So I have another week of events and lectures to tell you all about. This time I flew out to Boston for the American College of Rheumatology’s (ACR) annual conference. I left on Tuesday and spent basically the whole day travelling – Seattle to JFK to Boston, then a cab to the hotel (The Westin Copley Place – very very nice, and very very affordable thanks to the ACR’s resident travel grant and housing assistance!) I had a nice workout and a soak in the hot tub before heading to bed. On Wednesday, the conference opening ceremony wasn’t until the evening, so I spent the morning walking around… from the hotel over to Boston Common, through the Theatre District and back. I wanted to head up to Faneuil Hall as well, but I took a wrong turn and once I discovered this I didn’t think I had enough time to correct myself and get there and back… so I explored the inter-connected shopping malls/hotels near the Westin and then caught the shuttle to the conference center for:

5:30pm-7:30pm Opening Lecture and Awards
– Recognition of ACR Masters
– Recognition of 2007 ACR Awards and Distinction Recipients
– Recognition of 2007 ARHP (Arthritis and Rheumatism Health Professionals) Merit Awards and Lifetime
Achievement Award Recipients
– Presidential Address
– Opening Lecture: “Medicine in silico: The Information Age Comes to Medicine”

After the opening ceremonies, my roommate Erica (a 3rd year pediatrics resident with me at Children’s) went out for a nice dinner at the Atlantic Fish Co. where I had Chilean sea bass with lobster ravioli. Then we headed over to the nearby Sheraton where there was an “Opening Dessert Reception” – and what a reception it was! Considering there were about 14,000 people signed up for this conference, I guess I should have expected at least a few thousand to be in-and-out of the reception, but it was still more packed (and way fancier) than I expected. There were multitudes of different cheesecakes and coffee cakes, cinnamon ice cream (!!!), and fried-up chocolate chips cookies right in front of you; what a spread! After that, it was getting late, so Erica and I went back to our hotel.

The next day (Thursday) was fairly full of conference activities. Here’s what I attended:
8:00am-9:00am Pediatric Residents Welcome Breakfast

9:15am-10:15am Management of Complications of Systemic Juvenile Idiopathic Arthritis (JIA)

10:15am-Noon I walked around the exhibitions and looked over the abstract posters

Noon-2:30pm Lunchtime – but no restaurants within walking distance, so the convention center offers a Lunch Trolley that will drive you to a number of restaurants and pick you up afterward. I hopped on and decided to hop off at The Barking Crab. Two Canadian Physical Therapists were also hopping off there and invited me to join them, so I did. We had a nice lunch and some fun conversation about living in Thunder Bay.

2:30pm-4:00pm Biologics in Pediatric Rheumatology
– Muckle-Wells Syndrome – Effective Treatment with Anakinra
– Functional Outcomes of One Year of Treatment of Neonatal Onset Multisystem Inflammatory Disease (NOMID) with Anakinra
– Efficacy of Abatacept in Different Sub-populations of JIA: Results of a Randomized Withdrawl Study
– Abatacept Treatment of JIA: Safety Report
– Adalimumab is Safe and Effective During Long Term Treatment of Patients with JIA: Results from a 2-Year Study
– Safety and Efficacy of Over 8 Years of Continuous Etanercept (Enbrel) Therapy in Patients with Rheumatoid Arthritis

4:30pm-6:00pm Bone Health in Children and Adolescents with Rheumatic Disease
– Biology of Bone in Children
– New approaches to AVN (Avascular Necrosis)
– Childhood Osteoporosis: Treatment Controversies

That was a long day, and I was so ready for a work out, the hot tub, and my “heavenly bed”!

Friday was another jam-packed day of conference stuff as well as socializing.
7:45am-8:45am Rheumatic Disease Update: Adult and Juvenile Dermatomyositis/Polymyositis

9:15am-10:15am How to Decipher a Poster

10:30am-1:00pm Exhibitions, Abstract Posters, and lunch at No Name Restaurant

1:00pm-2:30pm Fellows Panel Discussion – All the pediatric residents attending the conference met with a few of the pediatric rheumatology fellows and discussed things like how did they choose rheum, how did they choose their fellowship program, how to go about figuring out a research project, things to think about in general when pursuing a sub-speciality. It was really interesting and helpful.

2:30pm-3:00pm Practical Pediatric Rheumatology Rehabilitation: What You Wised You Had Learned in Training
– Introduction and Overview
– Educational Rights
– Exercise and Fitness in Children with Rheumatic Disease

After this, I was tired and sleepy and worn down, and I knew I still had a long evening ahead of me, so I shuttled back to my hotel, had a nice work out and soak in the hot tub, and rested in my room for a bit. Then it was back to the conference center for:

6:15pm-7:30pm ACR Study Group: Pediatric Rheumatology: Update on Juvenile Scleroderma

7:15pm-8:30 ACR Study Group Reception

And to round out the evening, there was a dinner planned for all the “Seattle” folks to go to, so not only my co-resident and I with our fellows and attendings, but also 4 or 5 others at the conference who had done their fellowship (and or residency) training in Seattle. It was great to meet some more rheum folks from all around the country who had ties to Seattle… it was tiring to be so busy all day and then to go out socializing, but it was fun and totally worth it.

So that brings me to Saturday… there were sessions going on in the morning, but nothing exclusively pediatric or extremely fascinating, so I decided to take the morning off. That’s when I walked up to Fenway Park (see the last post for a photo). I got to the convention center with a little time to look at the abstract posters for the day, then it was off to:

1:00pm-2:30pm Faculty Panel Discussion This was very similar to the Fellows conference the day before, but it was led by 5 attendings from rheumatology programs around the country. They chatted with us about mentoring, choosing a sub-speciality, working on a career path, and how to manag to have a life and a career.

