For my practicum I went to the Center for Vein Restoration in Greenbelt, Maryland. Here I shadowed Dr. Vinay Satwah as he did different types of procedures on veins. At this site, Dr. Satwah and other doctors specialize in venous insufficiency. Some example of venous insufficiency include varicose veins, which are enlarged veins that are clogged up with blood, and spider veins, which is a less severe form of clogged of veins.
During the doctor’s procedures, he has a main assistant which I personally know. She, Sandra Ulloa, helped me get a phone interview with the doctor and he then welcomed me to the clinic. She helped me get to cite every day for four weeks at 5:30am.
When I would get to the clinic early in the morning, I would help Ms. Ulloa get and take supplies to the operation room that were going to be needed throughout the day. I would also help get supplies in order for Ms. Ulloa to make the tumescent for the day, which is the mild anesthetic used to numb the area of the leg that the operation will focus on. Throughout the day, I would be with Dr. Satwah in the operation room observing the different techniques he uses. Some days I would be in the diagnosis room, observing how the decisions for which procedure to do on which patient were made. Days I was not doing much observing, Dr. Satwah had me read many articles regarding how venous insufficiency starts and the different treatments. Mid way through my four weeks, a new intern had come so then my tasks were changed into explaining to her what was happening in the clinic in order to test my knowledge.
During my time at the clinic, I learned about what causes venous insufficiency. I learned about how the blood flows through the heart and which arteries it goes through to travel down the legs. When blood is going by up the legs on its way to the heart, veins are working hard against gravity. Since it is pushing against gravity, valves in the veins and muscles must work together to push the blood up. When valves start failing and do not push all of the blood up, some blood is left down below the valve where it accumulates. As it builds up, the vein gets clogged causing varicose and spider veins. When this gets severe, people may experience cramps, swelling, heaviness, and ulcerations in the legs.
There are four main treatments for venous disease. The first is compression stockings, which is the lightest of all the modalities. This is given first to the patients and is like a sock that goes around the shin and calf. It pushes the blood up how toothpaste is pushed out of a tube.
The next treatment is sclerotherapy. This is the injection of foam into veins through a butterfly needle. This is used on tangled veins and the foam helps close the vein up from the inside.
The heating of the vein is called ablation treatment. There is radiofrequency ablation treatments and laser ablation treatments. Both are used straight veins and warm up the vein from the inside in order for it to close. Radiofrequency is measured in degrees Celsius while laser is measured in joules.
Lastly there is phlebectomy. In this procedure, small cuts and stabs are made throughout the varicose veins in order to form openings. From these openings, the veins are pulled out. The veins that are come out are white and solid.
From my time at my practicum site, I learned to appreciate the small functions our body performs at every moment. I realize that we all take for granted what our bodies do for us and we do not always take care of our bodies like we should.
I have come to appreciate the specific part in medical science that these doctors decided to focus on. Many people just say they want to become doctors but focus on bigger parts of the body. I had never noticed how specializing in veins play a big role when it comes to people’s health concerns. I had never heard much about vein operations before this practicum, so this project open up my eyes to the many different professions there are in the world.
From doing this project, I have come to realize that the medical field is not for me. Although the procedures I saw were on veins, there was small amounts of blood most of the time. Although it was small portion of blood, sometimes it was difficult to look at. This has brought me to the conclusion that if I cannot tolerate a small amount of blood three days week, then I cannot deal with it every day as a profession.