Sunday, December 2, 2012
Season 9 Episode 2: "Love The One You're With"
Opening Message:
"Surgeons don't compromise. We exceed perfection; we operate 17 hours straight if we have to."
Red = Grey's Anatomy
White = Findings/Personal Summary
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- *Derek Shepherd* is a main character and has multiple hand fractures with a median nerve injury. In Shepherd’s case, his wrist is where most of the grievance is for him.
“Median Nerve injury at the elbow may cause symptoms to appear in the forearm, wrist and hang. Injuries to the median nerve at the elbow are either lesions- where the nerve is torn either partially or fully or compressed due to displacement of a fracture or excess fluid following injury." http://www.sportsinjuryclinic.net/sport-injuries/elbow-pain/median-nerve-injury
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- *Arizona Robins* another main character, has an open femur with a result of an above knee amputation.
Above Knee Amputation. “There is not enough blood getting down your leg to keep it alive. The lack of blood causes severe pain and allows serious infection to take hold. If left untreated, the leg will eventually get necrotic (become dead) and become life threatening. The only choice is to cut off the damaged part. This much be done high enough up the leg to an area that has a good blood supply to ensure proper healing of the stump. In this case it means an amputation through the thigh.”
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- *16 year old female in a sailing accident*
- She says that “She can’t feel her foot.”
- Her foot is hanging on by a nerve and she can still move her toes.
- She moved her toes with a nearly severed foot. The nerve, tibial nerve could still be intact which can maybe save her foot.
Tibial Nerve. “…it supplies the knee joint as it descends in the popliteal fossa and, continuing into the leg, supplies the muscles and skin of the calf and sole of the foot, and the toes…”
Even though viewers who are watching this scene may believe that this 16 year old girl shouldn’t be able to move her foot and toes because of how the foot is hanging on by a thread, it is possible though according to medical-dictionary.thefreedictionary.com because they say that the tibial nerve does supply knee joint as it descends in areas such as the toes during this particular scene which the female moved her toes.
The treatment that the doctors did was a surgery which was successful by restoring blood flow to the foot to where they can save it. The doctors tell the female that the next few months they will have to do a series of operations and she has to stay completely off the foot in order to get to full function.
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- *Roxy Meyer* – 30 year old female – Excess skin removal after a 100 lbs. weight loss 2 years ago.
- Excess Skin Removal. “During weight gain, the skin expands to contain the underlying fat and can often lose elasticity. If older individuals or people whose weight was excessive for many years lose weight, the skin and underlying tissue do not naturally return to their original size. A number of surgical procedures for removing excessive skin and fat are available.”
- Doctors set up a consult congenial for the hernia repair.
- Hernia Facts. Symptoms may include pain and discomfort and swelling on the surface on the abdomen or groin area. Trapping of tissues in the hernia (incarceration), which can result in the damage of death of the tissue. It requires surgery. http://www.medicinenet.com/hernia/article.htm
- She is cautious of her belly which there is a lot of skin that is just hanging on her belly.
- The doctors say that the incisions will be healed in 2 weeks and that she can have physical activity with her fiance.
- (After the surgery, doctors say that it will be 2 weeks until physical activity. According to emedicinehealth.com, "Recuperating from extensive surgical procedures can take time. Most people remain in the hospital for 24-48 hours after the surgery. Walking is important on the day of surgery.") I would agree with the doctors on saying that she will be able to do physical activity in 2 weeks but I still think that it will take a few more weeks for her to fully recover.
- After the surgery, the doctors say there is still a lot of swelling and bruising. The camera shows the stomach and all the flab is gone and her stomach is bandaged up. She doesn't look in pain at all and is walking around the room on her own strength.
