Probably my last Blogger post

The other day we got to go on a field trip down the Rhine river on a cruise ship.  Luckily for us the sun was out and we were able to soak in some much needed rays.  On the banks of the river, we were able to see some of Germany's oldest castles.  Apparently, only one of the castles on the Rhine has survived without needing to be rebuilt due to various wars and other conflicts.  After the cruise we got off the ship and toured that particular castle.  The castle was pretty neat and we were given some perspective on how people lived back in the day.  I cannot lie, however, my heart will always belong to Disney Castle.

I know that this is an over do blog, but when exams come around you really become pressed for time.

With that said last Tuesday was one of the most awesome experience of my life. I got the opportunity to shadow one of the anastesiologist at the Uniklinic here in Bonn. Now before you say anything, it was no ordinary shadowing experience.

It started off really really early in the morning and I was going to meet Dr. Delis whom you all would enjoy and I recommend you get in touch with him if you want to learn anything about medicine. Our first patient was in to have a sample of tissue taken from his spinal column. I will say for being an old man he was tough to opt to be awake for this entire procedure and it wasnt' very long but I bet it was painful.  But that wasn't the cool part of my day. It only got better...

The second patient was the golden ticket. Yes. This poor man was fairly old and had an issue where his vertebrae were fracturing and had to have a special cement put in to help with the pain and prevent further damage. An unfortunate issue to have. But, Dr Delis was so awesome that he allowed me to do somethings that a medical school student wouldn't get to do until they were in residency. I got to perform a tracheal intubation on  this patient. Oh yes, I just said. I got to intubate a patient and not just one I also got to intubate the patient afterwards. I was so terrified. All i could think in my mind is this man really going to let me intubate this patient on my own. And he did. Although he did help me he mostly let me do it on my own. And it was AWESOME!!! it was great.

Dr Delis said he wouldn't let me do it if he didn't think I couldn't. It was great, that was a time in my life where someone had faith in me and I had faith in myself. Sometimes I ponder about how my life is going to end up and although I tell myself that I can achieve my goals I don't always have faith in myself nor do people have faith in me. It was a great moment in my life because it helped me realize that who I want to be is very possible and that there is no reason to be scared. That I can do this. I am grateful for the experience that I had and  I am more than grateful for Dr. Delis for not only teaching me some of the coolest things ever but for having faith in me.

Almost the end of the semester!

Next Tuesday we depart from Frankfurt Airport back home. It will be a sad moment when we have to part our AIB staffs, German friends, and host family members.

After the final exams, there will be a lot of activities on the weekend. Theater play, fireworks, bike tour, and AIB party on the cruise! We will definitely have a great time before we leave Germany!

I bought a postcard illustrating the firework event in bonn, with a huge Beethoven firework exploding above the Rhein. I had never seen Rhein River at night, and I am excited to explore more of the beauty of the river and the city!

My host mom recommended some places to visit before I leave Bonn, then suddenly I realized that I haven't been to the Beethovenhaus yet! It is only a few steps away from AIB and I have only took a picture from the outside! On Saturday before the firework event, I want to visit Beethovenhaus so I can tell daddy I know more about Beethoven than him! :D

And There Goes the Amygdala

Last Thursday, I had the amazing opportunity to view two surgeries at the Neuro Clinic up at the Bonn Uniklinic.  With all the studying and test taking going on, it was refreshing to get out and get a glimpse of what I am trying to work towards. 

                Collin and I arrived at the clinic around 7:30 in order to meet up with Dr. Podlager, the doctor that would be showing us around that day.  When doctor Podlager came in, we were extremely surprised that he appeared to be no older than 30.  I myself was expecting someone more seasoned, so it was pretty cool to get to talk to a neurosurgeon that’s not a whole lot older than we are. 

                For the next 45 minutes, Dr. Podlager went over his day to day routine.  I was surprised again when he said that surgery is pretty much an 8-6 job there, with the occasional emergency case.  I was expecting crazier hours I suppose, but it was interesting to find out differently.  Doctor Podlager then took us to change for the surgeries.  After we were changed into our scrubs and weird clog/crock shoes, he toured us around the different OR’s before depositing us in the OR where the day’s first surgery would take place.

                The first surgery we watched was the removal of a pituitary adenoma.  Basically, the patient had a pituitary tumor that was pressing down on her ocular nerve and was causing her to slowly go blind.  In order to remove the tumor, the surgeon had to go up through the nose and then through the sphenoid sinus to access it.  First the surgeon showed us some X-rays and talked about how he would approach the tumor.  It was really cool to see the growth on the X-ray since we learned a little bit about how those images are produced.  After telling us his plan, the surgeon then proceeded with the surgery.  First, he made an incision on the inside of the patient’s nose, and then basically cut his way up to the brain.  It was amazing how much septum he removed.  It seems to me that it might be weird for the patient afterwards to basically have a hole from his nose to his brain, but I guess that’s not all that important.  Anyway, when he finally got to the tumor, the whole tumor removal was a lot less calculated than what I thought it would be.  Basically, he said, “If it’s yellow it leaves, if it’s white it stays”.  That didn’t sound all that scientific of a way to go about brain surgery, but he’s the one that knows what he’s doing and has the years of experience.  Maybe a little was lost in translation?  Anyway, after he scooped all the “yellow” out, he cleaned up the septum and sewed up the incision in the nose.  It was fast and pretty simple.  It was awesome to know that that woman would now be able to see better because of the surgery.  In a couple of hours, the surgeon had made this woman’s life drastically better.  That is what makes surgery special to me.

