Journal Entries

Date: 9/10/15
Week of 9/07/15
On Thursday, 9/10/15, I met with my mentor, Dr. Aakash Gajjar. Once I reached the UTMB
Health Multispecialty Center in Victory Lakes, I had first met with the nurse practitioner and she
gave me an overview of what I will be seeing with Dr. Gajjar. She also introduced me to a
wonderful website called National Comprehensive Cancer Network. For some time before my
mentor was available, I was able to discuss research ideas and explore the website. Once my
mentor was available, I had the chance to see patients. One patient presented a case of a low
hemoglobin level and was tachycardic (high heart rate). She also told my mentor that she was
facing rectal bleeding. Analyzing the conditions of the patient, the doctor decided that the patient
must be admitted to the hospital for transfusion and for the gastroenterologist to determine the
sight of original bleeding. I was also introduced to some colon and rectal diseases and how they
potentially could give patients a higher risk for colorectal cancer. It was an exciting first day and
I am looking forward to what lies ahead.
Date: 9/17/15
Week of 9/14/15
On Thursday 9/17/15, I met with my mentor, Dr. Aakash Gajjar. I had the opportunity to meet
and interact with three patients. Two of the patients had pilonidal disease/cyst also known as
jeeps disease, which is a condition that deals with a chronic infection of skin at the buttocks
crease. This condition is more prevalent in men in the time of puberty up to age of 40. One
patient also has had transpincetric fistula and was scheduled for a colonoscopy. I also received a
follow up on the patient from my first day experience who was dealing with rectal bleeding. She
met with a team of gastroenterologists and found that she has colon cancer in the left splenic
flexure which has been developed for a couple of years. The patient went through a surgical
procedure called hemicolectomy. At the end of my visit, my mentor and I discussed research
topic and decided to focus specifically on colon cancer for my mentorship. Also, at the end, I
took a picture with my mentor for my mentorship poster project.
Date: 9/24/15
Week of 9/21/15
This past Thursday, I went to the UTMB Multispecialty care center in League City. I was not
able to meet with my mentor as he had to leave League City and handle business in Galveston
earlier that day. Instead of observing my mentor, I followed around Dr. Hmoud, a fellow in the
division of Gastroenterologists. I was able to see 4 patients that day. Many of the patients came
in with abdominal pain and constipation. One of the patients had high grade dysplasia. This is
often an early sign of Gastroesophageal reflux disease. I talked to Dr. Hmoud about many
nonsurgical procedures like endoscopies patients could go through depending on the health
condition. For example, one thing I found interesting was what is considered as pillcam
endoscopy, which requires a patient to swallow a pill that has a camera. This camera takes

pictures of the digestive tract and provides images to the doctors whether there are any lesions.
At the end of the visit, I talked to the fellows and they gave me advice for college courses
leading up to medical school. This visit was quite good as I was able to learn about other health
conditions besides colon cancer, which is the main focus of my ISM project.

Date: 10/01/15
Week of 9/28/15
This past Thursday I met with my mentor Dr. Aakash Gajjar for about five hours. I saw about 7
to 12 patients. One of the patients had a complicated and sensitive case. The patient had
diverticulitis which perforated and caused peritonitis, an infection of the membrane that lines the
abdominal cavity. The patient had recently undergone a laparoscopic colectomy, removal of part
or whole part of colon. Dr. Gajjar now planned on having the patient get a balloon-assisted
colonoscopy which allows physicians to widen up colon. Often after surgery, adhesion occurs
and the colon will narrow. The colonoscopy will let him see inside the colon. The other patients
presented varying health conditions. One patient had a long tract fistula which extended all the
way from the rectum to the scrotum. In this case, the patient was facing pain due to swelling and
drainage. Another patient came in with hemorrhoids and was also in a stage of pregnancy. Dr.
Gajjar also had assessed the patient for the remains of anal cancer and declared that the patient
having no more signs of cancer. We had to patients come to schedule for a colonoscopy. At the
end of my visit, I talked to my mentor about taking a field trip day on October 8th to have
observation in the operation room.
Date: 10/08/15
Week of 10/05/15
For this week, I worked on my midterm presentation. I also worked on collecting artifacts. I
found a diagram of the colon and UTMBs pamphlet for developing colon cancer awareness. For
mentorship hours, I saw three colonoscopies and surgery for perianal condonlyma. One of the
patients showed signs of diverticular disease and polyps, which are precursors for colon cancer.
Another patient went through a colonoscopy because her family had a history of colon cancer.
She did not present any polyps looking at the images taken during the colonoscopy. This
experience was my first time being in the operation room and I got a firsthand experience on
understanding the necessary safety precautions in the OR. After watching the surgeries, I
showed my mentorship my weebly site and asked for guidance for research sources.