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- *Papa* - An older male patient with an Enlarged Heart
Enlarged Heart. According to mayoclinic.com, "Enlarged heart (cardiomegaly) isn't a disease, but rather a symptom of another condition. The term "cardiomegaly" most commonly refers to an enlarged heart seen on chest X-ray before other tests are performed to diagnose the specific condition causing your cardiomegaly. You may develop an enlarged heart temporarily because of a stress on your body...or because of a medical condition, such as the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms. While having an enlarged heart may not always be preventable, it's usually treatable. Treatment for enlarged heart is aimed at correcting the underlying cause. Treatment for an enlarged heart can include medications, medical procedures or surgery."
- Dr. Thomas is planning on doing a ventricular reduction surgery.
- According to Grey's Anatomy, ventricular reduction surgery is hacking off working heart muscle so that what's left can work efficiently.
Ventricular Reduction Surgery. This surgery is an operation that is in cardiac surgery which is ultimately to decrease enlargement of the heart. Comparing the definition of ventricular reduction to the Grey's Anatomy definition, I find that both are similar which is accurate with this specific surgery.
- During the surgery, Dr. Yang and Dr. Thomas are working together and sewing up the heart.
- Dr. Yang, before the surgery, suggested they should have done an LVAD surgery which Dr. Thomas said no because of the risk factors and also that if they would have done the LVAD then the patient (papa) would have died waiting for a heart transplant which would never of happened.
LVAD - According to webmd.com "... there are risks with having LVAD implanted. They include: Infection, Internal Bleeding, Heart Failure, Mechanical breakdown of the LVAD.
To me, with regards to the picture above, I could see how it would be difficult for having a LVAD implanted for an enlarged heart. The most concern that I would have would be mechanical breakdown of this device. I think the doctors in Grey's Anatomy did the right thing by doing a ventricular reduction surgery that was successful for the patient in this particular episode.
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Season 9 Episode 3: "I Saw Her Standing There"
Opening Message:
"The lab coats, badges, and scrubs all work together to indicate a person of authority. Someone you can trust."
Red = Grey's Anatomy
White = Findings/Personal Summary
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*Mr. Mays* - A male patient in his 30's- Rare Retroperitoneal Tumor
*Mr. Mays* - A male patient in his 30's- Rare Retroperitoneal Tumor
Retroperitoneal Tumor - "Pertaining to organs closely attached to the posterior abdominal wall and partly covered by peritoneum, rather than suspended by that membrane." http://medical-dictionary.thefreedictionary.com/retroperitoneal
-This episode starts off with a doctor telling an intern to do an MRI and a hemoccult because an intern believes that she found a rare retro peritoneal tumor. The results come back and the radiologist report indicates a retro peritoneal tumor in the male patient.
-Doctors tell Mr. Mays the news about the tumor and he starts crying because he says that he works out all the time, reads men's health magazine, doesn't eat anything to injure himself, and he feels like he is going to die for no reason. He is scared for his live and is very emotional because of this random health problem that he now has to deal with. He tries to run away and ends up outside the hospital where he is then confronted by Dr. Grey and she explains how it's a scary thing to go to and that this is a serious surgery.
-The doctor then tells him that the tumor is difficult to re sect and that it's not impossible.
-During surgery - With a tumor like this, the surgeon will know what to do when he is open and on the table so that the surgeon can get a good look at the tumor and then decide on what to do. They split his chest open and see the tumor that they need to take out and successfully does that.
-After the surgery, the doctors talk something about a Maddox Maneuver which they explain is a trauma move.
-"Maddox Maneuver was developed by Cattell and Braasch for right medial visceral rotation takes advantage of the avascular right colonic gunner in mobilizing the colon so that the surgeon might inspect the retro peritoneal structures behind it." - A book by Stephen R. T. Evans, M.D. called "Surgical Pitfalls: Prevention and Management.
-While looking at this case, the medical issue is rare and points out that anyone can get it, even if you are very healthy. In Mr. Mays case, he was very active and did the right things, but that doesn't mean that anything can't happen to him randomly. With this case, it shows that things do happen but the doctors are there to help you because that is there job which they to take seriously.
