Brent Armistead

This is me :)

Hello all!

Welcome to my first blog post! I will quickly go over a little bit about who I am, my interests, and my Senior Project: Seeing Eye to i, Using the iStent to Combat Glaucoma.

I am a senior at BASIS Scottsdale, a very math-and-science-focused school. I have taken many Biology, Chemistry, and Physics classes, and these are the ones that interest me greatly. Also, Psychology has been another interesting class, and I plan to major in it (though I am young and my mind will probably change). I always have loved studying people, just testing people’s reactions and always trying to understand their motives. With the Psychology class, it gives me the official terms for the trends and behaviors that I have observed throughout my life.

Outside of school, my favorite hobbies are basketball, karate, and sleeping. Last year, I joined the Varsity Basketball team (I am now the starting center), and it has been a blast ever since. 

I'm working on dunking like this though that will take a while

Karate has always been a passion, and I now pass on my knowledge to the little ones by teaching the Youth and Little Warriors classes at my karate studio. Sleeping is just wonderful. We all know this.

 

I wish this was me

As for my project, it is a continuation of ophthalmic research. My project has been going on since the summer before my junior year, so around two years. I am working with Dr. Yuri McKee at Swagel-Wooton-Hiatt Eye Center to test if a new device can cure Glaucoma. This device is called the iStent, and it is implanted in the eye during cataract surgery to act as an artificial drain. Since Glaucoma is an unhealthy level of intraocular pressure, the iStent helps to tackle this issue head on, hopefully giving us a cure to the largest cause of blindness. A unique aspect of this study is that we are comparing the iStent to a common Glaucoma surgery, the Selective Laser Trabeculoplasty (which is a mouthful, so we will call it SLT for short).

My role in this study, knowing that I cannot perform the surgeries, is data analysis and statistics. With guidance from Dr. McKee, I will compile all the data points, ranging from intraocular pressure before and after the surgery, number of medications used before and after, and best-corrected visual acuity before and after. After that, I will put all this data into a handy-dandy Excel spreadsheet and run some basic statistical analyses on it. With this information, and some pretty graphs, we can then deduce if the iStent truly works, and how it compares to the SLT, while also accounting for the effect of both surgeries on one eye.

I hope you are as excited as I am to learn about the iStent, and I hope you come back each week to see how its all going!

Make sure to subscribe to keep an i on my blog!

My Senior Project Proposal: https://drive.google.com/file/d/0B3j4J67eOP7zbWFtMnpRQmlWN0U/view?usp=sharing

Site Website: http://www.swhec.com

Week 10

It is that time, ladies and gentlemen.

The final week is upon us. It has been a wild ride, and I thank you all for joining me on this journey.

A journey through space and time

But enough romance for the time being. This week was a good week. Besides almost losing my insides during a basketball game on Wednesday, it was great.  Monday and Wednesday were special testing days, so I did many OCTs and Fundus photos. Tuesday and Friday were visual fields, and Thursday was laser day. Wednesday was packed… and when I say packed… I mean PACKED. There were moments when I lost all hope and I did not think I could survive (jk rofl lol). The weird waves of charts were no slouch though. Twice it went from zero charts to seven and it took over an hour just to catch up. Let's just say McDonald’s was not a wise choice for such a fast-paced and stressful day.

A large part of the week I spent making a draft of my presentation. It was interesting because I had to balance the work aspect and the research aspect of my project. The testing is an important part of what we do here at Swagel-Wooton, but it does not help with the study directly. Patient care is of utmost importance, so I always had to put the technician work first before the internship/research. Luckily, I had most of the data input done before I started the Senior Project, so it was not too much of a hassle to do both.

I thought this was a cool picture :)

My main goal for this entire experience was for… well… the experience. I wanted to embed myself in the research process as much as I could, and the combination of working as a technician and statistically analyzing the iStent and SLT were perfect for that. I can now go into college with a rare knowledge of what it is like to work in a medical office as a technician and to also know the ins-and-outs of medical research.

I will continue working at the eye center up until the month of June, but I will take a step back and only work part-time. The summers are less hectic because all the snowbirds leave, so they will not need me as much. I love working here, and I love everyone that works here. They are all amazing people and I cannot think of a better way to spend a summer then working with them.

Thank you for sticking with me through this journey and I hope you guys can make it to my presentation!

Week 9

Hello all!

Goals

This week was quite a bit slower than last week, but that allowed me to make good progress on my project. On Monday, I was in Special Testing running the OCT scans and Fundus photos. On Thursday, I was walking patients in and out of their laser surgeries, either YAGs or SLTs. The rest of the week was dedicated to visual fields, which are perfect circumstances to finish obtaining the necessary data. I finished all of the two-year follow up for the patients I am including in the presentation on May 6th. Since I cannot use all the patients in the study for the two-year follow up (the latest surgeries were June 2015), I will use the patients who followed up until today, so about half the total patient population.

More on the data, I revised the surgeries all the patients had. I checked to see if the patients underwent other glaucoma surgeries, such as other SLTs, iStent surgeries for the SLT patients, Xen Gel (a brand new procedure that I barely understand), G6/CPC laser (another procedure that I barely understand), and the like. Cataract surgery could theoretically decrease the pressure, but no patients had a cataract surgery after their glaucoma surgery.

