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The Hoeflinger Podcast
Welcome to the The Hoeflinger Podcast, where Dr. Brian Hoeflinger and Kevin Hoeflinger delve into riveting discussions about life as a neurosurgeon, the world of medicine, healthy living, fitness, and anything else that piques their curiosity. Dr. Brian Hoeflinger, MD, brings his extensive 24 years of experience as a full-time neurosurgeon to educate and inform. Get ready for engaging conversations that will broaden your understanding of the medical realm and beyond!
The Hoeflinger Podcast
#11: What is Spinal Stenosis?
In this episode, Dr. Hoeflinger gives a detail explanation of spinal stenosis, including symptoms, treatment options, and what surgery entails.
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It's Friday night here getting a little podcast in. We're gonna, I think, talk about Stenosis and explain like some surgery stuff. We have something want to start doing a. We're gonna start doing these for like ticktocks too, but uh, like a medical word of the week. Yeah, start doing some of that. But yeah, it's kind of funny.
Speaker 2:you know we're tonight, it's Friday night, you know we want to get it out for tomorrow morning and we were sitting here thinking we got to keep it going because we were learning statistics like what is it 90% of podcasts if you don't make it to 10 episodes? So we made it to episode 11.
Speaker 1:Yeah, no, I know, I think. Yeah, it's like 90%, don't make it to 10 or 20, and then like a 90% after that don't make it to the next 10, yeah, well, no, it's just that's like anything with like consistency, or like how many people you know start out the new year's with a goal and then by the end of gyms are packed. It's beginning of January and then by February I mean, you have to force yourself. Sometimes it gets busy. Obviously he's got a very busy schedule. You start trauma call today, right, yeah, but Sometimes you know you got to do something. No, necessarily the settings not perfect. It's where the discipline comes in. Also, I turn 26 tomorrow, so that's pretty cool. Yeah, Big birthday, I know, so it's weird. Another thing we talk is we're getting older at like time, because the longer you're here it all kind of starts feeling shorter proportion wise.
Speaker 2:But it's funny Well, you're. When you're younger. Everybody knows this. When you're younger, you can't wait for things to come, and so it seems like it takes forever because it's the anticipation. And as you get older, you're not waiting as much for things to come.
Speaker 1:So I think time goes faster and it just goes by a lot quicker and you kind of fall into a routine of life a bit, you know, especially after college, I think. I mean it's probably different for you like being in Medical school and beyond, because you were like so busy you kind of I think yeah.
Speaker 2:But yeah, it's never gonna go by when you're in it, and then all of a sudden it goes by in a blink of an eye. You say, wow, where'd it go?
Speaker 1:Well, because it's so weird thinking about like y'all past the high school, you see younger people. They look so small and they look so young compared to you and then you don't feel. You don't feel like that much older, but I remember now is younger. Looking up at like a 25, 26 year old, you think they're so old, right, but Tonight we would do.
Speaker 2:Um, we'll try to do it like a diagnosis. Like I was in a store today with my wife earlier and some woman had stopped me. She said she follows me on tic-tac and this is surprising. And she I don't know, it's tic-tac for YouTube. But I said we were asking what do you like about my tic-tacs? And she said well, I like that you actually teach us stuff and and you talk about medicine and open up your world about Surgery and things that we never have access to or hear about, as opposed to doing other types of things on tic-tac. So we thought maybe tonight we just pick a common diagnosis that a lot of people have and that's spinal stenosis. So Kevin's gonna ask a few questions about spinal stenosis and I'll try to answer, because sometimes if I talk I'm gonna miss the flavor of what maybe the average person who doesn't do fine surgery would ask. I think you know.
Speaker 1:Yeah Well, I think, just like with your tic-tac, sometimes you're surprised when we do stuff because to you it's just like every day, right, it seems normal, it doesn't seem like much. But then if you same with like the terms and stuff, when you and mom talking, use the big medical terms, everything like if you don't if you're not in medicine. It's a lot different, but I just start by giving just an overview of what spousonosis is, what someone who might present with what they might notice in their everyday life.
Speaker 2:Yeah, so spinal stenosis itself. It means narrowing of the spinal canal, whether it's in your neck or your lower back. It's narrowing of the spinal canal and spinal stenosis. Typically enough, my average person that comes in with complaints I mean probably 80 to 90 percent of time. What they're gonna say is you know, I've had this vague history of back pain over, you know, months to years, but you know, most recently, over the past two or three months, I've noticed that I get pain or discomfort in my butt, cheeks and my hips and I get pain or achiness down on my legs, um, numbness in my feet, and it, it inhibits you, right?
Speaker 2:So I mean, most people say, well, I can't stand very long or I can't walk very long because my legs hurt so bad or they get fatigued that I have to sit down and rest.
Speaker 2:And then I sit down and rest for a little bit and then I get back up and go a little bit further and I do okay, and then my legs just start to hurt so bad or they feel fatigued again and they're achy and I got to sit down and rest again, and so that's how people typically present with spinal stenosis.