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*Bryant* - A male patient in his 20's. - Scrotum Lymphedema
-Scrotum Lymphedema - "Scrotal swelling and enlargement can be caused by a variety of disorders. One of the more common causes of an enlarged scrotum is a hernia." This is very rare.
http://www.impotence.org/other-disorders/scrotal-lymphedema.htm
-Bryant is lying down on a hospital bed and Dr. Catherine-Avery walks in and see's something the size of a basketball in his pelvis region. He says that he can barely walk and that a few months ago it just randomly blew up. He has seen other doctors and all they did was prescribe him pills that never seemed to work.
-The website that I referred to about scrotal lymphedema also added that, "In many cases, our patients report that they were previously seen by number of doctors, advised to lose weight... and scheduled for various X-Ray rests, but not offered treatment." This is exactly what the doctor in Grey's Anatomy said during this episode about how Bryant has seen other doctors and they really don't do anything for it. Therefore, this is true in regards to this certain health issue in reality.
-The doctors take X-Rays and look over them and say, "He is so swollen that the surgeon has to use a scalpel to dig out the excess tissue until the testicles and cords hit the open air."
-Surgery happens and after the surgery, the procedure went as planned and was a success. They surgically removed the problem and Bryant can now freely move his legs while sitting down in his bed at the hospital.
-The scrotal lymphedema website that I am referring to in this section also talks about how this kind of problem has to be treated by surgery by removing the great amount of tissue, with regards to Bryant, that is exactly what they had to do. The episode gives good evidence and information about scrotum lymphedema that was very accurate to websites that I had looked up information about this type of problem.
-Scrotum Lymphedema - "Scrotal swelling and enlargement can be caused by a variety of disorders. One of the more common causes of an enlarged scrotum is a hernia." This is very rare.
http://www.impotence.org/other-disorders/scrotal-lymphedema.htm
-Bryant is lying down on a hospital bed and Dr. Catherine-Avery walks in and see's something the size of a basketball in his pelvis region. He says that he can barely walk and that a few months ago it just randomly blew up. He has seen other doctors and all they did was prescribe him pills that never seemed to work.
-The website that I referred to about scrotal lymphedema also added that, "In many cases, our patients report that they were previously seen by number of doctors, advised to lose weight... and scheduled for various X-Ray rests, but not offered treatment." This is exactly what the doctor in Grey's Anatomy said during this episode about how Bryant has seen other doctors and they really don't do anything for it. Therefore, this is true in regards to this certain health issue in reality.
-The doctors take X-Rays and look over them and say, "He is so swollen that the surgeon has to use a scalpel to dig out the excess tissue until the testicles and cords hit the open air."
-Surgery happens and after the surgery, the procedure went as planned and was a success. They surgically removed the problem and Bryant can now freely move his legs while sitting down in his bed at the hospital.
-The scrotal lymphedema website that I am referring to in this section also talks about how this kind of problem has to be treated by surgery by removing the great amount of tissue, with regards to Bryant, that is exactly what they had to do. The episode gives good evidence and information about scrotum lymphedema that was very accurate to websites that I had looked up information about this type of problem.
Closing Message:
"It might be hard for a surgeon to admit, but there is no shame in simply being human. It can be a relief to stop hiding, to accept who you really are and to let the world see you that way too. A little self-awareness never hurt anybody. Because when you know who you are, it's easier to know what you're about and ultimately, what you really need."
______________________________________________________Season 9 Episode 4: "Beautiful Doom"
Red = Grey's Anatomy
White = Findings/Personal Summary
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*Katie* - Mid 20's female patient - Complete Vascular Ring and an Aneurysm
Vascular Ring - "Vascular ring is an abnormal formation of the aorta, the large artery that carries blood from the heart to the rest of the body. It is a congenital problem, which means it is present at birth." http://www.nlm.nih.gov/medlineplus/ency/article/007318.htm
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*Katie* - Mid 20's female patient - Complete Vascular Ring and an Aneurysm
Vascular Ring - "Vascular ring is an abnormal formation of the aorta, the large artery that carries blood from the heart to the rest of the body. It is a congenital problem, which means it is present at birth." http://www.nlm.nih.gov/medlineplus/ency/article/007318.htm
Aneurysm - "An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. http://www.nlm.nih.gov/medlineplus/ency/article/001122.htm
-BEFORE SURGERY - Dr. Yang and Dr. Thomas checks out some pictures of a complete vascular ring and Dr. Thomas notices one of the biggest aneurysms' that he has ever seen. Dr. Yang says it formed because of a congenital heart defect and it has been there for a long time.