A funny thing about when I do the visual fields is that I always manage to be a little late. Whether I think I am supposed to be doing special testing, or I am caught up trying to learn another technician-specific job, I end up getting to the VFs later than I am supposed to. Luckily, I am doing something productive so it’s not a complete waste of time. Also, patients seem to like me so they do not complain about waiting a little bit once they arrive, VFs being the first test they do.

Enough said.

I focused on learning how to work up a patient this week. It requires six steps, give or take. First, I ask them about their medical history and if there have been any recent hospitalizations or anything like that (they usually say no thankfully). Then, I make sure they are not allergic to our medications, because that would be bad. Following that, I test their vision with and without glasses, so they read letters projected in front of them. I then give them a little card with a grid and a black dot in the center. The patient looks at the black dot and they tell me if the grid lines are straight or wavy/crooked. After that, I do what is called a confrontation, which is where they tell me how many fingers I am holding up using their peripheral vision. The next two steps require a light, so I grab a handheld flashlight basically, and use it to test their eye movement by having them follow my finger. It’s basically an ET moment because my finger is lit up form the flashlight. Lastly, I check their pupils to make sure they are contracting properly when exposed to light.

Thanks for reading and see you guys next week!

Week 8

Hello all!

I hope you all had a good week! Welcome to another week of researching and scanning and iStent-ing! Since I am working full-time basically, these posts could get a little repetitive. Just a fair warning.

Yeee

This week was another good week of special testing, visual fields, and escorting patients. Monday, Tuesday, and Wednesday were all special testing, so the OCT machine and Fundus photos. Tuesday got a little insane though. The way we communicate to each other what a patient needs (refraction, special tests, visual fields, workups, etc.) is with charts. We then use the charts with a convenient piece of paper on the front to navigate the patient through their eye care. Depending on what a patient needs, the chart goes into a rack in that location. For special testing, the rack is right outside the doorway of the room. Some call the deeper parts of the room the “inner sanctum.” But shhhhh it's a secret. On Tuesday, the rack managed to go from empty to full numerous times. The other technicians tell me that this is a usual and run-of-the-mill ordeal, but it was a little crazier than usual on Tuesday. I walked away for five minutes max, expecting the rack to be basically empty. One or two charts in that time is not too crazy. However, the rack went from empty to full, so around five charts appear out of nowhere. Now, the special tester goes from a somewhat lax and laid-back mood to I-AM-HORRIBLY-BEHIND-AND-I-NEED-TO-CATCH-UP-ASAP mode. Tuesday there were about three of those moments.

Basically us when the rack is full

As for the research itself, I finished fixing the average Pre-operation IOP and standardized it to six months prior. I averaged the pressures from six months before up until the surgery date basically. Today, I got to do my visual fields and organize my data. Multitasking at its finest (sort of). I just sit and make sure the patient does not look around too much, and the machine does that for me, allowing me to go do other things as he is doing the field. I sit at a desk right next to the machine and do the study mostly. I replaced the abbreviations of the patients’ names with their electronic medical record ID number. This lets me put the number straight into the database and find the patients significantly faster for when I need the pressure data.

That’s all for this week! Thanks for reading!

Week 7

Hello all!

Another week of the senior project is over... Time is flying by! It's already week 7!!!

Anyway, enough of me ranting about how our time is short. Allow me to try to make the most of it :)

My boy Gary Vee... follow him for some good motivation 

I had another week of working basically. I got started on freshening up the data, specifically the average pre-operation IOP. When I originally took the data, I did not standardize the pressures I took. Some patients had data all the way out to ten years before, and some had next to nothing. Me being silly old me, I just took what I could. Dr. McKee roasted me and said that that must have been “a lot of work.” He recommended using either six months prior or a year prior as a time frame, so I picked six months. It gets a little tricky sometimes when people’s surgeries are in different months, so the time frame shifts along with it. That took some getting used to. But I am about halfway done with that, and I will start getting the rest of the data after that. We are currently in the original six-month period of February through June, so I will get the rest of the 24 month follow up as time goes on (and I know what you are thinking… yes even past the senior project deadlines).

The most recent breakthrough in my job is that I am now doing visual fields, which test a patient’s peripheral vision. They put their chin in a big grey machine with a white spherical interior. Lights flash at them while they stare at a yellow dot in the center, and they click a button each time they see a light. A doctor can then look at the results and decipher if the optic nerve is being damaged, i.e. our old friend glaucoma.

 

Me

What I really have come to enjoy is spending time with the other technicians. When we get some downtime, there is a corner or a break room that all the techs can stand or sit and relax. Of course, I am horribly outnumbered by women (only three men besides the doctors work in the entire building). Somehow, though, I manage to survive. They say I am sassy, and I am proud of that title. They seem to find me fairly entertaining too, whether it’s my ridiculous fake dunks of charts onto tables or my absurdly large Hydro Flask. But everyone overall is really sweet and nice and we have a lot of fun. We all also love taking care of our patients, so the office has a great vibe to it :)

That’s all for this week! Thanks for reading, and see you next week!