My Campus to Campus

I am so glad that you have tuned in for another thrilling episode. Let’s first start by saying that last week was a short one. I was here from Monday to Wednesday evening, when I left for a gruesome trip back to Ithaca. As I left Olin, to catch the bus, it was storming like crazy. There was heavy rain and electricity in the air. As we left, I was thinking that this was going to be a long trip. Sure enough, a few blocks down was some of NYC’s finest, bumper to bumper traffic. The bus driver was insistent about continuing on down the same path so by the time we were out of traffic; I had whiplash and nausea. Upon arriving in Ithaca after about a 6.5 hour trip, I was starving. After grabbing a quick bite, I immediately began working on my daughter’s bedroom. There was a 5 drawer chest with my name all over it. I finished at about 3 AM. I grabbed a few hours of sleep and was off to the lab. My goal for my time in Ithaca was to run 3 experiments to complete my data set for a potential paper. 2 of the 3 went as expected but some monkey threw a wrench into the other experiment. So, after a superficial analysis, the paper is still moving forward but we will have to see what the data has to say.

Rewind: The “Fat Lip”

During this week, there was more of the same and a few once-in-a-lifetime cases. The first was a severe case of the “fat lip.” This patient was seen by a general practitioner as she had a really fluid-filled lip, a fat lip. There were no obvious culprits as she had received no trauma to the region of her face. This case seemed a little “fishy” and I am sure that the first doctor thought of domestic abuse. Well, it turned out to be much more serious. After CT and MRI, it was determined that the patient had an AVM in her lower lip. You can look back to my previous blog to refresh yourself on AVMs. The treatment for this AVM was embolization. It is hoped that the lack of blood supply will result in shrinkage of the surrounding tissue. If not, an option to be excision by a surgeon in Plastic surgery.

Neck Mass

The next interesting case was a neck mass embolization. This patient, located at Memorial Sloan-Kettering Cancer Center, presented with a complication from a C3-c5 fusion. Sometime ago, this patient was in a bad car accident and suffered from whiplash. This incident caused a crack in one of the vertebrae resulting in the fusion. This fusion was done with the aid of a titanium cage and screws that would allow the bone to the metal structure that was in place for support. That operation was a total success. After sometime at a post-operative check-up, the physician noticed some swelling and tenderness. After imaging, the patient was informed that a tumor was growing around and through the metal cage that was implanted to fix his broken neck.

Our job was embolization. Surgeons at Sloan-Kettering were going back in to remove everything which included all metal implants and the entire tumor. Without embolization, chances were very high the patient could bleed out before the surgeons were through. The patient was embolized, using polyvinyl chloride beads, successfully with few complications.

Well, stay tuned for the next episode. We have several interesting cases on the docket for this week. After three weeks of this, I am pretty comfortable and confident watching most procedures and operations. I have read up on and watched the most common cases several times. I find myself explaining to the newcomers just as people helped me before. I am totally enjoying the experience and can't wait for more.

Image of the Bottom Lip AVM (The "Fat" Lip)