Fun-a-day 14: Malaria and "twisted" 9-patch quilt

Malaria is a disease that I myself have only really seen once in all of my years in the lab.  It is a parasite that is spread through mosquito bites, and in the United States, mosquito control programs have made malaria almost non-existent here.  But in many tropical and sub-tropical regions of the world, malaria is a real threat, and causes millions of people to get very ill and sometimes die.  Most of the malaria cases diagnosed in the US are from people who have traveled from areas where malaria is present.  Indeed, the one case I "found" in our lab was from such a traveler.  A doctor can also order a malaria smear if they suspect this in their patient.  But malaria is a disease that "waxes and wanes", so a negative smear won't completely rule it out.

The malaria parasite spends part of its life cycle in the human red blood cell.  Other life cycles forms can be seen on a blood smear, but the "ring form" is the most common.  These little tiny rings can be seen inside of the red blood cell.  Luckily there is treatment for malaria, and ways to prevent it.

I made my red blood cells really big so that I could try to make the ring form of malaria easier to see and sew.  Once again, I got a bit frustrated trying to draw something using thread and fabric that is seen on a slide under a light microscope.  But hey, I'm learning a little bit each day!

Speaking of learning, I though I'd share a quick tutorial of a "twisted" 9-patch quilt that I just finished.  I was itching to get it done, as the blocks were finished a few months ago, but put away as I worked on Christmas presents.  I finished the top yesterday, and my husband was home today for lunch and helped me get a good picture of it (even though it was a bit windy).  One thing this quilt taught me is that black isn't all black.  I had some black fabric that I bought in Michigan, and used this all up.  When I bought what I thought was the closest match here in Oregon, only after sewing it all together did I really notice the difference!  Oh well...
A friend of mine told me about this technique about a year ago.  After seeing it on many blogs and in local quilt shows, I decided to make one myself.  It's super-easy and looks great when finished!  When a local store had a sale on fat quarters, I bought 8 of the blue batik fat quarters, then cut out 4, 9 x 9 inch squares from each of them, so I had 32 in all.  I took 2 yards of black fabric and cut out 32, 9 inch squares, and half a yard of the yellow batik, and cut out 8, 9 inch squares.  I sewed them all in 9 patch blocks like this:

Then I cut each of these 9-patch blocks in half both vertically and horizontally, like this:

Now I had 4 smaller blocks.  I twisted them and rearranged them into rows of 5 across, then sewed 6 of these rows together.  I had 2 left over small blocks.  I hope that makes sense.  If you haven't sewed one up yet, do it!  This one was so fun and easy!

Fun-a-day 13: Sperm Count

I hope I don't offend anyone with this post.  It's truly not my intent, but after doing the fetal hemoglobin block, it's only natural to do a sperm block count next!  So here it is!  Actually a sperm count is only part of a "semen analysis" test.  We also look at the motility (as a percentage) at different times after collection, volume, sperm morphology, and a few other factors.  If infection is present, we certainly note that as well.  When a couple is having problems becoming pregnant, it's usually the first test that a doctor orders, as it is an easy and noninvasive sample to obtain.  Yes, it's embarrassing, but also the rich source of much comedic humor!  It is also usually ordered after a vascectomy, and yes, I have seen sperm in a post-vascectomy sample, but only once that I can think of in my dozen or so years as a med tech.

When we look at the slide, we once again do a wet-prep, so there are no pretty colors, but I just couldn't help but make mine pink and blue, because it is, after all, the sperm that determine if a baby is a boy or girl.  We do the exam on low power, so they look very tiny.  I made mine a bit bigger than what we normally see.  It never ceased to amaze me just how many there are in such a tiny drop (many millions per milliliter).  On a slide, they have no clear "aim", so they swim in all different directions. Once again they really are a wonder to look at under the microscope!

Fun-a-day 12: Fetal hemoglobin stain, and WIP

OK  Babies are fun!  One of my favorite "special stains" to do in the lab was a "Kleihauer-Betke Stain" (KLB).  It stains only red blood cells from fetuses or newborn infants (that contain fetal hemoglobin).  The stain is an incredibly vibrant hot pink that's a lot of fun to look at.  We do it on an "Rh negative" blood type mother, when there has been a confirmed fetal-maternal bleed that surpasses the "normal" amount that a regular dose of "Rhogam" would take care of.  Make sense?  I didn't think so.  Rhogam is a drug, created to prevent a potentially horrible condition called "hemolytic disease of the newborn", luckily a disease that has been mostly wiped out due to Rhogam.  This happens when an Rh negative mother carries an Rh positive baby, and is exposed to their blood, usually at birth.  The first baby is fine, but because of the exposure, the mother will develop antibodies, or disease-fighting proteins that target and destroy future Rh positive blood cells, so if she becomes pregnant again with an Rh positive baby, the mothers immune system can literally attack its blood cells.  Rhogam prevents this from happening by binding up all of the Rh positive fetal or baby blood cells before her body can detect them.  I hope that makes sense.