                The next surgery we watched was the removal of temporal, hippocampal, and amygdalin tissue that was causing seizures for the patient.  The surgeon performing the second operation was much less talkative than the other guy.  It was understandable though.  I would much rather him concentrate on the open skull in front of him than talk to us.  I cannot describe how crazy it was crazy to see an actual brain.  It was truly an awe inspiring moment to see the gray lump of tissue that is responsible for everything that makes us who we are.  I would be so nervous having this man’s existence at the tip of my scalpel, but this surgeon calmly and confidently removed what needed to be removed, stopped whatever bleeding occurred, and fixed this man’s seizures that were creating so much suffering in his life.   After the surgery, we changed out of our scrubs, left the clinic, and returned to our lives full of tests and studying.  It’s not as painful now though, knowing what could possibly be in our future. 

A Hike through the Siebengebirge

The Siebengebirge is a cluster of 40 hills just southeast of our town, Bonn. We took an excursion with other students from the AIB internation study abroad program. Penn State-ers, LMU students and even some of the Texas A&M Visualization kids we never see! One Sunday we hopped on a train and started our ascent.

The view from Drachenfels

Trees like this don't fit in Texas

You can see at the top of the hill the Drachenfels ruins.

We first went up to the top where both the Hotel Petersburg is (a modernized castle) and the ruins of Drachenfels, which was slighted by the Swedes. Slighted as in destroyed. But now there's a restaurant and a tram to take you up the 321 meters to the summit. It was a very nice day, and turned out to get nicer as the day went on. We hiked along to another mountain all through a forest that reminded me of home (or more rather of Colorado and New Mexico).

Except for the ruins, they aren't in my backyard

A beautiful hike that reminded me almost of my own backyard. There even was a path that we crossed of donkeys, and a few folk riding horses also were visible on this trip. Eventually though, as we kept on throwing the Frisbee back and forth and conversing with the other students we so rarely see in our Biosciences program, it came to an end. We ended in a town called Oberdollendorf, coincidentally where Kristen lives! We were treated to a gorgeous flamekuchen, which is 'flame cake' or more like a thin, delicious, Mediterranean pizza without sauce. Other than that, the trip was simple yet awesome. 

Andrew and I then visited our professors house and got some gelato! Turns out our professor was living in a house and doing a timeshare kind of approach, and the house owner is an architect of sorts. A very avant-garde modern house, complete with a Zen backyard, pond-pool thing with a slide, and the coolest library style ladder loft closet... things. But it was creepy seeing the lair of my professor, where within the grading is and my sorrow lives.

Other than that, here are some more of my photographer-like photos!

From Drachenfels

Some of the nice little fields we passed by

Felt like this cute farmhouse was too much to resist

Because the panorama function is the best reason to buy a digital camera

Vale Tío!

Your first impression as you walk about in Barcelona is....vas is das? Haha, just kidding, but it really is among those lines. For a native Spanish speaker, it is obvious that the language being spoken is not Spanish, but Catalán. So what is Catalán? It is best described as a mesh of French and Spanish. It is truly beautiful. I consider the aforementioned languages the best out there, so it is pretty much ideal to me! I will say that it is too different from Spanish to be understood. As Dr. Wasser wisely stated, Portuguese is an easier tongue than Catalán to decipher!

On Friday morning, Carlos, Stephanie, and I were all packed and ready to take off to the motherland-essentially! As my second to the last trip for the semester, I am filled with great pride at the accomplishment of packing my weekend necessities in NOT a weekender duffle bag BUT a simple backpack. That's right, my precious Plum (violet Northface backpack) even had room for the souvenirs that were to be bought! Expecting the weather to be sunny and warm, I also had the advantage to literally pack light.

Well, that backfired. We blindly expected the weather to accommodate our visit. That was not the case. Catalunya was both rainy and chilly-less than ideal weather for our planned endeavors. However, that was of little hindrance for our strolls about the city. Carlos, having visited during Spring Break, had high expectations of returning and guiding us about his "home." He did an amazing job at guiding us around the beautiful city. It was rich in architectural detail and color-two things I have high regards for and more festivities to which my pupils took delight in! The liveliness of the people was also so great. Everyone was very welcoming, and the endlessness of the nights reminded me a lot of my Mexican ways which can easily be attributed to Spanish influence. Barcelona is a place I can definitely live in and never fully discover-a priority of mine for the future since I easily bore by routine. (*wink, wink to endless possibilities*) There, I felt infinite. Rain, snow, hail, or whatever else could not dim the vibrance of the landscapes.

Vale Tío, hasta pronto!

Jessica.

My best friends (:

Cooking Chinese for family

Two weeks ago at dinner table my host family and I talked about different cuisine in Sicily (my host dad is from Sicily), Germany, and China. They are fascinated when I described rice soup and dumplings, so I decided to cook for them on a weekend and give them opportunity to be exposed to authentic Northern Chinese food.

I took the bus on Saturday morning to visit a Asian supermarket called Jin Long. It is located one block away from Friedensplatz. I got vegetables, special sauces, jasmine rice, frozen dumplings, and green onion "bread".

It took me  more than 2 hours to make 4 dishes. Since I have a vegetarian host sister, 3 out of the four dishes are veggie.

I used veggie meat (tofu actually) in one dish but it did not taste very good :(

Before I leave Bonn I should cook some more for them!

