Monday, July 19, 2010

Week 5 - Jenny Puetzer

This week I changed things up a little bit and went to neo-natal rounds. It was a great change of pace to see all the cute babies, but then very sad at the same time to see how sick some of them were. There was one baby that was 4 months old already but still smaller than most newborns. It was very interesting to see all the doctors and fellows work together on rounds to determine what should be the next step for each neonatal and interesting to see a different take on the patient-doctor relationship.

This week I also went to grand rounds for arthroscopy. They had a very interesting presentation on what causes deaths most often in total hip and knee replacements. This was especially interesting since deaths are so uncommon in these procedures and definitely not something that we would get the chance to witness during our short stay at the hospital. Apparently, death, as we would expect, was more prevalent 10 years ago and beyond. This causes a problem with research studies that examine this issue since the orthopedic field has developed so much in the last ten years it is important research studies take this into account. The conclusion from the presentation and research was that pulmonary embolisms(PE) which used to be the number one cause of deaths in total hip and knee replacements was now third on the list for causes of death. This means the field has done very well at decreasing the risk of PE, but that now the field needs to focus on other causes such as blood loss or the use of tourniquets.

One improvement in the orthopedic field over the past few decades which has allowed for a decrease in the risks of surgery is arthroscopic surgery. I have had the chance this past week and all weeks I have been here so far to see countless arthroscopic surgeries. I find these surgeries very interesting because of the vast amount of different types of surgeries they are able to do, while still keeping the surgery very minimally invasive. Some surgeries I have seen so far with arthroscopy include arthritis clean up, menisctomy, torn cartilage removal, exploratory to find a cause, removal of mechanical issues in the knee, rotator cuff repairs, tendon repairs, reattachment of the biceps, and countless more. It is great to see how this improvement in technology has helped so many people. In the past all of these surgeries would require the person’s knee or shoulder to be completely opened up leading to increased risk of infection, longer surgery times, and longer recovery times. But now these patients are able to have 2 or 3 small incisions, an hour or less surgery with local anesthesia, and shorten recovery time, which in some cases means back to everyday activity after just one day. This is truly a great asset to the orthopedic field, and many other fields for that matter. It makes me wonder what improvements we will make in the coming decade to make this already optimized field even better. It will be truly amazing to see.

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