Hannover, Emden and beyond

Last week we took one of the best excursions yet. We spent a day and a half in Hannover and the "Harvard of Germany"- The Medizinische Hochschule Hannover. The first day we got to talk to the cheif cardiovascular surgeon. He is one of the best in his feild. He talked to us about LVAD's - Left Ventricular Assist Devices. LVAD's are used when patients have dilated cardiomyopathy or heart failure. They take over the pumping of blood when the heart cannot do it any longer. The LVAD's serve 3 purposes, they can be a bridge to transplant (which would be a fix while the patient waits for a heart transplant), a destination therapy (meaning it is the solution), or bridge to bridge (it is put in to wait for the next pump). There are 2 types of LVAD pumps- pulsatile pumps, which pump the blood with a rhythm like the heart or centrifugal pumps, which pump the blood in a constant flow. He also talked to us about a ground breaking surgery that he just performed. The surgery would not have been possible in the US because of the way our legal system works and for things like that, insurance would not cover so it would be out of pocket for the patient. It was inspiring to hear about such a story and it's a really strange thought that money was not part of the equation used to make the decision about what to do. The government covers it. That is such a foreign thought for Americans. It's hard to fathom. We also got to talk to another patient with an LVAD and he told us his story. He was really awesome. He was so in tune and aware of his device it was awesome to see a patient who cared so much. He was also an electric engineer so of course he had thought of ways to make it better. We were very lucky to get to talk to him. I really enjoy seeing patients who care about their health so much and are willing to follow the doctors instructions. It makes the doctors life easier, and honestly helps the patient stay healthier longer. The next day we got to learn about research being done with axolotls and spiders at the MHH. The axolotls were really cute and fun to watch. The research they are doing involves limb regeneration. They are trying to isolate the genes and their products that allow the axolotls to regenerate limbs so well, and working on how to apply that to human medicine. I think it's really fascinating research and it would be really cool to work on something like that. The axolotls just seem like really interesting animals to work with. Plus, limb regeneration will be a huge deal as soon as they figure out how to apply it to humans. They explained that they do have some problems because they have not sequenced the whole genome of the axolotls, so there are gaps. They use a RACE PCR to analyze the genetic samples. They have found that lypoxygenase (LOX) when it is present then human tissue heals faster and causes faster wound healing in mice. The LOX is transfected into the human or mouse cells and works transiently so the concentration decreases over time. They are definitly making progress and I think it's really exciting. The same people working with the axolotls were also working with spiders and their silk. They harvest the spider silk from the spiders, sterilize it, and then they can make strong cords with it or if it is placed in a wound then the wound heals faster. I really want to harvest some spider silk, sterilize it and then put it in a cut next time I get one. I want to see how it works. I think that we should start using that as a regular wound treatment. I guess a lot of people would probably be bothered by that, but I think it's really neat and it doesn't freak me out. They kept the spiders in a big room and they let them roam free. That was kind of a creepy feeling, walking into a room and realizing you're surrounded by spiders. I was afraid one was going to fall on my head or something. I'm not really bothered by spiders, but I don't want them on me. None of them really moved, and we were told they don't like to come down so we were perfectly safe. Plus, they were not known to bite people and weren't poisonous. After we finished with the spiders and axolotls we went and talked to a nephrologist and internist. He talked to us about the downsides of the German healthcare system and then talked about dialysis. It was interesting to hear about the downsides of the healthcare system. It can be costly to the people in the form of the amount of taxes they pay and the limits on what the doctors can and cannot do and how many of each procedure they can do results in corruption in the system. I'll save the healthcare discussion for another blog. We talked about dialysis down in the dialysis wing of the hospital and first he described the 2 different types of dialysis. I was not aware that there was 2 different types, I just thought that dialysis meant you had to go get hooked up to the dialysis machine multiple times a week. There is another type of dialysis called peritoneal dialysis that uses the peritoneum as the membrane to filter the blood. A tube is inserted into the peritoneal cavity and dialysis fluid is used to fill up the space. The tube is plugged and it is allowed to sit to allow the transfer of toxins across the membrane, then the tube is opened and the dialysis fluid is drained. This seems like a much more natural less traumatic way to clean out the blood when the kidneys loose function. It is not a good option if you like to swim or things like that because you can't with a tube that opens to your insides because of the risk of infection. We also got to see a patient on the dialysis machine and he explained to us how it worked. It was really interesting, but it did not look like something that was fun to be on. After we finished at the MHH we took a train to the cute little town of Emden. We went out and got fresh fish for dinner and tried the real Schnapps. It is used as something to help your digestion and it was not very nice to drink. You sip on it and it was funny to watch everyone cringe everytime they took a sip. Friday was one of the funnest days we've had on the program. We took a ferry to the island of Norderney and took a hike on the mud flats of the Waden sea. The Waden sea is home to the adorable seals and it is very important in the migration routes of birds, because several stop there to refuel before continuing their migration. We got to try this catus like grass, it was interesting, more salty than anything. We got to walk the flats bare-foot, which I was happy about because the shoes I had were not very comfortable and slightly too big. The first mud we walked on had a clay like consistenty then it changed to sandy and then it got really thick and deep, that part was my favorite. The guide showed us the little crabs that burrow into the sand and dug up a mussle. We also dug up some blut worms that burrow down into the sand. The guide also showed us that the top layer of the sand was a redish brown color because the iron reacted with the air forming a rust color and then the lower layer was black because it reacted with the sulfur and it was anaerobic. The worms burrowed down to the anaerobic layers so their blood has a special hemoglobin that has a very high affinity for oxygen to allow them to do that. We had a worm race to see who's worm could bury itself the fastest. The weather was perfect for the walk and at one point the wind died down which was abnormal for the area. On the way back in from the walk we stopped and the guide found some fresh oysters. Only 2 of us from the group were brave enough to try them. I was one of them. Until that point I had never had an oyster before, so this was my first experience. It was one of those experiences that happens maybe once in a lifetime. The oyster was ok, it was more salty than anything. It was crunchy so I didn't really chew it because that kind of freaked me out. I think it was just pieces of shell and sand. It didn't turn my off from oysters but now I'm curious to try them at a restaurant. Oh yes, we also tried a piece of seaweed that we found on the flats. It wasn't bad, I would cook with it. It was the bright green, pretty seaweed. One of the things I've learned about myself on this trip, I'm am not by any stretch of the imagination a picky eater. I am really open to eating different things, and I've been able to just order things without much fuss. That was the end of the mud walk and afterwards we visited the rehab clinic on the island. The rehab clinic was so much fun, the research they were doing was also really interesting. They had evidence showing that staying on the island had a healing effect and that the air was really healthy. I thought that was awesome. I really wish I could have stayed there longer. Their research facilities were very high tech and that has some really neat equipment. They did all sorts of different research. All the patients were monitored and they tracked the results from their stay on the island. It seems like a really awesome place to work. We also got to tour their physical therapy facilities and they let us try out a balance machine which was much harder than it appeared. We also got to try the medicine balls. They were awesome, I'm totally investing in one when I get home. They seem like a great, fun work out. I really enjoyed the island and I wish we could have stayed longer, especially after seeing their massage rooms. They had a warm salt water pool, a mud wrap, massages, hydrotherapy, a sauna, it would have taken no persuasion for me to stay. But, alas, we could not and that evening we took a ferry back to Nordeich Mole and caught a train to Bonn. Our trains got delayed and we caught all our connections by pure luck. It was a pretty exciting trip.