Distant Family

This weekend I traveled all by myself to a very little town called Hofgeismar. So little, that it was made up of seven or eight villages, making up a total of around 27 thousand inhabitants. Why did I choose to travel here on my second to last free weekend in Germany? And alone at that? Because I have family there! When I say family, I don’t mean Americans who traveled to or even moved to Germany, I am talking about my ancestry. If you go back on my family tree to my great grandmother, my mother’s, mother’s mother. And then you look at her father, he moved to America from Germany. His name was Julius Menke and he was born in Hombressen, one of the seven villages that make up Hofgeismar. Now, his parents are where my family and the family that I stayed with connect. One of Julius Menke’s siblings had a daughter, who had a daughter named Renate (pronounced ray-naugh-tuh). So naturally, Renate is my Grandmother’s second cousin. Renate and her husband Harold Still live in Hombressen, in the house that Renate’s Grandfather built with his own hands, right down the road from where our common relatives, the Menke’s, once lived (the Menke house is still there). Renate’s daughter, Silke (sil-kuh), Silke’s husband, Jörg (yorg), and Silke and Jörg’s children, Christian (christy-on) and Florian, live in the main city of Hofgeismar. If I did my calculations right, Christian and Florian should be my fourth cousins. And how did we keep in touch with my fourth cousins? How did I find out that I even had fourth cousins? That is thanks to my grandmother’s love of genealogy. She has been compiling details of our family tree for as long as I can remember. My grandmother and grandfather also love traveling Europe and so when they found out they had relatives in Germany, their next European tour included a stop in Hofgeismar. They have been back at least one more time that I know of and took all of their children and their spouses (my parents, aunts, and uncles) with them. Now one of the 5 grandchildren has visited (me), and I hope the others will have a chance to get there someday soon as well.

I can describe my time there in two words, food and castles. This was the kind of place that you think of when you think of Germany. The houses had the traditional outlines of squares and triangles made out of wooden two by fours on the outside of the structure. There also seemed to be a castle on the top of every hill. OK, maybe not every hill, but at least two of them! And these castles were used in the stories made by the brothers Grimm. The first castle I visited was Sababurg, which was the inspiration and setting for the fairy tale, Sleeping Beauty. The second one I visited was called Trendelburg, and was the inspiration and setting for the fairy tale, Rapunzel. The view from the top of Rapunzel’s tower was outstanding, especially with everything finally turning green here in Germany. Even though it was a dark and rainy day, I could still appreciate the beautiful hill country around me. According to Harold, when Julius came over to America, he was looking for a place with a similar landscape as Hofgeismar. He ended up in Carmine, Texas in the north east and I could definitely see the resemblance.

At every chance they could get, Renate and Harold would stuff me full of food, stating that “I was only staying for two days, but I had to eat a week’s worth of food.” Rolled beef, dumplings, potatoes, red cabbage, cake, and cinnamon pears were just lunch. Dinner included 8 different kinds of meat, bread, and cheese served on round, wooden pallets. And brunch the next morning was similar to dinner, but with 8 new kinds of meats, cheeses, and breads. Everything was DELICIOUS!

Renate and I spoke about the same amount of each other’s languages. We could both only produce very simple sentences, but we could understand a lot more than we could speak. So if I spoke to her in English and she responded in German, we could usually figure out what the other wanted. Everyone else in the family was could have conversations with me in English but when it came down to sitting around the table at a meal, I would just try and soak up as much of their language as I could. I would catch a verb here or a noun there. After they would finish a subject, Jörg would see the dazed look on my face and give me a brief summary in English.

Being with Family from another country was an amazing experience in itself. The whole family was very welcoming and friendly even though they had never met me before. The whole adventure was a lot of fun and really encourages me to explore more of my heritage. Also, traveling alone without anyone or anything to fall back on may make you feel uncomfortable at first, but it is a thrilling and rewarding way to experience a new place.

Sports in Germany

2 weeks ago I experienced a whole slew of athletic events that German’s participate in. The first was running a marathon. Ok, half of a marathon, but it felt like a full one to me. I may not have trained exactly like I had wanted too; instead of increasing my mileage in the last few weeks of training, I was running less and less. My one accomplishment in the last few weeks of training was buying a 3 euro pair of headphones so that I wouldn’t have to wear a pair of over ear headphones. That was probably the best move I could have made. Because even though every day up until the race, it was below freezing temperatures, the day of the race was around 70 degrees Fahrenheit. I don’t think my sweat glands remembered how to function after being so unused for 3 months. In short shorts and a light t-shirt, I ran these 21 kilometers and at every water stop I had to throw water over my head to cool off. But then again, this wasn’t just some leisurely run. First of all, I had a goal of being under two hours. Secondly, I had told all of my classmates about it, and they were all expecting me to win the race. I might have come off as a little bit cocky… oops. So, I was really pushing myself in this race. I did fine up until the 15^th kilometer.  It was when I told myself that I only had five more kilometers that my body said that that was too far. My pace dropped from a five minute kilometer to a seven minute kilometer. I finished around 1 hour and 51 minutes, well under my 2 hour goal. The worst part of the entire race was the last kilometer. At kilometer marker 20, I only had 1 left. But after you run half of that and turn the corner, you see three inflatable arches! “I made it! The pain is over! I can finally stop running!” But no, it’s just the three inflatable arches that tell you that you have another kilometer to go. So apparently the race is 21.5 kilometers long, guess I missed that part. Then over the next kilometer there are inflatable arches everywhere, each one making you think you are about to finish, only to find out that it says, “You are all heroes!” At this point, I don’t care if I am a hero; I just want to be done. Eventually, I finished the race, stuffed myself full of food, felt sick because I ate too much food, and then fell asleep on the floor of my school building.

The next day was the Bundesliga match (Germany professional soccer) that we were scheduled to attend as a giant group of Americans. Apparently, half of the people who signed up to go had either never played soccer as a child, never watched it on television, or never played the FIFA video game (which is how I got into the sport, so much fun). So while I was appreciating the game, others were bored and just talked to each other the whole time, silly Americans. The match was between Dusseldorf and Bremen. I choose to root for Bremen because as a Bonner (someone from Bonn, Germany), I love Cologne. And the Cologne people are rivals with the Dusseldorf people. So therefore, I am against Dusseldorf (I found out later that Bonner’s actually would have rooted for Dusseldorf in this match but I was fine because I liked Bremen’s colors better anyways). The game was a lot of fun, even though it ended in a 2-2 tie. Dusseldorf scored once at the beginning of each half, both on counter attacks; and Bremen scored once in the middle of the first half on a counter attack break away, and the second was a own goal by the Dusseldorf defender. I got a good laugh out of that one.

