John Thomas will have to do

In the last two weeks, I’ve spent most of my time in the clinic and OR. I saw several interesting and pretty nauseating cases. Let’s start in the clinic.

There was a patient with an infected hematoma on his leg. It was pretty disgusting to look at immediately after he took off his bandages. Basically there was a putrid, fleshy black spot on his shin. Dr. Vouyouka had to debride the wound so that it would heal properly, which consisted of surgically removing the dead tissue and irrigating the area. From the patient’s groans and screams—no, he wasn’t put under—the debridement seemed to be an excruciating procedure. Afterwards, gauze was packed into the wound beneath the dermal layer. Moral of the story: take care of your wounds!

In the OR, I saw a thrombectomy that was performed on a woman with a leaky brachial artery in her right arm that resulted in a nasty hematoma. Truthfully, the doctors didn’t really know why her artery was leaky but went and opened her up anyway. I guess they were planning on fixing the artery but found, or maybe even created, a thrombus.

The bloodiest case I saw was a below-the-knee amputation. This was also the most straightforward case I observed during my summer here so far. As you can imagine, Dr. Vouyouka basically cut through all the layers to get to the bone. The bone had to be sawed and any arteries that were cut were tied up. They cut the leg in such a way that the calf muscle was used as a flap to cover everything.

Lastly, I saw a carotid endarterectomy (CEA), which involves the removal of an atherosclerotic plaque from a carotid artery. There are certain complications with this procedure, such as ensuring blood supply to the brain, which is done most often by using a shunt to deliver blood and electroencephalography (EEG) to monitor the brain. To diagnose a stenosed carotid, magnetic resonance angiogram (MRA) or ultrasound is used to determine how much occlusion has developed in the blood vessel.

I wanted to mention CEA last because my summer research project is directly related to this procedure. I am analyzing clinical data and trying to make sense of the differences between men and women in the events leading up to and after their CEA. Some parameters included in my data-mining include: presence of hypertension, high cholesterol, coronary artery bypass graft (CABG), transient ischemic attacks (TIA), cerebrovascular accidents (CVA/strokes), myocardial infarctions (MI), and restenosis.

It looks like I should be able to finish my data collection and analyze everything by the end of this term. I’m also excited about going back to Ithaca and working in the new BME building. One thing I’ll miss about NYC is the Michelin-rated restaurants I’ve been lucky enough to eat at. After eating the hanger steak at JoJo, I can die happy.