Week 3 - A Shorter Week
This week was a shorter week due to the July 4th holiday and some of us took advantage of the day off by going out to Coney Island for the majority of the day.
Wednesday was back to shadowing in the hospital where my morning started off in the OR for a brain stem biopsy. The patient had an MRI taken earlier in the day and so what was originally only supposed to be a biopsy became a craniotomy when a second tumor was detected in the new MRI that Dr. Schwartz wanted removed. Careful planning and positioning for the initial biopsy allowed for only a single area of the skull to be affected for the additional craniotomy to be done to remove the tumor. While there was supposed to be a second surgery to remove a brain tumor in another patient, the surgery had to be postponed until the next day due to complications.
Later, I had shadowed Dr. Gauthier as she examined her patients. I was able to see just how much patients with multiple sclerosis are affected by their lifestyle or life choices and how much they have to consider their medication choices based on that. For example, a woman came in for a checkup after having been off the medication for some time in order to safely have a baby. Between her last MRI scan and going back on her medication before her visit, she had a new area of numbness as well as a couple new lesions in her more recent MRI. A concern based on the effect of being off the medication came up before when another woman wanted to have a baby but was told that a lot of planning would have to be done to stop and start treatment again in order to do so.
Other cases had negative effects on the patient, not by choices such as wanting to conceive, but through poor life habits such as frequent smoking. Patients with MS came through the clinic and have had variable degrees of stamina with how far they could walk before tiring out, some a few blocks, others a few miles. Those who could not give up smoking had significantly less stamina and one patient had reported suddenly losing consciousness and having a fall while sitting as a result, to which Dr. Gauthier attributed not to the chronic disease of MS but to the additional symptoms brought on by the patient's smoking habit.
What I experienced this week for immersion can be summed up to the fact that the heterogeneity of patients' backgrounds as well as new, unexpected results, makes clinical work much more difficult to the physicians, more so than for controlled lab conditions.
Wednesday was back to shadowing in the hospital where my morning started off in the OR for a brain stem biopsy. The patient had an MRI taken earlier in the day and so what was originally only supposed to be a biopsy became a craniotomy when a second tumor was detected in the new MRI that Dr. Schwartz wanted removed. Careful planning and positioning for the initial biopsy allowed for only a single area of the skull to be affected for the additional craniotomy to be done to remove the tumor. While there was supposed to be a second surgery to remove a brain tumor in another patient, the surgery had to be postponed until the next day due to complications.
Later, I had shadowed Dr. Gauthier as she examined her patients. I was able to see just how much patients with multiple sclerosis are affected by their lifestyle or life choices and how much they have to consider their medication choices based on that. For example, a woman came in for a checkup after having been off the medication for some time in order to safely have a baby. Between her last MRI scan and going back on her medication before her visit, she had a new area of numbness as well as a couple new lesions in her more recent MRI. A concern based on the effect of being off the medication came up before when another woman wanted to have a baby but was told that a lot of planning would have to be done to stop and start treatment again in order to do so.
Other cases had negative effects on the patient, not by choices such as wanting to conceive, but through poor life habits such as frequent smoking. Patients with MS came through the clinic and have had variable degrees of stamina with how far they could walk before tiring out, some a few blocks, others a few miles. Those who could not give up smoking had significantly less stamina and one patient had reported suddenly losing consciousness and having a fall while sitting as a result, to which Dr. Gauthier attributed not to the chronic disease of MS but to the additional symptoms brought on by the patient's smoking habit.
What I experienced this week for immersion can be summed up to the fact that the heterogeneity of patients' backgrounds as well as new, unexpected results, makes clinical work much more difficult to the physicians, more so than for controlled lab conditions.
Comments
Post a Comment