11/13/15

This was another irregular day; I didn’t have school and Dr. Nguyen had a resident lecture to give early in the morning, so I ended up going at 8:00 instead of 6:50. So, I skipped valve conference and went straight into pre and post-op patient checkups. I usually don’t see a lot of these, but since I didn’t have to get back to school at a certain time, I was able to get involved in two of them:

The first was very, very standard (this is good); the patient was a woman in her mid-60s, who was recovering from an open-heart valve replacement (I can’t remember if it was aortic or mitral) a month or so ago. She was doing fine, but was concerned with the development of bacteria over her scar. To remedy this, she was given some betadine, an antiseptic used for surgery prep. Daily applications of that, along with some gauze, would be more than enough to deal with her issue.

The second was a pre-op patient, a man in his early 60s who worked at an auto shop. He had mitral calcification (his mitral valve was blocked and couldn’t pump as much blood as it normally could), type 1 diabetes, and some breathing issues. Throughout my time in the room with him, he brought up how his vision and memory hadn’t been very sharp in the past few weeks. This led us to believe that something was wrong with his carotid arteries (which lead to the brain). This could be a possible clot, which is an entirely different issue for another department. A recurring theme throughout the time I spent with him was the difficulty he had with the medical terms being thrown around. He was hesitant to attempt saying the names of the surgery options he was given, even refraining from saying cardiologist or MRI. This gives me extra incentive to pursue the stenosis project with Dr. Nguyen; it’s so integral that people know the scope of their condition and what exactly is wrong with them. 

10/30/15

Quick Update: for those of you that actively read this blog (if there are people who do), both Dr. Nguyen and I were out of town last week, making me unable to attend. He will be gone this following Friday as well. I might be going this Wednesday if possible, or at the least discussing the animation project with him and using that info as the next blog post.

Last Friday, I spent most of the morning in the hospital at valve conference. Most of the patients had aortic or mitral stenosis, with nothing too irregular. None of the patients had extreme defects or early heart irregularities, and were mostly old patients in their 70s and 80s that had a past of heart disease. I’ll talk about a few of the cases. 

The first was 66 y/o woman with mitral regurgitation (valve is loose, leaks when pumping blood or drawing blood into the heart), moderate-to-severe in condition. Most of the cardiologists in the room recommended a MitraClip, a minimally invasive catheter-based valve repair device. This did not take long to go over, but more interesting and lengthy case discussions followed shortly after. Another patient had a bypass done in the early 2000s, with a subsequent aortic valve replacement in 2005 that came with some complications. Heading to the present, she was recently admitted to the hospital with acute kidney injury (as well as the continued heart problems), and has been on dialysis almost every day because of this. Aside from her kidney issues, she needed work on both her aortic and mitral valves. Going even further, her lungs were functioning poorly. There was a long discussion over how to deal with this woman’s serious conditions- she’s a high-risk patient with limited long term benefits from invasive surgery, so the best thing right now would be simple medical care and making the rest of the time she has left pleasant. Just being in the room while these talks deciding a person’s life were happening feels very odd, but I’m glad that I was able to get a glimpse into the harder decisions that must be made in a hospital.