Week 4: HIV Services (Monday)

I have yet had another character change…all these changes are kind of stressing me out,but I think it’s for the better now.

It also didn’t help that the film director guy I was supposed to meet forgot our meeting–We are definitely meeting Wednesday and I’ll let you guys know how it goes.

I have decided on fish with the help of my two coworkers–David and Amir. Amir pointed out that new prisoners were called fish. So there came the idea of fish…and I am STICKING to it because time is running out.

Also fish are SO much easier to draw and I drew a bunch of scenes yesterday! I think the idea is here to stay if I like drawing them so much~

Look it’s a wounded fish!

Fish Cartoon!

Week 3: TSC

Week 3 has been bit of craziness. I am so posting all these late since I’ve been super busy.

So this week I decided to split my days up between HIV services and TSC. I did Monday, Tuesday, and Wednesday at HIV Services and Thursday and Friday at TSC because I needed to do an interview with Tom Young, the Nurse Practitioner (NP).

Thursday

I polished up and finished two protocols for the policies and procedures manual so that TSC could quality for the Ryan White Grant. These two protocols were for security measures and in case of breaches. Surprisingly this effort took longer than I anticipated. It took a good week to do all the research necessary to mold our own individualized protocol here because it is such a small clinic and does not have all the as I like to describe it “guns and steel walls” . In addition, I never knew just how difficult and it was to find properly written policies and procedures online. Some were mediocre and others were just too detailed and didn’t apply to what I was doing. Hopefully, what I have complete passes as a qualified protocol to be used. I feel like a lot of me was winging it and molding a piece of clay to fit the designated mold. Alas, it is done.

Friday

Today was really interesting. So I got to meet the NP here and I got to have lunch with Poliana, Tom, and a pharmaceutical representative.

One word: wow. I find it so amazing just how knowledgeable she was about all the recent news and studies on HIV medications. They were throwing around names that I could barely keep up but did have some insight on thanks to Jackie. And the way Tom and the pharmaceutical rep were tossing out ways to use different drugs to treat different severity of Aids/HIV was amazing. It was like hearing the scientific method in normal conversation and applying to real people and scenarios. Another thing I found really interesting was just the politics of it all. It’s all business and social exchanges all rolled up together with health care problems and ways to fix it. The synergy that was going on was astounding.

Something I think I’d like to point out and a piece of life advice that truly transcends all aspects: there is good and bad in everything–people, places, situations, and cultures. It’s something I’ve learned not only from my living experiences but also being exposed to the pharmaceutical rep. I say this because for the past year I have been reading about how terrible the pharmaceutical industry is with all it’s representatives and monopolies. Yes, these are all bad, but there are good people in the industry too. At  the end of it, something that Tom said that really resounded>>>> to me..it’s all business as much as people don’t like to hear that health care is a business. There isn’t a point at saying how bad it is or how we need to fix it…as sad as I am to say this, it is a necessary “evil” or “good” call it whatever you want to call it. So you might as well just deal with, work with it, and mold it to your own needs.

Nurse Practitioner interview! 

My interview with Tom was awesome also. I feel so blessed for being exposed to such amazing individuals I have met thus far. Tom is an NP from Hawaii who has seen HIV/AIDS from its beginnings basically in 1981 and has dabbled in just about everything from R&D to HMO’s to primary practice and he’s getting his PHD!? This man does it all and it just goes to show that no matter what  I end up doing that I can still continue to learn and go forth if I want and that most of all I am not restricted by whatever my initial degree or what I choose. Life is really what you make of it and meeting people like Jackie and Tom just goes to show me that I can do it. I just have to commit to something and pour my heart out and I can keep learning and do whatever if I choose to.

Week 3: HIV Services

Monday

I was still looking at Animations videos.

I tried to get the jail department or their IT department to give me any adobe software…looks like I”ll be doing the 1 month free trial. Hopefully I can finish it on time. I am seriously concerned.

Also ordered a cheap wacom tablet… I wish I’d brought my own :( I would have if I’d known I would be putting into good use.

Tuesday

I am starting to draw now…I have no idea what characters so I just started drawing people and I am going to scan my drawings so I can fix them up in photoshop…wow it’s surprisingly going to be really difficult  because I realized I have to draw every.single.movement. that the characters do….

