A Day in the Life of a Spine Surgeon

I was unable to get an interview from my mentor, so the best I can do is explain the consistent schedule of a surgeon (or at least what I saw). First, the day usually starts off with either early morning clinic or surgery, and depending on the surgery, it could last a while. A lot of a surgeon's day (from what I saw) consists of surgery or clinic except for the day or two in a week where they meet with their colleagues and collaborate on confusing or interesting cases that they would like the other physicians' opinions. Other than that, their day consists of those two things, but again this was only what I saw. Thank you for reading my blog posts and this will be my last on this blog page.

EMGs and SSEPs

Day 12

For the first part of the day, I was in radiology and to be honest, it was the most boring thing I have sat through throughout my whole internship. The best part was that we got free breakfast. We watched about 3 or 4 Xrays and the rest of the time was spent sitting around, so it wasn't too thrilling. The rest of the day was great. I got to watch a hip replacement and Dr. Lawton allowed me to hold and look at the ball of the hip of the patient and it was one of the coolest things I have seen in my life. They had to replace this ball because it was very arthritic and there was no more cartilage on the ball, so it was rubbing bone-on-bone. Today was up and down, but it was still a great day.

Day 11

Yesterday, I caught a stomach bug, so I did not go to my internship. Nothing to blog about for Day 11.

Day 10

I did not do my blog for Friday, so here it is. Friday was a good day. I spent the first half of the day with Dr. Robert Wallach. I enjoyed it because he cleared some terminology for me and he is also a hilarious doctor. After lunch, plans changed. I was supposed to go to nursing at Mercy, but instead, I went to an emergency spine surgery for a man who slipped in his kitchen and fractured one of his lumbar vertebrae. I was there until 4:40 with Caleb and I found it pretty fun. Friday went by fast, but I enjoyed it.

Day 9

Today was one of the best days in this internship, even though it was tiring. Today, I spent  most of the day in the operating room watching a specific lumbar fusion called an XLIF (extreme lateral interbody fusion). I'm not going to go into what all of that means, but they start the process by going in through the side of the body where the herniated or degenerated disc is. After the incision, they use a dilater to find where the nerves are. Then they remove the disc and place a spacer with a bone graft in it. Then, they stitch the wound up and flip the patient onto his/her stomach. Then the surgeon makes an incision in the back to get to the vertebrae that needs fusing. After that, a cage made from pedicle screws and metal bars is inserted where the fusion is needed. Then the patient is stitched up and that's it. There's actually a lot more involved, but I'm not going to go into detail. The patient I viewed today had a 4 level fusion. She was fused from L2-S1(2nd lumbar vertebrae-1st sacral vertebrae). I was amazed at how smooth most of the procedure went. I  was in the operating room for about 5 hours, so it is not a short procedure. I think the time spent was worth it.

Day 8

Today was a different and unusual day for me. This morning, I was in a case conference, where all of the physicians get together and talk about complicated cases or cases that may need another surgeon's opinion. That was a good experience. After that, I spent the next three hours in a respiratory ICU, which cares for patients with severe lung diseases or problems. Between the horrible sounds and the sad atmosphere, it was not the best experience ever. I finished my day off by having a meeting with Dr. Youssef and some of the other physicians and research staff. At first, it was a little intimidating, but throughout the meeting, I felt a little more comfortable. So, besides the time spent in the ICU, today went pretty well.

Day 7

Today felt oddly long compared to most of the other days, probably because I spent 95% of it in clinic. Even though it was a long day, I enjoyed today's learning experience. I learned a little more about the indications of bursitis, the inflammation of a bursa nerve, and I saw an interesting case involving a T11 fracture that was so bad that Dr. Orndorff is going to bring up the case in front of other surgeons and physicians on Wednesday at the case conference. I enjoy working with Dr. Orndorff because he works extremely efficiently, but at the same time, takes the time to show me the Xrays and MRIs of patients and explains what they have exactly. He speaks extremely fast, but I feel like I'm catching on. I'm exhausted, but today was worth it.

Day 6

Today I spent the first half day at ASC watching Dr. Bohachevsky of Spine Colorado perform epidural injections into patients' spines for treatment mostly. I found them to be really interesting, but they also looked extremely painful at the same time. Dr. B (nickname) is really nice and explained all the processes and what was happening step by step. The rest of the day was research, but my tablet died, so I went through the information packets in my binder which had really interesting information, and that was my day.

Day 5

Sorry I did not post on Friday, but here is Friday's blog post. All of Friday was mostly clinic. Only the first hour was an hour for work time. The rest of the day was basically packed with clinic hours. I didn't see too many different cases and situations than I have the rest of the week, but I did enjoy it. Other than that I don't really have much to post for Friday.

Day 4

Today was pretty slow, but there were some new learning experiences today for me. This morning, I shadowed Dr. Goodman in clinic and we saw a very unusual form of a fracture. It's called a Maisonneuve fracture (named after the French doctor) and it is a form of a spiral fracture(fracture that progressively tears other tissue and fractures other bones). This man had a fracture in his fibula and his ankle while tearing the membrane holding the fibula and tibula together. This man had surgery in January and is in his third month of recovery. He is doing a lot better and he was actually really friendly to me unlike the other patients we dealt with. Today was slow and a little uneventful, but still had its amazing moments.

Day 3: First Day in Surgery

Today was a great new experience. Throughout the first half of the day, I got to view a type of spine surgery called an ACDF or  an Anterior Cervical Discectomy and Fusion. During this type of surgery, the surgeon's objective is to remove the cervical disc that is compressed in the patient and then insert an allograft (cadaver or patient's own bone replacement) and fuse the cervical bone sections back together with a small metal plate and screws. This surgery is meant to treat degenerated disc disease mostly. This was an exciting experience for me because I got to see what a human spinal cord looked like as well as a degenerated disc. Most people would have called it disgusting, but I find it fascinating. The rest of the day was spent researching EMGs and SSEP(Somatosensory Evoked Potentials), both are forms of neuromonitoring. Today was a better look at what more there was to come.

Day 2

Today was a great and productive day. I spent 2 hours of the day in an X-ray lab seeing all of the different processes and machines they use. One machine uses re-usable film that captures the image then scans the film and inputs it into the database. The other machine captures the photo and instantly sends it to the computer which uploads it to the database instantly. I also spent some time learning more about MRI's and how they give a better, in-depth photo of bones and tissue than X-rays do. I spent the end of the day doing clinic with my mentor, Dr. Orndorff, and I was able to learn more about arthritis and other spinal diseases and where they usually occur in a spine. Today was another day of learning and it was another great day.

Day 1

Today was an intimidating, but inspiring and exciting beginning to my internship. We got a loaded schedule and binder at the start of the day, filled with information of simple anatomy that we had to know for a lot of our internship. Part of the day was spent learning some of the simple anatomy required for spine and orthopedic surgeons. After lunch, I met my mentor and we discussed possible ideas for a project topic that would work for what I will be learning throughout the experience. The idea that interested me the most was researching neuromonitoring and basing my project around that topic. Neuromonitoring is used to monitor neural reactions that happen when a nerve is damaged or hit during surgery. It makes spinal surgery safer. Teh rest of the day was spent researching my topic and turning in paperwork needed by Mercy. Today made me even more excited than I was already.