Week 3 - Round and Round I Go

You might expect from the title that I've been going on a lot of rounds. Nope. Just one. I've been hopping about the entire week to different departments--and occasionally into the lab.

23 June 2014

I started off the day with pediatric ICU (PICU) rounds at 8 AM with Dr. Pon. It was definitely a different experience from the plastic surgery rounds, notably the length of care and the amount of information regurgitated. In plastics, no more than 5 minutes were spent per patient, but this was generally fine since the residents and med students just changed dressings and checked up on the patient. At the end of the round, the team gathers somewhere (generally in the hallway) and recaps the 1-1.5 hour round.

In the PICU, the full story and history of the patient since admission to the hospital was explained before any further treatment. The attending was also constantly grilling the resident for alternatives and justification to the diagnosis.

I've outlined some of the patients in the 3-ish hour visit:

1. 6 year old boy diagnosed with Rhinovirus, which according to the trusty Wikipedia article, is the a major cause of the common cold. This kid did not look like he had the common cold with multiple breathing problems. Either way, they injected a slew of drugs (perhaps antivirals?) and continued to monitor him.
2. 18 year-old girl (I didn't think 18 year-old patients were considered pediatrics... the more you know) who was apparently found disoriented and non-responsive. Apparently it was a planned suicide via overdosing on some drug after some relationship issues (awkward). Yeah. Let's not commit suicide over a breakup kthxbai. (But seriously, people should seek help in these situations.)
3. Young girl with a possible staph infection.
4. 17 year-old girl that had leukemia and received bone marrow and core blood transplant.
5. Young boy received surgery due to multi-organ failure from E. coli contamination.
6. 11 year-old boy had a shunt placed in his brain because of a mass that was removed.

Next, I went into Dr. Spector's office hours, and some of the cases were... interesting. I'll just highlight two of them.

1. 22 year-old male patient had a HUGE open on his thigh (lateral) which stemmed from a 12 year-old salmonella infection. 12 YEARS. Oh, the femur is also infected. No big. I'll just go on with my life WITH THIS HUGE LACERATION ON MY LEG. The patient came in for a consultation, and Dr. Spector told him that a fibula flap transplantation is needed, and the procedure is highly risky and needed to save his limb.
2. Older male patient (think ganster-esque) with his man servant came in to change some dressings. The dressings were located on his underside (i.e. his bottom). Okay, sure, whatever. Things happen. When he was taking off his pants, we saw sores all over his leg, and apparently it was from shooting up heroin. Alright. Seemingly normal. But when he flipped over, there were LARGE gaping holes the size of my fist. I have no idea if this was associated with heroin, but I won't be injecting heroin any time soon (at least not near my legs).

24 June 2014

I went into lab and sectioned slides. Very exciting. I also saw a skin graft procedure, which was very quick.

25 June 2014

I finally met up with Dr. Skubas from the cardiac anesthesiology department, which was interested in 3D printing of heart valves. I went into the OR with him to observe an aortic valve replacement due to calcification. Apparently, most procedures here use bioprosthetic valves instead of mechanical valves since there is no added benefit to the patient from using mechanical valves (these patients are elderly--70+ years of age). Dr. Skubas showed me the 3D echocardiogram, which is an amazing piece of technology, but the rest of the procedure, although interesting, was quite bland since the surgeon (Dr. Girardi) was not a big fan of talking. Everyone in the room was silent once the procedure started, which is in contrast to many of the plastics procedures.

26 June 2014

I observed two cardiothoracic surgeries involving coronary artery bypass graft (CABG, or cabbage). Again, I found the procedure interesting, but I didn't learn much due to the lack of talking in the OR. Oh well. It comes with the territory, I suppose.

27 June 2014

I went into lab and did great things. And by great things I mean sitting around until lab meeting because the time kept getting pushed back.