Dr. David Doman host of Housecall invites Dr. Ann Hwalek, a Thoracic Surgeon at MedStar Georgetown University Hospital to discuss why she choose this type of surgery for her career, what medical conditions she handles, how medical decisions are made, and the surgeries she is successful performing at the hospital. A Thoracic Surgeon handles everything in the chest outside of the heart. Some medical conditions seen are Lung Cancer, Emphysema, Lung Disease, Pulmonary Infections, Esophageal Cancer, Mediastinum (Between Lungs) Cancer and Infections. Being a Gastroenterologist, Dr. Doman is especially interested in the surgeries performed on the Esophagus which include Esophageal Resection for Cancer, Hiatal Hernia, and Achalasia.
Dr. Hwalek is busy with treating early stages of lung cancer due to the screening criteria by their primary care physician of patients over 55 with a history of smoking or who have recently quit smoking. Requesting a screening CT scan, 1 per year of patients up to 10 years after they have quit smoking. CT scans have helped tremendously in early detection and can now offer a cure with surgery based off this scan. To strike a balance of curing cancer and keeping lung function a group of pulmonary function tests are required. These tests shows over a large series of patients based off the amount of lung surgeons need to resect, they can anticipate what their lung function will be. For the most part resection is offered to patients expected to make a full pulmonary recovery.
Trauma is a very important for Thoracic Surgeons. Gun shot wounds to the chest may require 2 major incisions; Median Sternotomy (opens up the breast bone in the middle of the chest) and Thoracotomy (in between the ribs). Surgeons will do tests like an ultrasound and echocardiogram. Also, a physical exam is conducted to see where the would is and photos can be taken to help evaluate the damage of the bullet. It all depends on if the patient is doing well or if their blood pressure is dropping and needs some blood products. Bullets entering because of the heat it puts off are for the most part, sterile. Bullets close to the major blood vessels by the heart or lungs most likely will need to come out.
Watched this episode below to learn more about life as a Thoracic Surgeon. Visit MedStarHealth.org or call 202.295.0560 or email Ann.Hwalek@MedStar.Net.