Over the past two weeks I have seen
a lot of interesting stuff both in clinic and in surgery. So starting out two weeks
ago. This was a very hectic week because of the shear amount of patients that
had to be crammed into it before the doctors left for their much earned July 4th
vacation to the beach. Either we didn’t see much of noteworthy significance
(common stuff to see in the Shield’s clinic) or the doctors simply didn’t have
the time necessary to teach the students what everything that they were seeing
was. I am betting on the latter. The doctors left midway through the week
leaving the students in the hands of the fellows and attendings. We learned
much while under the teachings of the attendings and fellows while the doctors
were away, basic stuff that they mostly assume we know already. The pace was
much more laid back compared to usual and the other doctors in general were
less stressed and more willing to take the time to teach. I got to practice my
skills with the indirect which was nice.
Last week: The Monday started out
as usual, an interesting and insightful conference on the topic of ocular
tumors. This one happened to be an intro for the new residents which was good
since I rarely understand all the terminology in the regular lectures that they
give. The day continued and we saw patients. At the end of the day we witnessed
an interview of Dr. Carol by ABC news in regards to a recent cluster of 3 high
school students (each attending the same school) who had uveal melanoma and
lived within a mile of each other. The reporters wanted to know if there could
possibly be a correlation between the teens and their cancers. Dr. Carol
believes it to be a coincidence.
Tuesday, there was a quick EUA in
the morning followed by clinic time. We saw a man who had a dome-shaped macula.
This is apparently a fairly new finding only having been found in the last
three years; it is very rare to see.
Wednesday was EUA day as usual, the
doctors were in a good enough mood to let us use the indirect to see the back
of the eye. Nothing really out of the ordinary to report at least not in my rotation.
After work I went to the Brauhaus to watch the Germany vs Brazil game.
Thursday was surgery day. I
witnessed another enucleation (surgical removal of the eye). This one ran
smoother than the last. There was an iridocyclectomy (removal of an
iris/ciliary body tumor by resecting the iris) apparently this is a surgery
done very few times a year by the doctors here, so I was lucky to have
witnessed one.
Friday was very noteworthy. I
started my day across the street at Jefferson Neuroscience Hospital. I was
there to witness a IAC (intra-arterial chemotherapy) with Dr. Jabbour. While I
was there witnessing the microcatheter being thread up the thigh, past the
heart, up the neck, through the brain, and into the ophthalmic artery, I met a Peddie
alumnus of the class of 2000: Lauren Gallagher. She was really nice and taught
me all about what they do in the basement of the hospital. She actually pulled
out a bag that was stashed in her locker containing a couple thousand dollars
worth of used coils and stents, among other things. During the IAC, there were many different types of imaging used to show the vessels including one where optiray (a dye) was injected to show the flow and pumping of the blood vessels under the X-ray. They took a series of photos in different planes while this was in the patient's bloodstream and compiled them into one single 3d-roadmap of the brain's blood network. This is then laid on top of a live x-ray showing the catheter being threaded through the arteries. As you can probably imagine, this helps immensely in the surgery to keep everything as precise a s possible to minimize the risk for complications. While I was down there, I managed to go see another
procedure where the fixed an aneurysm by threading many thousands of dollars
worth of platinum coils into the aneurysm itself to stabilize it and keep it
from rupturing. In the case of the IAC, the prepping took about an hour, the
threading about 15min, and the chemo about an hour and a half. It happened to
be the third year med students first week in the rotation so I got very lucky
by having them ask all the questions that I would have never thought of. I
thanked Dr. Jabbour for letting me watch his procedures and then headed off
back across the street to go see my mom perform surgery. She was doing muscle
reconstructions to fix strabismus. During one of the surgeries, we found one of
the patients to have excyclo-rotated muscles, we assumed the condition to be
congenital. Friday was also the day when we got introduced to the new research
project that we will all work on until we leave. It has yet to be fully
explained to us, which will occur after clinic is done today.
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