When we do a KLB Stain, we determine by actually counting the number of fetal cells (seen as bright pink) vs the number of maternal (the mom's) cells (see in the black as thin rings, because the stain lyses them).  We give this to blood bank, who then can determine how many additional vials of Rhogam to give to the patient.

I have a personal story about Rhogam.  It was first used in Spring of 1968, just a few months after my twin brother and I were born.  My mom is A neg, I'm O pos, my brother O neg.  After birth I had severe jaundice (which can be a sign of hemolytic disease of the newborn), and was given a complete blood exchange transfusion.  My brother was not.  I know my parents tried years later to have more children, and my mom never got pregnant, so I often wonder if this exposure happened with my mom.

On another note, I'm linking up with "Freshly Pieced" blog's WIP Wed.  I thought I'd show you what else I've been working on.  I made some Kindle covers for gifts for Christmas, and the response was so good that I decided I'd try to see some.  Here's what my kitchen counter looks like today.  You can see my sewing set up in the background... I use our dining room table to sew on.  I do a lot of shuffling things around here!

My "design wall" (ie our bed) has a quilt that I'm itching to finish.  I started it in October, then put it away for after Christmas.  It's a "twisted 9 patch" quilt that was so easy to make, looks great, and all I have to do is sew the blocks and rows together.  Hopefully today, because my bed is also where I fold clothes and I have about 4 loads going today.

Fun-a-day 11: Gout

Maybe I should call this "not-so-fun-a-day", because some of these diseases I cover aren't at all fun, including gout.  But once again, it's quite a different story under the microscope.  Gout is caused by needle-shaped uric acid crystals that get into synovial fluid, the normally clear quite thick fluid that surrounds the bones of the joints, like elbows, knees and toes.  All it takes is one look to see why it would cause really severe pain.  I watched my dad go through bouts of gout (really didn't mean to make that rhyme).  The pain was bad enough to send a grown man who rarely went to a doctor, to the ER.

We don't see these very often in the lab, because collecting the sample, is very invasive, and must be done by a doctor.  We use a special polarizing lens (similar to polarized sunglasses), that makes the crystals glow yellow on the vertical plane, blue on the horizontal plane.  Setting up the microscope often is the most time consuming part of the process.  The background is a vibrant fuchsia, and we often see white blood cells in the background, which aren't normal, but are there either from infection or inflammation.  I tried to use purple thread in the background, but am not too entirely happy with the results. 

It's Tuesday, so I'm also linking up with Quilt Story's blog, full of wonderful fabric projects every Tuesday.

And I just have to say that the horrible shootings on Saturday have left me in a real funk.  We recently found out that my husband's aunt and uncle used to live very close to where the shootings took place, and also helped out with Giffords' 2008 campaign, so it's understandably left them quite shaken.  I also think a lot, and remember the deep grief I felt when my own dad was suddenly and unexpectedly taken from our family 2 1/2 years ago (from a pulmonary embolism).  My heart goes out to all of those families who are grieving right now.  I can't even begin to understand what they are going through, but know their pain has to be enormous.

Fun-a-day 10: Urine crystals

We got a lot of the white stuff yesterday, about 4 inches, enough to cause a 2 hour school delay this morning.  With so many tiny snow crystals out there, I thought it'd be fun to put a few urine crystals on my quilt.  A few of you have asked what I'm doing here.  I mentioned in this post that I decided to participate in a January "fun a day" project, through our local community art center (the Pendleton Center for the Arts).  It was started by the Art Clash Collective in Philadelphia as a way to be creative each day for a month, then get together as a local community and share your projects in February.  I think it's such a fantastic idea!

So today I tried to "draw" a few of the most common urine crystals that we see in the lab.  Since urine is such an easy and non-invasive sample to get (ie., pee in a cup), a urinalysis is a very common test ordered by the doctors.  It's amazing what information can be learned from a urinalysis.  It involves 2 parts, a chemical analysis, usually done by a "dipstick", and a microscopic part, looking once again at a "wet prep".  So once again, no pretty colors, but the crystals that we sometimes see are incredibly beautiful.  I'm learning that painting with thread is really a poor substitute for what we see under the microscope.  The light comes from below, and some of theses crystals are 3 dimensional, which refracts the light, making them just glow from within.  If you do a Google image search for "urine crystals", you'll get a better idea of what they look like.  The square "diamond" crystals are calcium oxalate, the rectangular ones are triple phosphate, and the flat ones that look like a Dairy Queen sign are uric acid.  Normal urine is a clear liquid that is sterile until it leaves the body.  The chemical make up can change quite a lot in patients with kidney problems, but also in many other organ diseases and infections.  Of course a urinalysis is also what we use to detect a bladder infection.

And even though I'm not a big sports fan, there's no escaping the fact that the University of Oregon plays a really big national football game tonight (Go Ducks!), so I decided to stitch some green and yellow "O"s into the background!!

Sometimes crystals can be seen in the urine because of kidney stones, but they can also be seen as a normal precipitate that forms as the urine cools.  You'd normally never see more than 1 or 2 different types of crystals in one sample, so this quilt block is just a collection.  Different ones are present in acidic urine, vs alkaline, or basic urine.