I also participated in another two Bonnsai Frisbee practices. Apparently, they signed up for their championship tournament while I was off in Berlin so I won’t be playing with them for that but I do get to help them train. They have enough players usually for two games to go on at once and I have been placed on what I like to call the practice squad for the tournament team. My goal is to make them better so that they can win the German championships.

So, even though I have stopped running, I have picked up playing ultimate Frisbee to relieve my stress from studying and to start preparing for tryouts back at Texas A&M for next Fall. 

One week to go!

The semester is winding down and now we only have one week to go before heading home. This next week is stocked full of tests so we will keep busy until Friday. The weather has been a lot nicer here lately, thank goodness. We have been able to enjoy some nice sunshine and dry weather. This past week was just filled with tests and projects so there is not much to report on. I'll blog again for the last time in Germany next weekend!

Rocking out in Germany

One of my favorite things to do back in the States is attend concerts of various sorts in big cities like Dallas, Houston, and Austin. So when the chance came to see a really cool band here in Germany my fellow students and I jumped at the chance. The band was Imagine Dragons and the best way to describe their music would probably be an indie rock sound. They played in good ol Koln just up the river and it was glorious! We started the night off right by buying a shirt from the band vendor and getting right in the middle of the crowd for maximal intensity. The opener for them was a slower band that didn't seem to get the energy levels of the crowd up too much but they were still fun to listen to. When Imagine Dragons came out on stage though it was an explosion of light smoke and awesomeness. For a good hour and a half it was nothing but rocking out to the music and having a good time. One thing that I noticed that was really disappointing was that there was no crowd surfing going on during the show which is one of my favorite things to do at concerts like this. I even asked a few Germans around us why this was like this and apparently things like that just don't happen at concerts.

Neurosurgery at the Uniklinic

Last Thursday I went to the neurological clinic at the Uniklinic in Bonn, Germany for my directed studies class. It is one of the major neurosurgical facilities in Germany with consistently over 2500 surgical interventions per year; therefore they perform surgeries ranging the whole field of neurosurgery. Their particular focus is devoted to epilepsy surgery, neurovascular surgery, surgery of intrinsic brain tumors, and complex spinal procedures. Dr. Podlager met us in the first floor of the neuro-building at the Uniklinic where I was able to ask him a few questions about the daily routine of a neurosurgeon in Germany. The daily routine for neurosurgeons is mainly an 8-6 job just like any other. Mainly they have scheduled surgeries in the morning with the occasional trauma patient that needs emergency surgery, but by around 3 most scheduled surgeries are over with and paperwork is and meets are completed in the afternoon. It sounded very much like what a normal surgeon back home would go through in a day so it was interesting to learn that medical practices are mostly the same no matter where you are in the western hemisphere.

The first surgery we went to observe was a pituitary adenoma removal. The tumor had been growing on the patient’s pituitary gland and was pressing against the optical nerve thus slowly reducing the patient’s vision over time without them noticing too much. On the patients MRI I was able to see the growth being a slightly off color than the normal tissue and how it was causing the nerves to bend back on itself as the tumor grew further and further forward. It was really interesting to notice the color contrasts on the MRI after working with an image processing software like Matlab and knowing what exactly was needed to generate the end result MRI. When the surgery started the Doctor Vater, came in and took a look on the real time x-rays to make sure his approach through the sphenoid sinus was correct. Because they were constantly taking x-rays to observe where they were going we had to wear lead aprons to block the radiation that was being constantly used in the room. It was really interesting to see that once they had reached the tumor the process of removing it was less fine-tuned than I had imagined. The surgeon simply said “everything that is gray. Remove it. Everything that is white/yellow. Leave it alone!”. Maybe to my untrained eye it looked very ambiguous in regards to what he was removing but I’m sure that some white/yellow tissue was removed in the process of his scooping out of the tumor. Another thing that startled me to discover was the fact that the patient’s septum was completely removed and nothing besides sponges used to stop the bleeding were placed in the space before the doctors sowed the wound shut. Also there is now a direct hole from the patient’s nose to the bottom of his brain! The surgeons didn’t seem concerned with the possibility of a brain infection which was a little unnerving to me now that I know everything that could go wrong. The trip was great and I learned a lot about how surgeons work and that I'm not too sure I want to do that for a living.

Marksburg: The Indomitable Fortress

I only gave it that silly title because of the fact that the Marksburg castle was never conquered! Possibly the only one in Germany to never be conquered!

Looking as un-conquerable as ever

"Key of the castle, key of the castle"

This fortress built in 1117 was pretty cool. Our tour led through the castle, showing us the royal quarters, the family chapel, the cannon tower and the "Hail Mary" tower (in the center of the photo, the tall one). I call it that because it was intentionally used as the last chance for the residents of the castle. If they were being attacked and had the castle walls penetrated, the family and other residents would run into that tiny tower and wait for help to come. But if help didn't come in a few days, well then they sorta climbed down the tower and gave up.

The tour guide was super cool, and even let a few of us help with the exhibition. I got to hold the key for an awesome 20 seconds, but still managed to take 2 photos of me with the key. The guide would use trap doors and other devices to disappear and reappear, which was actually more awesome and less childish than I just described. And also, Cliff got to dress up with a pig helmet and a sword!

Everybody wants a piece of that key.
But Fisher will never get it.

The iPad, making photo taking look more like a tourist dilemma
than an actual process of art

So here are more pictures of us acting like we do best; as goofs.
But this was only part of our trip today!
We also went on a cruise of the Rhein river!

Michael's taking a rest before he has to hold the key.

On the sunniest day we'd had in... forever, we took a cruise on the river! The girls were lounging and tanning and the guys were... just being guys. There also was this bee that almost stung Jordan, and a slide on top of the ship that I took a part in sliding down. As we traveled we saw the Loreley Rock! Apparently it was a really cool rock that I didn't realize until we had passed. But we saw many other castles and fortress (that were conquered in the past), and the Mausturm (mouse tower)!

