1. Meniscal Repairs, Lateral Epicondylitis, and the Removal of an External Fixation Device?
This week I got to scrub in to surgery on Monday, where I saw meniscal repairs, lateral epicondylitis, and the removal of an external fixation device. My preceptor, as well as a resident and fellow helped explain what was going on during surgery. Everyone knew their anatomy really well, and although I remember the majority of it, after I realized I still need to review little details I may have glanced over during the year.
On Tuesday during clinic, my preceptor allowed me to see patients on my own. I would see patients and then report back to him after I had taken a history of their chief complaint, and had done physical exams, and would then say what I thought the diagnosis was, and how I would treat it. Being more involved, time in clinic flew by, where once we were done I was surprised it was so late in the day.
For my research project, I met with my resident again this week, and finished up the first draft of a survey I will be sending out for my project. Below is a picture of me and my preceptor, Dr. Kris Jones!
2. OR Prep... Let the Pimping Commence 😩
This week I got to see some pretty awesome cases. This young guy came into clinic unable to do almost anything with his hand. There were no signs of hand trauma and only little pain. I had no clue what was going on. Dr. Gray asked to see his elbow and there was our problem, he had a huge cut on the medial aspect of his elbow. Almost immediately it made sense, the ulnar nerve is primarily responsible for the muscle of the hand with exception of a few. It seemed like a simple discovery but it made my week.
It was sad to know this young guy could possible never regain full function of his hand but it was a great learning experience. I can’t wait to see what we find in the OR next week. I pray it isn’t as bad as it seems on exam. That was only one of the very cool and rare cases we saw this week. I see tons of carpal tunnel and trigger finger cases, sometimes I feel like I could diagnose them myself and that excites me. After only three weeks I have picked up on patterns of diagnostic importance and better understanding why certain treatment options are better for certain patients.
There is certainly a science to it all but people rarely speak of the art of medicine. There is beauty in the interactions that physicians have with patients and the level of trust that has to be established in such short amounts of time. Often I am unsure if I am learning more about the science ( anatomy, navigating the OR, names of important diseases) or the art ( interacting with patients, having positive interactions with colleagues, delivering news in a way that’s impactful but not crippling). Either way I have grown as a person and future physician and I’m looking forward to week four and beyond.
3. Did Someone Say, "Physical Therapists"? 😅
Good Saturday evening everyone! I hope you are all having a productive weekend! This week was really exciting as I got to independently work with patients in following their rehabilitation session. I walked patients through their exercises for a 1-4 month post-op ACL reconstruction as well as ones with shoulder pain.
I met with the woman who I am following for the case study I am researching and writing.
She was extremely descriptive about her total knee revision and we proceeded with her treatment today. Compared to two years ago she is night and day better! It is amazing to see the impact of physical therapy everyday I am interning here. She came in 2 days post-op with a walker, however this week she was much more lively and with only a cane. She did calf stretches, side steps, heel prop, and sitting knee flexions.
We had a staff meeting where one of the physical therapists took us through a full active range of motion in our neck, shoulder, hip, and ankle. I also got to try instrument assisted soft tissue mobilization on one of our athletic trainers. I learned after taking that video that the tool was at too steep of an angle 😅 Instead, it should be at a 45 or 60 degree angle depending on how much pressure one needs.
4. Polycythemia Vera is REAL
I spent most of the week in the Interventional Radiology department. The shift usually starts at 7:15 am where the department begins discussing the upcoming cases. It was great to see Dr. West and the rest of the department discuss treating patients with conditions that I have mostly seen in textbooks. I quickly came to the realization that conditions like Polycythemia Vera are real and not an just an intellectual exercise to make medical students suffer.
Thanks to the attending physicians and fellows, I witnessed a plethora of procedures. I saw transjugular biopsies, TIPS narrowing, G tube placements, percutaneous nephrostomies, chemoembolizations, etc.
Interventional radiologists can treat many patients who are suffering from various diseases. I love their ability to improve the quality of life in patients using procedures that are minimally invasive. My experience this week solidified my aspirations of becoming an interventional radiologist.
5. "I Believe What You Were Trying to Say was... Thank You"
Here are some highlights of my week! On Monday and Tuesday, Dr. Davis gave me time to write out the methods and introduction section for our first project. She then took the time to help read over my draft and edit what I had written. It felt great to have a working manuscript together! I also spent time attending resident lectures and shadowing the MSK Reading Room.
On Wednesday, Dr. Davis and I met with the head of the anatomy department to see if he would allow us to use the cadavers for a portion of our study. We then had a chance to practice collecting some ultrasound data with the cadavers.
On Friday, I had an amazing experience - I got to learn from Dr. Suranyi who is a cardiothoracic radiologist that uses “4 D Imaging” - which is like a reconstructed CT scan that you can play like a video clip. He asked me a bunch of questions until he was sure I understood the pathology and anatomy of each patient. I learned a lot!!
Overall, I am so grateful for the experience and the wonderful people who are taking the time to teach me. Today, I am starting the day by filling out one of Nth’s thank you cards to the professor who wrote me a letter of recommendation to be an Nth Dimensions scholar!