Medical Imaging? who Me?

I have had several of my recent friends give me the skeptical eye and ask me "why are you taking that Functional Magnetic Resonance Imaging course?"

The answer lies in my background (before I met most of you!), so let me tell you.

When I graduated from the University of Iowa, with a BS degree in computer science, Hewlett-Packard hired me right out of school, and I moved to the Bay Area.  I was an engineer, on embedded systems, making patches, analyzing system core dumps, organizing trade show exhibits, and teaching courses in operating system internals and driver writing. I was an operating system engineer, which included unix.  So in short terms, I programmed devices, including medical devices, and I understand at the root level how the MRI system is controlling all of the devices that capture the MRI image.  I have been involved with unix systems since 1989. Man, that makes me sound OLD! :-)

While in California, my Mom became chronically ill with a disease called COPD, and during that time I also had a child; my Mom was too sick to travel to California to visit us.  That, along with sitting in my car for 2 hours 1 way to work with an infant.... incented me to move back to Iowa and take a position as an engineer at MCI.

While at MCI, I programmed a network controller, an IVR, which provided phone services which included  1-800-Collect. I'm sure you have heard of that.  I was one of the lead architects of that system, which carried other traffic as well, 7 million calls per day in fact.  During my time at MCI, I had the opportunity to work on video compression and encoding technologies called H.323 and H.324, and working with IBM Research, built a prototype of a service very similar to what we now know as Skype.

I credit my Mom for all she did to help me in these endeavors, as I travelled ALOT back then, and my 2 girls loved to go to Gramma's house while I was away for work.  My Mom survived over 10 years with her COPD, and I think she did because she knew how important it was for her to take care of her favorite grandgirls.  My Mom died in 2006 at the age of 79 of COPD and lung cancer, and I really miss her.

My Mom, Liz and Tori, in 2005 before she died.

So, The fMRI course is particularly interesting to me, because I used to program devices, including medical devices, and work on video encoding and compression.   Reminds me of being 20 again I guess, and I think it's alot of fun!  :-)

MERF - Medical Education and Research Facility

The University of Iowa Hospitals and Clinics is one of the largest state teaching hospitals in the US.  I am taking Health Economics, and I feel really lucky to have class at the MERF, or the Medical Education and Research Facility:

UI Healthcare Fast Facts

It's probably one of the most beautiful buildings I've ever seen.

In Health Economics this week (if I may overly paraphrase and still get this right!) we talked about how the increasing cost of health care is outpacing the annual domestic gross national product (GDP).  Health care costs are increasing to such an extent, that if the economy and the health care system were to continue to run at this same pace, that Americans would spend more $ on health care, and discontinue buying other goods (like housing, food, cars, etc).

That is quite an interesting forecast, as I'll be 85 years old in the year 2040.

"Hollowing Out the Middle"

This fall, my daughter Liz took a Social Psych course at the U of Iowa, and brought home the book "Hollowing Out the Middle, The Rural Brain Drain and What It Means for America" by Patrick J Carr and Maria J Kefalas.

I was deeply moved by reading this book, and since I've been on campus for just a week, nearly all of my professors have mentioned this at the first class (I'll paraphrase...) "we're going to educate all of you highly intelligent folks in (pick a subject) so you can leave and make lots and lots of money!" 

"Hollowing Out The Middle" is an excellent book, if you're from Iowa or have roots in Iowa.  In 2001, the MacArthur Foundation funded the 2 sociologists/authors of this book to travel to and live in Iowa to gain understanding of exodus of young people from rural America, like Iowa.

The authors make up town names to protect the innocent, but at some points in the book, I'd guess that the sociologists picked a small town somewhere between Manchester and Dubuque.

The sociologist segment the citizens of the Iowa community that they meet into these groups:

• The Stayers - the working class
• The Seekers - Kids that join the military and then come home
• The Returners - Those of us who left Iowa, and then came back (like me)

It's a good book, and a quick read.  The sociologist's findings are that the culture of Iowa is to send our kids to the state universities (Iowa or Iowa State), educate them well, and encourage them to leave Iowa and pursue fabulous lucrative careers.  After all, any Iowa parent is so proud to have their son or daughter at Iowa or Iowa State. Once our best and brightest leave Iowa, they raise families away from Iowa, enjoy the amenities of life that the extra cash provides, and never want to return. Nobody wants to uproot a child from school or leave their friends behind, moving is hard.  That's the obvious and right thing for the best and the brightest people to do, move away and find a great job.  There's nothing wrong with that, and that's ok.  Iowa will never have the great weather, beautiful mountains, or the fabulous beach amenities which draw both young and old people away.