Speaker 2:Um, and that's due to the pinching of the nerves. You know, the narrowing of the spinal canal pinches the nerves, um, so it becomes very debilitating. I mean, there are people who get to the point where they can't walk anymore because they have so much pain. They, you know, they go from walking to using a cane to using a walker and then a wheelchair, and it's not necessarily that they're going paralyze it, because the pain in their legs is so bad that they can't take it anymore, you know, and so they have to be sitting most of the time. So it really can affect your life, and it doesn't always have to present exactly like that, but it's usually something where people it comes on very slowly and gradually and it just becomes very debilitating in their life, you know yeah, sorry, I just wanted to make sure the camera was going.
Speaker 1:I just wanted to make sure on that because so, but yeah, so I think a big thing there is. You know, a lot of people have back pain here and there, like I think even sometimes in my girlfriend would say there are people my age, like I bet, but that's not a lot, you're gonna have general aches and pains in your back. It's what sounds like there is. It's the progressiveness, it. It progresses right to a point. Well, it's.
Speaker 2:A lot of people say I have sciatic. So some people come in the office and say I have sciatic and I say where's your pain? That goes to my back. And I say, do? It doesn't go anywhere and say no, it just stays in my back. I mean, that's really not sciatica. Sciatica is pain down the sciatic nerve distribution and so true, sciatica is the pain that goes down the butt, hip and the legs. It's the stuff down the legs. That's the true sciatica and that's what surgery works very well for. But you know, pure back pain is not sciatic. So I think that's a big misconception to people yeah.
Speaker 1:Um well, I always think that's, uh, really cool. We've discussed this before, but I think it's really cool how you can tell, by the nerve distributions and what, where people experience pain, where they're weak or something, because we can talk about. Why don't you start?
Speaker 2:Yeah, so if you're like if you're going to go and see your surgeon or a doctor about this. What I try to do I want to find out you know what distribution is that pain in? So you know every nerve from the back goes in a different distribution. And so if you, if you look at it, I have people take a paintbrush. They said, you know, just think about having a paintbrush and paint on your body for me where that pain goes. So some people go well, my pain starts from my low back into my butt and it goes into my groin and kind of the inside of my thigh and that's the third nerve distribution.
Speaker 2:So that gives me an idea what level the stenosis may be at. And then some people come in and say well, it goes right down the front of my leg, you know, just like my shin splints, or it's just crampiness in the front of my leg and that's a fourth nerve distribution.
Speaker 1:And then some people saying fourth nerve distribution what?
Speaker 2:Well, so what are you going to do about that?
Speaker 2:So there's different levels of the spine.
Speaker 2:So you know, between the second and third bone in your spine there's five bones of your lower back right, and each level we call it like L one, two, that's between the first and second bone, and L two three would be between the second and third bone, so between the second and third bone, that's where the third nerves come off, and so when people have that pain on the inside here you might think their stenosis could be at that two, three level People who have narrowing the spinal canal between the third and fourth bone, that usually pinches the fourth nerves and so they'll paint pain down the front of the leg.
Speaker 2:And then pinching of the nerves between the fourth and fifth bone, that pinches the fifth nerves, and those nerves go from your hip right down the outside of the leg and off and on to the top of the foot into the big toe, and then the very lowest level, called L five, s one that's between your fifth lumbar vertebra and the tailbone. People have pain in their butt, cheek and then pain right down the back of the leg into the calf, and so when people do that, it just gives me an idea of where the pain may be, and then I can correlate it to their MRI, because when you're as a surgeon, you know you have to make a decision is surgery appropriate or not?
Speaker 2:So you want to make sure that the pain is going in the distribution that you would expect it to, based upon what I see on the MRI, and so it's kind of like putting things together a little bit, and it's not always perfect, and there's some people that come in with pain down the back of the legs and yet they have narrowing at a level above where you think they have it. But that's a general idea of things and that's how I approach it when I see them in the office.
Speaker 1:Well, that's what I was going to say too. It's a good way of pairing stuff and it's kind of checking because you'll you'll perform your kind of you know little tests on people having to push back against. You have them describe their pain and stuff like that to paintbrush. But then then it's when you look at the MRI, it's actually narrow, that say, 2, 3, l2, 3. Then you're like, ok, that makes sense, that makes sense. And then and then it's more likely to, if you did do surgery, that that's actually going to be something that.
Speaker 2:Yeah, because if the symptoms fit what I see in the MRI, those obviously are the people who do the best. I mean, when your symptoms fit what you see on the MRI and you do surgery, people do wonderfully. Now if you took somebody who has symptoms that don't really match what you see on the MRI, it's less likely surgery is going to help. So you really got to try to put things together when you're talking to surgery To, it's about there's no guarantee with surgery.
Speaker 1:Surgery is about creating the most likely scenario that someone's going to do. Well, you want to take the highest percent chance. You know it's maybe there's a 20 percent chance of surgery doing anything to find out necessarily worth it.
