Week 6: Carolyn

This week was filled with clinical exposure, and I was surprised to see even more types of patients. As I see more and more of these surgeries, it is clear that even a specialist such as Dr. Bostrom is constantly presented with challenges throughout his career. Patrick and I were able to shadow together on Monday and observe two interesting knee cases. One case involved re-aligning the patellar implant to improve the comfort and abilities of the patient. This was particularly interesting because it involved altering the soft tissue around the knee. The procedure still required a large incision, however the surgical site did not need to be nearly as large as the primary replacement surgical site. Much of the soft tissue remained in place throughout the procedure. We also observed a conversion procedure from a unicompartmental knee replacement (prosthesis on only one femoral condyle) to a full knee replacement (prosthesis spanning the distal femur and proximal tibia).

Later in the week, I joined Dr. Bostrom on his morning rounds to visit patients and assess their recovery. These were the very same patients whose joints I had seen in the operating room. This connection was incredibly interesting, and certainly put a face to the anatomy. I continue to be surprised by the patient questions – constantly trying to push their limits of post-operative activities, or trying to prove that another physician had made an error and caused their disease. Few are interested in the disease process or the equipment currently in their bodies – I feel that this just re-affirms the fact that our society is losing interest and general knowledge in science.

While some of the patients may be difficult, I saw some very inspiring patients in the clinic this week. Many of these patients listened to Dr. Bostrom intently, and were grateful for his counsel. These are the patients that recognize that they may not be able to run a marathon again in their lifetime, but that these operations will still greatly improve their quality of life. I expect that these are likely the patients that follow their physical therapy routines more accurately, and have the motivation to heal to their new capability levels, therefore increasing the chance of success of the operation.

While shadowing in the OR yesterday, I saw a plastic surgery procedure – in an orthopaedics hospital! One of Dr. Bostrom’s patients needed a muscle transplant to their knee, so he paired up with a plastic surgeon. This surgeon expertly removed a portion of muscle from elsewhere in their body and reattached it over the patient’s knee. This involved very precise reattachment of the vasculature from the native tissue to the transplant. Without the vasculature correctly reattached, blood would not be able to get to the tissue and result in tissue death, or too much blood would accumulate in the tissue and result in tissue death. This portion of the procedure was incredibly long and required use of microscopic tools.

Back in the lab, I extracted more RNA from cortical and cancellous bone, as well as from bone marrow. I obtained a new protocol for bone marrow RNA extraction that resulted in even better quality measurements. Next week, I plan to send a portion of all of my samples to the genomics facility here to get a more quantitative assessment of the quality of my extracted RNA.

Outside of lab this past week was filled with an adventure to Brooklyn dressed in 90’s style. Patrick and I also spent a day this weekend exploring the old churches in lower Manhattan as well as a trip across the ferry to Staten Island.

My friends and I were also able to explore Coney Island this weekend, and we got in a trip to the aquarium for Regan, who loves aquariums.

My family is here this weekend to visit so I am looking forward to spending time with them in the city. My dad was able to come a day early and worked in the city during the day. Last night, we went to see Jerry Seinfeld at the Beacon Theater. This was a great show, and especially fun for us as “Seinfeld” is a show my family has always watched together.

My dessert recommendations for this week include the syringe-injectable doughnuts from Clinton Hall. If you order doughnuts and they take a little while to come out, you might be lucky and get them for free like me and Patrick! Patrick and I both agreed that the raspberry filling was the best.

I would also recommend Baked by Melissa, which specializes in small bite-sized cupcakes. Not only are they adorable, but they were also pretty tasty! I chose mint, cookie dough, and a cookies-and-cream-filled purple cupcake.