Week 2 - First time in the clinic and OR!

This week has been nothing short of incredible. I spent the majority of my week shadowing Dr. Spector in the clinic and operating room. I met with a ton of patients and saw a handful of fascinating surgeries.

Monday was the first day of clinic. Lots of patients came to see Dr. Spector and his team with appointments ranging from pre-op consultations, post-op examinations, and same-day treatments. One of my favorite cases was a post-op exam for a patient who had undergone a breast reduction. She was completely over the moon with her successful surgery and you could really see how much of a difference in made in her life. Another memorable case was a patient who had severe burn scars on their body and was in the middle of their reconstruction journey. Multiple tissue expanders were previously placed under the skin and the expanders were filled with saline in order to stretch the skin for surgery. Every few weeks, the patient will return to the office to fill the expander will more saline until the skin is loose enough for the final reconstruction surgery. When I think about tissue expanders, it is usually in the context of breast implants. It was really interesting to see how tissue expanders can be used for burn scar reconstruction as well.

Tuesday was the first OR day! It was a very intense surgery that lasted the majority of the day and was performed by a head and neck surgeon, an oral surgeon, and Dr. Spector. The patient had a very large carcinoma on their tongue which had to be removed. To remove the tumor, the patient's jaw had to be cut in half so the surgeon could access it. The tumor removal left little of the patient's tongue behind, so Dr. Spector's task was to reconstruct the tongue using skin from the thigh. Dr. Spector and his team removed a flap from the thigh and reconstructed the patient's tongue. During this part of the surgery, Dr. Spector used a microscope to visualize and attach the blood vessels between the thigh skin and remainder of the tongue. It was pretty late in the evening at this point, so unfortunately I had to step out of the surgery before the patient was stitched back up.

Wednesday was also an OR day with three surgeries. The first surgery was a mastectomy, lymphadenectomy, and implantation of a tissue expander. It was quite interesting to see how the cancerous breast tissue is removed in one large piece, mostly using a cauterizing tool. After the main breast tissue was removed, the surgeon began removing a couple of the neighboring lymph nodes that the cancer also had spread to. To ensure that all of the cancerous tissue had been removed, the surgeon also took several small pieces of surrounding tissue within the chest cavity which were sent off to pathology. Dr. Spector and his team then took over and inserted the tissue expander into the breast pocket and sutured up the patient. The next surgery was a patient who was undergoing abdominoplasty and liposuction. This surgery was particularly cool because the tissue from the patient was collected and we delivered it to the research lab for experiments. The final surgery of the day was the removal of basal cell carcinoma on the patient's scalp. Since it was such a big resection, it was thought that the patient would need a graft to cover the skull. Luckily, the patient had a lot of excess skin on the scalp and the incision was able to be sutured and stapled closed.

Thursday was another clinic day and we were able to see cosmetic procedures such as Botox and Juvaderm facial fillers. These are quite popular and I have had friends and family get these procedures so it was insightful to see how the procedures are done. After clinic, we went on patient rounds with Dr. Spector and the plastic surgery residents. The highlight of the day was seeing the patient from Tuesday's tongue surgery. They were looking so good and recovering very well. It was incredible to see the patient's transition from cut open on the operating table to them sitting upright in a chair, all put back together again.

Friday, today, was a lab day where we discussed our research projects a bit more and had our lab meeting! It was great to learn more about everyone's project in the lab and see their most recent data.

Looking forward to another exciting week!

Kylie