Final Day

In this last post I would just like to thank both my mentors for this incredible opportunity to observe the life of a surgeon.  It was an incredible and inspiring experience.  After seeing both of these doctors do amazing work, I am seriously considering starting down the long road to becoming a doctor.  I love the ability to change someones life that goes along with this career, and the constant forward motion in the medical field.  Being able to pinpoint the problem, figure out a way to fix the problem and then actually fix the problem is an amazing task that takes a lot of knowledge and creativity.  Looking inside someone at the pieces that make up that specific human being is incredible.  The medical field comes with responsibility, sadness and loss but on the flip side had the ability to heal, help and make a difference.  

Slippage

In your spine you have vertebrae and disks that work together to keep your back curved correctly and function.   Today I saw a surgery where the patient had a slippage of one of the vertebrae.  One of the vertebral bodies is out of alignment causing instability in the spine.  In the surgery that I observed the surgeon took instruments and place two screws in three vertebrae.  L4, L5, and S1, L5 was the vertebrae that had "slipped" essentially.  Once the screws were placed a rod was put between L4 and S1.  A device was then used to pull L5 back into place.  The outcome was better than expected.  The vertebrae was back in place and there was a space where the disk used to be.  To add more stability,  a mesh bag was placed in the space between L5 and S1 filled with bone.  This would fuse the two vertebrae together.  Over all very interesting and exciting day.
 
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTc6epmLzLGj0UT3PlOMQOjmsJRs6qTkkTXeeA0RC-wxB7NjQpMFKOHCJtoVo6kobnIumLMCTehiESe-aJZeRNmrtNYde27RlcuIM3oi8Ed0b6ugvANRsKGliG5vAizb2CRwXK83mTVg0/s1600/lumbarspine.jpg

Osteogenesis Imperfecta

Osteogenesis Imperfect or OI is a disease that causes extremely fragile bones.  It is a congenital disease caused by a gene defect.  The severity of the condition depends on which gene was affected.  Because of the fragility of their bones people who have this disease are very prone to fractures.  depending on the severity of the disease it could cause bowed legs and arms, kyphosis, and scoliosis.  The patient with OI that I saw today, thankfully had a mild case of the disease.  Currently there are no cures for the disease, but there are measures to treat the symptoms,  OI is categorized into different types depending on the severity.  Some of types are demonstrated in the figure below.

 

Craniotomy

Today I saw someones brain.  It was pulsing with the heart monitor, it was a purple grey color, and had a bright blue vein running across.  It was one of the most incredible sights I've seen.  The procedure started with a incision across the skin of the skull which was then pulled apart to expose the bone.  Then holes were drilled into the skull and then a drill was used to connect the holes.  Once the skull flap was remove, the dura, a protective layer between the skull and the brain, was then retracted.  This exposed the brain.  The purpose of this was to remove a malignant brain tumor where the cancer from her lungs had metastasized to the brain.  The surgeon then proceeded to  remove the tumor.  I could not tell the slightest difference between brain mater and tumor, but when I asked about it later he said that he can tell by how it fells, the color and other indicators that he learned from experience.  It was a very large tumor and took about five hours to completely resect.  One part of the removal process involved a tool that aspirates the tissue using ultrasound waves which, in a way well beyond me, turns the tissue into liquid. Tools like that really show you the crazy and amazing advancements in medicine.      
 
http://drugline.org/medic/term/craniotomy/

Are Doctors Trying to Turn Us into Borg?

Medicine has come a long way, but still has a long way to go, however, modern technology and procedures are pretty incredible.  Because of arthritis and other wear and tear to our joints they sometimes need replacing.  What do we do? Well we create new tissue out of some high quality synthetic material, slice open the knee and stick it on in.  For those of you who are not Star Trek fans, Borg are creatures that are half human and half machine.  They are evil of course, and fly around turning more people into Borg.  Anyway, thinking about knee replacements and seeing a doctor place screws in someones back makes one wonder.  At some point will we be able to replace every piece of our body?  Medicine is an amazing field that allows one to live longer and hopefully better lives.  Medicine will continue to advance and create more opportunities for humans to heal.  I am honored to watch these amazing doctors do there work.  Below is a video of a knee replacement.
https://www.youtube.com/watch?v=YengS_Z1jAs


http://www.avera.org/mckennan/services/pain-management/procedures/total-knee-replacement/

What Exactly is Arthritis?

I talked about arthritis is past post as a cause of a problem but I haven't really explained what it is.  Arthritis usually begins with a break down of cartilage in the joints.  Cartilage allows the bones to move smoothly together and it also absorbs some of pressure on the joints when one is walking or lifting something.  When this cartilage is worn, the bone begin to have direct contact with the other bone involved in the joint which causes inflammation, pain and stiffness.  In response to this new pressure and irritation the body will sometimes grow new bone in attempts to lessen the pressure.  Unfortunately it usually hurts more than helps, as was seen with spinal stenosis and how these bone spurs can put pressure on nerves.

We're All in This Together

After a long and exhilarating  drive, I was driving the stick shift, I arrived in Farmington, NM.  I shadowed a different neurosurgeon today in clinic.  We saw a lot of cases with varying degrees of spinal stenosis and a herniated disc, both of which I have seen the corresponding surgery.  It was very interesting to experience three different doctors and to see the different way they handled themselves and addressed/diagnosed problems.  It was not only the doctors that I observed and contrasted, but I also looked at all the different jobs that go into running a hospital.  This day was a great opportunity to look at some of the other career choices in the medical field.  Each person in a hospital has their own special way of contributing the the healing and care of patients.