GOl Week 2 (June 12- June 16)-Plus my time in a new city!

 Hi all! Rachael here with a new exciting update on everything I have learned and experienced this week! Last weekend I spent some time in Ocean City, New Jersey with one of my friends participating in an internship there. I had never been to New Jersey and I had heard that I couldn't pump my own gas, but it was interesting to actually experience it! I was introduced to the boardwalk and was able to spend some time in the Atlantic Ocean. 10/10 weekend experience!

This week I spent some more time rotating through tissue services and the Transplant Information Call center (TIC), received a didactic overview of the transplant pregnancy registry (TPRI), and an overview of family services. In addition, Francesca and I volunteered at a Juneteenth health fair where we educated black and brown communities on organ/tissue donation and encouraged individuals to register as an organ donors and to educate their friends and families on the beauty of organ and tissue donation. Below, is a detailed outline of my week! 

Monday (June 12): Today I participated in tissue services. I received another tour of the supply room and was able to talk and form closer partnerships with the tissue services staff. I was also able to see a human heart for the first time in my life! And not only see it.....but I actually was given the opportunity to scrub in, gown, and glove, and then hold this donor's heart in my hands! I was also given the opportunity to make the Hinge cut (cutting near the front of the heart almost through the tissue but not quite in order to create a hinge) and assist the recovery specialist with washing the heart with saline three times before packaging it to be sent to processing facilities so that they may recover the heart valves and tissue. I was also able to hold the right saphenous vein (The longest vein in the human body! It extends from the top of the foot and up the inner sides of the leg and stops around the groin area) that was recovered from this same donor and also help wash the tissue before packaging. Saphenous veins are used to assist in bypass surgeries.  This was truly an amazing and unforgettable experience. Due to HIPPA laws and legalities, I was not able to take a photo, however, I will forever have the mental image. In addition, I was able to see the recovery specialist clip the ribcage from the donor's spine to reveal the heart and lungs beneath. I was able to touch the lung and was shocked by how soft the tissue was. This was one of the most memorable days of my life and an incredible experience! 

Tuesday (June 13): Today I spent my day in the TIC and was able to listen in on another successful family call. I spent half of my day listening in on the tissue calls, coroner calls, funeral home calls, and referrals from hospitals. The second part of my day included seeing the organ side of things within the TIC (Kidney/Pancreas). I was able to see one of the TIC staff track kidneys, the pumping of kidneys, and the process of calling transplant specialists to see if they would like a specific kidney for their patient. I was surprised because I always thought that the moment a kidney was a match, the doctors would jump on the organ and want it for their patient, however, there is a whole other side to the decision. All of the transplant specialists wanted to wait for Pump numbers (see how the kidneys are filtering waste products), which is done at an off-site facility, and if the cuff (where the recovery specialist split the kidneys apart from one another) was large enough for easy attachment to their patient. Overall, today was an educational experience and showed me another part of the organ donation/receiving process. 

Wednesday (June 14): Today I was able to observe two cases! Usually, there is only time in the day to see one, but there was a case the morning I arrived. I was able to see a bone and skin recovery, however, this one was different because they recovered what they call En-Block which is essentially recovering the entire segment of the upper leg and lower leg/foot (Not including toes) to be sent to the processing facilities. They were able to do this because the donor was a relatively young donor. This was also an interesting case for me because I had not yet seen a tissue donor who was also an organ donor so there were already sutures in the donor's chest area. I was also able to witness the specialists put the donor back together with the adjustable corn fiber stilts. Overall a pretty cool and new experience. The second case I was able to observe was another heart valve recovery where they recover the entire heart for the processing facility to create grafts and recover valves. Again, the clipping of the ribcage was incredible. This donor also donated their costal cartilage which can be used to create external ears for children born with Microtia (cartilage of the outer ear is absent or underdeveloped). This was another amazing day. 

Thursday (June 15): Today, I learned about the Transplant Pregnancy Registry (TPRI)  which is a system developed in 1991 by Dr. Cincent T. Armenti. The TPRI studies the outcomes of pregnancies in female organ recipients and those fathered by male organ recipients. Surprisingly, the outcomes of pregnancies from father organ recipients numbers match relative to the outcomes of pregnancies without transplants. Unsurprisingly, the outcomes of pregnancies in mother organ recipients show how high-risk these pregnancies can be. This is an incredible system that studies the immunosuppressant and anti-rejection medication outcomes on the mother during pregnancy, the outcomes of the pregnancy, and the growth/development of the child or children resulting from these pregnancies. We also received an overview of family services that reach out to donor families and facilitate grief counseling and letter sending if a donor family or recipient wants to send a message to the other. I also participated in a Webinar that discussed the process of talking to families and how much our words can impact the decision to donate. 

Friday (June 16): Today, Francesca and I had the day off in order to prepare for the Juneteenth event on Saturday. I have never been to Philadelphia before, so she wanted to show me the Reading Terminal Market. My first impression when I walked in the doors was "Wow that's a lot of people". Growing up on a mountain in the middle of nowhere did not allow for a lot of group interaction. After about an hour, I started to feel more comfortable and less overwhelmed. We went to tea shops, bee shops, the Amish cheese and milk store, looked at a French cloth store, and candy store, and I had a real Philly Cheesesteak for the first time. Maybe we didn't go to the right place for it because I was not impressed (Those from Philly please don't come after me haha!). We passed by this one chocolate shop that had these cute chocolates in the form of organs with cute sayings. To the upper right is a photo of the lungs I saw with the message attached. 

Saturday (June 17): Today was the Juneteenth event. We spent half the day tabling and educating the black and brown communities on organ and tissue donation while working to ease any concerns and quench myths about organ donation and the process. A huge disconnect we discovered was that many individuals would be willing to receive a life-saving organ, but not willing to donate. Now, the match process is never based off of race, socioeconomic status, sexuality, or gender, however genetically it is shown that specific races are better matches and can decrease organ rejection rates. A huge myth we needed to educate and work to quench is that doctors and medical professionals are going to let someone die so that they can use their organs and this is just not the truth. In order to donate a life-saving organ, you need to pass away in a hospital facility and be brain-dead in order to donate an organ. You cannot be an organ donor if you pass away from blood loss or cardiac death. We had been taught and heard about the mistrust in the healthcare system (And there is great reason for that mistrust to be present when looking at history), however, it was a whole other story to actually witness the misunderstanding and lack of trust. One woman approached our table and registered to be an organ donor. She had told us a story saying that her loved one needed a kidney and a pancreas but she had never considered registering as an organ donor herself. It was A beautiful moment full of a lot of emotion, education, and understanding. We walked around the health fair handing out bags with T-shirts, and educational materials, and offering to educate and ease any concerns that some people may have had. It was a beautiful day filled with beautiful people and beautiful moments. Attached are some photos of the table, us interns talking to people and having an amazing day on the historic and beautiful Juneteenth day. 

This week was truly an amazing, educational, and outstanding week. I was able to observe and hold a human heart and vein, assist with cleaning these tissues, observe En-Block muscle and bone recovery, witness family calls and organ allocation processes, observe another heart recovery, learn about the TPRI and family services, see more of the city and Reading Terminal Market, and experience a life-changing and incredible event that has filled me with the desire to educate more people on organ and tissue donation.