A Hectic Day; 4/14/11

Today was quite a hectic day. It was Dr. Williams’ birthday, so it was tempting for everyone to just sit around and just eat the whole time. Dr. Williams was also on call (the best birthday present a doctor can have). When I arrived to the clinic, Dr. Williams was gone, taking care of a displaced tibia fracture in the ER. When he returned to clinic he was 30 mins behind his afternoon schedule. There were also problems with the ICCHART software (used to organize patient medical records). A tech was present to fix the glitches but computer access was limited because each device had to be modified individually. At one point everyone was using one computer. Despite all the chaos, everyone was able to get their job done at the end of the day and I was able to see a few interesting cases.

One of the cases was a SLAP (superior labrum interior to posterior) tear. I was briefly introduced to this injury before, but Dr. Williams took the time to go into a bit more depth about it. A SLAP tear is an injury to a piece of shoulder cartilage called the labrum. This cartilage surrounds the shoulder socket (glenoid), helping to keep it stable when you move. Your biceps is attached to your shoulder by a biceps tendon. This tendon connects your biceps to the labrum at the top of the shoulder joint. A SLAP tear happens when the labrum is damaged where the biceps tendon is attached. Several symptoms that accompany this injury include: A dull throbbing ache in the joint, loss of strength, and difficulty sleeping due to shoulder discomfort. To treat this condition, a patient has three options: 1) leave it alone 2) strengthening the other supporting muscles of the shoulder through physical therapy 3) arthroscopic surgery to reattach the labrum to the glenoid, this option is also followed by physical therapy.

I have been in the clinic long enough to have seen the most common cases as well as rare ones. But even with the most common cases, there is always something new thing to learn. I have been particularly tentative to the classic conditions of each injury and seeing if the patient fits what the literature proposes to be a typical candidate for an injury. These injuries typically target a specific age group or are tied in some way to another condition the patient has. For example, middle aged women with diabetes are the most susceptible to adhesive capsulitis or “frozen shoulder” (a condition which limits the shoulder’s ranged of motion.

Overall, it has been an eventful day and week. I’m looking forward to working harder and learning more in the remaining weeks.