Author: lyndonw650

This morning I shadowed Dr. Kurt Ehlert. Dr. Ehlert specializes in general orthopaedics, but repairs lots of fractures. He was also one of my father’s professors when he was in medical school. We had a very light schedule this morning. Most doctors see 15-22 patients per clinic, but this morning we only had 7.

Because of the light schedule, Dr. Ehlert took the time to teach me how to identify fractures and even tested me on a couple ofx-rays. In the beginning it was difficult, but after a few tries I got the hang of it. He also helped me to learn and identify the major bones of the body, as you can see below on on my well-labeled image of Senor Bones.

While meeting with patients, sometimes D

r. Ehlert would ask me what a certain reaction to a mobility test or movement meant. 9/10 times I’d be making an educated guess. Luckily, sometimes I’d see the same thing with multiple patients. Some of the x-rays I was even able to correctly identify the fracture by the end of the clinic. At this rate, you can catch me operating next week!

In the afternoon I had the opportunity to shadow Dr. Ronald Summers. Dr. Summers specializes in sports medicine,such as knees and shoulders. He sometimes still will do total knee repl

acements, but doesn’t do total hip. He does surgery on items such as ACLs, menisci and rotator cuffs.

I got to see Dr. Summers give a lubrication injection to a woman to help her rehabilitate her knee. He used euflexxa, or sodium hyaluronate, which is a hyaluronic acid use to cushion, lubricate and protect the joints. Before inserting the injection, he sprayed a very cold spray to numb the skin. I noticed a change in color in the skin once it numbed. After he left the patient he showed me the spray and even sprayed it on my hand. I can confirm that it is, in fact, very cold.

Dr. Summers played football at Stanford U

niversity, so it was interesting talking about what it was like being a student-athlete and pursuing medicine. He majored in Human biology, and balanced playing for the football team. He recognizes that times have changed in terms of assisting student athletes and believes tha

t will be beneficial as I hope to follow a similar collegiate path.

Dr. Summers helped me to learn how to diagnose how a fracture occurred based on the x-ray. The lines in which the bone broke are reflective of how the injury occurred. For example, if the breaks spiral, often the bone twisted too far. If it is a straight break across, it often came from direct impact.

I started off my adventure at Wake Orthopaedics in Cary this morning with Dr. Sarat Ganga, who specializes in trauma and fractures. The majority of the morning, we looked at X-Rays and and met with patients who had already broken their bones. All of the patients were post operation, but each was at a different point in time of recovery.

Dr. Ganga did a lot of tibia and patella surgeries, and he kept reminding the patients how their ultimate recovery goal was to be able to completely straighten out their leg while standing. When a patient can do so, it takes a lot less stress off of their quads. If they are constantly bending their knees, it can cause the quads to flair up and could cause problems with the muscle.

In the afternoon I shadowed Dr. Curt Hanson, who specializes in sports medicine and total joint replacements. We saw lots of arthritis and some fractures, but most of the patients were either post or pre operative meetings.

An interesting patient to interact with today was one who was addicted to narcotics. She was whiny and complained about crazy pain while her mobility was exceptional. It was interesting to see a patient like her in comparison to a patient who wanted to get better as soon as possible with a happy, positive attitude.

I noticed Dr. Hanson’s little quotes he mentioned every time with a pre-op patient. He would always end with “Let’s Get you Fixed”. I enjoyed today’s clinic with Dr. Hanson because of how he explained each procedure, MRI and X-Ray so in depth to me so I would be on the same page as everyone else in the room. He even asked me if I wanted to try to talk to some patients, but I quickly rejected the idea as I knew I lacked the knowledge to have a productive conversation.

There’s a nursery rhyme, little melody-esque song that I remember from my childhood called “This Little Piggy”. The original poem is as follows:

Our first patient we saw was a man who had ruptured his Achilles. I thought it’d be interesting, as I suffer from Achilles tendinitis. But while looking at his x-rays and listening to Dr. Thompson diagnose the surgery, recovery time, and what it actually meant for the Achilles to be ruptured, I quickly realized it was hitting too close to home. I excused myself quickly to the bathroom, as I was losing vision and felt like I was going to vomit. I made it to the bathroom, didn’t throw up, but put some cold water on my face and brought myself together. I didn’t pass out! But it was definitely close. It was definitely a beneficial day for me today- I know now I have no interest in specializing in foot and ankle, and especially not wounds.