…Of course I am still looking at Animation videos.

Yucky human nurse!

Yucky Human

Wednesday

Agh. Another character change. Thank goodness I didn’t invest too much in people on Tuesday. I was mainly doing background scenes for the animation (phew). SO Kate wanted the video/cartoons to be sexless to not create bias…I had no idea what I was going to draw…

SO what did I decide? PEANUTS! Why? Because I could mold them anyway I wanted to….they have nothing to do with anything I honestly just couldn’t think of anything. :( hopefully it will work out?

I got my tablet today though!

I did draw a cute peanut too!

Cute Peanut picture

Week 2: HIV Services

Wednesday

This week at HIV Services, I had to edit Jade–the previous intern’s script  and visualize how I wanted the video to be. I have realized that making a movie is much more extensive work than just writing a script and having people act on it. Then I decided to see how much time this video should take….so what did I do?

….drum roll….

I looked up airplane commercial videos–now I know this sounds utterly ridiculous but what better way of condensing information in a short, informational, and entertaining manner? I am pretty sure I watched waaaay too many for my own health. At one point I was pretty much talking to myself like an airline crew’s voice… But I think this definitely gave me some headway on where to start.

This is how I imagined the video….

I also had my meeting with had my meeting with Joe and Kate…but of course not without getting lost and running in multiple directions due to people who live there but don’t know where they are standing either. Seriously I think smartphones with google maps services on them are the best inventions ever.

SOOOOOOO change of plans unfortunately/fortunately….I am now animating in this video….wow. Okay I can draw and I’ve used flash like once….So I am honestly a bit nervous. I never expected all my IT and art knowledge to ever kick in in the science field or for this internship, but thank goodness I have them. (AH I am only here for pre-med internship–help!) But I mostly nervous and a tad excited as well…so we’ll have to see where it goes.

This is what Joe imagined the video have more:

I have to learn flash…or maybe there’s an easier way so I don’t have to reinvent the wheel.

Friday

I have had over 30 tabs open—mostly animation videos…dear lord. That is all I have to say for this day. Intense research is going on.

Aaaaannndd Back to the drawing board.

Week 2: TSC

Tuesday

I finalized my the TSC’s needed fixes on the website and started working on the policies and procedures manual on security protocols.

I have gone through so much literature that I just want to puke. Just kidding…… but it was a lot though. Who knew it required so much reading right to have a “correct” policies and procedures manual. I’m pretty sure if I had bothered to screen shot how many tabs I had…it would be too much. I’m talking 40+ tabs.

 

Thursday

If you’re interested in knowing more about cool HIV/AIDS medications here’s a link!—–http://www.aidsmeds.com/articles/DrugChart_10632.shtml

 

On Thursday, I spent half my time with Jackie lecturing to Poliana and I about the different types of HIV medicines and how they work. We had a real patient come in and she told us to evaluate based on his illnesses and symptoms what type of HIV medicine combination would be best. I definitely thought that was way cool because I got to learn how protease (PR) inhibitors, reverse transcriptase  (RT) inhibitors,and  nucleotide/nucleoside reverse transcriptase inhibitors (NRTI’s).

Here’s a blurb from http://www.webmd.com/hiv-aids/guide/aids-hiv-medication?page=2

Reverse transcriptase (RT) inhibitors help block an important step in the HIV life cycle. There are two types of RT inhibitors.

Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) stall reproduction of HIV. They force the virus to use faulty versions of building blocks.


Non-nucleoside RT inhibitors (NNRTIs)
 bind to the RT protein. This disables it, keeping HIV from making copies of itself.

I also learned about 3 different type of Hepatitis’ and the differences between them all….for example

Hep A: You usually get hep A from food or water. And you there exists neutralizing antibodies for it so it can go away. One only has a viral load when one is currently sick.

 

Hep B: Hepatitis B is usually transferred via bodily fluid (i.e. from sexual interactions such as vaginal fluid), blood (needles), mother to child (most often in Asian populations–something I found REALLY surprising), and needle injectors.  You can get a vaccine for it to develop antibodies against the virus to neutralize, but you can’t cure it. Usually the antibodies are surface ones and in terms of HIV/AIDS medicine you would use something with tenofovir/lamivudine in it with the HIV medicine.