Speaker 2:I mean so even before you get to surgery. So then then what's the treatment of spinal stenosis? So you know, most people who come in with spinal stenosis and are symptomatic, if they have a normal exam, they don't have a weakness of the muscles and everything is okay from that perspective. You know, normally we'll try therapy. First, we'll do some water and land therapy for six weeks and that works very well for a lot of people. I mean I have people coming with severe narrowing of the spinal canal, bad pain down their legs. Get them into therapy. They come back six weeks later and they'll feel 80 percent better. Now it may not last forever but certainly it's helped them a lot.
Speaker 2:And you know, in an older person or someone who can't have surgery, that's not a bad deal to get better with temporarily, with some physical therapy, you know. And then if therapy doesn't work, you could try pain management, try some pain shots. You're back and often that can be helpful. Again, they're temporary but can be helpful. And there's other things people try. I mean people go to a chiropractor, which everything in moderation, right. I think a chiropractor is fine as long as it's done in moderation.
Speaker 2:Some people go to a massage therapist, some people go to acupuncture or dry needling they call it. Some people get light traction done. So there's a lot of different things that you can try, but in the end sometimes those things don't work. You know, and if you're narrowing it so bad and your symptoms are so bad and the conservative measures don't work, then then it's time to think about surgery, and in the right person. I mean surgery for spinal stenosis works wonderfully. I mean, anybody out there who has those types of symptoms and who has spinal stenosis. I wouldn't be afraid of surgery because it works wonderfully, in the right patient. Just got to make sure that you're the right person for surgery.
Speaker 1:Yeah, but I think too, yeah, like right. There is people think I think surgery is fine, you surgery all the time, but surgery is always like that, your option of last resort.
Speaker 2:That's what you always say, yeah, and I mean not always, but most of the time. But I mean, think about it. I don't. I don't want you to come in If I do your surgery. I don't want you to come back in a month and say I'm no better and then come in at three months and say I'm no better. So when I do surgery on people I really want to make sure you're the right candidate, because I want you to come back in and feel good, because most people after spinal stenosis surgery will feel 70 to 90 percent better routinely.
Speaker 1:Yeah Well, some of your patients when we've done like the patient testimonials there, because I think they've just been living with that pain for so long or it's just a nuisance to your life, you can't do all the things you want to do. So I think people are so happy because it's it's pretty quick. They wake up after, like some people even at the day or two after surgery. They're like moving around the house.
Speaker 2:Yeah, the best example I can give you is one of my best cases, but it was years and years ago. But it was an elderly gentleman who came to see me. He couldn't really walk anymore because the pain was so bad. When he came to the hospital he literally was in a wheelchair because he couldn't walk because of the pain. So you know we had talked and he had had this for a long time and I was very honest with him and saying you know, surgery can help and some people it helps tremendously, but other people maybe if it's been going on so long you may not get as much relief as you want.
Speaker 2:But you know he'd been through the conservative measures. He had no quality of life, he couldn't walk using a wheelchair, so he wanted to have the surgery done. So I had did his surgery and he hasn't. He had walked for like two or three weeks. He'd been in a wheelchair, so I did his surgery. Everything went perfectly fine. I come in the next morning early around six thirty, and he's not in his bed and I'm wondering. He's not in the bathroom and so I started to panic, love him.
Speaker 2:And what happened? Did something happen to him overnight? I didn't know about it. Is he an ICU or you know? All these crazy thoughts are going through my mind. So I went out to find this nurse and when I'm walking in the hall, he's out there walking in the hall. And so this is the guy who wasn't walking when he came in and the next morning he was out walking the halls by himself. So I got him back to his bed and I talked to him and he said I feel so much better, my legs don't hurt. And he said today is my birthday. He said you've given me the best birthday present I've ever had in like 80 some years. He said it's just, I can't believe I'm walking and you've changed my life. But that that's an extreme example of how good spinal cord surgery can be. But it's true that some people are like that.
Speaker 1:So well and that's with. With that it's you can have those cases and you have some people who surgery doesn't really make an impact. But you take the chance when it's the setups there where they've got a high likelihood that it will be at least like 50 plus percent pain reduction. You know, I mean it's hard to say with anything but a lot of people I mean just seeing all of the patient surveys we've gotten to when people, when surgery does go right, it can be a terrific thing.
Speaker 2:But it's like anything. So the sooner you do the surgery, the better people do. I've learned that, so you know you take somebody who has symptoms for two or three months and do their surgery. They'll be better prior within days to weeks. You take somebody who lets it go for three or four years and they've tried everything under the sun because they don't want to have surgery and then finally, four years later, they decide to have surgery. Those people can take months and up to a year to get better and sometimes they don't get that 70 or 90 percent. They might only feel 20 or 30 percent better.
