Week 4: Scrubbed in the City

Tibra Wheler

We are officially over halfway done with our immersion term. From getting some things done in lab to seeing a couple surgeries, this week was very exciting and productive. On top of everything going on in lab and clinic, I of course had some great and even free food while enjoying more of what NYC has to offer.

Over the weekend, I enjoyed appreciating some great art at the Metropolitan Museum of Art. It still amazes me how many different exhibits there are in the museum and how it’s pretty much impossible to see everything in one day. I also enjoyed some wonderful views of the city from the rooftop garden at the Met. After all the walking in the museum, we decided to get dinner from the Meatball Shop. I was so full after that meal that I didn’t have room for dessert.

On Monday, I shadowed Kirsty as she continued to isolate RNA from the loaded cartilage punches. The RNA isolation is definitely a long and tedious process, but Kirsty helped to show me proper techniques as well as some tricks for getting great RNA from the samples. Once the RNA was isolated we wanted to check the RNA values on the nanodrop to make sure the values were greater than 1.6. While nanodropping the RNA on the machine we noticed that we weren’t getting consistent results from the machine for the same sample. We decided to freeze-thaw the samples so that we could test them on another nanodrop the next day.

For dinner that night, we took it real New York style by eating at a food truck called Halal Guys. Afterward, we grabbed dessert from Billy’s Bakery. I got strawberry shortcake with pudding served in a glass jar. It was just the cool dessert I needed after a hot day.

Tuesday, we found another nanodrop to test our RNA values. The results were promising as our values were above 1.6 and they were more consistent when multiple drops were run for the same sample. Because our values looked good, Kirsty could run reverse transcription (RT) on the samples. RT is a process in which an enzyme, reverse transcriptase is used to generate complementary DNA (cDNA) from an RNA template. Later that day, I was scheduled to watch a Tekscan sensor be placed in a cadaver knee and placed on the knee simulator. However, while the Tekscan sensor was being placed in the knee, the tech noticed that the knee had fairly bad osteoarthritis (OA). This was a problem because the knees that had been run on the simulator before were all healthy knees and this study wants to look at stresses and strains during walking in the healthy state. A knee with OA is not comparable to healthy knees so they decided against using it and are planning to do another knee sometime next week.

That evening was the evening for free food. It happened to be Cow Appreciation Day that day so Chick-Fil-A was giving away free entrees for anyone who dressed like a cow. So yes, I (along with a couple friends) dressed like a cow to get free Chick-Fil-A. I mean, who wouldn’t do that for free food? Afterward, we realized that the date was 7/11 which meant free Slurpees from 7-Eleven so we went there for dessert.

My time to go in the OR finally came on Wednesday! I started shadowing Dr. Ranawat in clinic that morning. We met with a few patients who were having pain ranging from shoulder to hip to back pain. It was nice to see Dr. Ranawat interact with his patients and see how he determines next steps (surgery, physical therapy, etc.) for patients experiencing pain. After clinic, he had two surgeries scheduled so I went up to get my scrubs and other necessary clothing so that I could go observe in the OR. The surgeries that he had scheduled were both hip arthroscopies for femoracetabular impingement (FAI). FAI is a condition in which extra bone grows along the bones that form the hip joint. This gives them an irregular shape so they don’t fit together properly. Because of this, the bones rub together causing pain and limited mobility. The surgery is done with a camera scope which is inserted through small incisions. The FAI can be fixed by shaving and trimming bone around the area to create a better fit for the joint. Because the surgery is done using a scope, I could see the entire surgery on the screen that was setup in the OR. As Dr. Ranawat was clearing away cartilage and bone, he was explaining what he was doing and why. During the surgery, x-rays would be taken so Dr. Ranawat could see the placement of his tools as well as what the bone was looking like. My first time in the OR was definitely a learning experience for me clinically. It also taught me that I probably don’t need to be a surgeon, because my feet, legs, and back were killing me after standing in the OR for so long.

It was back to lab on Thursday (where I can actually sit and do work). The morning was filled with our usual meetings. During lab meeting, everyone gave updates on their progress. Then at the soft tissue orthopedic meeting, some summer students gave presentations on their work. One of the presentations was about cryotherapy, which is the use of cold materials like ice for medical treatment. The student was trying to gather data to determine the mechanism behind icing injuries and to see if it actually helps. I found it so interesting because as someone who is active, I’ve always iced when I got an injury but I never thought about why or what was actually happening that makes this treatment option work so well. That afternoon, more cow knees came in for us to dissect cartilage from. This time there were four knees so I was able to dissect on myself. It was a little nerve-wracking because I didn’t want to cut the wrong thing or touch the cartilage with the blade because we try to keep it as sterile as possible. Nonetheless, I did it and the cartilage on these cows was beautiful. After getting the cartilage we made punches from it and inserted them in the confinement ring. We will load these cartilage punches next week.

Yesterday evening, I went to see Anastasia on Broadway with some friends. It was an amazing show to see. I haven’t been let down by a show yet. I’m really hoping that I can go to at least one more before my time in the city is over. Before the show, we got dinner from Tehuitzingo, which is the place to go for great authentic Mexican cuisine. Dessert for the evening came from Schmackary’s which is famous for their cookies. I got a Schmacka-doodle cookie which is their take on a snickerdoodle – it was delicious.

This morning, we had our weekly immersion meeting with Dr. Prince. We just discussed our various research projects and any progress or troubles we’ve had. After the meeting, I headed to lab. I changed the media on the cartilage punches that were in the confinement rings. Then Kirsty showed me how to set up the plate for polymerase chain reaction (PCR). PCR is used to amplify a few copies of a segment of DNA across several orders of magnitude. This generates many copies of the DNA so that it can be analyzed. For our purposes, we want to check gene expression and be able to compare it before and after loading. To make the PCR plate, we pipetted the cDNA (which we got from the RT on Tuesday) along with primers and a fluorescent marker. After the plate was finished, we placed in the BioRad machine where a protocol was already saved for the times and temperatures we wanted to run the plate on. We will analyze the data on Monday so fingers crossed for some nice results.

The weekend is here and I’m escaping the city for a few days. Until Monday NYC!