2:30pm-4:00pm Pediatric Rheumatology: Determinants and Markers of Disease
– The Immunopathology of Early Untreated JIA: Comparing Oligoarticular and Polyarticular Disease
– A High Density SNP Genomewide Association Study in JIA
– A Pooled DNA Microarray Study of Methotrexate-Treated JIA Patients
– Serum Levels of Osteoprotegrin and Receptor Activator of NF-kappaB ligand in Children with Early JIA: A 2-Year
Prospective Controlled Study
– Validation of a Diagnostic Score for Molecular Analysis of Hereditary Autoinflammatory Syndromes in Children with
Periodic Fever
– B Lymphocyte Stimulator (BLyS) Expression in Pediatric Systemic Lupus Erythematosus and JIA

4:30pm-6:00pm Management of Psychiatric Illness in Children and Adolescents with Rheumatic Disease
– Diagnosing Common Problems in Children with Rheumatic Disease
– Drug Management of Childhood Psychiatric Illness: What Rheumatology Caregivers Need to Know

Then Erica and I shuttled back to our hotel and went out for a nice dinner at a Japanese restaurant called Haru. On our walk back to our hotel, we stopped off at the Marriott’s lobby bar because there were a couple people doing live music, a guy singing with his guitar accompanied by a girl playing the violin. It was nicely done and I really enjoyed listening.

And finally, today (Sunday). After getting up and checking out of the hotel, we headed to the conference center for:
8:00am-9:00am Physical Therapy Management of Pediatric Rheumatology Issues

9:15am-10:45am Streptococcal Related Rheumatic Disease
– Immunobiology of Group A Strep Infections
– Post-Strep Arthritis/Acute Rheumatic Fever
– Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Disease (PANDAS)

11:00am-12:30pm Rheumatologic Skin Disease
– Cutaneous Vasculitis
– Nephrogenic Systemic Fibrosis/Nephrogenic Fibrosing Dermopathy

Then the conference was all but over… I still had a little while before my plane, but I headed to the airport anyway and dropped in at the Admiral’s Club with my one-day pass (thanks A.J.!) and here I sit, typing this entry.

Whew, what a jam-packed couple of weeks I’ve had. At each conference I’ve felt like “this is what I should be doing” and it’s hard for me to separate out which parts of each specialty are most interesting. But I think I’ll head home and decompress a little, then come back to the decision after a while. Good thing I’ve already decided to take a year off before fellowship, otherwise I’d need to be applying right now (which would mean I’d have to have my mind made up about what I want to do)!

I arrived in San Francisco on Thursday afternoon, and got all checked in at my hotel (The Cartwirght, A Larkspur Hotel) and then attended the Invited Residents Welcome Reception in the evening. I met up with a couple of attendings from Children’s there, and also got to meet a few pediatric residents from around the country (and Canada) who are also interested in nephrology. It turned out to be a fun evening, and the “appetizer” food was very good and quite filling.   🙂

On Friday my schedule of events included:

10:00am to 11:30am: Practical Genetics of Renal Cystic Diseases
ARPKD (Autosomal Recessive Polycystic Kidney Disease)
ADPKD 1 and 2 (Autosomal Dominant Polycystic Kidney Disease)
Tuberous Sclerosis and Von Hippel Lindau

11:30am-Noon: Primary Care Issues in Nephrology
Rheumatology for Nephrologists

Noon-1:30pm: Lunch at the Firewood Cafe in The Metreon (a mall of sorts) and then walking around to look at the posters of new research and exploring the exhibition hall (and collecting freebies from the companies)

1:30pm-3:30pm: One Renal Biopsy is a Picture, the Second Biopsy is More a Movie: The Importance of Repeat Biopsy in the Management of Patients
FSGS (Focal Segmental Glomerulosclerosis)
IgA Nephropathy
ANCA-Associated Vasculitis
Lupus Nephritis

After all that, I really needed a break, so I walked back to my hotel, had a nice rest with some TV watching, then ate Thai take-out for dinner. The next morning I set out for another day full of lectures:

10:00am-Noon: Nephrology Quiz and Questionnaire
Transplantation
Fluids & Electrolytes
ESRD/CKD (End Stage Renal Disease/Chronic Kidney Disease)
Glomerular Disorders

Noon-1:30pm: Lunch over at the Metreon again, this time at Luna Azul. Then more time in the exhibition hall.

1:30pm-3:00pm: Measures of Kidney Function Beyond Creatinine
Cystatin C in the US Population: What Do We Know?
Use of Iohexol in Measuring GFR (Glomerular Filtration Rate) in Chronic Kidney Disease of
Childhood
Estimating Equations and Direct Measurements of GFR: Assessing CKD Progression

4:00pm-6:00pm: The Genetics of FSGS
FSGS as a Prototype Podocyte Disease
Genetic Screening in Steroid-Resistant FSGS
Mutations and FSGS: Alpha-Actinin-4, TRPC6, and NPHS2 (including Obesity Related
Glomerulopathy)
Treatment of FSGS and its Recurrance

What a packed day… I had a nice take-out meal from Sanraku for dinner (a Japanese retaurant) and a fresh baked cookie from the hotel lobby for dessert. And that brings me to today… I’m taking the morning to catch up on some e-mails and do a little work on some things I need to get done by next week (and I’m going to be travelling all this week) and then at noon I’ll have the Residents Program Closing Lunch, after which I’ll hang out probably at a coffee shop somewhere for a little while and then make my way back to the Oakland airport to fly home this evening. Then on Tuesday I get to fly to Boston for another fully packed week of conference goodness!