the world. This person wasn't elderly; this person in particular was of a similar age to me, and blind. This sweet, sweet, dear person would smile every time I put my hand on them, so excited to receive the sacrament. The family was there today and the love was so palpable. The patient would laugh and you would have thought angels were singing as the parents would love and tease. It was so touching.
In that same room is another patient, who faithfully watches the Conference talks each Sunday. As we prepared to offer the sacrament to her today, we realized that we didn't have our prayer card, which is a printed card that holds the sacrament prayers (since you're carring tons of stuff with you, they laminated this little card-so helpful!). Scriptures were lent (since we don't carry ours haha, go figure-we are Mormon), and offered to us so that we could finish our work. Oh the blessings of one patient to another.
The funniest part of today was early this morning...Tyler and I walked into the Hope Chapel, only to find our Stake Presidency's 1st counselor waiting to talk to us. Dread filled my heart-we thought we were going to be called back to our family ward and, don't get us wrong, but the Medical Branch is home now. So, out we marched into a hallway in the hospital, and pulled a few chairs together, and President Smith extended calls to each of us. Tyler was called to be in the Bishopbric/Branch Presidency-seriously, I feel like its the same. Anyway, the Branch Presidency consists of two senior gentlemen, and a young elder. Tyler will now serve with the Branch President and his other counselor, and they are such fun men! As his counterpart, I was called into the Relief Society Presidency, as the 2nd counselor, which is funny, because here's what happened:

President Smith: "Krista, we would like to extend to you a call as the 2nd counselor in the Branch Relief Society Presidency."
Me (blank look on face): "We have a Relief Society?"
President Smith (laughing): "Its not a regular RS, and you'll be working directly with Sis. Smith and Sis. Stotich."
Me (contemplating....): "We have a RS? Are you sure I can accept a call I never knew existed?"

Either way, they extended our call for 8 months, which is AWESOME and I now get two callings. 2nd counselor in the RS Presidency (which is hilarious because I loathe RS sometimes-but this is different = no fluff), and then guess what else?! After our services and wrap up meetings had concluded, the Branch President approached me, and because they had released a specific couple today from the branch...guess what my next calling is:

You have got to be kidding me. Tyler can already hear my dad laughing in his head. How ironic - my mom got the same call a few weeks ago, and since neither one of us knows how, I decided to tease her just a little. Welp, here goes nothing!

Hope your week was spectacular! Tyler and I laughed and played the whole weekend and we hope that yours was filled with just as much joy!!!