Tag: 18ClaudiaZ

Today I was at Alamance Regional Medical Center learning about Radiology from Dr. Hoss. At the beginning of Work Experience, I was not super excited to do radiology, but after the first week at WakeMed I was excited for it. At WakeMed and Carolina Ear and Hearing we looked at many scans but I could not understand them for read them.

I followed Dr. Hoss, who is an interventional radiologist (IR). This means that he can perform procedures such as stents and fluid drainage. In the morning, he performed two minor procedures each lasting fifteen minutes and looked at scans the rest of the time until 12. At 12 he was apart of a medical conference to discuss patients that had difficult cancers. For example, some where in a difficult location or of a strange composition. Here the group of doctors all brainstormed different ways to treat the patient and then decided the best route. I really enjoyed getting to watch this. In the afternoon, he performed two more procedures and looked at scans for the rest of this day.

Today I was at UNC for a nursing lecture on heart surgeries and heart attacks. I got to sit in on the lecture and learn about pre-op and post-op care of heart surgery patients. During post op, nurses are to watch for changes in blood  pressure, body temperature, white blood count, incision, and check for possibilities of infection. Then the lecture moved on to learns about warning signs for each of the above and how to treat them. The second half of the lecture focused on heart attacks. It covered how to know whether the patient was having a STEMI or NSTEMI heart attack. A STEMI attack requires immediate care and will result in death within minutes. A NSTEMI heart attack is less severe and does not require immediate attention. A STEMI heart attack will show a different EKG then a NSTEMI heart attack as seen below.

Today was the last day with Dr. McElveen. We were at The Duke Raleigh Hospital observing him perform ear surgery. In the first surgery, he replaced the stapes bone with a prosthetic. Dr. McElveen performed this by going in through the ear canal and peeling back the ear drum to replace the bone. This surgery only took about an hour. In the second surgery we saw, Dr. McElveen placed another prosthetic by cutting behind the ear and accessing the inner ear that way. We then returned to the clinic and learned about Audiology, Hearing aids, cochlear implants, and various hearing tests.  Below is a picture of the inner ear and the small prosthesis that was placed.

Today we moved to a different location- Carolina Ear and Hearing Clinic and we observed Dr. McElveen. He was in his clinic today seeing patients. He saw many patients – as soon as he would finish with one he immediately moved to the next room. He saw patients until 12:30 when he took a lunch break. Dr. McElveen was off until 2:00, when he started seeing patients again until 5:00. In the afternoon, Nell and I learned how to patient history, symptoms, and learned how to present. This was very exciting and lots of fun to learn.

No pictures could be obtained today due to privacy violations.

 

Today I saw a CABG surgery done via a robot. I found this incredibly interesting. The machine reaches over the patient and has four rotatable arms. One arm is used for the camera inside the body and two other arms are inside the patient. The doctor controls the two arms from a control desk away from the patient. The doctor was able to use the arms in a wrist rotation, which allowed for better  maneuvering inside the body. This surgery lasted from 8:30-1:30. Next, we mimicked the Linq implant with a practice device. Lastly, we watched a triple lead pace maker implant. Below are all of the devices that have been given to me over the past week.

First, I saw a procedure done by two surgeons. They placed a micra pacemaker and then performed an ablation. Next we saw a link procedure. In this a small device records the heart rhythms for up to three years. This was done because the patient had a stroke and they didn’t know why. After this, we saw a pace maker replacement. The battery had died after 10 years, so they left the leads in and changed the device. Then we saw a procedure where the doctor wanted to put the leads in the atrium and the his bundle; however, he could not, so the leads were placed in the normal position. Lastly, we saw a procedure to determine if a patient needed bypass or a stent. The patient had a clogged artery that could not be safely solved with a stent and will need bypass surgery.

No pictures could be obtained for today due to privacy violations; therefore, above is a picture of fluoro with contrast to show a blocked artery.

Today I watched two open heart surgeries. The first one was a less invasive valve replacement. I was able to watched two hours of it. I learned about the different possibilities for open heart surgeries, ways, and reasons to do a more or less invasive procedure. The second one was a triple bypass surgery. The doctor took an artery from the leg and used it to go around the blockage. I was able to watch four hours of this surgery.

On my first day, I saw three heart procedures. The first was a surgery dealing with a pacemaker and a defibrillator. During the procedure, Dr. Hamrick added a third lead to the pace maker. During this, I learned about improvements that are being made to pacemakers.  Below is a picture of the beginning of nanotechnology being used for hearth surgery and pacemakers. The second and third procedures were both A TAVR. This was a value replacement via a catheter coming in from the femoral artery.