-They explain to Katie that there are going to be 2 surgeries: The first one will repair the aneurysm, and the second will deal with the defect to prevent another aneurysm.
-IN SURGERY - The aneurysm blew and the hole keeps getting bigger and blood keeps gushing out. They hold the pressure with their hands and cloths. She is losing a lot of blood at this moment. A different doctor jumps in and says to put her on bypass which is "a surgical created pathway that is circumventing the normal anatomical pathway..." http://medical-dictionary.thefreedictionary.com/bypass
-AFTER SURGERY - She is lying there with a tube in her mouth. Yang says, "When the patient wakes up, if she can speak and move her arms and legs then they will know that she will have good blood flow."
-She then wakes up and is responsive. She is awake, speaking, and moving her extremities which is a limb of the body which could mean her hands or feet. She says that they can do the second surgery.
-The risk of the second surgery is very risky and the patient could die. Katie had to sign a paper for the second surgery to happen. If she didn't sign the papers then a different route would have been that she could live with this for years with another risk of an aneurysm.
-Again, Grey's Anatomy isn't making up information when it comes to problems with patients. For an example, a doctor in the show says that the aneurysm during the surgery could have blown which in Katie's case it did. When I was looking on a reliable website http://www.nlm.nih.gov/medlineplus/ency/article/001122.htm they also explain that a possible complication during surgery was, "Rupture, which can cause massive bleeding... Massive bleeding is commonly seen with abdominal aortic aneurysms, mesenteric artery aneurysms, and splenic artery aneurysms. Therefore, when the doctors in this episode say that during the surgery that the aneurysms could have blown, its very common when it comes to this type of surgical procedure which means that Grey's Anatomy is not making this stuff up.
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*Melissa* - Young woman - Cyclist versus auto accident
-Dr. Grey comes up to an accident where a young female was hit on her mike and her right shoulder is underneath the tire and is responsive while talking to Dr. Grey. She can barely breath and Grey says that if they (the crowd) don't move the car off of her then she is going to die. About 10 people help her move the car off of her till the paramedics get there.
-They bring her to the hospital and she is Grey says that she has multiple crush injuries and that she needs a trauma OR open right now.
-They are in surgery and there is a lot of blood that the suction keeps clogging up. The doctors say "that the break is near the femoral artery and she is losing a lot of blood."
-Femoral Artery - "The continuation of the external iliac artery after it passes under the inguinal ligament. The femoral arteries supply oxygenated blood from the heart to the lower extremities." http://www.medterms.com/script/main/art.asp?articlekey=40601
-I can see this to be a true definition compared to a scene in Grey's Anatomy of when Melissa was lying down with the car on top of her shoulder, she was loosing oxygen and was going in and out of consciousness. Comparing that to the definition of a femoral artery, there is very similar information that is very accurate compared to the show.
-After surgery they monitor her for the next 24 hours because its a crucial time after what surgery they did to her (they don't tell what surgery it is that they did).
-Dr. Grey keeps an eye on her patient to make sure she is okay and to make sure her vitals are correct.
-In this scene, Dr. Grey doesn't get much sleep and keeps an eye on her patient. This could mean that doctors are really dedicated to their work and do really try to save each patient that they can, no matter how tired they are. This is a positive stereotype in this type of media towards real doctors in real life.
-Melissa wakes up and is being fed from a doctor. Dr. Grey meets Melissa and all she remembers is that she was trapped under something and that Dr. Grey was there. Grey seems very happy and appreciated of her work to see that he patient is healthy.