Speaker 2:And it's not because surgery didn't work or do the job. It's because it went on so long the nerves became damaged. I mean nerves will get damaged eventually if they're squeezed long enough and hard enough. So for those of you who may have this kind of condition out there, I mean you know you should talk to a surgeon and if it's been quite a long time and nothing else is helping, there comes a point you have to decide do I want to consider surgery or not? Because somewhere down the road surgery won't be helpful if you let it go too long.
Speaker 1:Yeah, so we talked about you know what an overview of what people symptoms they present with. You wanna talk about. Like actually in surgery, what do you do so the narrowing of the spinal canal? When you look at MRIs it looks the spinal canal's like the-.
Speaker 2:Waste of an hour glass. It gets all pinched off. Yeah, it's really tiny, so it looks just like the waste of an hour glass when you look at it on the MRI.
Speaker 1:Yeah, so you can. It's very clear to see on an MRI, actually, if you like, once you know what to look for, so you can. There's some like very extreme examples, but then what do you actually do with the procedure and why does that help? Right?
Speaker 2:so the way I do the surgery. I'm sure there's different ways that other surgeons can do it, but I think there's a standard baseline to what all surgeons do for spinal stenosis surgery. But so after you make your incision in the back which is usually in the midline is a way I make it in the middle then you come down and whatever level you're going to do, you have to expose the bone over the back of the spine. So you know the bumps you can feel on your back, like if I push on my back. There's those bony bumps in the middle. Those are called the spinous processes and those bone.
Speaker 2:That bone is attached to what's called the lamina bone, which overlies the back of the spine. So we all have bone over the back of our spine. So the first thing I do is expose that bone, so the muscles are attached to the bone. You kind of separate the muscles from the bone, let the muscle drift off the bone and then get retractors in that hold the muscles back. Now you're looking at the bone and then you take an x-ray right with some markers to mark where you're at. So you know a hundred percent you're at the right level.
Speaker 1:And what now? So they do the x-rays mid, so like once you've done all that, then they stop.
Speaker 2:And then that one, yeah, we stop for a second and then we'll have the x-ray team come in and take a sterile x-ray. Make sure we're at the right level. I mean, that's how I do it. Maybe some people.
Speaker 1:And what's the important, that's a safety check.
Speaker 2:Right, yeah, because you know, I mean you don't want to have surgery done at the wrong level. I mean if you're narrowing is at the four or five level and somebody does your surgery at three, four level because they didn't take an x-ray, you're going to wake up and not feel better. So I mean I'll always get an x-ray. There's been times I'm almost positive at the right level. I still do an x-ray because every once in a while you're just not where you think you're at.
Speaker 1:And that's just being like doing all those extra safety you get. So much can go wrong if you're doing something where there's not a problem.
Speaker 2:Yeah, it's just. I mean, I don't know if it's a standard of care, but it's my standard of care, that's what I do. So once I do that, then you have to take the bone off the back of the spine and we have various instruments that bite the bone away. I use a drill to thin the bone off.
Speaker 2:What I'm trying to do is I'm trying to open the spinal canal. So usually I'll take the bone off in the middle at first so I can see the spinal sac, and once I get the spinal sac exposed a little bit, you can see how narrow it is. I mean, honestly, it looks just like the waist of an hourglass being all pinched off.
Speaker 1:And then Another good example you know, like a straw, and then if you like, pinch that straw closed. It's like that, because it's like there's this opening and then so you can't get it. There's like, no, not that there's anything flowing, but it's just completely pinched like that.
Speaker 2:Or if you think about one of those long water balloons. One of those long balloons, like a clown blows up and it gets really long. You know, if you took your fist and you squeeze the middle of that balloon right, that's what spinal stenosis would be. You know it's normal above, normal below and then narrowed right in the center. And so once you start to take that bone and tissue off the back of the spine, so when you start to lift that bone off, you can watch the spinal sac just balloon right back up at surgery. So when I'm done with surgery the spinal sac is back to its normal size. I just had a great example this week of a lady who had bad spinal stenosis and I mean it was worse at surgery than it looked like on the MRI. But it's how slow you have to go. Just bite that bone off very slowly off the top of the spinal sac. But as I did it, you could just.
Speaker 1:You could just watch the spinal sac just balloon right back up and so yeah, that's pretty crazy, it's pretty cool, so you have to see it like that.
Speaker 2:So you have to be very careful, obviously. But I mean she did great. I mean she went home the next day and her leg pain was already better. She was out in the halls walking. So you're basically taking the bone and tissue off the back of the spine to open up the spinal canal and unpinch the nerve. So that's how we do the spinal stenosis surgery. You know, some people, if they have a slippage of their spine or some instability of a spine, they might need a fusion with rods and screws. But I'd say most people I do spinal stenosis surgery on just need a simple what's called a laminectomy where I just take the bone off the back of the spine to open up the spinal canal. For most people, if it's one or two levels, the surgery takes an hour to an hour and a half to do. Usually I'll keep the patient overnight and they go home the next day. On occasion I might let somebody go home the same day, but-.
