Noah Rainer: Spinal Cord Injuries, Week One

Hello! My name is Noah Marie, I am a student at MCHS in Cortez CO,  and I just spent the last week in Louisville Kentucky interning at the Frazier Rehab Institute in research concerning individuals with a Spinal Cord Injury (SCI).

First day at Frazier– Feat. Ellie by the 15th floor elevators

My internship started at 9:15 on Monday morning with a tour of the The Frazier Rehab Institute -part of the University of Louisville: Kentucky Spinal Cord Injury Research Center (KSCIRC)- where I got a general overview of what my internship would be like. When I got there I was crazy nervous but I was surprised by how understanding everyone was and thankfully the kind lady mentoring me, Andrea, was ready with a schedule and was super happy to have me there. After the overview, I spent an hour reading over some articles on basic knowledge I would need to understand-it was mostly information concerning ISNCSCI (International Standards for Neurological Classification of Spinal Cord Injury) , AISA grades and FNPAs (Functional Neurophysiological Assessment). The first day I was there my lunch was scheduled right after my readings, and it was for 30 minutes, which was typical throughout the week.  After lunch my first day was really interesting. My afternoon started with me observing a 3 hour session for a participant in locomotor research, and afterward I spent an hour learning how to process data using programs made in house specifically for the ANR (Adult NeuroRecovery program). That Monday finished with me observing Andrea provide information to an individual interested in participating in a research study for individuals with a SCI. The phone call were conducted to inform them about the eligibility requirements and screening process and also what the study would be like if they then decided to participate. 

The display of electrodes Prior to placement for NMES training

My second day was similarly intense but also very different, which was a common theme throughout the week, my days were always full and interesting but never the same. My day started around 8 when I observed a training session where they taught me how to run the computer program that collects the data for the study, then was later able to practice with past videos. And lets just say that was pretty cool, at first I thought I couldn’t get it but the instructor was really cool and I picked it up really quickly with him guiding me. Tuesday was really eventful, I was allowed to observe an MRI scan for tissue analysis and afterward I had a few extra minutes so the team member who processes the data gave me a run though on how to analyze MRI scans and get useful information -like muscle composition- and color coded 3D  images. I also had a rotation with the engineering core where I learned about the different projects they do to help with research projects or help the QoL for an individual. The team did things like repair broken electrodes used in NMES training and other complex tasks that they complete casually, they are an impressive and vital team.

A display of Standard equipment used in transfers and mobility- power chair, gait belt, slide board, and Hoyer sling

I was kind of nervous going into Wednesday because first thing in the morning I had 2 hours of training going over reading I had done about how to care for an individual with a SCI in events like pressure relief and transfers. I felt like even though I understood the readings I was unprepared to perform things like applying a gait belt or a hoyer lift. But when i got there all nervousness faded away and the instructors demonstrated all the motions and explained everything till we felt confident. I was really happy because I was the volunteer when they needed to demonstrate a technique or a visual representation of a movement, so when I left I felt confident in how to perform these techniques if ever required. Afterwards I worked on some special projects till 11:30 in a cubical on the 15th floor, this was mostly practice running the computer for training sessions using past videos along with some reading I did on current studies. After lunch I spent my afternoon observing screening sessions for locomotor research and learning different ways they collect and use data.

Thursday starting at 8 I shadowed the same participant throughout the morning through different types of testing. These finished a little early due to complications so I was able to go to lunch a few minutes early and have time to try and pick up my badge and TB reading. After lunch I had an hour to track sessions before what was supposed to be my second rotation with the engineering core. We had to improvise my schedule a little so I spent my afternoon with Sharon, a member of the engineering core, who took me to Dr. Hubscher’s Lab -in a building nearby-  to work on data analysis for procedures for electrodes placed onto a rats spinal cord at the T10 level and the effects on the bodily systems of the rat, specifically the bladder. When I arrived the procedure for the implant was still happening so I was able to observe and ask questions. This was really cool and I learned so much regarding the anatomy of the spinal cord. However there were unforeseeable complications with the rats respiratory system and I also witnessed CPR for the animal preformed using a 3 ml plastic syringe and at first the animal started respiration but quickly passed a few minutes later. This was like a crash course in anatomy because I was then allowed to dissect the rat as they guided me through how to perform a dissection. This was a very informative experience as I learned first hand the anatomy of the abdominal cavity and respiratory system  in a mammal and also the parts to a spinal cord including different vertebrae locations and gray vs white matter in the spinal cord. Because of the complications in the procedure -that was supposed to go till 6- the team got out early and I went with Sharon to where the engineering core was based back in the Frazier building. This is on the 14th floor of the Frazier building, in what used to be the Jewish hospital. There she taught me the basics of soldering and let me practice, but I need a lot more practice before doing something important like fixing electrodes so we agreed I’d practice with some older semi-destroyed ones first.

Friday was a blast, I had to be there early to get my TB skin test read then I went to a training session and ran the computer program while the PT watched over me. Then back on the 15th floor I practiced running the program for training sessions with NMES (Neuromuscular Electrical Stimulation). Twice On Friday I went to the 11th floor break room where a really great person named Amanda when over the readings I did prior to my arrival and explained in depth the anatomy and medical complications regarding the spinal cord. I also attended a seminar given by two grad students about their research projects that could be applicable to SCI knowledge.

Photo with mayor of Louisville at intern banquet-Featuring Ellie, Miniah, and me

Ellie is a fellow Pintern staying with my same host family here in Louisville and after work at Frazier (where she also interns) we were both able to attend a banquet hosted by the Mayor for all interns in Louisville. This was a really cool experience and we learned a lot about the city. And of course Ellie, Miniah -another super cool intern from Frazier- and I all snapped a photo with the mayor.  

My host family, Brigid and Graham made us a sign to welcome us!

So I arrived on Saturday the 16th to Louisville, and about 3 hours before I met Ellie. She is the super fantastic person interning at the same place as me and she stays with the same families. We first met Brigid and Graham at the airport and they had a sign and everything they are fantastic. Later we met David and Angus, who are also super great! Brigid is a super talented musician and the first night we got here we went to her gig at a house party and totally had a great time swimming and listening to her music!

Lake Side Swimming area <3

The kids are absolutely wonderful and so great to be around I really feel like I fit into their family! They give Ellie and I so much independence but also made sure were always included! We love to go with them to Lakeside, a beautiful pool built into an inside of an old quarry, and swam for hours. Today we went walking a few miles down a beautiful street filled with shops, cafes, and boutiques. It has been a fantastic week here, I absolutely loved it.