Finally, some people have asked how big these are, and how it's coming together.  I made the blocks 8 inches square, with a 5-6 inch diameter (soup bowl-sized) circle that I ironed then appliqued on, using "wonder under" fusible interfacing.  I plan to use binding to join them all together.  I've never done this, so any tips would be much appreciated!  I did some trimming, and this is what it looks like so far.  Enjoy!

Fun-1-day 9: Fungus among us

This is the quilt block that I sewed yesterday morning.  It has 2 different types of yeast or fungus that can cause problems in our bodies.  On the left, is my attempt at the yeast, "Candida albicans", the main cause of genital  and oral (thrush) yeast infections. "Trichophyton rubrum", on the right is the main cause of skin fungal infections, including ringworm (which is NOT a worm, but does make a ring-shaped patch on the skin), athletes foot, and jock itch.

In the lab, the doctor will order a "KOH prep" to be performed on skin scrapings, or swab to detect these.  KOH, or Potassium Hydroxide, lyses, or dissolves all other cells, and makes the fungal cells easier to see.  It's done as a "wet prep", where the sample is directly examined under the microscope without drying and staining it first. Once again, I used a little creativity, and a little variegated yellow thread for the background.  The yeast and fungus is stitched in grey.

Just like bacteria, yeast and fungus live all around us and in us, normally causing no problems.  In fact, yeast is used to make wonderful food and drinks, like bread,  blue cheese, beer and wine.  This is NOT the same yeast that cause infection though, and it concerns me that when I searched yeast on Google tons of information came up on "yeast free diets", and the like.  Just like this blog, you shouldn't believe everything you read on the internet!

Yeast and fungal infections can be a particular concern in immunocompromised patients.  These patients have a weakened immune or disease fighting system because of cancer treatment, or diseases like AIDS, which affect the immune system.  Yeast and fungi are superb at taking advantage of the change in the immune system, and can rapidly multiply and cause symptoms in large numbers.  In the gut, a course of antibiotics will kill off all the competition for food by killing bacteria, thus allowing the yeast to rapidly multiply, causing yeast infections.  Once again, "icky" subjects, that become beautiful under a microscope...

Fun-a-day 8: Blood bank

I had already finished my art clash collective Fun'a'day quilt block this morning when we heard on the radio about the tragic mass shooting today in Tuscon, Arizona, at US Rep Gabrielle Giffords public meeting.  Needless to say, we're stunned and horrified.  My  thoughts and prayers go out to Representative Giffords' family and the families of all others involved.  We have family in Tuscon, my husband's aunt and uncle, the recipient of the 50th anniversary quilt that I recently blogged about.  So we are also concerned about them.

As a former medical technologist, my thoughts immediately went to those in the hospital labs all over the city who work in blood bank, including those at the University Medical Center in Tucson.  Also as a former med tech, I have been directly involved in too many traumas to count.  My first 2 jobs were in small hospitals, where I was routinely called to traumas in the emergency room to draw, or collect blood.  I have also worked in blood bank when these traumas came in.  I know first hand what the hospital workers, not just doctors and nurses, but many other departments go through emotionally when they are facing such a situation.  The only thing that makes it bearable is the incredible teamwork that happens and comes together while we all try to save a life.  It's really something that can not be explained.  But my thoughts and prayers go out to all of the many hospital workers, including medical technologists who are working in these cases today.  In situations like this, the teamwork extends to all of the hospitals in the whole area, as well as police and EMT's, firefighters and even people you wouldn't think of, like cab drivers who pick up supplies for us, or couriers who deliver needed blood products and supplies to the hospital.

I wasn't really planning on doing a "blood bank" quilt block, as my plan was originally to do just slides and stains that we see under the microscope (thus the circles), but I felt compelled to stitch together this unit of O negative blood to add to the project today.

People with O negative are called "universal donors", because O negative blood can be given to anyone with no adverse reactions.  If you transfuse the "wrong" type of blood into a patient, it can be fatal.  In a trauma case, we don't have the time to "type and cross match" the blood, so the doctors order O negative blood initially to give to the patient.  The blood bank in the lab will draw a blood sample before any blood has been given to the patient, then determine the blood type ( A, B, AB, or O), and the Rh factor (either positive or negative).    In a cross match, we take blood from the donated unit (we use the little segments that trail off of the unit on the left), and mix, or "cross" it with the potential patient or recipient to see if it's compatible.  In a trauma, as soon as we know the patient's blood type, we switch to "type specific" blood.  That's cross matched too.  It's critical that we keep an adequate supply of O negative blood on hand in case of traumas, but also because people who are O negative can only receive O negative blood.  People who are AB positive are the universal recipient, and can be transfused with blood from anyone with no ill effects.

Forgive me if I don't make much sense today.  The TV has been on all day, and it's hard to concentrate.  But I just wanted to continue this project in a way that helps me make sense of what happened today.