Speaker 1:What now? Couple other questions. So when you take that bone out, is that go like medical waste? Do you know what happens to that?
Speaker 2:Yeah, I think it just gets thrown into a medical waste garbage. I think we know, but it's not. I don't think it's right. It's like what's the most you've ever taken off.
Speaker 1:Have you ever taken off like had thick off, like almost all of around?
Speaker 2:the-. I mean I've taken off like five levels of the back up. So if the lumbar spine is L1 down the first sacral S1, I've taken all that bone off. So like how much?
Speaker 1:material. Do you think that is? Are you telling us, like, bone-wise, do you think that? Like, did it feel like a tray up, or-.
Speaker 2:No, cause. I mean I take it off in piecemeal and I take the bone off piecemeal and I use a drill, so it's hard to tell how much comes off it. It had to show you a spine model to see it.
Speaker 1:And then finishing up, hayden's about to join us in a second too. But just the last thing would be how the finished surgery off. Once you're done with that, you just suture up right, close up the person.
Speaker 2:Yeah, so once you're done with surgery, then the next step is really take your time is to stop any bleeding, right, so you take your time to stop the bleeding. Both before I take the retractors out and then after I take the retractors out, I always look around, make sure there's no bleeding. You irrigate the wound out real well and then, once you do that, you sew the muscles and what's called the fascia. So there's a fascia, is like not a tendinous material, but it's a. It's attached to the muscle. And so when you pull the fascia together, you're pulling the muscles back together. So I sew that layer together. That's down deep, and then I sew the skin together with dissolvable stitches. And then sometimes you have to put staples in or just stereo strips with little pieces of tape he's muslin' it.
Speaker 1:Yeah, no, we got Hayden join us, my sister's fiance.
Speaker 2:But anyway, so yeah, so you just sew things up in layers, then you put a bandage on and that completes the surgery. So so that's kind of a nutshell of spinal stenosis what it is, and treatment options, including surgery, and for some people surgery is a big deal.
Speaker 2:It's a big deal in their life, but it can change their life too. I mean when you get to the point where you can't exercise, you can't play with your kids, you can't go to the grocery store because it hurts so bad, or you can't even walk across your own house to your bathroom because it hurts so bad, I mean it really changes people's lives and anybody who has it out there right now I mean you know what it feels like. Anybody who had the surgery, who's had the surgery and done well, will know what a difference it can make.
Speaker 1:Yeah, but yeah, if you like kind of overviews like that, let us know. We could do some of his other commissions you do regularly or some other things. But let us know if you like that, that's fine. That for me.
Speaker 2:And if you leave, if you did watch this podcast, you wanna have a few questions. You could leave some comments or questions. We'll try to answer them for you. Do our best to do that.
Speaker 1:And again, obviously this is not medical advice, it's just his opinion on the way things, how he does stuff, because obviously we can't get back to him.
Speaker 2:Everybody does it different.
Speaker 1:But if you are experiencing that, you would say the first step for people would be to see their primary care physician, see your primary care physician and then if they think you have something you need to see a neurosurgeon for, they will have you see a neurosurgeon.
Speaker 2:Or they may say maybe try some therapy first. So always touch base with your regular doctor.
Speaker 1:But, like you said too, the importance of not waiting too long. So, if you do think you have some issues, take charge of your health. Your health is so important. Go take. Even you might not no one likes going to the doctor, but sometimes just getting the ball rolling. It takes some time. So good to do. But we're joined here now by Hayden. We're going to switch gears a little bit. Hayden is in college right now. This is your first time on the podcast, right? Yeah, first time on the podcast, His maiden podcast. You've got to talk it a lot, but what's it been like starting school again? Do you want to tell people about what your aspirations are yeah.
Speaker 3:so I think you know I had I've been out of school for a long time and you know I had the idea of wanting to go into healthcare for as long as I can remember and I kind of just really went for it this year because I felt I had the support necessary to go through it. So you know, I'm doing a biology degree for an undergraduate right now, hopefully med school after that. So this is your first quarter, right? Yeah, yeah.
Speaker 2:Is this semester or semester? It's semester, yeah, okay. So you started in August, right, it was August, right. So then two months, yeah, all right.
Speaker 3:What's the first?
Speaker 2:two months it's been getting good grades.
Speaker 1:He's been getting demanded by the.
Speaker 2:Well, he only got like a 92 on the Tesla here. I'm sorry, I gave you a.
Speaker 3:I'll never make it to med school. Oh, that was excellent. He's got straight names. Yeah, we're like midterm right now. I've had. I just did my math midterm. I don't know it's a lot. I don't want to jinx it, but it's been a lot easier than I expected. I think I worked it up in my head more. I think a lot of it is just showing up.
Speaker 1:Yeah, but you're pretty. You and Christy both have been pretty diligent. You guys are both obviously putting in time to make it seems easy when you're putting in the time and doing stuff, but if you let yourself fall behind, you can build up a lot.