Not the Mouse Tower

An Amateur Sketch

The Mouse Tower, in all it's glory

The Mouse Tower is outside of Bingen, and the story goes that a miserly Bishop, Hatto II of Mainz, was the only man in the town with any food during a famine in the 10th century. When he jacked up his prices, the beggars became restless   and hungry. They didn't cease begging him for food, so he tricked them into going into a barn where he would hand them food. But instead had the barn doors locked an razed the barn to the ground, peasants and all. As they were passing away in agony, he commented on their screams as those of "squeaking mice". As he planned to go to his castle and sleep, an army of mice besieged his castle until he fled. He fled to the mouse tower in the middle of the river (because mice aren't very good swimmers). Yet as many mice died, even more mice made it to the island and besieged his tower to eat him alive.

The Cosmic Egg, but more commonly
known as a Wolfmother album

Anyway, we visited this town of Bingen, as it was the home of Saint Hildegard, a girl who at a young age in the cloister distinguished herself as a visionary. Although modern science attempts to disregard her mysticism as a symptom of her frequent migraines... Still very interesting, she accomplished many paintings and writings, even invented her own alphabet and language that to this day is still not deciphered.

Also in the same museum, remains and tools of an ancient surgeon were found. Blood-letting, trephanating tools and iron scalpels were found!




All in all, this trip was exceptionally fantastic, had a little bit to do with our major, a lot to do with the gorgeous weather, magic, migraines, theology, tourism and stories about sharing your food. We even saw our bus driver (to and from Berlin, Eddie is his name) outside of the Marksburg.
Plus I got a ton of photos to use as wallpapers for my computer. The Upper Rheinnland really is gorgeous.

A day at the Bonn Frauenklinik!

Neonatal intensive care units (NICU or NIPS in Germany) started right after post world war 2. However, it wasn’t until the 1970’s that they became firmly established in all hospitals in developed countries. They have continued to evolve greatly since the 1970’s and now play a critical role in hospitals. I received the opportunity to get a first-hand look at a modern women’s hospital and NICU at the Uniklinik Frauenklinik in Bonn, Germany. The Uniklinik was first established as a private institution in 2001 and is currently responsible for the care of more than 1,700 newborns annually, of which about 80-90 very small preterm infants with a birth weight below 1,500 grams. The hospital deals with congenital malformations of which 100 are operated in the first days of life per year approximately 150 newborns. The clinic is both a hospital and research center and is known most noticeably for their research into Twin Transfusion Syndrome, pediatric infectious disease, and perinatal neuroprotection.

During my time at the Uniklinik two babies were born, each of them by caesarian section. I got the chance to see both from different view points. During the first C-section I was in the operating room and witnessed the entire surgery.  The first incision was a lateral cut made into the abdomen just above the bladder of the mother. A second incision was then made into the uterus. After that the amniotic fluid was suctioned out, first with a syringe and then by a suction tube. It was a definitely a surprise to me how much volume was in it. The baby was then delivered and the umbilical cord cut. After this, every layer was either stitched (innermost layers) or stapled (outer layers) back together. This surgery was slightly more gruesome than other ones I’ve seen because, due to the speed at which they need to get the baby out, the surgeon was less precise and careful during the whole procedure. By this I mean she literally used her hands and body weight to pull back the top fat and skin layer and to dig around and detach layers inside. Also, I couldn’t understand exactly what was going on because everyone in the operating room spoke German, but I believe there was a complication during the C section. Normally the mother is kept awake but is given a local anesthesia. Part of the way through the surgery when they had already stitched her part of the way up, the anesthesia must have made her nauseous and she ended up vomiting a couple time. This must have made some of the internal stitches rip out because unlike a normal C-section that is supposed to take 30 minutes or so to stich up, it took over an hour and a half.

For the second procedure I stayed in the room where the newborn gets its first examination immediately after birth. This viewpoint was a lot more enjoyable. Unlike the first child delivered who had a low respiratory rate and was therefore later admitted into the NICU, the second child was happy and healthy. In the check-up they helped him get out his first cry, trimmed the umbilical cord and looked at his respiratory and heart rate and color and counted all of his fingers and toes. Ten finger and toes later and they were wiping him off and wrapping him up an overwhelming amount of blankets. He was ready to go and off for his first visit with his mom. This was the first time that I had seen a birth or even a baby that was that new. People always sound cliché when they talk about “the miracle of life”, but it really was an unbelievably incredible and unexplainable experience to see the process and newborn that up close and personal.

After the C-sections I was taken back to NICU to shadow the resident pediatrician for the U2 check-ups (2 day-1 week after birth) of the babies born in the hospital. That day there were three babies there for examinations by Dr. Welzing. He explained how to read records, what to check for during the exam and how and why, tips for the check-ups, and he even let me and the other two students have a go at it. By the grace of God, the parents gave consent for three college girls to attempt to examine their newborns. It was a quick but extensive exam. He first did the things that he needed the child to be calm for; auscultation of the heart, lungs, and head (for a shunt that could lead to hydrocephalus). This was done after making sure to “protect himself” as he put it, especially with little boys. That point was greatly stressed to us. Next, the femoral pulse was taken for which Dr. Welzing had some tips also. The fatness of babies can make it hard to feel their pulse but they tend to occasionally pause their breathing and this is the time when it’s easiest time to get the pulse rate if you’re have issues measuring it. This is when we were handed the stethoscope and allowed to try it ourselves. Reflexes were then checked including the Babinski reflex (Big toes flex out and other out when stroked on the bottom of the foot), Moro (drop hand outwards with a sudden shift in position, also known as startle reflex), Galant (legs and hip swing to the side of touch application when stroked on the back), sucking, rooting, walking, and the Palmer grasp (Finger gripping). These reflexes check for normal development, especially normal neural development. Eyes and ears were checked for cataracts and hearing. Muscle tension in the arms and legs of the babies were tested along with their hips by pressing down on the feet when they were perpendicular to the hips and then splaying them out. This checks for whether they or easily dislocated (pop out when pushed down on) or if they already are (can’t be splayed out). Of course by this time the babies had had enough so he finished by administering the standard vitamins; Potassium to decrease the risk of bleeding and vitamin D with Fluoride to help bone formation He also stressed all the “ back to bed” points for SIDS which was interesting, especially after just having a whole presentation on it this semester.After the check-ups I received a tour of one of the units in the NICU. The children in the unit varied in the degree of their complications from just small size from prematurity and Down’s syndrome to a handful of children that had more extreme conditions. One of the doctors walked me and the two other German students through the room to examine and talk about the children’s conditions and the physical implications they had on the children.

