Over the last couple of weeks, I have been amazed with the different opportunities that we have been provided here academically, and I feel blessed to have experienced numerous things on this trip that I would not have been introduced to if it had not been to this trip. Not only was I provided the opportunity to shadow surgeons in order to watch different kinds of surgeries, but I am also fascinated by our ENMODES project and the recent lectures in BMEN 401 regarading Nazi Euthanasia and the Doctor's Trials.
A week and a half ago, half of our class went to a hospital called Uniklinik, where we got to dress up in scrubs and go in operating rooms to watch surgeries. First, I was sent into a room in which a man was undergoing a mitral valve replacement. Although I did not get to see the entire surgery, I got to see an ultrasound in which the mitral valve was opening and closing to allow blood flow, which was an awesome experience. I then went into another room in which the patient had just undergone CPR, and the surgeons were trying to figure out what was wrong with him. The man had undergone a coronary artery bypass and aortic valve replacement surgery just the day before, and he was having heart problems, so the surgeons decided to rip his chest back open in order to see what was going on. The man had an extreme case of edema, for the skin on top of the head sunk in a half finger length when proded and upon opening the eyes, the surgeon showed us that the capillaries in his eyes were leaking an extreme amount of fluids. When they opened up his chest, I was able to identify the pericardial sac, and I got to see a beating heart, which was absolutely crazy. Just as Dr Wasser described it, the heart was beating violently, but it was growing weaker and weaker. Our surgeon began to explain the different waves for the ECG machine and what each signal meant, and before long, his heart rate dropped to 30/20. I began to watch the heart again... beat, beat... ... ... All of a sudden, the guy's heart stopped, and I realized that I just witnessed something that could become very catastrophic. Within 30 seconds, about 20 more doctors walked into the room and very calmly began to massage the guys heart and gave him epinephrine, which shot his heart rate up to 220/120 before bringing the heart rate back to normal. It turns out the guy had undiagnosed pneumonia and would probably not make it.
I then went to watch a similar surgery in the next room. The surgeon was extremely nice and gave us a lesson about the anatomy and physiology of the heart, and they even hooked up the guy to an ECMO device similar to the PCMO device that we will be designing. They hooked up the inlet cannula to his right atrium and the outlet cannula to his aorta, and they were running into a problem in which they were having bubbles flowing in the blood in the device, which is exactly what we are trying to fix with ENMODES. It was cool to see that the work that we would be doing would really be potentially fixing a problem in the real world. The surgeon then cut open the aorta and replaced the aortic valve, which was an amazing thing to watch. Later, I also saw the end of a hernia removal surgery and a hip replacement surgery, which were both awesome but a bit more gruesome and painful to watch. Overall, my experience at Uniklinik was one that I would not trade for the world.
As we continue to work on the device design project, I am slowly beginning to realize that our device could have a serious impact on the PCMO industry, and it is interesting to see just how many ideas our class is developing in order to come up with a solution. The biggest difficulty about this project is finding a feasible solution, especially since we have no way of testing our product's effectiveness at the moment and everything is all theoretical. Our group has decided to use centripetal acceleration in order to produce centrifugal force within a cannula that will separate the bubbles from the blood. The bubbles will then enter a chamber that is coated in a chemically-treated silicon inlet port that is impermeable to blood. As a back up, we are using a cobalt oxihydroxide porous membrane that is electrically charged to serve as a defoamer to remove any bubbles that escaped the compartment. Our current problems include determining how fast the blood must travel through the cannula to overcome gravity and go back into the heart and finding a voltage that is safe to use on the patient. The project is very cool, though, and we present our designs to ENMODES on Thursday.
Finally, we learned about Nazi Euthanasia and the Doctor's Trials in BMEN 400, which was both one of the most interesting and one of the most depressing lectures that I have ever attended. We were given in depth information about the Nazi's "Aktion T-4" and their testing of mass sterilization and killing in order to form "the perfect race", and it was interesting to see the events leading up to World War II as well as the trials and punishments given to these people after the war. School has been very interesting lately, and I am so thankful for the opportunity to study here. Spring Break is five days away, and good times will surely follow. Until next time, God bless!
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