Speaker 2:So what do you think for? Like, because there's always people out there who we get questions through the last year about I'm in college and I want to go into medicine, maybe be a neurosurgeon or be a doctor, and so you're doing it. I mean, they're thinking about doing it in high school, or there are people who just start in college. So how are you preparing to get to medical school? Like, what, did you have a counselor that helped you with classes? Or for somebody out there who's really wondering I want to be a doctor, I'm just starting college or going to start college, how do I go about planning to get the right courses so I can make it to medical school?
Speaker 3:You know, yeah, so I.
Speaker 2:Because you're doing it right now.
Speaker 3:So Definitely initially. Like when you are enrolling in college, going through the right avenues to like declaring your major right away because you don't want to go in and be undeclared and take a bunch of classes that you don't need, and then talking to your academic advisors just saying, hey, I want to be on a pre-health track specifically for medical school, but I think most of it it's all encompassing. So if you are on a pre-health track, usually those classes are all prerequisites for like PA school, medical school, podiathe, like all of it.
Speaker 2:So you had a specific advisor who told you what classes to take, or did you pick them out on your own.
Speaker 3:So when I enrolled I just when I was going through the process I just listed my major as a biology major and then on a pre-medical track and then when I went in for orientation they had all of us that were assigned to this academic advisor come in and they had plans set up for us already. So depending on where you're at, how you scored on your pre-high school stuff, you'll probably be in different classes than some of your friends, maybe depending on how you did on the ACT or what class you took in high school. But generally they're going to come up with a four-year plan where you meet all the prerequisites.
Speaker 1:Yeah, I remember when I was 12, I was saying there's resources online. You can see all the different things you need to get for different majors and different minors. It can be confusing to look through sometimes, but definitely getting acquainted with that. So you're not just relying on advisors too, because also there's people I know who put a ton of time into it. They would try to pick out the teachers they wanted. There are some teachers who are different. A lot of people took this one art class for the art credit, which was funny.
Speaker 1:There's this one it was Italian history or Italian movie history, so that was a class. Lot of people like to take and use watch movies and critique them. But there's different ways. So, yeah, I think speaking with your advisor and using those resources, kind of taking charge of that, because you hear it about it all the time. But some people will be like, oh, I wasn't even taking, I don't have all the things, or I had to take an extra semester because they didn't even realize they were on the right track.
Speaker 3:Yeah, and that's a shame, because you put all this effort into four years thinking you're going to be prepared to go right into the next step, and just fall short, not really because of you, but because of a lack of communication with an advisor.
Speaker 2:And has anybody told you like so I'm so far away from them? Has anybody told you like what do you think your GPA realistic it has to be if you're going to try to get in the medical school? Have they told you what a minimum GPA would be at the end of college, so I've heard a couple of different answers.
Speaker 3:I'm personally going off of what's posted on the website for the medical schools that I'd be interested in, and I think a strong application is like a 3.8.
Speaker 1:Yeah, that's a hard undergrad too, it's not so no, it's really becoming it's. I have some very smart friends who were waitlisted for a couple of years, or did they get into medical school, or some, I think who just kind of decided they weren't going to go into medicine anymore because but you have to, it's super competitive. There's there's more and more people, and a lot of people want to go into medicine.
Speaker 3:So it's very competitive. They're not just looking at it's kind of broader than just academics, because you can have a 4.0 GPA going into it, yeah, that's, that's great.
Speaker 1:But if you don't have any of the other things they're looking for. They're going to be put on the, you know wait list or whatever, they're not going to look at your application.
Speaker 2:Well, and you're starting in a lab, right, you're going to do some volunteer work in a lab.
Speaker 3:Yeah, yeah, so I started a week after fall break.
Speaker 1:And how did you get tell people about how you got? You took some initiative there. You've been messaging people or emailing people, right yeah?
Speaker 3:So I mean I knew I know people that have gotten into med school without any research experience at all. I knew I know that it's something that they look for and I wanted to do something that I was interested in. So I started emailing all the professors. I went to the undergraduate research department and looked at all the professors, looked through some of their publications and just seeing what they do and whether I'd be interested in it at all Because obviously not everything is going to be very interesting to people. So I specifically wanted to do something that focused on my cancer research and it just so happens the department chair for the biology sciences does cancer research, looking at markers and a symmetric cell division and some stuff. That's kind of over my head right now, but I can ask plenty of questions.
Speaker 1:You got a small one. I mean, I think that's what's so great about just college in general, but especially if you put yourself in those environments where you can just absorb things. You got to start somewhere where you don't know anything and you just slowly being around that environment, and a person like that is obviously very smart himself.
Speaker 3:Yeah, I don't think they. He kind of told me they don't really expect anybody coming in, especially first year. There's not a lot of people coming into those labs as freshmen. They don't really expect you to know everything. But I'm just excited to be there and kind of see what I can learn along the way.