Often between 10-20 million viral counts means you have it.

 

Hep C:  Hepatitis C is solely from blood and remains largely an occupational health issue because of needle sticks. Anyway that infected flood can go through pores and is from needle sharing and injections. It can affect men and women and people who have hep C remain chronically affected.

 

 

Lastly, I learned about ritonavir and it’s awesomeness essentially. So ritonavir is usually used in highly active antiretroviral therapy (HAART)–it’s when you combine a bunch of drugs basically for HIV therapy to treat multiple things. What’s so cool about ritonavir is how just a tiny amount can boost  protease inhibitors instead of using as a protease inhibitor by itself (which studies found that many had liver issues when used excessively because of the way ritonavir works— it “inhibits the liver enzyme that normally metabolizes protease inhibitorscytochrome P450-3A4 (CYP3A4)” .

Week 1: TSC

photo

It looks all warm and dandy right? It’s a lie. It’s quite windy and cold on the bridge. Nonetheless, it’s still beautiful~

Tuesday

On Tuesday, May 21st I went to Mill Valley to the TSC clinic.

I got lost a bit…more like 25 minutes, but eventually found my way. It was a 1 hour commute and a relatively quiet.I met Poliana, who helped me get settled in SF and has been my main email correspondence. It was a bit of an introduction day again. She taught me about how HIV works and the different types of tests and drugs used in HIV/AIDS treatment.

“AIDS” status is determined by the number of CD4 cells (helper T-cells. So basic break down: when your viral load of HIV is high, you’ll usually have a low CD4 count making you more vulnerable to infections.

One receives “AIDS” status when you have a CD4 count of 200 cells/mm3 of blood or less; once you’re diagnosed though, you never lose that status, even if you raise your CD4 count. Treatment is available to raise your CD4 count, which will then lower your HIV viral load.

I also looked at details on what I could do to help fix the website after learning all this.

Thursday

I basically fixed the website. The best part of this day was meeting Dr. Tolsky who teaches residents at UCSF. One word for this woman: Awesome. Same goes for my boss Poliana (she’s awesome because she is literally the lifeline of this clinic)

But about Dr. Tolsky–She taught me how to read charts and her life background is just so engrossing. She wasn’t always a doctor and in fact didn’t even major in biology. She is just so interesting. And she taught me how to read charts and I got to do a heart disease risk assessment using Framingham’s index by reading labs and charts. It was just so amazing to see how much all the labs at school actually inter weaved together. From LDL readings to western blots to check for HIV antibodies. Finally it all makes sense and is surprisingly useful and exciting to finally have the big picture.

Week 1: San Francisco and settling in at HIV Services

My first week was absolutely crazy~

I drove from Las Vegas after my flight to San Francisco. Housing was also difficult and problematic but was sorted out on Sunday May 19th whilst also looking for the HIV Services office…My dad and I drove to the office and discovered it was just a door. Initially I thought we had the wrong office, but I called in on Monday to find out it was indeed the office. I had a moment of freak out honestly…google maps has failed me before.

First Day

So my schedule as of now is MWF–at HIV services in downtown and TTH at Mill Valley at the Tom Steel Clinic.

My first day at HIV Services as a bit of an introduction. I read up on what Jade had done and where I was supposed to pick up. It felt a lot like administrative work, which is what I wanted to learn about. So all in all, lots of reading and understanding how the organization worked. I was really thankful that my coordinator, Kate, helped me transition so smoothly. She started me out by reading and fixing the Policies and Procedures manual since it needed to be finalized before I dipped my feet in mapping out  the video.

By Friday, I had outlined the whole manual and created and outline menu for Kate as well. We reviewed the details and such~ But there is still so much to do!

I also developed a story board template –with the help of my sister and started inputting my edited manuscript onto the story board. I also had to map out kind of an imagine what I was going to do and who would be talking etc.

Lastly, I had to prepare questions for Joe since Wednesday I had a meeting with Joe (head of jail health services) and Kate to discuss the visions for the video…