1. CAST Away!!!
I had another awesome week here in Baltimore. On Monday, I saw patients at White Marsh clinic. I watched Dr. Oni evaluate 13 patients and strategically speak to a patient about being habitually late (she even showed up late to surgery). Tuesday, we spent in the OR and had 3 total knee replacements and 2 total hips. Wednesday, I spent at the Kennedy center with Dr. Michael Thomas who is my mentor from Las Vegas and knows Dr. Mason through Howard. On Thursday, we had a casting workshop pictured below. The first picture is of Carla who is an orthopedic tech and putting a cast on my arm; the second picture is with Nick Runge (who is also working with Dr. Oni this summer and he is Jordan’s boyfriend) and the third picture is of me and was taken by Dr LaPorte (residency director). Yesterday, was another OR day where I saw 3 total knee replacements and 1 hip!
I hope everyone is doing well and enjoyed the 4th!
2. So What Do You Do? I Work in a Pool 😎
I hope you all had a great 4th of July holiday! This week, I got a chance to intern at the aquatic center and see what it is like to rehabilitate patients underwater. The pool is beneficial because it allows patients who are not able to fully weight bear to still benefit from exercise and physical therapy. The movements underwater are all concentric due to the force of the water. For instance, when flexing and extending the arm, it works both the bicep and tricep. All the movements performed on land can be modified to be done underwater. They even have an underwater treadmill, which I got to try out!
I wanted to go into this internship as open-minded as possible so I can explore all specialties and eventually choose one. Going to the aquatic center reminded me of why I chose to go into physical therapy in the first place, which is to make it more accessible to everyone, especially my sister. This inspired me to perform exercises with my sister, who has down syndrome, at the pool. The pool is one of her favorite places to be and although we were exercising she had a great time and did not want to leave. Attached are videos of me walking on the treadmill underwater and my sister and I taking laps around the pool. Have a great rest of your weekend everyone!
3. Project C.U.R.E.
As with most, this week was a little different due to the holiday. Monday was clinic as usual, I saw 21 patients split between morning ortho clinic and sarcoma clinic in the afternoon.
Tuesday and Thursday were OR days. On Tuesday, I scrubbed in for a tumor resection from a patient's forearm and on Thursday I scrubbed into another tumor resection (shoulder) and a total hip (posterior approach).
Friday was my only research day unfortunately, so I had to rush to finalize some last minute data collection, while trying to corral my preceptor to look over my abstract.
Today, I completed my Nth Gives Back project at Project C.U.R.E with Thomas Coleman. We stocked duffel bags with medical supplies that would be delivered to developing nations. It was a fun experience, despite the combination of a warehouse and the Texas heat.
This week allowed me to spend more time with Dr. West. I really appreciated how he explained to me what he was doing during the procedures. One of the key things that he emphasized was post-operation presentation. An IR will quickly develop a bad reputation if patients continue to leave their table looking like they survived a horror film. Thank you Dr. West for taking me under your wing.
This week I continued to work on my project and shadow. My project will be about IR's pre-operative interventions of certain pancreatic cancer patients, and how these interventions can increase the quality of live post-procedure. It is something that I am excited about.
A procedure that fascinated me this week was a DEB-TACE. DEB-TACE stands for drug-eluting bead trans-arterial chemoembolization. In this procedure small beads are mixed with doxorubicin (a chemotherapy drug). These beads coated with doxorubicin are then delivered precisely to a tumor via the patient's arterial system, resulting in arterial embolization and down-staging the cancer. The down-staging (decreasing the size) of Hepatocellular Carcinoma tumors can allow a patient to become a candidate for a liver transplant. The patient that I saw this procedure performed on had an anatomical variation with respect to his hepatic blood supply. His liver was supplied via the superior mesenteric artery instead of the celiac trunk. The IRs were able to visualize this using an angiogram with contrast. It was good to witness something that I will be discussing on my poster presentation.
5. SWET (Same Way Every Time)
Style. So often when we hear this word we may think of runways, models, New York fashion week, designer belts and shoes but we forget that personal style is not limited to our clothing and accessories. Our personal and professional style (ie- the specific way in which we do things) is extremely important and it is what will set us apart as surgeons and practitioners. This week I had the opportunity to work with my preceptor’s partner. He’s an older gentleman 61 (compared to my preceptor’s 36) and being in the OR with him made me realize how much of this job is style based. The general premise of the procedures remains the same, a total hip or a total knee or an ACL repair or rotator cuff repair, the principles don’t change. However, everything else from the execution to the approach to the tools used is what sets surgeons apart, it is their style. So being in the OR with someone who was just shy of the combined age of my other two preceptors allowed me a glimpse into the old school. His process was completely different then both of my two preceptors from the prep through every part of the surgery. Even the tools he used in surgery, he told me some of them were almost 40 years old. While that initially sounded crazy to me, and I wondered to myself if he wouldn’t benefit from utilizing more modern instruments and techniques, on the third total knee we did that day I understood why he operated the way he did. That was his distinct style and he had been comfortable in it for the past 30 years (a true creature of habit) and that’s what allowed him to generate reproducible results and consistent good work. So ultimately, it answered the question for me, No, he should not modernize or use different instruments or tools if his patients are getting superior care and he is comfortable with how he is working, his motto of SWET (Same Way Every Time) shouldn’t be tampered with. It was a great reminder to me that my career as an orthopedic surgeon will have my unique fingerprint on it based on where I train and the techniques and instruments that I feel most comfortable with and it had me start thinking about what my fingerprint on orthopedic surgery to be and how I want to shape it. Definitely an inspirational and thought provoking experience.
PS- also got to guest cohost his ESPN 710 LA Weekend Morning Show and Podcast, incredible experience!