Week 4 - Julie

My fourth week at the hospital was different, because I focused mainly on obstentrics (OB). I got to attend morning rounds, and learn about the different complications pregnant women have, requiring them to remain in the hospital until the baby is delivered. It was interesting that hypertension is such an important vital to follow in pregnancy. After rounds I observed a cesarean section operation.  I had seen one in Tanzania, but this one was performed much quicker and with a smaller incision. The care for the baby when it first arrives into the world follows a very specific sequence. Ripping the muscle layer was pretty graphic, but I learned it is ripped and not cut so that breaks occur along fiber lines, making the healing process quicker. 

I also observed a natural delivery. This was even more exciting because the husband and mother of the patient were in the room. I was at first nervous about introducing myself and asking if I could observe, but they agreed and in the end I think I was helpful support for the mother. This birth was much more animated and exciting. When the baby was born the father was in tears and there was so much celebration. The patient was obviously in pain during the labor, but was able to control herself from screaming. Then after the birth she seemed to go back to normal without much pain, but was very cold from all of the hormones. Since the mother had a 101 degree fever while in labor they gave her antibiotics before the baby was born and then wanted to check the baby for a possible infection. I also learned that babies should not make a grunting sound, as this indicates they are having a harder time breathing. But in the end the baby was healthy.

One surgery I saw this week was a tracheotomy from a woman who had a cancer mass on her trachea. The ENT surgeons placed in a breathing tube, and then removed her trachea and the lymph nodes. It was the plastic surgeon’s job to take the pec muscle from under the breast, and reconstruct a trachea around the breathing tube. In a few weeks the tube will be removed and the pec flap tissue will serve as the woman’s trachea. I also got to see the pathology lab when the trachea was brought there. It’s amazing how quickly the pathologists can see a sample and determine if there is cancer or the type. I learned that they can quickly determine the cancer type by using cryo-frozen tissue histological sections and then tell the surgeon while the patient is still on the operating table. Since these samples did not require immediate attention, they will be done with H&E staining with normal fixation and take about one week. It was also interesting to see how they label the complex tissues: using tissue paint to orient each sample. Next week I hope to observe more surgeries, and also see patients in office hours. I would like to see the trachea tube removal.

For my project, I finished learning the skills for histology. I spent many hours becoming proficient in using a microtome. It was important to learn how varied the samples can be when they get to this step: some are much more fragile and the care of each sample also depends on the type of tissue. Now when my project requires this skill, I should be able to perform this step by myself and achieve good sample images. I also got to attend the lab’s 200^th lab meeting! Next week I will be making collagen scaffolds, embedding cells in them, and allowing them to culture for a week.