Journal Entry #1

For about two years now, there have been two personal research interests of mine: the medical system's ignorance of cis-gendered women and POTS disorder. It all started at the beginning of the pandemic; my anatomy and physiology teacher at the time had bravely decided to put her planned curriculum on pause and instead prioritize more discussion-based learning while we were all at home on distance learning. During this time, we had been assigned a few Ted Talks to watch, take notes on, and then discuss, and one happened to be titled "Why Medicine Often Has Dangerous Side Effects for Women." 

That day, I ended up falling down a several-hour hyperfocus session, certainly much longer than I had originally intended on the subject, but the idea of an entire portion of the population being excluded from equitable medical treatment was just too horrifying, shocking, and interesting or tear my eyes away from reading. A few weeks later, and after some more hours invested in research digging, I declared "Gender Medicine" as my topic for my GSI project. I've been working on it ever since. 

The first time I had ever heard of POTS was also about two years ago; I had been out boating on a family excursion and, long story short, after swimming back to the boat, someone very close to me clearly needed a moment to recover afterward. Being the fit person they are, I was stumped: it hadn't been too far of a swim and it certainly couldn't be too much for them- they had been on the competitive swim team, after all. After checking in, they informed me they have dysautonomia, a condition associated with an improperly functioning autonomic nervous system. More specifically, they have POTS which stands for Postural Orthostatic Tachycardia Syndrome. If we translate that medical jargon, postural has to do with the position of the body, orthostatic has to do with standing, tachycardia means a high heart rate, and a syndrome is a set of similar symptoms that all indicate a certain condition or disorder. 

So, now we come to my personal project for the rest of this semester within STEAM: I plan to learn more about the daily struggles of living with POTS by connecting with my close loved ones diagnosed with the syndrome, in addition to doing more research myself. Just from what I've experienced with them so far, I've been able to catch a glimpse into how disruptive POTS symptoms can be, and how much of one's everyday life can be impacted. As part of my project, I'd like to explore options of how these everyday disruptions may be aided.
On top of this, I'd like to create either a checklist or a flow chart that can be integrated into a physician's protocol to ensure that patients of any gender are being treated equitably by their health care professional. 

(Source: https://sdgs.un.org/goals)

On a macro level, there are two issues at hand that I'm looking to cover: gender equality and health. These two issues are included amongst the 17 United Nations sustainable development goals, and by no chance either; in the beginning stages of our project, we were tasked to pick certain sustainable development goals that not only interest us but that we're also passionate about in order to guide our developing project. 

Even before this in the project timeline, everyone in our class constructed mission statements that resemble what we're dedicated to, what we believe in, etc. My mission statement is 

"Plan for success, expect the best, never settle, don't let your confidence dwindle. We are our own best advocates in medicine, in relationships, in life, and I aim to inspire everyone to take charge of that."

I think one's health and well-being is something that we're all entitled to, and part of my mission statement is that I want to empower people to take charge of their health and their bodies. Of course, that is easier said than done, but I aim to approach the topic of health from an equity point of view. In other words, I believe it's long overdue that the medical system acknowledged the differences amongst all genders and has equitable medical care accordingly available. 

Putting that into the context of my personal project, I want to work on a new addition to the medical protocol that is helpful for giving cis-gendered female patients equitable treatment globally. On top of this, I'm looking at developing a newly engineered salt tablet or salt/electrolyte-based additive to foods and/or drinks that may help with keeping up blood volume in hypovolemic patients and may mediate some chronic symptoms women with POTS experience. Speaking of women with POTS, while I plan on designing these salt tablets so that they may be helpful to anyone with POTS, my target population is women with POTS, considering that women are more likely to be diagnosed with the condition and women do still currently experience a grossly unfair lack of medical testing, research, evidence, etc. Case in point, cis-gender women are far more likely to develop/ be diagnosed with heart disease, autoimmune conditions, and chronic pain compared to men, and yet still the majority of medical testing is done on cis-gendered men and male cells, but that's a much larger topic for another time. 

(Source: einfochips.com)

To accomplish my product goals, I plan on using the "design thinking" approach, as pictured to the right. When I first worked with this process back in October, it was very attractive to me because of the strong emphasis on empathy and the creator's connection to the target population intended to receive the product, creation, etc. As I'm starting my personal project now for the next few months, this process seems so fitting for me to start with empathizing with women with POTS, further defining which issues are most prevalent or disruptive, and creating solutions from there. 

Coming this next week, I plan on researching which salt tablets that are currently on the market have proven to be effective for managing POTS symptoms. I'll also be looking into Atul Gawande's Checklist Manifesto, as I came across it a few years ago and I think it would be a great model for me to start building my gender medicine flow chart. 

So far, I've looked into the following sources below:  

From my research so far, I've learned a couple key points crucial to my project: 

• There are different kinds of POTS that are characterized by what causes the syndrome, 
• this is good for me to know going into my project so that I can best assess which kind(s) of POTS and which related symptoms are realistic for me to tackle 

• Some physicians recommend for POTS patients to take in 10-15 grams of salt daily, meaning that they're ingesting around 5850mg of sodium 
• Considering I'm planning to develop a useful salt tablet, these numbers are good to know in order to calculate how much salt I should be using 

• Around 40%-60% of women that have POTS and have gone through pregnancy have reported that their symptoms were more manageable during pregnancy 
• I looked into this phenomenon further and it seems like this is a result of these women retaining more of their blood volume due to being pregnant, which helped in mediating some of the most common symptoms that are linked to hypovolemic POTS. If I can consult with an OB/GYN to figure out which hormones or physiological chemicals cause the body to retain more blood volume, perhaps this could be another ingredient to take into consideration for POTS patients to help them retain their blood volume. 

Overall, I'm thrilled to be working on this project and to be able to have the opportunity of time to invest in researching and devloping solutions on an issue I'm so passionate about. I'm excited to see what research I can find and what I'm able to come up with.