Dr. Meredith Grey in this episode is showing how much she cares about this patient because she wants her patient, and all her patients, to see their families because that is very important to her.
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*Dr. Thomas* - An older doctor - collapses out of nowhere
-Dr. Thomas and Dr. Yang are doing a surgery...
...and during it, Dr. Thomas stares for about 5 seconds and collapses to the floor. Dr. Yang is in a judgement call on what to do because when he collapsed to the floor, the patient started bleeding out. Dr. Yang tries to stop the bleeding while watching Dr. Thomas lay there unresponsive.
-Nurses react to Dr. Thomas and say that they don't have a pulse. They shock him with a charge of 200. There is no response so they charge him with 300. A doctor comes in and then does CPR and he is still unresponsive. He then is pronounced dead right there in front of Dr. Yang.
- CPR - "Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. http://www.mayoclinic.com/health/first-aid-cpr/FA00061
-When it comes to Dr. Thomas, it is thought that he had a heart attack which is the reason for his collapse.
-The shock charge that the nurses were giving Dr. Thomas is called a Defibrillator.
- Defibrillator - "Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmia's, vetricular fibrillation and ventricular tachycardia...consists of delivering a therapeutic dose of electrical energy to the affected heart..."
-When it comes to Dr. Thomas in this episode of Grey's Anatomy, again, I can see how treatments to help Dr. Thomas are accurate to try and revive him to where is heart is working. In this particular case, he dies in the show and the doctors and nurses tried to bring him back to life by doing CPR and also to try and give him electrical energy which wasn't a success. The way's that the doctors and nurses went to try and bring him back to life were accurate.
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Season 9 Episode 5: "Second Chance"
Opening Message:
"Doctors have never had all the answers. There was a time when you were sick; we just drained your blood like you were getting an oil change. Were constantly having to rethink what we thought was true, and redefine it."
Red = Grey's Anatomy
White = Findings/Personal Summary
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*Brian* - 17 yr old male patient - Liver Cancer Symptoms
- Brian passed out in class, has severe abdominal pains, tremors, and he is hyper sensitive. He has severe pain in his stomach. Doctors check him out and say, "He is distended and has tenderness in the upper quadrant."
-Dr. Grey goes up to the patient and lays his head back on the pillow and gets a clump of hair from his head. She says that they need to get tox screens and an abdominal CT. They don't know what it could yet.
- Tox Screens - Toxicology tests "checks blood, urine, or saliva for the presence of drugs or chemicals. In rare cases, stomach contents or swear may also be checked. Drugs can be accidentally or deliberately swallowed, inhaled, injected, or absorbed through a skin surface..." http://www.webmd.com/a-to-z-guides/toxicology-tests
Abdominal CT - "An abdominal CT scan is an imaging method that uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomography. http://www.nlm.nih.gov/medlineplus/ency/article/003789.htm
-Dr. Grey checks the liver on a the CT screen and looks very concerned about what it looks like. Doctors are now talking to the parents that they don't know if it's cancerous but there is a mass on his liver and they want to do a biopsy and the parents give the go ahead to do so.
-That isn't the only thing. The doctors then tell the parents that Brian as the symptoms of: john disk, hair loss, and high blood pressure that is all consistent with the use of anabolic steroids.
- Anabolic Steroids - "Most anabolic steroids are synthetic substances to the male sex hormone testosterone. They are taken orally or are injected. Some people, especially athletes, abuse anabolic steroids to build muscle and enhance performance."
-Parents are upset as Brian gets defensive. The parents say that he isn't even an athlete, he is a model. He says that the reason why he took steroids is that he wanted a shot with a girl to like him and that he barely uses them.
-DURING SURGERY - They find out that he has cancer and they get all of the cancer out, but there will be a re-occurrence if he continues to abuse steroids.