Speaker 1:I think that's probably what the biggest thing people look for, too, is the eagerness to learn and to improve, like grow.
Speaker 2:What's been your favorite class so far?
Speaker 3:I mean I enjoy my biology class. I think it's a little much. I'm not a big fan of these huge lecture halls where there's like a million different people in there and some people aren't paying attention so they're like talking in the back. It's a little distracting. I mean you get over it. Personally, it's funny. My favorite class right now is world religions. I find it really interesting.
Speaker 2:That's cool and what's it been like? Because I see you guys studying, so it's funny, like Christy would be over there studying something totally different than what you're studying. Yeah, because you're not in the same class right now. So what's that been like that you guys both studying, you know, at night, you know it's something.
Speaker 3:Every day is different, you know, but Christy is definitely. She has more credit hours and she's taking more credit hours, so she's studying longer than I am, usually by nine o'clock or like once. I feel brain dead and I'm not retaining information as long as my assignments are done and turned in like I'm done.
Speaker 1:I'm done for the night.
Speaker 3:But it's cool because some of her classes have some overlap in what my class are talking about. So she'll have me quiz her on like note cards, or I'll hear her talking while she's taking notes and I'll put some input in.
Speaker 1:So it's a collaborative thing. You got any tribute for him? You got the stuff you've learned. Anything you need to stump him with? I don't think so. I don't have any other data, but Christy has stumped me on some stuff. Do you think being around like you know my mom and dad when they talk, you know medical terms and all that? That's kind of giving me more familiarity, or you're not in any classes yet that really touch upon stuff.
Speaker 3:I'm not really in any classes that touch on it, but I still I feel like it's almost like a leg up. You know what I mean. Yeah, I also find it like really interesting when I remember you like coming home talking about like how you know different ways, you know the differences between how you do a certain surgery versus how maybe a partner does surgery. Just hearing about it is really interesting.
Speaker 1:Yeah, you got anything else you want to share.
Speaker 3:No, I just figured, I just got so we were going to do.
Speaker 1:let's see, let's not say no, I was going to do this thing we were going to start doing it's like a medical term of the week. Do you have one? Then let's see if he knows it. I don't know what it is yet, but I probably won't know it.
Speaker 2:I'll just throw some terms out.
Speaker 1:Just know you got to pick one, Okay Encephalitis.
Speaker 3:Swallowing on the brain.
Speaker 2:Okay, that's not swallowing on the brain, but anyways.
Speaker 1:Christy's in the background trying to guess too. I'll be honest, go on the brain.
Speaker 3:No.
Speaker 2:I've heard it a lot but I don't know what it is. So it's just a general term for, like, inflammation of the brain. So inflammation can cause swelling, christy, but it's still inflammation of the brain. Itis means inflammation, toncelitis, what is that?
Speaker 3:Inflammation of the tonsils Gastritis.
Speaker 1:Gastritis. No, that's why I think.
Speaker 2:Inflammation of the gastric lining.
Speaker 1:Well, no, but that's kind of why I want Esophagitis.
Speaker 2:Inflammation of the esophages.
Speaker 1:But that's kind of the point of why I thought it'd be interesting to start doing like a medical term of the day would be too much, a medical term of the week we could do, because that's what people, I think, miss sometimes is that these words seem super complex and crazy, and they aren't a bit, but a lot of times there's a lot of chicken reasons each one, and once you know that like the layout of stuff, you can start to understand more, or even just knowing.
Speaker 2:like you hear all these terms, a lot of people don't know. Itis means inflammation for the most part. So anything you put itis on Bronchitis.
Speaker 1:Bronchitis inflammation of the bronchials, so little things like that, well timeology, which is pretty cool, and then it helps a lot with knowing stuff.
Speaker 3:So we've heard about like my college experience so far. How do you think your guys' experience has differed from what it looks like for Christy and I coming in?
Speaker 2:Well, I tell, the biggest thing from what I remember is that we had to, we went to class, we had to go to class and all our tests were in class, like there was nothing. Well, computers when did Apple computer start? Like 86 or something? So I mean, there were no computers there were no laptops, so I'm just saying I mean it was done.
Speaker 2:Handwritten tests the most tests were graded by hand had to be in class to get the notes. If you weren't in class, you weren't going to get the notes and you weren't going to know what was on the test, so we had readings and stuff. I think that's the biggest difference. You guys are online. A lot of your tests are online. Now, didn't you just take a test, or Christy took a test?
Speaker 1:online.
Speaker 2:You know, not even a class. So that's the biggest difference.
Speaker 1:I usually just a lot of times yeah, so many assignments, so many. Do you guys use Blackboard, or which one do you use? Yeah, we use something else at Ohio State, but there's usually an online platform like that. A lot of teachers with the textbook. They'll be by the online access too, because they send. Gauge is a huge thing.
Speaker 1:And they have you. I mean, I sometimes think it's some teachers are a little lazy. I think it assigns all the homework for them and auto grades for them. They do everything through that. So that is annoying.
