SHAC Clinic

SHAC stands for "Student Health Action Coalition".

It is a student-led clinic that provides free services to the underserved population of Carrboro and Chapel Hill, NC. Every Wednesday night from 5:30PM until the last patient is seen (generally 11PM), volunteers from the health profession schools run the clinic, including medical, pharmacy, nursing, public health and social work. 

A little bit of info about how it works: 

A patient will arrive at the clinic either by appointment (preferred) or walk-in and will be put into the system by a nursing student. He or she will get vitals checked (blood pressure, height, weight, heart rate, respiration rate) and then the nursing student will go into the room where all of the volunteers are and a pharmacy student will take the chart to see the patient. 

Once the pharmacy student has the chart, he or she will see the patient and ask what the patient's chief complaint is (regular check up, fever, earache, etc.). The pharmacy student will also ask the patient what regular medications he or she is taking, ask about any medical allergies, and ask if he or she would like to get the flu shot (administered by other pharmacy students). 

After that, the pharmacy student leaves the patient and goes back to the room to find a medical student team. The med team assesses the patient and writes a SOAP note. Depending on the situation, a prescription may be needed. 

If a prescription is needed, the med team will confirm with the on-site Attending, and after approval they will have the pharmacy student write the prescription. The Attending signs the script and the pharmacy student goes back to the patient and counsels him or her on how to correctly take the medication. If the medication is part of the SHAC Formulary, then it can be dispensed on site for free (something new this year made possible by a grant the Clinic received). 

Finally the patient is able to go home! 

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Last night was my first time volunteering at the clinic. There are only 6 spots per Wednesday night for pharmacy students, and 3 of them are for PY1's. Needless to say, the sign-up fills up quickly! 

Normally there are 3 PY1's and 3 PY2/PY3's and are put in pairs throughout the night. However, last night 2 of the PY2/PY3's canceled, leaving just 1 veteran volunteer. This gave the PY1's more opportunity to do things on our own. 

I was partnered with a PY2 seeing my first patient and she did all of the talking. The second patient, I spoke but the PY2 was there to watch and make sure that I was hitting all of my points. My third patient, I saw all by myself! It was a great experience to talk to a patient and figure out what he or she was coming in for. I felt like a real pharmacist! 

Along with speaking to the patient for the chief complaint and flu shot, there were a few prescriptions that were written last night as well, and I got to write one! It was hydrochlorothiazide, a diuretic to help control hypertension (high blood pressure) by reducing the total blood volume. I also got to counsel the patient on how to correctly take the medication :)

It may seem simple to counsel, and it generally is, but you just have to make sure you say everything clearly and understandably. 

Just for example, I'll demonstrate: 

Because hydrochlorothiazide is a diuretic, it will make you go to the bathroom more than you do now. It is recommended that you take this in the morning instead of at night so that you're not waking up in the middle of the night to go to the bathroom. This particular script was written "1t po qd", or "Take 1 tablet by mouth once daily". If you miss a dose, take it once you remember, but if you remember close to the time when you would have been taking the next tablet (say, a couple of hours), then just take 1 and keep to your normal schedule (don't double up). 

Your blood pressure should lower after the first couple of days, but you won't be able to feel a change. It's important to regularly monitor your blood pressure either by your own home-machine or you can go to any local pharmacy and they will have monitors there you can use. Because it lowers your blood pressure, you may experience some dizziness if you stand up quickly. This should go away after a couple of weeks, so in the mean time just be sure to be careful standing or sitting up quickly. 

What questions do you have for me (open-ended questions!)?

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Overall, the experience was very valuable. The patients were great and very informative of their issues. Working with the medical students was interesting and I enjoyed the discussions with the Attendings of the patient assessments and prescription recommendations. I also convinced a patient to get her flu shot.

SHAC Clinic was the first of its kind in the country, and from what I hear many schools will visit to try to develop their own type of SHAC. It makes me very proud to be a UNC student to be part of such a great organization! I was able to sign up for a couple more nights this semester, and I can't wait! 

Hard Work Pays Off

Normally I hate discussing grades and I hate looking at my tests afterwards because normally... my grades aren't great. Most people think that I'm smart just because I'm Asian, plus I'm really good at taking notes. But the trick is actually studying the notes, which normally I'm either too busy or too tired to study.