            The first child examined had a diaphragmatic hernia. This is a defect that creates a hole in the diaphragm. This causes the abdominal organs to be shifted up into the chest cavity.  When it is congenital, as in this little boy’s case, it causes pulmonary hypoplasia (incomplete development of the lungs) and pulmonary hypertension (high blood pressure). Therefore, he suffered from a pneumothorax (one collapsed lung) and was on CPAP (continuous positive airway pressure) as well as ECMO (Extracorporeal Membrane Oxygenation). His condition has also led to other developmental issues. His x-rays showed that he was not only barrel chested but the diameter of his ribs were very thin compared to other normal neonatal x-rays making them more fragile and he continues to be an extremely small size despite his age (roughly 2 months if I remember correctly).

            Another one of the PreNates suffered from a rare (1 in 40,000) genetic defect called Prune Belly that results in lack of the presence of abdominal muscles. It is believed that this is due to an enlargement of the bladder and intestines. The enlargement prevents a development in the abdominals resulting in skin folds on the stomach (“pruney-ness”) for which the defect is named. This syndrome often goes hand in hand with undescended testes and kidney problems both of which the baby at the Bonn NICU suffered from. The complication meant that the child was receiving ECMO and jet ventilation along with many other treatments. Due to the extended ventilation he furthermore suffered from a bilateral pneumothorax (two collapsed lung). This is normal in prenatal children who lack adequate amounts of surfactant and for prenatal children that are forced to be on ventilation. The condition normally corrects itself as the child develops and is weaned of ventilation, but they had previously tried to take him off of it but within a few hours he was placed back on it. The list of complications is long, but when talking to the doctor’s they still thought the little guy had could have a chance.

The reason I was sent to the Uniklinik Frauenklinik was because of my interest in pediatrics. Although this was neonatal and not pediatrics it is the closest I was able to get. My trip to the center was fun and educational and greatly exceeded my expectations. I was finally able to integrate some of the things I have been learning in Physiology with real life situations which was awesome. On top of that I learned a great deal of things that you would never learn in a classroom or a textbook, but that only comes from experiences and talking to trained and practiced people. Dr. Welzing gave me many good examples of this. For instance he made sure to show and tell us to never leave the child during a check-up. He said that it happens more than you would think that doctors leave the baby for a second and he/she rolls of the examination table. It seems like a common sense and a simple thing to not leave the patient, but it’s something that I’m not sure if they always teach in the classroom. Then when you’re going through procedures you’ve learned in a textbook you don’t always take into account that now you’re working on a real person that moves around and has emotions. Another example from Dr. Welzing was to always keep a heater to warm your hands up with so the baby feels more comfortable and keeps a better temperament for the examination.

Besides just from an educational standpoint, I think this visit was a very important step in solidifying my career path decision. I was able to witness almost every process that occurs up to the point when I would be handling the child from the birth to the NICU of the sick/premature babies to the first in hospital check-up. While I enjoyed it, I am sure that the pediatrics is more suitable for me. Without a doubt NICU can be very rewarding. You get the chance to save babies lives and make parents and families extremely happy, but I do not think people can understand the extreme amount of physical and emotional stress that the doctors and nurses go through every week in that ward. Not only is it hard to watch such small, helpless babies hooked up to so many tubes and machines but it’s a hard truth to bear that despite their lack of life experienced yet, some of the babies hold no chance of survival or shot of living a full life no matter what you do. While I was there the ward got a call from the parents of the child with prune belly. He was one of a set of triplets and with the extensive problems that he was undergoing the parents had decided to request that the doctors stop treatment. This was both heartbreaking and upsetting to me especially since the doctor’s thought there could still be a chance. I felt this way and I had only seen the child for a few minutes. I cannot even imagine how the staff felt after personally taking care of the child for so long. There was definitely a different atmosphere throughout the ward after this occurrence. Sadly, this was not the first time this had happened that week. When another student went on Monday she was also told that a parent had just called to ask that treatment be stopped. I do not think I would be able handle, or maybe it’s just a matter of not wanting to handle, such high stress instances as often as those doctors do. While I understand that pediatrics may have its ups and downs and hard times, circumstances with such a large magnitude of strain and tension and pressure are few and far between compared to NICU. On the other side, spending time in the examination rooms felt right and almost natural for me. I loved interacting with families the babies and their parents and being able to talk and joke with the parents who were all on an emotional high with the arrival of their newborns. It was a completely different environment from NICU and interactions with the people and parents were almost polar opposites. The pediatric side of the ward was interesting and fun and I can confidently say that this experience has made me able to picture myself happy and thriving in that same position just a few years down the road from now.  

A-Achen: the little town

The Aachen Rathaus (Town Hall)

We took a day off a few weeks ago, and visited Aachen, I nice little town only an hour east of Bonn. We visited the Imperial Cathedral, or the Royal Church of St. Mary along with the treasury of the relics held in the Aachen Dom.

A history of heart valves
Some designed by Helmholtz at the bottom of the display

But before that, we visited the Helmholtz Institut of Cardiovascular Engineering! An amazing place of research and cutting edge technology in the field of heart valves and pumps.

