Week Four:
Children’s Hospital Colorado Center for Gait Movement and Analysis

July 17, 2015

Time is zooming by here in Colorado! I am almost at the halfway point of my time here at Children’s. Data collection, which I know you are all dying to hear about, is now more than halfway done. Hopefully by the end of next week, at the latest halfway through week 6, all of my data entry will be done. After that we will take some time to clean up that data and then I will start on the paper! I’m particularly excited about this, and a little nervous, because my last big research project was on Prairie Butterflies in Iowa, a little different from supracondylar fractures. But, thankfully my RA (research assistant, each intern reports to their departments RA) is incredibly experienced when it comes to writing these kinds of research papers.

While most of this working week was spent in my office entering data I did have the opportunity to get out a few times. On Tuesday morning I attended the weekly ‘Center for Gait Movement and Analysis (CGMA) Data Review’ session. This is a blast to watch. The orthopedic surgeons, physical therapists and residents come together to discuss the best course of action for a patient. (This is the lab I talked about in my first blog, there’s a picture in that entry if you want to see what it looks like.) The physicians are… characters. They tend to get off topic, joke with each other, talk about soon to arrive grandchildren, but eventually, sometimes with prompting, get back to the patient. The decisions the physicians come to in this meeting can have drastic implications for their patients. Sometimes in fifteen minutes they will decide to go in for a surgery, to lengthen, remove, or re-orient bones. Other times, they will see a post-op success case and no action is needed. It is exciting to see the collaboration between the physicians. It seems like a lot of patients, including myself, go to a doctor and expect them to know exactly what the problem is. But, that’s not the case for the Orthopedics here. Physicians present patients and have an idea of what they would like to do, but they rely on their peers to help make the decision that will be most beneficial for the patient.

On Thursday I got the chance to shadow a nurse practitioner in Orthopedics. For anyone that isn’t familiar, a nurse practitioner (NP) is a mid-level provider. They, usually, have worked for some times as a nurse, usually as an RN, and then go back to school for their doctorate in nursing.  They can see patients on their own, prescribe drugs and even set up their own private practice, unlike a physician’s assistant (PA). The NP I was shadowing works in general Orthopedics, assists in Orthopedic surgeries and also works on the hospital’s tumor team. As far as an NP goes, she’s very unique. In clinic that day we saw a variety of fractures, at all different stages. The first one was actually a supracondylar, my study fracture! The patient was in her very last stages, she came in to get her cast taken off and have the pins in her elbow removed. Remember, this is a pediatric hospital. This little girl was not excited to have three inch metal pins yanked out from her arm without any kind of numbing agent (this is standard procedure, it shouldn’t hurt very much its just a scary concept for kids!) Aside from the pin extraction I saw fresh fractures coming into be diagnosed and those down the middle of the road, halfway healed.

After my official shadowing time was done my NP invited me to go on rounds with the tumor team. I, of course, accepted. We visited three patients. All children with cancer. Two were very recently diagnosed and neither was more than seven years old. The other patient had been diagnosed years ago. As interesting as visiting these patients and hearing about their cases was, the visits were heartbreaking. Overwhelmed and scared parents, little kids hooked up to dozens of wires. Pediatric Oncology is not for me.

Thankfully that was on Thursday so the weekend was just around the corner. On Saturday I went hiking with the family to Hanging Lake just outside of Glenwood Springs, it was very therapeutic and helped me to forget about the cancer ward.

This next week will be more data entry. But, on the bright side there is a Cornell Student Send-Off for the incoming class this weekend and Castle Rock! I’ll be going to meet all the new students and alumni. Hopefully I’ll have some photos for you next time!