Week 1 - Aniqua Rahman

I am shadowing Dr. Susan C. Pannullo this summer. Dr. Pannullo is a Neurosurgical Oncologist. Her medical specialties include the treatment of benign and malignant brain tumors and Stereotactic Radio Surgery. She used to perform open skull surgery, but now she only focuses on radiation surgeries.  She sees patient at Weill Cornell Medical College (WCMC) every Monday, Tuesday and Thursday. She usually sees patients in New Jersey every Wednesday and lectures at WCMC every Friday.

This week, I had a chance to experience different brain tumor cases with Dr. Pannullo. Most of her patients came for follow up check ups and consults, and few of them were new. Below are some cases:

•  A 42 years old left handed male, came with his mother. His latest MRI showed reappearance of tumor (Granular Cell Astrocytoma). He had surgery towards the end of last year. 90% of the tumor was removed by the surgery and a shunt was placed. MRI images of April 30, 2014 showed tumor regrowth. Dr. Pannullo suggested Chemotherapy drug (Temozolomide) and radiation therapy.  Patient doesn’t want to have chemo drug, probably will just have radiation therapy.
• 26 years old male patient, tumor regrowth. He became paralyzed and stopped communicating about two weeks ago. His case is very critical and chance of survival is very low. Dr. Pannullo still recommended Novo-TTF Therapy (This therapy is under clinical trial; Glioblastoma recurrent therapy).
• 34 years old lady with extreme headache. She is taking medications, but side effects are unbearable (extreme skin rashes). Dr. Pannullo recommended vascular decompression surgery. It’s an option, totally up to the patient whether she wants to deal with the side effects or just do the surgery.
• 52 years old female patient., came with her friend. Tumor removal surgery was performed and now everything is going fine. Came for regular check up.
• 64 years old male, had surgery and was under chemo. Wife wanted him to check with Dr. Pannullo. He is doing fine, but there are shoulder pains and fatigues. Dr. Pannullo suggested MRI scan to check if there is any sign of shoulder arthritis.
• 76 years old patient, came for regular follow-up check ups.
• A patient from New Jersey. Novo-TTF therapy was demonstrated to this patient by a clinical research coordinator.

Other than visiting patients, I went to a senior citizen center in 76^th E street with Dr. Pannullo. Here, Dr, Pannullo had to give a talk on Brain tumors and available treatment options. Dr. Pannullo is highly involved in many outreach activities and this talk was one of them.

In addition, I went to the Tumor Board Meeting (Every Tuesday 4:00 pm, Starr Building, Floor 6A). Doctors, residents, fellows went over 25 different cases. Doctors went over the biopsy results and MRI images of all those cases and discussed extreme abnormalities and possible treatments for each case.

Dr. Pannullo had to go out of NYC for the last two days of this week. So, I shadowed one of Dr. Weinsaft’s patients with David Bassen.  Together, we followed a heart attack case under supervision of Dr. Michael Knight. This patient is 69 years old, who had heart attack and symptoms of heart failure afterwards. She had two stents implanted in the morning, but her cardiac output was very low. Therefore, she had to be admitted to Catherization Dept. and her heart functionality was stabilized using Balloon Pump (IVBP).