Date: 10/15/2015
Week of 10/12/2015

This past week, I did not meet with my mentor. He was not in the clinic on Thursday, the day I
usually attend. I believe I will be meeting him Thursday October 22nd to continue completing
my mentorship hours required. I did however practice my mid term presentation and do
extensive research. For my mid-term presentation, I presented my presentation in front of family
members a couple of times and they gave me feedback for improvement. Initially, my
presentation was over the limit of time. I then realized I needed to make the information clear
and concise when I present. I worked to get around 8 minutes. I worked on extensive research as
usual in the study of colon cancer treatment. I read more about chemotherapy and its
effectiveness. I also read abut other systemic therapy used to treat cancer. I found couple of
sources which I will use to complete the assignment due the 23rd of October.
Date: 10/22/15
Week of 10/19/2015
This past week I could not meet my mentor because he was not at the clinic. I plan to make up
the hours this week. I got my activity hours completed. Majority of my ISM activities for this
past week included working on completing my research assignments, designing research
questions and gathering data. As I completed my research assignments, I found more graphics
and images to include in my final presentation and product (educational pamphlet). My objective
in the survey questions was to understand how aware the public is about colon cancer and
screening for colon cancer. I also wanted to see how many people have gone through the
screening procedure. I designed thirteen questions to fulfill my objective. I am hoping to have a
mixed group of people for my survey results, but I hope about half come from the age group of
50 years and older, which is the expected age group to have gone through a colonoscopy or colon
cancer screening. I hope that I can discuss my survey results the next time I meet my mentor. I
am looking forward to meeting my mentor this Thursday.

Date: 10/29/15
Week of 10/26/15
This past week I met with my mentor for four hours. We planned out interview dates and who I
will be interviewing. We also went over my survey results. We talked about the survey results
will be beneficial in the creation of my final product and how I plan to continue to receive more
results as the nine weeks continue. Lastly, we talked about taking a field trip day in the near
future to witness some surgeries. We had many patients coming to schedule for a colonoscopy.
One patient was actually facing rectal prolapse and my doctor discussed with the patient the use
of magnesium citrate for the bowel prep of a colonoscopy. One of the new things I got to see was
an analysis of the results of barium enema, which is a medical procedure that examines the
colon. Along with seeing patients at the clinic, my mentor talked about the new Da Vinci Xi
Robotic Surgical system. He talked about the pros and cons of robotic surgery. It was very

educational and helped me understand how surgery is becoming more advanced with the increase
of technology.
Date: 11/05/15
Week of 11/02/15
I did not meet my mentor this week because he was not at the clinic this week. I worked on my
research on Monday and Tuesday. I learned more about how nutrition and diet can have a
substantial effect in the prevention of colon cancer. I also read about some new cutting edge
research that has developed to increase the effectiveness in the treatment of colon cancer. I also
developed my invitations and determined my evaluators. I had contacted all my evaluators this
Wednesday. I also talked to my mentor about finding a conference room to complete my
presentation at Victory Lakes UTMB Specialty Care Center. I will be meeting up my mentor and
the nurse practitioner to complete my interview and make up the hours. I am hoping to get an
email response from my third person I am interviewing. After completing the research, I have
started to add the information into my final product.