Speaker 2:It's funny when you say Blackboard we're referring to it too, that's just to get online software Right, and I think of Blackboard. We had Blackboards and the teachers would write with chalk chalk on the Blackboards I had.
Speaker 1:Blackboards in high school, elementary school. I mean we started getting smart boards, okay. But I mean everyone knows what Blackboard is. A lot of teachers still like my accounting teacher always just used the Blackboard. He was so funny. He would I don't know how I would say it he, if someone like came in late and like messed up, he's just like leave. Or if someone's phone goes off he's like leave, he would publicly shame them. It was so funny. I think it's funny too in the huge lecture halls like you're talking about. It's so funny what people are doing all the time. There's people online shopping on the laptop.
Speaker 1:There's people playing video games Like why are you even showing up here?
Speaker 3:I sat like I didn't sit like right up front the first day and I thought like all the people that were going to be there were going to be there. So there was. I was in the in cap of a row and like 80 people showed up like five minutes late because nobody could figure out where the room was and it was just it was a mess. So like after that, after seeing what people were doing and just like getting feeling like the professor was getting drowned out by all this noise behind me, I was like I got to sit closer up front. Yeah, it's a little ridiculous.
Speaker 1:I think there's just a major difference between showing up to class and being present in class, same with being attentively paying attention, taking notes, you know, actually engaging with what you're learning, because the people it makes such a vast difference. People are like, oh, like I don't even know what's going on. I'm like you're talking the entire class. You're like texting on your phone, playing games. You know what's that? You're not really. I rather make the most use of my time. I'm going to have to sit in class. I'd rather make the most of it. I think the same as with studying.
Speaker 1:I used to like study alone most of the time and people like let's go to the library, because most people go to the library, they're studying for five, 10 hours. They're not. They're like I studied so much for this test. I'm like you didn't study. You're socializing. You're not like focused. I'd rather take two hours of focused study time than sit with friends and study for the 12 hours, unless the only time I would with people who's more so is if I've already known the material, then like explaining it with them or teaching it back and forth can be powerful. But when you're trying to learn it, it becomes that focused learning time is so much more powerful than doing it with just people, for sure.
Speaker 2:Because it becomes a socially when I once go is a social event. Sometimes you really want to study. Go by yourself and just for me anyway, yeah.
Speaker 1:Well, it's not. It's one of those things it's not like everything in life is not fun, like that's not something that's meant to be fun, but it's. It's cool in a different way, like learning stuff and actually trying to, because you have to think too a lot of times some people get stuck in the mindset of just trying to do good on a test, which is is okay, but trying to understand things deeper is the true point of learning and retain it long term to improve your ability to do something, yeah, application, and it's incredibly rewarding, like, even though it is sometimes very boring, it's incredibly rewarding to see that that work pay off yeah.
Speaker 3:And it's, you know, the short term.
Speaker 1:Definitely. I mean, I think that's what's good about school and as it's too bad. It's like after school and there's that feedback system where you're getting, you get grades and stuff. So it forces you to do stuff and you get to see like, am I doing well or not? It gives you a real time feedback, like if you need to change something or not, or if you're doing well. If you're getting A's, then keep doing what you're doing After, like college or the highest level of school you complete. I feel like a lot of people there is nothing like that to learn anymore. You're not forced to learn, so people don't like file their interests and stuff. They just kind of fall off from where because learning seems like a chore in a way. It's in people. Yeah, it's interesting, like I don't know. I feel like I do like passive learning.
Speaker 3:like looking at articles and stuff. But yeah, in the social media realm, like especially before I started school, like if I worked a really long day, like I'm not looking at anything that's informative, like I'm looking at like stupid stuff on the tech tab.
Speaker 1:Yeah, I mean, there's nothing wrong with you know, enjoying yourself and watching Netflix and other stuff, but I think it is good, like long term. I think sometimes you feel like your brain feels fried, like when you just are only consuming like these really like mind-numbing things, some things you see on social media, but that's and kind of like how you create your mind and your life is what you consume. If you consume bad food, bad information, bad, you know, just kind of garbage, then you don't feel as good, even though it might feel good in a moment. So, but no, I think it's really cool. I think I always love something about being like a nice old university, a college in America. I love all like the old architecture. You're just surrounded by so many things. Like I love seeing the libraries, I love seeing the business schools and the medical schools, seeing all that stuff. There's like kind of an aura or feeling of being on campus, like you're all there to learn.
Speaker 2:Well, there's history there too.
Speaker 1:There's history and there's kind of the power. I think it's so cool when everyone's just everyone's coming together to learn. You get to engage with so many different types of people in different fields, diverse backgrounds, so it's a really cool time to get to experience all that. So, but, yeah, I think that's the end of that episode. We'll wrap it up tonight. But, yeah, thanks for watching and listening and, as always, any suggestions. You may have some words of encouragement to Hayden as well. That's right. But all right, bye guys, bye guys.
