What I learned today about medicine.




A few radiology-based images and a diagram.

1:58 pm, by alliedhealth
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Day 38, 39, & 40 / Radiology Day 1, 2, & 3 

3/26/2011

     This week my rotation was radiology, also known as diagnostic imaging. This is the same sect of the hospital as where I spent my summer internship, however I explored less familiar areas of radiology, making the most of my precious time in the area.

     My first day was spent with the MRI technician. The MRI uses magnetic qualities of protons in the nucleus of each somatic cell, when exposed the radio-waves proton energy is released producing an electrical signal the MRI and computer reads and translates to images. The exam I saw was for a possible post-surgical infection of a talocrural joint, (ankle joint). Using the MRI it was determined that within the joint there was an inflammation, proving infection.

     I went to the UltraSound part of Diagnostic Imaging on my second day. UltraSound, US, uses high frequencies of sound which reverb after hitting an anatomical part, which are targeted using amplitude for depth, the echo is read by a computer and a crescent-shaped image is produced. The technician allowed me to sit-in on an exam in which the person had been feeling nauseous and had possible inflammation of either liver, kidney, and/or gallbladder.

     On my third day in diagnostic imaging I saw a very interesting radiology procedure I saw over the summer called a barium swallow. A barium swallow is a test in which a patient has multiple low-dosage x-rays taken of them over a sequence while drinking a barium solution. The barium outlines organs involved in digestion and allows for clarity in images produced by the low-dose x-rays. The patient I saw had acid reflux due to a hiatal hernia, in which part of the stomach encroaches upon the esophagus creating a small atrium.         

1:51 pm, by alliedhealth
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Day 35, 36, & 37 / Cardiac & Pulmonary Rehabilitation Day 1, 2, & 3

03/19/2011

     This week I was assigned to go to the Heart Station of the hospital. The Heart Station, abbreviated as HS, is an area specifically designed for cardiac related testing ranging from an average EKG, electrokardiogram, which I saw throughout the hospital, to a more sophisticated cardioechogram, which I only witnessed in catherization lab, and even a place for blood sampling, only to be sent in the laboratory of course. However my knowledge of the HS is only outside information, for the staff at the HS were rather unwelcoming, and instead of wasting their time and mine by standing in the waiting room, I made a goal: to make lemonade out my lemons, I went to the peripheral cardiac and pulmonary rehabilitation center of the HS.

     In Cardiac/Pulmonary Rehab Center, which I will, (for personal use), abbreviate as CPRC, I was welcomed with open arms. The three staff members were all quite friendly and even had me help them out, which I am not only willing to do, but enthralled. On Day 1 and 3 I focused on the cardiac side of the CPRC, here I witnessed cardiac rehabilitation, in which patients were on a program designed not only regain heart strength after heart disease, surgery, or myocardial infarction (heart attack), but also increase mental health and improve mood all through exercise and conversation. While the patients were on treadmills, rowing machines, and elliptical machines the therapists would monitor their heart rhythm through remote EKGs and measure blood oxygen, also known as pulse-ox and SPO2, with pulse oximetry monitors, a fingertip clip that measures both pulse-ox and pulse. I was fortunate enough to be able to measure patient’s oxygen saturation levels and pulse with the use of the monitor. 

     I was able to see a test on the pulmonary side of CPRC by being pseudo-patient myself! There was a scheduled appointment I was planning on sitting on, however the patient canceled and i took his or her place. The test was called a pulmonary function test (PFT) including: spirometry, lung volume, diffusion of gases, and airways resistance. Spirometry is the measure of airflow, which includes speed and volume of air inhaled and exhaled. I’ll admit, personally 113 Liters of air flows through me every minute. My lung volume is 6.03 Liters of air. I actually do not have the skills to describe my diffusion of gases, in which I inhale a mixture of gases and a monitor reads how well I absorb the gases and displace CO2. My airway resistance, measured in (cmH2O/L/s) is 1.88. For those who test poorly due to COPD and asthma or other pulmonary diseases respiratory therapy is offered.  

     I was very elated that although I did actually observe the real heart station, I still learned a lot in the CPRC.  

5:18 pm, by alliedhealth
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Her is a picture of a knee arthroscopy from an endoscope.

3:11 pm, by alliedhealth
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Day 32, 33, & 34 / Anesthesia Day 1, 2, & 3

03/13/2011

     “FINALLY,” I thought, “I finally get to go to the OR!” Although the surgical aspect of the operating room was not my focus, I was still enthralled to be able to go the OR, and for a whole week nonetheless. My focus for this wee was anesthesia, literally meaning the absence of senses is a very difficult and engaging role in an operation. I learned that an anesthesiologist must monitor a patient’s life signs constantly and respond to any changes in behavior immediately.

     On my first day after suiting up properly with surgical scrubs, dressing my face with a mask, and donning gloves I was reading to entry an operating room. My first surgery to witness was a woman with her cervical region of her spine displaced and needed to be manually realigned. Dr. E was the anesthesiologist of the operation and taught me in a very engaging fashion. He had me hold her mask, it was only feeding her oxygen not actual anesthetics, and retrieve certain small items for him such as surgical tape. He told me since she will be tested to respond to pain during her surgery, to ensure they didn’t destroy nerves controlling motor skills, she was given an intravenous anesthetic, Propofol. This drug puts the patient into a deep sleep but allows him/her to feel pain, therefore sensitivity testing can occur. The patient, of course, had local anesthetics for her region of surgery.

     Due to smaller room sizes and more intense surgeries I was not able to be as interactive with the anesthesiologists, but did witness very neat surgeries. One was a prostatectomy, the removal of the prostrate accompanied by the removal of the vas deferens  due to an enlarged prostate. In this surgery the DaVinci surgical machine, the surgeon sits about five feet away from the body while controlling a larger machine with small, intricate arms that operate of the patient while a nurse assists. One of the arms included a camera that allowed me to watch the surgery endoscopically. From this surgery I learned that the more body fat you have, the more difficult and time-consuming surgery is. On the third day I watched a knee arthroscopy, a operation that is minimally invasive treating torn or inflamed tissue of joints in the knee using an endoscope. In this surgery the patient had damaged to his meniscus and needed this inflamed tissue removed.          

3:10 pm, by alliedhealth
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