This morning I shadowed Mr. Sean Russell, a physician assistant who specializes in joint injections through ultrasounds. He does injections in most any joints in the body, but today I was able to see in the shoulders, knees and hips.

The injections consist of cortisone, kenalog (a steroid) and either marcaine or lidocaine, depending on if they want short or long term effects. The syringes looked like normal shots, except the needles were all around 4 inches long. Each time the needle would go all the way deep into the skin, which caused visible discomfort to the patients.

The process began with an ultrasound on the section of the body needing the injection. The ultrasound allowed Mr. Russell to see where the needle needed to go exactly. The needles needed to go in precise spots, such as between the glenoid and humeral head in the shoulder. Using the ultrasound, he’d mark a specific location that he was going to insert the needle. His assistant would then spray a cold, numbing spray on the skin to help ease pain. He’d first insert a numbing medicine, then change the syringe (leaving the needle injected) to put the medicine into the body. It was a quick process, but was described as feeling similar to bee stings inside their body. These injections cause immediate relief because of the numbing medicine for 4-6 hours, but the cortisone won’t kick in until 48 hours later.

The patients receiving treatment were often patients who didn’t need surgery now, but would in the future because of arthritis in their joints. One older man walked into the room for his 6th time getting injections in his shoulders, and proclaimed, “Good ole Uncle Arthur is trying to break me, but he hasn’t got me yet!”

Below are pictures of the ultrasound machine and one of the syringes. 

Today I had the opportunity to shadow Dr. Timothy Harris. Dr. Harris is a trauma surgeon who specializes in total joint replacements, specifically knees and hips. When he’s not doing this, he also often performs operations on most any bone fractures.

While shadowing Dr. Harris, I saw a plethora of patients, most with hip and knee injuries. While most patients that saw Dr. Chappell on Tuesday were initial meeting, the multitude of patients today with Dr. Harris were patients meeting either pre or post operation. Although a few were there for initial meetings, most had already had previous encounters with Dr. Harris.

Although because of Wake Orthopedics policy I am unable to go into the OR until I am 18, today I was able to watch Dr. Harris inject cortisone shots into 3 different patients. My favorite injection was a woman who was regularly scheduled  for a second cortisone shot since her initial wore off, and her husband, in the same room, at the same time, in both of his knees. I couldn’t help but chuckle at how cute the older couple was, and how well joyfully they both took the shots despite the immense pain. 

Today was a day devoted strictly to working on my project. In the morning, I worked in an office space to continue compiling the final data for my project in Microsoft Excel. I spent all morning sorting through each patient’s operative report to determine age, gender, graft type, months since surgery, and the femoral fixations. For some patients, I additionally noted if they had a meniscus repair or a microfracture as these affect data. In total, I sorted through approximately 150 reports. The next step in the project is to begin an analysis of the sorted data. Based on the results, I will find averages and find trends and sort the data based on it.

To continue to the research, I will be calling each patient to discuss whether their surgery was a success or a failure, depending on whether or not they needed a revision surgery. A lot of work is still impending, but the data shall be interesting to see when it’s all said and done!

This morning I began my adventure at Wake Orthopedics. The morning started with an orientation of the North Raleigh Wake Orthopedics office. I met some of the physician assistants, got to know the ins and outs of the office, and was given a little work space for when I am working on my project.

Over the course of the next two weeks, I will be both shadowing different doctors and working on a project. The project is co-authoring an article with my father to be submitted for publication to the American Academy of Orthopedic Surgeons. The article is comparing the success and failure rates of autografts (replacement of tissue with tissue from the patient) versus allografts (replacement of tissue from a cadaver) in Anterior Cruciate Ligament repairs. Today, I spent time compiling the data from surgeries over the past 5 years, including information such as age, gender, type of graft, additional surgeries performed, and the femoral fixations implicated. I also collaborated with my dad to construct the abstract of the report.

In the afternoon I shadowed Dr. Jon Chappell. Dr. Chappell specializes in sports medicine, specifically shoulders. I had the opportunity to shadow him in all of his clinics, listening in to his meetings with patients. I was intrigued watching him explain x-rays and MRI’s to the patients. His capability to identify and explain each individual tendon and ligament in the x-rays. A common thread I noticed was how he performed similar mobility tests on each of the patients to determine their condition. Based on their answers and responses, he then came up with a plan for normally the next 6 weeks.

I enjoyed the first day and cannot wait for tomorrows adventure!