With devices that inspired some thoughts behind our semester long project in our Physiology course, and practical applications of Computer Science (Labview and MATlab), Helmholtz is a good idea of what it means to study biomedical engineering and what research is.

Guys laughing, wearing jeans and t shirts, and watching an artificial left ventricle pump viscous fluid for hours upon hours. Just casually working with sophisticated equipment and intelligent people, some very cool things going on in this field.

After that, we went to the town of Aachen, famous for their Printen, a type of ginger bread (and I took away a huge chocolate covered gingerbread bunny). I also rediscovered my love for bratwurst. At the market in town, I ate two bratwurst mit brotchen (cooked sausage with bread), imagine a hotdog, except with a delicious hotdog and a delicious bun.

It's hard to tell, but on the left and right are images of
yellow bombs falling onto the city of Aachen.

In the treasury were relics such as Emperor Charlemagne's tomb and a map of New Jerusalem on a cross. In the Cathedral is the throne of Jesus Christ's second coming, and the remains of Charlemagne. This Cathedral is named the Imperial Cathedral, as it was the site of German Coronation for 42 monarchs for 600 years. Even despite it's history, it was yet another site of destruction from WWII, memorialized in the replacement stained glass in the choir hall.

It's a jaguar. Or a puma. Just on a statue.
I had to have a photo with it.

Also I found out that this is the town of statues. Around every corner and in every platz (square) there was a new statue. My favorite was one that had adjustable hinges! the most popular one in town.

All in all, a very fun little town. It had a quaint feel that made me feel like I was in the Germany that you hear about in the movies! As opposed to the Germany you hear about from my blogs, hah! I'm still holding onto my chocolate gingerbread bunny, maybe some of y'all will get a piece!

Official (half) Marathoner!

The Sunday after we got back from Berlin, we had the Bonn Marathon.... To run or not to run, that was the question, but of I course I wasn't going to back out! (My heart said YES, but my knees said NO... and perhaps I should've listened to them!) Of course the morning of the race, I left the house without my number or chip, so I had to race back and grab them. The trams were also running really weird due to the marathon, so I ended up having to powerwalk over to the old AIB where the race started. (Guess that counts as a pre-workout?) I have never been so excited/nervous/dreadful in my life. Since there were literally thousands of people running they started us off in groups of a couple hundred. (We lucked out and ended up in the front of our starting group.) There's not much to say, other than my right knee tried popping out about mile 9, and some nice old man grabbed my arm to help support while I was jogging since I was apparently limping that bad. haha But I refused to walk, and eventually it kind of went back in. My foot was also on fire, and even though I had pre-wrapped and tapped it, I could feel the blister forming.

Normally when I think of three miles, I laugh because that's not very far at all. But let me just tell you, when you are in as much pain as I was in, and you realize you've only completed 10 miles and still have 3 more to go, that is the LONGEST 3 miles EVER. I was probably clocking a 15min mile at that point, but I did NOT walk. Sadly, I couldn't even force myself to pick up the pace when I saw I only had two miles left... But finally when I realized it was only a mile and half left, I convinced myself that if I could just go a little faster, then I would be done faster! (This resulted in a maybe 12-13min mile haha) And I must say that the end of the race was totally confusing. They had one sign saying 50m, so of course I took off sprinting to finish, only to realize that no, that sign meant TURN in 50m... and then they had balloon arches way before the finish, so you couldn't even tell where it actually ended. But somehow, somewhere, I got a final wind and managed to sprint across the finish line.

Say what you want, but I'm dang proud of my 13.1 miles in 2:28:15! I have honestly never been in so much pain in my life (it seriously might've topped my surgeries) so I'm not sure I will EVER run that far again. But it's pretty nice to know that if I had to, I could do it! (And how awesome is it that I can say I ran my first half marathon in Germany?!)

**Sorry for no pics! I'm having trouble getting them to show up in iPhoto, but I'll try to add some!

Flashback to Berlin!

Berlin was off to an interesting start, as Laura, Nicole, and I had gotten home from Alghero, Italy around 2am. And since Laura and I had not gotten our clean laundry back before Friday, we hadn't even started packing for this week long excursion. So after packing and showering as quickly as possible we still only got about 3hrs of sleep because we had to be at the Hofgarten by 6:30am. Not to mention, we had stayed up very late on Saturday WHILE in Alghero studying, and I had studied the whole plane ride, and basically the whole bus ride back from Frankfurt Hahn INSTEAD of sleeping, only to receive an e-mail when we got home telling us that we would not be taking our biochem test until the week after Berlin.... WOW... AWESOME... (we had planned on taking it during our bus ride to Berlin since that would be over 6hrs, and that way it would be over and we could enjoy Berlin, and not have a biochem and physiology test in the same week. But then, of course, we ended up having phys and biochem back to back the next week, but that's a different story entirely!) Anyways, since I didn't have the test anymore, I got to catch up on sleep on the bus ride! After a very long bus ride, we finally arrived in Berlin in the afternoon. 

We checked into the Hotel Alex, (I shared a room with L/L like usual) and then met up to go on a quick city bike tour. Our guide, Sion, was really interesting, and we got to see quite a bit, but I'm not sure it was an official tour, because there was a lot we didn't get to see.. (but maybe Berlin is just that big! I'm not sure!) While on the bike tour we saw different parts of the Berlin wall, watch towers, Checkpoint Charlie, the Jewish memorial, the Bundestag, and the Brandenburg Gate. But by the end of the tour we were all pretty cold and famished. 

Lauren and I at the start of the bike tour!

The Checkpoint Charlie Sign. 

Checkpoint Charlie!

Jewish memorial. There are no names, because we do not know the names of every Jew that was murdered or affected by the holocaust. The floor in between these massive blocks actually dips like waves, and by the time you reach the center the blocks are almost ten feet over you, giving a claustrophobic and uneasy feeling. (At least that was the intention of the artist.)

