Week 3

This week I continued to work on my two research projects, as well as shadow both clinicians I am working with.

Early in the week I mainly focused on my research with Dr. Hartl's group. I have been helping on data analysis for a paper they are writing. It has to do with the incidence of recurrent spine surgeries for people with a certain type of procedure. For example, when doing a fusion surgery, they secure that level of the spine and it loses natural movement. This puts extra stress on the levels above and below where the fusion is, so after time, some patients need additional surgery to correct new problems above or below the original level of surgery. Or what happens is patients don't have a fusion, but eventually the dysfunction returns so they then elect to have a fusion. I'm learning how to navigate the Epic Pro system that houses all patient information, which can be somewhat overwhelming with the amount of scans and files for each patient. Some of the things that we care about beyond surgical data is general patient data - like DOB, BMI, M/F - and more specific patient data - like family history of certain diseases, osteoporosis. We are also tracking patient scores for pain and body function pre-surgery and post-surgery.

I was able to shadow Dr. Hartl some more, this time in the hospital, not the Spine Center on 59th street. One patient was very interesting because there was clear leg pain and weakness, as well as trouble walking, but the scans did not show anything that would normally cause it. There was no nerve compression at L4 or L5, so it wasn't obvious what was causing the pain and weakness. I spoke with Dr. Hartl afterwards about options for this patient and he said that surgery is not possible without a clear target. It doesn't make sense to put someone through a multiple hour procedure just in hopes that you find something when in the OR.

I also shadowed Dr. Ana Krieger at the Center for Sleep Medicine. The patients here were very different from those at the Spine Center. Some patients were only sleeping less than five hours per night due to work life, while some patients were falling asleep throughout the day due to narcolepsy. Some patients had trouble falling asleep, while some patients had trouble staying asleep. Interestingly, many patients had problems with horrible nightmares making them feel exhausted even after 7 hours of sleep. I also noticed that weight has a huge correlation with sleep disorders, meaning that patients who were tired often ate food to stay awake, which lead to increased weight. This would lead to worsened sleep at night and more tiredness during the day, continuing the cycle of weight gain. And some patients noted that late at night when they couldn't sleep was another time when they would just snack on junk food for hours.

I have noticed that many patients in both the Spine Center and the Sleep Center are overweight, so I'm going to watch my pizza intake for the next few weeks while still in Manhattan.