Carolyn: Week 3

Week 3 was short but productive for me. In the lab, I attempted another round of RNA extraction from mouse bone samples. Although my RNA quality values are still not ideal, I have identified several steps in my methods which may need to be changed or further perfected. My lab manager returned from vacation this week and helped by providing more suggestions to continue to improve the RNA quality. In addition to my RNA extraction work, I was trained to use the µCT equipment in this lab space. A fellow lab member from Ithaca came to NYC this week to learn this technique so I was able to go through the process with him.
On Thursday of this week, I shadowed Dr. Bostrom in the operating room and was able to see several surgeries. This time around, I was positioned to have a much better view of the surgery, and Dr. Bostrom even set up a camera for me to view the surgery from above. He performed several procedures, including a revision of a hip arthroplasty using a custom-made implant. This patient had been in the OR during my first week but was unable to be successfully intubated and therefore did not have surgery. Her body was much more cooperative this week, and she underwent a successful procedure. Throughout the procedure, the design engineers continually communicated with and gave advice to Dr. Bostrom. These interactions are unique to this hospital and interesting to witness.
With the variety of cases performed by Dr. Bostrom, there are always interesting differentiations for each patient. During one total hip revision, after implantation of the final implant, the surgical site was filled completely with iodine. This was emptied soon after and the site was closed, but the application of the iodine will likely decrease the risk of infection. During a total knee arthroplasty, I noticed that there is very little guidance for the removal of bone from the patella. Both the tibia and femur are equipped with guidance systems during this procedure to ensure that the cuts made by the surgeon will be compatible with the shape of the implant. However, no such guidance system was used to cut the patella. Dr. Bostrom was teaching a resident how to perform this surgery and was clearly very skilled at this portion of bone removal. However, the resident was relatively new to the procedure and likely could have benefitted from a guidance system. Anterior knee pain is a prevalent issue for those who have undergone TKA’s and I believe this may lack of consistency of the bone removal across patients contributes to that issue.
After observing several patients in the OR, I have started to notice differences between the patients. Significantly, I was surprised how easy it is to notice differences in bone appearance. The patient who received the custom implant had bone that appeared rough, geometrically inconsistent, and darker in color than a younger healthier patient who underwent a primary total knee arthroplasty later that day. While the color could be due to the application of the electrocautery throughout the procedure, it could also indicate tissue necrosis or osteolysis.
Outside of the lab this week, I was able to spend time with my boyfriend, who was visiting from Rochester. We met up with a mutual friend and explored Ellis Island and lower Manhattan. Unfortunately we only took one photo with all three of us pictured!



My boyfriend and I also made a stop at the Museum of Natural History to check out both the space and the microbiome exhibits – so we were both satisfied! Later in the weekend we were also able to attend a comedy show with some of my friends in the Immersion program. My boyfriend likes food almost as much as I do, so we were sure to try several fun new things. These included (but are not limited to) French dip sandwiches, Hong Kong egg waffles, and Cambodian food!



My dessert recommendations for this week include Eggloo’s waffle with ice cream (pictured above), and the matcha cream puff from Bibble & Sip (green dessert in left photo) . I will admit that my boyfriend and I both tried the giant milkshakes from Black Tap as well (and they were amazing), however we both did not feel too well that night, so I will likely not head back (milkshakes pictured in right photo). 



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