This past week has been very exciting.
On Monday I got a lot done and power-housed through a bunch of surveys and the like to further the study that I am doing with Dr. Jain. Next was a meeting at the Medical School about the Health Expo once again as the planning stages are moving forward and more and more is being completed as more and more comes up.
Tuesday morning Kunal (the new Rodham Intern) and I were able to go to cardiology at the hospital and watch a TAVR (percutaneous aortic valve) case surgery which was pretty amazing. Having seen surgeries previously, the two things that shocked me the most were the number of staff in the actual OR and the price of not the surgery, but the equipment that was used to insert the replacement aortic valve, (not the hospital’s equipment, but what they had ordered) $32,000 for basically a valve that is less than an inch.
Prepping for the TAVR procedure
The surgery was amazing and very precise, as it was done via the femoral artery as many heart surges are now, yet this procedure is relatively new. Basically the doctors thread a catheter via the femoral artery to the aortic valve and then inset the replacement valve( using the $32,000 equipment) to a extremely precise location that is the source of the majority of the risk for this operation. The valve is inflated by balloons and the new valve’s leaflets push out the old leaflets, thus improving the valve altogether.
Because the pulmonary artery and valve are so near in proximity, a slight misplacement of the valve could cause the leaflets to actually block them (very bad!). One of the the surgeons explained the procedure to me as “hours of boredom, leading up to ten minutes of terror.” We were able to view the surgery from a sort of viewing gallery, where we were able to see all of the imaging that was done to place everything on a screen in our room as well.
Anyways, it was a good start to the day, which was followed by watching a TEE (a trans-esphogeal-echocardiogram) which is another way of viewing the heart using ultrasound but the sensor is actually fed down the patient’s esophagus, to get a better view. Of course the patient is under anesthesia and unconscious. I was concerned when the patient’s heart rate dropped below 35 very quickly and then reversed and went back to normal, but it was later explained to me that it was due to the vagus nerve, which is in proximity. So that was pretty amazing as well!
Afterwards I joined Dr. El-Bayoumi and Ms. Tracie Bass at a meeting that they set up with the Advocates for Youth organization and Family Matters. Both are amazing non-profits that address health in the D.C. area. Family Matters covers the entire spectrum of age, beginning with infants from teen pregnancies and going up to senior services as well. They do a lot of work with foster kids as well to make sure that they are more comfortable and have a better life, and with other at-risk kids, young adults, adults and seniors.
One of the things they are most proud of is their camp a few hours outside of D.C. at which they host groups of all sorts of kids and young people. They recently hosted a camp for homeless children as well.
Family Matters is an outstanding organization which I have poorly described because they have many more accomplishments and are truly making a difference in people’s lives through the D.C. area.
Advocates for Youth is a sex education organization that creates a safe place for young people to talk about sexual health and experiences they might have had, or just a place for them to open up when they would not otherwise do so. It is also an amazing organization that really makes a difference in many young people’s lives and its influence reaches across the country.
The meeting, set up by Rodham, was held to bring the two organizations together to meet for the first time. This is one of Rodham’s goals because even though there are hundreds of non-profit organizations in the D.C. area, many of them have no idea about other programs that are similar in nature or could prove to be symbiotic.
After that meeting we went to another Barry Farms meeting with the Student Orientation Committee at which progress was made as the pieces start to come together.
On Wednesday I returned to residential clinic with Dr. El-Bayoumi, and once again got the chance to shadow one of the very talented residents at GW for Internal Medicine. It was a short day and because Dr. El-Bayoumi had private clinic for the rest of the afternoon, I went home early and continued to work on my study with Dr. Jain. (as you can see it takes up the majority of my spare time, but it’s still amazing in my eyes!)
Thursday was horrible because I overslept, but I still made it into the clinic, albeit a little late, and was able to see an multitude of patients with the residents. One had conjunctivitis following a skin replacement over old 3rd degree burns, a benign cyst and a olecranon bursitis, or the inflammation of the bursa on the elbow. It’s most common cause is from long term pressure on the elbows such as resting them on a desk or chair. This of course made me nervous because i tend to rest my elbows on the desk at school…
This man was in a lot of pain, but when the rheumatologists took a look at his elbow with the ultrasound they really didn’t find very much fluid and they also noticed a scab at the site of inflammation. Because bursitis can also be septic bursitis, and because the inflammation could also just be of the skin, they decided not to drain the fluid for fear of transmitting the infection to the bursa if it was not already there and was only on the surface. They gave the man heavy antibiotics and a recommendation to return in a week, to see if the swelling had gone down or, if it was still inflamed, to drain it of the fluid.
After clinic I attended Grand Rounds again, which was about transitioning young people from pediatric care to adult health care and the number of young adults that are not covered by insurance. For example, the majority of adults aged 18-24 did not see a doctor regularly. When they did see a doctor it was in the emergency room. Obviously this is a problem, so they were discussing transitioning to better care for the young patient so that they are still getting healthcare.
Afterwards I sat in on two of Dr. El-Bayoumi’s conference calls. The first was with her contacts at the FDA taking about finances and explaining the importance of the Health Expo, what is was and its pertinence to the FDA, and also their warnings on medications and prescription medications and their impact. After that was a call with Wholesome Wave which is a non-profit food organization in the D.C. area which is giving better access to healthy food for those who are disadvantaged.
Afterwards was another Health Expo meeting and things are chugging along.
Friday was a bit slower as I came in later for another conference call with Dr. El-Bayoumi and Ms. Tracie. Later I did some work and had discussions with Dr. Jain, followed by another conference call with Dr. El-Bayoumi and a former orthopedic surgeon who has a newer non-profit in D.C. which is working to expose kids to health professions (particularly orthopedic surgery) and is also sending young people on internships around the country (similar to Pinhead!!). They talked about how they might want to collaborate and have their program and H.E.L.P. overlap a bit.
All in all it was a pretty amazing and eventful week and I am looking forward to my last week here as I will be in the hospital wards with Dr. El-Bayoumi. But I am very sad that I only have another week, because I have really come to love D.C. (despite the oppressive heat!)and I am really enjoying the work I am doing here. I am so grateful to be working alongside and observing some of the most amazing people I have ever had the pleasure of knowing.
The Washington Monument
Once again, I cannot thank you enough not only for this opportunity, but also for connecting me with a few of the most truly wonderful people I have ever met!
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