Week 1 - Mia Huang

 I can't believe it has already been a week since I arrived in New York City. This past week, I shadowed Dr. Dan Riew from Neurology and Brain and Spine department. Dr. Riew specializes in cervical spine surgeries, including spinal fusion, disk replacement, and laminoplasty. I watched a couple of surgeries on Monday and Wednesday. It was really fun and interesting to see the surgeries! With laminoplasty, Dr. Riew enlarged the spinal canal by drilling apart the lamina and connecting the two ends with bone plate and screws. Laminoplasty treats spinal stenosis by enlarging the spinal cord canal so that the pressure on the spinal cord can be relieved. 

My research project this summer is to develop a design proposal that details the function and technical specifications of a paper-thin and ultra small pressure transducer that can be put inside the disk replacement implants. Ideally, the pressure transducer will be connected to a drain that extends outside of the body for a couple of hours. Post-operatively, after the patient removes the incision cite dressing where the rubber band drain was sutured to, they will pull the drain out, along with the pressure transducer. After that, we can do some calculations and analysis with the pressure transducer and determine how much pressure was experienced within the disk replacement implant. To move the design project forward, I talked with a medical device company sale representative about the specifications of the disk replacement implants in order to determine the specific dimensions of the pressure transducer, 

I also watched Dr. Riew's clinics on Tuesday and Thursday. I learned about how to look at a MRI scan and tell if the spina fusion has healed yet. I learned that with shots that contains local anesthesia and steroid injected to different levels of the spine, we can determine which level is the symptomatic one. If the pain disappears within 5 - 10 minutes after the injection, the injection level is symptomatic. If the injection does not help with the pain, it means that that level is not symptomatic and may not need surgery unless it is absolutely necessary. It was shocking to learn that the cervical spine level 6 and level 7 holds enough pressure to crash a finger by just moving the head up and down. It was also very surprising to see that many patients suffer from neurology deficit experience muscle atrophy on their dominant limbs. I also learned that narcotics can lower patients' tolerance of pain with significantly affect patients' recovery from surgery. Patients who have been taking narcotic experience more pain post-operatively than patients who did not take narcotic before surgery.

On Friday, I watched interventional radiology procedures. It was very cool to see doctors remove pus from abscess with the help of CT and ultrasound. The CT helps the doctor locate the abscess pockets. After the doctor put some needles at those places, another CT was taken to make sure the needles are at the right place. With the ultrasounds, the doctor was able to insert the needle further into the abscess pocket and drain it. 

It has been a really fun week and I certainly learned a lot. Look forward to next week!

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