- In this episode, the doctors explain how Brian's symptoms of anabolic steroids is that he there is hair loss and also high blood pressure. This is very accurate to real life symptoms of anabolic steroids which, according to http://www.drugabuse.gov/drugs-abuse/steroids-anabolic they are: high blood pressure, liver damage and baldness. In Brian's case, this is an easy comparison to real life and Grey's Anatomy's definition of anabolic steroids and the symptoms of it. Also, Grey's Anatomy includes the whole thing about cancer in his liver which in comparison to this reliable website that I stated in this section is that a symptom can also be liver damage.
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*Older male patient* - Homeless person - Mitochondria Disease
- Mitochondria Disease - "Mitochondrial myopathies are a group of neuromuscular diseases caused by damage to the mitochondria-small, energy-producing structures that serve as the cell' 'power plants.' Nerve cells in the brain and muscles require a great deal of energy..." http://www.medicinenet.com/mitochondrial_disease/article.htm
-The patient tells the doctors that he starts puking and then it goes on for days. Doctors believe that the reason for this is because of alcohol in his system.
-He says that he hasn't been drinking anything and that his stomach hurts so bad that he gets so nauseous that he wishes he would die. He then pukes on a doctor on accident for the 3rd time.
-Doctors gives him tests and they come back negative for drugs and alcohol. Patient also says that he is freezing to death which is another symptom that he is having. Doctors then order an abdominal CT scan which comes back completely clean.
-Another symptom that he is having is that he gets headaches as if his head has gotten run over by a truck and "the whole world gets louder and brighter and he has migraines."
-Doctor then says that he comes up with a cyclic vomiting syndrome which has been linked to mitochondria disease. They usually see it a lot in kids which the symptoms are: extreme nausea and vomiting for days. The migraines is what triggers the vomiting. There is no cure but since he has migraines, they can treat the migraines. They give him a box of "Sumatriptan 100mg" that helps migraines.
- Sumatriptan - "Sumatriptan is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes is accompanied by nausea or sensitivity to sound and light).
- When looking at Grey's Anatomy and this particular patient and the symptoms that he has, I find it accurate to real life situations when it comes to someone having migraines. When the patient explains that he has symptoms to where he is sensitive to sound and light, Grey's Anatomy actually gives him Sumatriptan in this episode which is a cure for symptoms of sound and light. So far, Grey's Anatomy's medical health portrayals have been very accurate to what I have been looking up while comparing the TV show and to sources that I have been looking at. Also, symptoms of mitochondrial disease that he has of vomiting is 100% accurate to http://www.medicinenet.com/mitochondrial_disease/article.htm when they explain how vomiting is a symptom of this disease that they talked about in this episode.
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*Jamie* - young female patient - Lumierre Disease
- Lumierre Disease - "A potentially lethal form of sore throat caused by the bacterium Fusobacterium necrophorum, a common inhabitant of the mouth... Lumierre syndrome develops most often after strep throat..." http://www.medterms.com/script/main/art.asp?articlekey=21380
- Doctors tell the mother that Jamie's throat causes a concern to them. Mother asks if its just a sore throat and the Doctors say that its probably just an infection and the swelling is abnormal. They want to run some tests to be for sure.
-Dr. Miranda Bailey says that Jamie has a persistent sore throat and that there is sever swelling on the left side of her neck.
-Doctors get a CT scan and says that she might have lemierre disease. Lemierre has symptoms which is pneumonia.
- Pneumonia - "Pneumonia is a lung infection that can make you very sick. You may cough, run a fever, and have a hard time breathing... They (people) may need to be in the hospital."
-When comparing Grey's Anatomy definition of lemierre disease and also pneumonia to the webmd source that I found, I find both comparisons very accurate in the definition of each other. Jaime was hospitalized and also had the symptoms of these health problems. Again, the comparisons are accurate which I believe that the Grey's Anatomy health side of the show is to be true and very accurate.
Closing Message:
"It can be scary to find out you've been wrong about something. But we can't be afraid to change our minds, to accept that things are different, that they will never be the same. For better, or for worse. We have to be willing to give up what we used to believe. The more were willing to accept what is, and not what we thought. We will find ourselves exactly where we belong."
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