Last Week of Immersion

This week mainly comprised of me writing my ORS abstract for the conference that is coming up. However, on Monday I was able to shadow Dr. Goodman and few of her colleagues around the hospital and the office. There were two patients that were particularly interesting to talk about. The first patient had Psoriatic arthritis (PA). This is where the body develops an immune reaction that is nonspecific and causes rashes to form on the skin. Unfortunately, this immune reaction sometimes attacks the joints as well. This patient was on Humira, which I learned seems to work relatively quickly (within 1 week). This is different from other AI drugs, such as methotrexate. This patient was having vertigo while on Humira, which seemed to be a big problem and also had pitting of the nails (common with PA). Some new tests that I watched included some specific coordination tests that helped the doctor diagnose if he had any problems with his nervous system (sometimes PA can affect this). This patient also had knee replacement surgery and had some bad nerve pain in his legs. The doctor was only concerned that his vertigo might be the cause from a MS like disease, which is a very rare side effect from taking TNF inhibitors (Humira). Overall an interesting case.

The second patient was a RA patient with severe deformities in her hands. I learned that these deformities could not be corrected. The patient had a bad infection so that she stopped taking her RA medications (which was advised). The patient actually had a reconstructive surgery with her hand to fuse her joints in her thumb so that she could preserve her "pincer movements" with her hand. According to doctors, this is one of the most important tasks that patients need to be able to perform with their hands. The patient also had tendon reconstruction because the deformities and the intense inflammation from her disease caused a couple of tendons to rupture in her wrist. She is doing okay now, but doctors worry that her quality of life is not going to be that good due to her advanced state of disease. Her RA is well controlled, but it was a sad case to see.

Nothing else really happened this week. I plan on working on my report now. It will be on my project and what I learned from my clinical experience over the summer. Time to go back to Ithaca!