Week 2

This week is similar to last week where I followed Dr. Miller to check on patients every day. A lot of Dr. Miller's patients have been discharged and Unfortunately the office for approving scrubs and OR access has been slow in response and I finally got an account on Friday.  Also a lot of test results came out from last week and Dr. Miller is able to apply the right antibiotics to the "unsure" patients. I shadowed Dr. Henry on Monday afternoon and some patients were surprisingly ill. Mostly patients I have been observed at HSS only have fractures or joint replacement and bacteria makes it more complicated however people with self immune diseases or genetic bone problems are suffering a lot and doctors often work together to discuss the right dosing so parallel treatments are not affected. There is one case of lupus patient who is under going kidney dialysis came to Dr. Miller about pain in mosquito bites. Turned out that patient have chickpox and the symptom that patient has is classic shingles. 

We had the meeting from radiologist Dr. Prince on Thursday at 11am on Thursday. We discussed cases from X rays, CT and MRI. The case for me is an external fixation example which was an easy guess because I visited one patient with this treatment once. I think I will go back to the basic principles of those imaging tools because I felt a lot of easy questions like why this show up, what color should it be, what type of imaging was used and why, etc can be answered easily if I know the mechanisms of imaging better. In the afternoon after I got back to Dr. Miller, he took me to see a radiologist to check on one of his patient. We looked at the MRI which showed some abnormal fluid (I really appreciate the lecture earlier to help me understand) but not a clear sign of infection. This patient complained about abnormal pain in shoulder but no other symptoms. I stayed late to watch they taking fluid from shoulder and lavage samples using ultrasound to locate the fluid. The procedure looks extremely painful as a huge needle was inserted and they were moving around to find fluid sample which was not quite enough for analysis. 

I didn't go to the weekly meeting on Tuesday but I went to the bug of the week meeting on Wednesday as mentioned in last week's post. Some very interesting fungi and bacteria as always but there is a sample from a burn patient is particularly sad. The one bacteria shown is a super resistant strain which they haven't been able to find a treatment. It is also very rare and the last patient who had it was years ago and that patient died a few days later and the doctors said the chances are small for the burn patient too. I went to a lecture by Dr. Henry on Friday at 1pm on urinary tract infection and arthroplasty. He presented and analyzed statistical data from literature which is actually quite limited. Few studies have been done in this area. The conclusion is that it is inconclusive and they will still follow the standard guidelines on what HSS has. I was constantly confused during the lecture as doctors used a lot of abbreviations and I still have trouble following them. Another interesting aspect I noticed is that those lectures consists mostly data analysis which is like the follow seminars I attended last week. This is very different from graduate schools where people usually spend a slide or two.