The findings of the sociologists also say that Iowa should invest in the people who want to stay: the working class.  Economic development in Iowa should focus on businesses where employees have either a high school education or a community college education, as those are the folks who will stay here in this state. Makes sense.

I found the book very interesting;  this was something I already knew as I live it every day.  I am grateful I have had the career opportunities here in this state that I have had, but I have found it quite a struggle many times as companies come and go from Iowa and a regular pace, and will most likely continue to do so.  As an MBA, I found it easy to start and run a business here, and I enjoyed having my own business most of my career.  But, I am sure I am not the average Mom you would find walking the streets of these small towns, as  I'm a single mom with a master's degree in business administration. I often feel like a fish out of water.  But, I do love it here in Iowa.

If you'd like to read "Hollowing Out the Middle" you can learn more about the book at this website and purchase it online:  

Hollowing Out the Middle, The Rural Brain Drain and What It Means for America"

Functional Magentic Resonance Imaging for Dummies

My first week of class has been really cool, I think I appreciate these unique opportunities more now that I'm an old fart than when I was a teenager.

Today's campus highlight for me was the 1st functional Magnetic Resonance Imaging (fMRI) course at the U of Iowa Carver College of Medicine.  Functional Magnetic Resonance Imaging is used in cognitive neuroscience research, meaning, research of your brains functioning when stimulated by different things (sight, smell, hearing, touch, etc).  Researchers will come up with studies like "what does your brain do when you listen to music?" and then a subject will lie on the table, listen to music, and an MRI will measure the the increased blood flow to different parts of the brain stimulated by the music. U of I researchers will then conduct their research studies using the images. It sounds just that simple, but I'm sure it is not.

A current research project that was recently publicized is one by a U of I researcher on alcoholism:
MRI Research on Alcoholism

Here is a photo of the Siemen's MRI at the Magnetic Resonance Imaging lab that we toured today:

I won't try to go review all of the physics equations on magnetism and aligning protons to measure RF energy to generate images  .... as I'm sure I did not grasp all of it either.  But, some of the light and fun things we learned today was that the big donut contains the magnet that is always 'on'.  The magnet is so powerful, it can suck something as big as a chair or a floor buffer inside of it (as shown below when a custodian left the floor buffer in a similar lab), so please use caution when in the lab was the message.  Here's a photo of such a phenomenon that Dr. Magnotta showed us today:

 

Here is a video on what happens if something like an oxygen bottle is brought into the MRI scanning area:

Oxygen Bottle in the MRI Video

We also covered how the MRI works on the inside, as shown in this diagram:

Essentially, the subject is positioned between the magnets, and because human's are predominately made up of water, the magnets cause the protons in your hydrogen molecules to align, the aligned molecules are generating RF (radio frequency) energy, and this RF energy is picked up by the RF detector of the MRI, and these signals are digitized into the MRI image file and stored on the computer.  

Frequency of various types of waves (from strongest to weakest, the ^ means 10 to the power of X...)

• X-rays ≈ 10^19,
• Ultra-violet ≈ 10^16
• Radio ≈ 10^7 (MRI)
• Visible Light ≈ 5x10^4

X-ray energy is a trillion times more energetic, and thus is more damaging to your body. Radio waves are not ionizing (cancer causing), the strength of signal in MR comes from the number of protons and not the high energy.

If you'd like to learn more about the MR Research Facility at the University of Iowa, you can go to this link:

University of Iowa MR Research Facility

Thursday January 20th

Not much has changed since I was last in college, which I believe the last time I was on campus for a course was 1991 in downtown San Jose, at San Jose State University.  I recall college being a lot warmer than this, as today in Iowa City, it's about 14 degrees, and walking everywhere, while tremendous exercise, is colder than hell, and there is something to be said for working in an office :-)

I've met with my advisor at the College of Public Health, and everything is a green light 'go'.  I've already completely enjoyed my first week of academia, away from the office drill, so there's no looking back.  If everyone thinks they're going to be working at a job every single day of their life between age 22 and age 70, your nuts.  Give yourself a break, breathe the fresh air and live a little!  For me, this is going to be a great semester!