Brandenburg Gate with my girls! (Laura, Lauren, and Nicole)

 Tuesday we met bright and early to visit the Charité. Our guide was really interesting, and we got to see a lot of really neat exhibits. The Charité has the largest gallstone collection, and some of the stones were bigger than chicken eggs!!! They also had real, preserved human organs that showed what the tissue was supposed to look like, and then an example of what diseased tissue looked like. It was pretty neat! After the Charité tour, we had some free time for lunch, so a group of us went over to see the East Side Gallery.

East Side Gallery! "Stay Free"

East Side Gallery

After lunch we went back to the medical skills training center. There we had a short lecture on German medical schools, and how their programs are set up. Then came the fun stuff. :) We got to practive intubating a dummy, we listened to different heart sounds on a mechanical dummy (we listened to regular sounds, and then to either a stenotic or regurgitating valve and had to guess which!), they had a suit that basically consisted of a lot of braces and weights and there was supposed to imitate how it feels to be really old. You would have to lie down and then get back up, which was actually really difficult! They also had a bunch of different goggles you can wear that were supposed to mimic different optical diseases, I basically felt blind with all of them... And finally they had these awesome "tremor" gloves that sent tingling shocks through you hands to cause tremors.  We then had to try to write our name, and drink a glass of water. Let me just tell you, it was challenging enough to even pick up the pen! (Perhaps this was due to the pain that the shocks caused, whereas most patients don't feel shocking pain, they just can't stop the trembling of their hands, etc.) In fact, some of us tried to go all the way, but the pain was soo intense, and your poor hands would just distort themselves in strange ways. It almost looked like reptar hands! This was supposed to allow us to know how our patients with these kinds of issues will feel. (Trembling from old age or Parkinson's, etc.)

Wednesday morning we met up with our guide Sion again who accompanied us to the Sachsenhausen Concentration Camp. I don't really have a lot to say about that, except that it was a very sobering and depressing experience. I simply don't understand how humanity can be so cruel...

"Work makes you free"
This statement might've been true for true criminals, but if you were Jewish, no amount of work would ever set you free. What's worse, is that even after being freed from the camp, many survivors went back to live, because they had no where else to go. After so many years away, they didn't always know the status of their families or homes.

"Neutral Zone" but if a prisoner step out into the sand that used to be there, the machine gunner had permission to shoot, no questions asked. 

 I ended up going back to study after that tour, but no regrets! We toured the Deutsch Bundestag that evening, which is the German government. (Kind of like our White House) As my interests involve science, this was far from my favorite part of the trip. But I guess it was good educational experience, and I certainly learned quite a bit! (About America and Germany! haha) And the view from the top spiral was pretty cool!

Thursday was, by far, my most favorite day! (Even though, of course, it decided to rain....) We started off the morning by checking out and heading to the natural history museum. (Our guide was little rude by trying to tell us that she would have to cut our tour short since we were late... ummm ok? We didn't really want a tour anyways.... hah) (I'm assuming since everyone had written about how much we had liked the natural history museum in Vienna, but hadn't had enough time to actually get to spend time and appreciate it, our coordinators interpreted that as we wanted a guided tour in Berlin....) Not to mention, our guide was CLEARLY not a science person, as she proceeded to tell us that the very tiny horse ancestor chose to evolve/grow bigger because bigger animals do not eat as much, when you compare the body weight/food intake ratio.... Well I might by that bigger animals might have a lower ratio...but that's definitely NOT going to cause an animal to "choose" to grow bigger...and reguardless, a larger horse with a smaller ratio will still out-eat a tiny horse with a large ratio anyday...  Anyways, we still got to see some pretty neat things! Like the tallest dinosaur exhibit in the world!

Example of the old style of stuffing an animal... thank goodness this has changed! (At the Natural History Museum)

The tallest dinosaur exhibit in the world!

 Then after the museum we got to go to the Berlin Zoo! :D So even though it was chilly and rainy, we persevered on, and boy am I glad we did! I hadn't been to a zoo in a long time, and I forgot how much I enjoy them. There's so many different animals that you never even think of until you see them! I thought it was especially neat to go in Germany, because I feel like they have a few different kinds of animals that we don't have in Texas. (but I could be wrong..) And after the aquarium it even stopped raining, aka: picture time! :D I will never forget the monkeys though... they are so interesting, and human-like, but don't appear to have the same self-concept as us. Especially the oragutan that Nicole and I saw who picked a MASSIVE booger and then proceeded to snack on it......

The otters were SOO adorable at the zoo! They kept barking and then swimming up to the glass right by our feet. And the one in the water here was playing with a gold coin!

Lions! They had to be brought inside due to the bad weather.  I had never been this close to a lion before!

That evening, around 6pm, we left Berlin and headed to Duderstadt. It was another long bus ride, but our hotel there was awesome! It was sooo big, and old styled, and even though I had to sleep on a pull-out couch, I basically had my own "living room" area to myself so L/L didn't wake me up in the morning! :D #happycamper 

Friday morning, we went and toured the Ottobock factory. I thoroughly enjoyed the "experiments" part of it, and actually getting to see how the prosthetics work. (I've never realized how much your foot does!) Then we had an interesting lecture from a worker who actually had a prosthetic leg, and who even got to go snowboarding with it! Talk about awesome! However, after the fun part, we had to actually tour the factory part....which was really long...and not exactly what I would consider "interesting." (For starters, I'm not an engineer, so I didn't really care how they build the prosthetics, and secondly, I have no desire to be a factory worker.. so I don't really care how things are boxed up, or how they are stored in really big warehouses....) But we survived, and then got to get back on the bus to head back to Bonn. 

The super neat double rainbow we saw on the bus ride home!

That week definitely flew by! And I wish I hadn't have had so much to study for so I could've enjoyed the city a little more...but what are you going to do? At this point we still had three weeks left!