My first mini-wave (test on a Monday and another on a Wednesday) of tests didn't go so great, and I had a LOT of catching up to do. I like to blame work and extra curriculars, but there's really no one to blame but myself. But hey, I was getting used to a new way of learning!

Anywho, this second REAL wave [that took off 10 years of my life from all the stress] was the true test of my intellectual capabilities. And self-coping capabilities, might I add.

This time, I had to seriously prioritize my time, create a study schedule, and not be lazy. In undergrad, I never had this kind of load even during finals. But maaaaaybe I just didn't try as hard as I should have :)


Overall, the end result was something I could be proud and satisfied with. It wasn't perfect by any means, but it definitely ended with a BANG!

1) First came physiology. I really like this class because I feel like it's right up my biologically-trained alley. Even though physiology is a required pre-req for pharmacy school, there seems to be a LOT more information in this class than at UF. Also, it's the class that we get our first introductions to basic drug therapy.

This was the first test of the semester; it only has one midterm and a final - YIPES! This test consisted of endocrine and cardiovascular systems, and hematology. In addition to all of the hard-core facts, we learned how to read lab values applicable to hematology (white blood cell count, red blood cell counts, hematocrit, and how mean corpuscular volume relates to the types of anemia), different drugs that affect the nephron (different types of diuretics act on different parts of the nephron to yield different results. COMPLICATED!), and the various ways to regulate blood pressure (high blood pressure medications work directly on the heart, or indirectly via the nervous system or blood volume with kidney regulation!)

Ended up with a high B on the test, but with the quizzes and assignments I'm still pushed up to an A. Phew.

2) Three days later was pharmaceutics... What is pharmaceutics, you ask? Hmm... how to explain this in a better way than hell... I'm kidding; I actually find it very interesting. This was the second test of the semester, and it was about solids, gases, and solubility. Amongst other things, we learned about how drugs are formulated to increase their solubility. You would think that all you would need was a drug that dissolved easily in water, right? But it's actually a delicate balance of water solubility and lipophilicity (dissolvable in lipids, aka cell membranes). It's also difficult to create drugs because your it has to travel through vastly differing environments from your mouth to the extremely acidic conditions of your stomach!

But anyway... this was a test I wasn't very happy with, but I wasn't the only one! I knew this ish like the back of my hand, but silly trick questions got me. I got a few points above the average, and I heard that the class is curved overall so I'm just going to move on and try even harder on the next one...

3) Two days later was health systems. We learn about Medicaid, Medicare, uninsured, different health care models of the world, the health care team, etc. I think it's interesting, but class is so damn BORING and it's a 2-hour block right after lunch. Not a good combination for paying attention.

Good thing all you needed to know what was exactly on the slides, and BAM, just made the A mark.

4) And finally... Monday was the big kahuna: biochemistry. I had all weekend to prepare, and that I did.  About 16 hours each day! This was the test I reeeeally needed to do well in because if I didn't, let's just say I may need to re-take it.

Coming out of the test, I felt pretty good. I was able to answer each question and felt confident in the questions that required lots of calculations. I felt nervous because I heard other people talking about getting different answers to some questions I was iffy about. But I braced myself for B (don't get me wrong, I would have been very happy with that!).

During the LAST class today, the last day of school before fall break, grades went up.

I never brag about my grades, but I felt like proclaiming this to the world because I was about to cry from happiness. 96%!!!!!!


The main reason I'm so happy is that I am now confident that good grades are possible. Our professors aren't trying to fail us, but are genuinely making sure that we know the material and to be better pharmacists for it.


And now, it is Fall Break!!!!!!!!!!!!!!! Even though I'm working 4 out of the 5 days, the mental break is much needed.

PHEW.

Cilantro-lime rice with Fajita Chicken

I was craving some rice from Chipotle, so I decided to try making it myself! And what goes better with rice than some fajita chicken?

Cook 1 pound of chicken, cut into small pieces...

...until no longer pink!

Add some seasoning mix, per directions. 

Cook rice in whatever method you choose. 

When cooked, melt/mix in 2 tablespoons of BUTTAH.

Add in some chopped cilantro... about 1/3 cup.

 Add the juice of 1 lime.

And eat up!