Tuesday, July 27, 2010

Katie - week 6

This past week was very busy for me with a variety of activities. For the second week in a row, I attended the Center for Skeletal Dysplasia with Dr. Raggio at HSS. Here is where we get to meet with patients who have a type of skeletal dysplasia, most often osteogenesis imperfecta or achondrogenesis (most common form of dwarfism). After meeting with patients all morning, there is a patient conference, where the whole team, including the orthopedic surgeon, social worker, nutritionist, and genetic counselor, gets together to discuss the progress and status of each patient. One of the most interesting things that happened this week was a patient who was diagnosed with Robinow syndrome a very young age. However, now that he is 18 years old, Dr. Raggio's team is unconvinced that this is his diagnosis, and they will want to keep meeting with him to figure out what type of skeletal dysplasia he truly has. We also met with another patient how has Type I osteogenesis imperfecta and a number of allergies, but who has not been following her doctor's protocols. She is supposed to be cutting out certain foods for weeks at a time so that she can hone in on what foods to which she is actually allergic, but the 13-year-old female is having big compliance issues. The Center for Skeletal Dysplasia is always interesting because the cases vary greatly, and I enjoy the team approach to these complicated patients.

Also this week, I had the opportunity to shadow Dr. Bostrom, an orthopedic surgeon, for a day as he met with patients for follow-ups, infections, and for new visits. During this particular day, he was "triple booked" with 4 pages of patients he was supposed to visit within 10 hours, so it was a very hectic day. I was able to see a lot of different cases, though. Some patients were recovering from a knee or hip replacement very well, while others were having pain issues, and one had a horrible infection. Others were getting advice on whether they were a candidate for a total knee or hip replacement. Furthermore, some were doing very well post-op according to Dr. Bostrom, but the patient was unhappy with their abilities at this certain point in time. One of the highlights from my day with him was meeting a famous actress and patient of Dr. Bostrom. Because of his reputation, he has quite a few patients who are famous.

Also this week I shadowed Dr. Bostrom in the OR for an entire day. I saw a hip revision, a knee revision, and a total hip replacement. The second two surgeries I was actually allowed to scrub in on, and so I had a perfect view of the entire process! Seeing the total hip replacement up close was by far the coolest thing I have done on immersion term so far. I was so shocked at how fast the whole process was. Dr. Bostrom's part was done in about 45 minutes! He has to rotate the hip so that the joint pops out, saw off the femoral head, drill a hole into the cancellous bone of the femur, fit a post, drill the acetabular cup, hammer in the metal cup, snap on the plastic cup, pop the hip back in, then sew up. It was incredible to see it all in action and to see all of the drills and saws that are used in orthopedics.

This week I also finished analyzing the retrieved knee implants. The next step in my project will be running statistics on everything to reveal our findings. I will be meeting with one of the research engineers to discuss the best strategy for this analysis.

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