On the road to immersion (Week 2)

 It's week two and I am continuing to shadow Dr. Irina Sobol and her team at Weill Cornell Cardiology.

After looking at a few post-op patients, patterns are starting to emerge as to how a patient exam is performed. A typical patient exam starts off by enquiring about the mental constitution of the patient i.e., how is he/she is feeling and whether the VAD sounded alarms of concerns. The VAD is then hooked up to a device that shows the device ID of the pump, how much time is left before batteries are needed to be replaced, volumetric rate (litres per minute), pump speed (revolution per minute) and many other parameters that can help diagnose any complication with the pump performance. Once it is ensured that the pump is working correctly, the patient's legs and jugular vein is observed. This was a new thing for me and the reason why these particular body parts are examined is because heart failure patients exhibit fluid retention. Based on the outcome of the examination, diuretics are increased or decreased. Another important item that is enquired about is whether the patient is getting enough exercise or not. After a patient is discharged from the hospital with a VAD implant, the long-term goal is to have daily 30 minutes of submaximal aerobic exercise, such as walking or biking. This is advised so that the patients are able to regain their strength and typically the process is initiated by a physical therapist. I am yet to learn more but I made these observations and hence, decided to pen them down. In future blogs, I aspire to get enough knowledge so that I can visualize what patient care looks like at different stages of recovery.

As for my research project, I will be looking how two different modes of surgery sternotomy and thoracotomy affect at the inlet cannula positioning. In the past, the inlet cannula malpositioning has been correlated to strokes in patients so, it will be interesting to see what our investigation results in.

Abhishek


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