MHH visit!

On Wednesday, I went with Andrea to the Medizinische Hochschule, Hannover, to meet with Dr. Jan Kielstein and learn about issues with kidneys for our independent study paper! The focus for my paper is complications of long-term hemodialysis, and I was certainly not disappointed by the answers Dr. Kielstein provided me.

When we arrived at the MHH ("em-ha-ha," in German), we were met by Dr. Kielstein who took us to the medical student patient presentation meeting. The first student, who we later learned had received some of his schooling at Yale, made his presentation in perfect English. Sadly the rest were in German, but I was able to understand almost everything except the medical terms that were very different from their English versions. After the meeting, Dr. Kielstein paired us up with Klaus and Michael, the student from Yale and another student. They took us on a brief round of the renal ward, and showed us two patients who had IgA-related kidney complications. Thankfully, we had just learned about IgA nephropathy in class, so we were able to understand the disease mechanisms.

After sitting around for a while, looking over patient charts, we went to lunch and got to learn about Klaus' and Michael's experiences in America. Klaus had studied with his older brother at Yale for a couple of years, and actually had a couple questions about current AMERICAN football. This was a bit surprising, but pretty cool.

After lunch, we were pretty much done for the day because they had a long meeting. Andrea and I decided to go to meet up with the other group at the Regenerative Medicine Institute, but by the time we got there it was time for me to go meet Nathalie, the vet student who would be hosting me that night. We went back to her apartment and dropped off my things before going to pick up her boyfriend Matthias from "work." The reason I have that in quotations is because work today consisted of a barbecue with his workmates. Apparently that situation happens fairly often...go figure!

Fairy, the biter

We had to then go home to let their three ferrets (Luna, Cookie, and Fairy) out, and we spent a while messing around with them. They're hilarious, hyper little animals that apparently like being tossed onto couch pillows. Also, Fairy was a mean little thing that liked to bite toes and fingers, and actually drew blood when doing so. After talking for a while about Nathalie's year in Australia and Matthias' time in Canada, they put the ferrets to bed, and we followed not long afterwards. The two of them were great hosts, and helped me to practice my German, since they had pretty much perfected English.

Genius dialysis system

The next morning, we woke up at 7, had breakfast, and everyone parted ways at 8: Matthias went to another hard day of work/social hour and Nathalie took me back through the maze of apartments to the tram stop. We said our good-byes and I got on the tram back to the MHH. I met Andrea there, and we waited to meet Dr. Kielstein at 8:30 to go with him on rounds through what is basically the "transplant" ICU. Here, he showed us a couple of patients' arterial blood gas test results and walked us through the process of diagnosis. Thankfully these were some simple cases, so after he told us to look first at the pH, we knew to look for indications of either renal or respiratory issues. High carbon dioxide levels pointed us to respiratory acidosis, which was exactly what the patients were being treated for. After we made it through all ten rooms with brief English explanations of the conditions and everything else being discussed among the medical students in German, Dr. Kielstein took us down to the dialysis ward. There we learned about the peritoneal dialysis, normal hemodialysis machines, and the newer "Genius" machines. These were basically portable tanks of dialysate where fresh dialysate is taken off the top, run through the system, and deposited back on the bottom. The chemical and temperature properties of the fresh and used dialysate kept a clearly visible line between the two layers, and enabled both to be contained in the same vessel. The dialysate is also mixed specifically for the individual patient, with customizable electrolytic concentrations and addition of certain other chemicals. A UV light in the central tube in the liquid storage vessel ensures that the solution is kept free of little nasties, and allows the tanks to be reused after drainage and a short rinse cycle. We learned how to set up the system for use and how to connect it to a patient from Mike, the "Genius Guy," who was a very patient teacher. He also showed us a system he had developed on the fly for one patient who needed urgent removal of a specific toxin, where one dialyzer would not work quickly enough. Apparently his ability to do this had saved the patient's life.

After the end of a long day, Andrea and I headed to the Hauptbahnhof and headed back to Bonn....much the wiser!