For my degree, the plan is to be totally on campus this semester and take all the courses I can that are only offered on campus for this program, and then because of the curriculum for this particular program, I can complete the degree off campus with online courses that are left if I wish and go back to work this summer.  What a deal, back to work....  :-(

So, today's most interesting factoid for me came from my Medicare and Medicaid homework readings, most notably, from an article 
Rowe & Kahn (1998) " Breaking down the myths of aging  "

Where Rowe & Kahn say there are 6 Myths to aging:
1. To be old is to be sick
2. You can't teach an old dog new tricks
3. The horse is out of the barn
4. The secret to successful aging is to choose your parents wisely
5. The lights may be on, but the voltage is low
6. The elderly don't pull their own weight

And in summary, they say that even though we're all getting older, we're not getting sicker, dumber, less productive, and nor are we giving up sex! That is good news, isn't it?   - lol

Day #2 of Student Life

Day #2 as a college student was quite boring actually....  as it was spent doing mother duties rather than student activities.  First and foremost on the agenda was to get Tori enrolled at Prairie Point 9th Grade Academy.  We made it to south Cedar Rapids in spite of the blizzard, and Tori took her placement exams and she was able to get her course schedule in place.

While Tori was placement testing, Liz (my daughter and fellow college student ) and I went to the University Book store and purchased our books!  Liz bought Biology and so forth, and I purchased my book for one of my other courses "The US Health care System", which is an overview, soup to nuts, of our healthcare system. This course is one of the first courses of the College of Public Health at Iowa that covers the basic structure and operations of our US Health care System, just like the course title says.

I am also taking a SAS course, which is a statistical package used for data analysis, but was unable to ascertain if a book was available for this class or not, as the instructor had not yet posted anything on ICON, ICON stands for Iowa's Course Online system for students, and is the portal for professor/student communications at Iowa.

I meet with my advisor on Wednesday morning, as it appears I'm charting new territories with 'Health Management Analytics' as a major at Iowa, and I need to understand the prerequisites for a course I'd really like to take which is "Health Insurance and Managed Care".  And, I could not find any courses with the topic of 'marketing' for health care in the college of Public Health, as marketing is offered by the Tippie College of Business; (and I already have a master's degree in business.....) so we need to chat about that too.

In The Beginning....

This is my first post of my first day as a on campus graduate student of the Health Informatics Interdisciplinary program at the University of Iowa.  I'm 45 years old, and the mother of 2 beautiful and talented daughters.  One is a freshman at Iowa studying Chemistry, and the other is a freshman at Prairie Point 9th Grade Academy studying teenager mahem.  As I see it, this is the first day of the 2nd half of my life (assuming I'm heading on to age 90 or so), and there is no time like the present to get started.

My focus in my studies has several names in the industry depending on who you ask:

• Health Care Business Intelligence (BI)

• Health Care Administration Analytics or Informatics

and specifically, I'd like to focus on sales and marketing (customer relationship management) and financial performance (managed care, medicare/medicaid), so the business side of health care.  


I'm really excited to say, I have a a lot of homework already assigned!  Woo hoo! I will not bore you with all my homework, but I hope to pick a focus area each week and blog about it.   Today, I'll tell you about my Medicare and Medicaid course (as he's the first professor to post the syllabus).
I hope to blog these experiences regularly to inspire those of you to follow your dreams and embark on an adventure such as this on your own.

This week, the learning objective in the Medicare and Medicaid course is to

Characterize the aging population and review patterns of health service use

some of the readings are 'surfing' assignments (my hasn't school changed!) and are focused on statistics involving  'old people'

http://www.agingstats.gov/

http://www.aoa.gov

            http://www.healthyagingprograms.com/index.asp

Next week for this course, we have a field trip to Chicago to visit the American Medical Association and the American Hospital Association.

http://www.aha.org/aha/about/index.html

            http://www.ama-assn.org/