1st Week of Immersion

Sorry for posting my first week's post as a comment, but I copied everything over to this page. Not much happened for me this week but I was able to shadow some rheumatologists with Jason. I was also able to attend the comprehensive arthritis program (CAP) clinic as well, where they examined a patient and as a group discussed what they thought was the best course of action for him. At this clinic, the patient had a valgus deformation with her left leg because of a prior car accident. He also suffered from some genetic deformities. It was definitely a hard case and it led to some good discussion.

I would say that my favorite part of the week was the CAP clinic. I found it very cool how the doctors assessed the patient and there was some very good discussion points that they all addressed. It was nice to see how they thought through the process and came to a consensus about the patient. The more experienced doctors were able to coax the fellows in the right direction if they thought a course of action was not as good as it could have been.

I also liked seeing patients in the exam rooms as well as visiting patients in their hospital beds. The exams that the doctors gave were very thorough because a lot of patients exhibit many symptoms from several conditions, which made it more difficult to discern what was actually going on. It seems like the default solution to everything in rheumatology is to apply some sort of steroids to calm down the inflammation in the joints or in other areas, and the long term solution depends on how they respond to the initial steroid treatments. The most interesting case was was with an older woman with rheumatoid arthritis. She had taken many different medications hoping for one that did not have significant side effects. Some of the drugs were very effective, but she stopped using them because of the side effects. Now, she refuses to take almost anything because of the thought of side effects. This made it very difficult for the doctors to treat her problem, which lead to frustration on the doctor's part. It seems like patients in general are very wary of a lot of side effects of some of the more powerful drugs out there.

I look forward to being in the OR next week, as well as exploring some other areas of medicine.