Week 6 - Mia Huang

The last week of the clinical immersion term has been incredible and productive just as previous weeks. I continued to shadow Dr. Riew's surgeries and clinics. I saw the MRI for a Chordoma bone cancer patient on Tuesday. The young patient had a huge tumor in his brain. When the tumor was surgically removed, the patient was left with a large cranial cervical junction and required a cervical fusion all the way from the skull to the bottom of the neck. However, the cervical fusion he had done before was not very good. For a fusion all the way to the skull, the patient will not be able to move their neck at all, but in this chordoma patient, the bone plate at the back of his neck has a very bad skull to neck angle, so that he can only maintain a very flexed position, in which his chin is almost touching the chest. The patient and his family went to Dr. Riew for a cervical fusion revision. Dr. Riew plans to take out the bone plate from the back of his neck and replace it with a plate to create a better back of skull to neck angle, so that the patient can extend his neck to a more comfortable position, even though he will not be able to move his neck. I learned that though the majority of the tumor was removed, it is still growing and the patient won't have many years to live. It was very sad to see a patient who is so young and suffering from tumor and there is not much we can do to help him. 

Later this week, I was working on the pressure transducer design proposal and the presentation. As I described in the blog a couple weeks ago, the artificial disc implant has two pieces and we need to put the transducer in between the ball area without interfering with the disc ball and trough mechanism. The disc implant is extremely small, which requires the pressure transducer to be paper thin, and less than 7mm in diameter which is 1/4 of an inch. The pressure transducer needs to be packaged and sterilized before implantation as well. I have written up a more detailed design proposal and will send it to the BME MEng program for them to actually build the pressure transducer. I have met with the sales rep of the Medtronic LP Prestige disc implant and they kindly gifted us a set of the implant for us to test on. Hopefully in the near future, we can have the pressure transducer available to use and study how post-operative maximum neck flexion and extension pressures affect the long term surgery recovery outcomes.

The immersion term has been a wonderful experience. I learned a lot about the hospital system, shadowed more than 25 surgeries, and met many patients during clinics. Most importantly, I met so many wonderful people, including my clinical mentor Dr. Riew, his fellow Dr. Scott Zuckerman, and the nurses. I want to thank them for teaching me over the past six weeks, and want to thank everyone who made the immersion term happen despite all the obstacles. Last but not least, I got to know many people in my cohort very well and became really close friends with some of them! The immersion term wouldn't be the same without all my friends and I already miss playing ping pong games, checking out different restaurants, exploring the city, singing in the car, and playing piano with them!

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