Plastics Week 6 – Lindsey

This week I branched out from my mentor and visited a lot of the other departments. I went on NICU rounds, PICU rounds, Pediatric Cardiology rounds, spent a day in labor and delivery, as well as an afternoon in endoscopy. Labor and Delivery was a very rewarding experience. I was surprised how much I enjoyed it, and how quickly all my hesitations went away. Matt and I went together and were able to see a vaginal delivery as well as a C-section. We started with the C-section, and it was amazing how quick the surgery was. Before I knew it the baby was out and crying. He was beautifully pink and perfectly shaped, as it didn’t have to make his way through the birth canal. The vaginal delivery was a different story. The mom was a nurse in the psychology department and was what the obstetrician called the ideal patient. “This is the perfect birth for these students to see,” she said “no complications and they get to see what happens when you really push.” The mom had no drugs, and worked hard through her contractions. Only the very end was extremely difficult for her and even then it was better than any televised birth where the mom is in so much agony and screaming for her life. I held one of her legs and gave her the appropriate pressure throughout her contractions. When the baby came out, they plopped her on top of her mom’s belly and prepared for the placenta.

It was a spontaneous delivery of the placenta and the doctor pimped Matt and I a little as she was delivering the placenta and closing up. “how long can you wait for the delivery of the placenta? What are some of the complications of manual delivery? What do you have to watch out for?  How do you know the placenta is about to separate? ”   I thought back to my Antropology of birth class and realized I actually knew the answers to all of these questions. It was a good week. We also saw a 3-D ultrasound. I found myself wanting a baby, as they were so cute.

 On the Pediatric Cardiology rounds one of the Fellows was pimped by an attending as to the formation of interrupted aorta and its pathology. He said there are two models for disease formation, which is generally true for all congenital heart defects, a hemodynamic model and a genetic model. When asked what genes were linked he said NOS-2 and you could tell he was really nervous and unsure as to the correct response. He was right in some ways, NOS-3 is a shear stress related gene, whose expression changes have been correlated to changes in structure. The gene therefore supports the hemodynamic model, rather than a genetic model for the defect formation, or rather as researchers are coming to learn, the two are not mutually exclusive. There are no gene mutations currently linked to interrupted aortic arch. It was satisfying to see how my research really fits into their work here and know that at some pt we’ll help lead to better treatment of these illnesses.