Week 4: Backbone in the OR (We Have Spine)

I can hardly believe we’re already at week four, I feel like the time is flying by! During clinic on Monday, I again saw a wide range of patients. The first had had a carotid tumor, and the treatment caused them to lose nerve function on one side of their face. A dermal graft was inserted to help stretch the mouth back into place and regain the original symmetry. In addition, the patient received many sutures to help align their facial features. The patient had an issue with leaking tears because their eye no longer aligned with their tear ducts and so the tears were not being constantly removed from their eyes. I also learned that because the patient was receiving radiation as treatment for their cancer, it would take them a few months longer to heal than a healthy patient.

I got to see Dr. Spector remove a mole from the other patient and observe the small air follicles that were growing in the tissue. The patient got to decide as to whether they wanted their mole shaved down or to have an incision made instead, which would alter how the scar would form on their face. Another one of the interesting cases was a patient with multiple expanders which were very difficult to access. They brought them into the procedure room and removed the port, so they were able to finally fill it with saline before reinserting it. Dr. Spector discussed how in rural areas they would often leave the port external so that the patient would be able to fill it up on their own. Later, back in the lab, I got to see a member of Dr. Spector’s lab use the cryotome to create sections of their sample on a slide.

For the next two days, I got to watch surgeries. They did a muscle flap on a patient who had spinal surgery, unfortunately, I mostly just saw the tail end of the procedure. Then I got to see a liposuction and breast reduction, where we got to bring research specimens up to Dr. Spector’s lab. One thing that is fascinating is how the makeup of the breast tissue is expected to change as the patient ages. While a young patient is expected to have fibrous breast tissue, an older patient is likely to have more fatty tissue. Last, I watched a hernia removal from a patient who had previously had a kidney transplant, liver removal, and a few other hernias which increased their likelihood of getting another hernia later on. I then got to go back to the lab and learn how to do microsurgeries (albeit on a sponge and glove) where I got to see where my technique may have been going wrong. While I had been learning at home, one feature that made it easier here is that my trainer was able to look through the microscope with me due to its design and tell me where I was going wrong. Strangely, I found the much smaller 9/0 suture much easier to handle than the 2/0 suture.

I then when back to the clinic, where I saw a few patients receiving Botox injections and hyaluronic acid fillers. It was interesting to see that even though the patients respected Dr. Spector and came back to him after about a decade of injections, many wanted dramatic, fast-acting results. Dr. Spector, on the other hand, would insist that slower, more subtle changes would have the best long-term effect. He showed us photos of how the patients looked when they first came in years ago and there was a clear difference. I also got to see a couple of post-op patients who had previously received a fibula transplant to treat their oral cancers. It was amazing how well they had healed in just a short period of time – to the point where I was not immediately sure what kind of procedure, they had done in the first place. To wrap up the week, I went to the lab meeting where everyone in the lab gave updates on their week and their future short-term plans. I am excited to receive grafts back from Ithaca in the upcoming week so I can get started on my summer project!

-Halle