Erin Guty ’13, Orthopedic Associates of the Greater Lehigh Valley

On the first day of my Princeternship I arrived at the Philipsburg office of the Orthopedic Associates of the Greater Lehigh Valley and was greeted by Dr. Nick Avallone ’97. From 8:30 in the morning until 12:30 we saw patients with various injuries. I observed two cases of Dupeytren’s contracture, which happens when there is a thickening of the tissue of the palm and fingers. The buildup of scar tissue causes one or more of the fingers to forcibly bend inward and the patient would have trouble straightening it completely. It was informative watching Dr. Avallone go through the process that he uses to diagnose each patient. He performed physical manipulations to assess what moves cause the most pain. Certain areas and types of pain are indicative of specific injuries. Also he utilized imaging techniques like x-rays and MRIs which he then used to indicate where the injuries could be seen on the images. Combining all this information he would give his diagnosis and inform the patients of the available options. Depending on the type of injury these options could include physical therapy, steroid shots, or surgery and possibly some combination of the three. Dr. Avallone also took me to a meeting about the Concussion Center which was very exciting because I had just finished writing my junior paper on the neuroscience behind concussions. I enjoyed listening in and recognized much of what they were discussing from the research that I had done. I also learned about a new concussion measuring technique they are hoping to implement. It was great speaking to Dr. Avallone about his experience at Princeton as well as the medical school process. Since I am majoring in psychology, it was also interesting to hear about how he used his background in psychology in the orthopedic field.

On the second day, I went to Dr. Avallone’s office in Easton. Again we saw patients from 8:30 am until 5 pm with about an hour break for lunch. There was a wide range of cases including carpal tunnel syndrome, tendonitis, and arthritis. I was able to see baker’s cysts which are buildups of joint fluid behind the knee. Also, I shadowed the physician’s assistant, Shannon, who pointed out pieces of important information regarding each injury. I watched her give a shot into a patient’s knee to help with pain around the joint. She showed me the anatomical markers of the body that one uses to find the best spot between the joints to inject. There was also a variety of other interesting conditions to observe such as Osgood-Schlatter’s disease, rotator cuff tears, carpal tunnel syndrome, and fibromyalgia. The cases presented a varied collection of orthopedic disorders, including many that I never knew existed.

On the third day, I met Dr. Avallone at Warren Hospital to observe a day of surgeries. I was able to watch two knee arthroscopies, two cyst removals, a finger surgery and the removal of a tumor, to name a few.  The knee athroscopies are performed inside the knee itself with the use of special tools and a scope camera. It was amazing to watch such precise work done in a very small area of space, with the doctor using the video image as his eyes. The day of the surgeries was informative in every way. Not only was I able to see exactly how things were performed, but all the doctors and the staff working there were willing to take the time to point things out and explain them to me. As much as I learned through simply observing, I gained even more knowledge through Dr. Avallone and the other team members telling me how everything was working and why certain things were being done. I felt very welcomed and the experience was an invaluable one. Realizing how much I enjoyed my time there really solidified my pursuit in the field of medicine. This experience in orthopedics made me realize that I could spend my whole summer in this kind of atmosphere and it affected what internships I am applying to.  I am so grateful that I was able to have this opportunity!