Tuesday, July 6, 2010

Week 1,2,3

These three weeks have been a fabulous experience where I have acquired medical knowledge which I never thought I would be able to obtain.

In week 1, I was able to observe several surgeries, but the one that called my attention was a surgery on a male patient who was suffering from cervical spinal stenosis. Cervical stenosis is a degenerative disease where the spinal canal is narrowed and produces a pressure on the spinal cord. The operation lasted five hours and it was very intense.

In this surgery, the techniques have been used since the 1950s and have become widely accepted in the treatment of this disease. The structural integrity of the column is restored with autograft or allograft fibula, typically combined with the placement of instrumentation such as screws. The use of an anterior cervical plate offers the advantage of conferring immediate stability, increased fusion rates, and a decreased incidence of graft extrusion. Additionally, they also added an internal fixation which decreases the need for postoperative rigid brace immobilization [Mayr et al. 2002]. After the surgery is done the patient will be subject to a lot of physical therapy which will help him to gain back the life that cervical spinal stenosis to away.

In week 2, I was able to see how Dr. Kupershtein, a fellow doctor, helped a 50 year old female patient with scoliosis. My first impression was to see the x-ray of the patient and observed how severe her condition was. Her spine was curved from side to side. This surgery was made in two steps; in the morning the patient was opened on her front and an allograph was placed. The allograph contained growth factors that would allow the bone to grow again. In the afternoon the patient was opened on her back were several screws were used to prevent more curving of the spine. This surgery lasted 12 hours and the patient was taken to the recovery room after that she would start physical therapy.

Week 3 was different from the previous two weeks. I was able to go on rounds in the neonatal ICU. I was able to hear the different conditions that each patient had from the residents. There were two doctors in charge Dr. Jeffrey Perlman and the fellow doctor Dr. Tanvi Kamdar. One of them was a 28 weeks female patient with HIV and hypoglycemia. The patient lost weight therefore the body fluids were decreased to increase her body weight. Another case was a 28 weeks female patient who was born from a female with cycle cell disease. The doctors were also concerned with her body fluid and decided to increase them. Also, they turned off the light therapy that the patient was subjected to.

Overall, I am highly impressed with the level of technology that the Hospital for Special Surgery and Weill Cornell Medical College are using to improve people’s lives. At the same time I was able to see that most of this technology is available because of hard working researchers.

Mayr, M., & Suback, B. (2002). Cervical spinal stenosis. Journal of Neurosurgery, 1(96), 10-16.

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