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Eye surgeon walks through cataract surgery

Eye surgeon cataract

"So typically, when patients arrive in the preoperative area, we meet and make sure that the plan is correct. And then the nurses will put a small IV in your hand through which we can administer a very, very gentle sedative. We also give you many eye drops to prevent infection and to dilate the pupil as widely as possible before we take you to the operating room.

Once in the operating room, we make sure that you're positioned comfortably on the table. There is a large microscope that goes between your face and my eyes. It's quite large and it's in between us (I take it for granted now) and so my view of your eye is quite magnified. And with the foot pedals, I'm able to focus in and out and zoom the microscope- and that's the right foot. And with the left foot, I'm able to control the irrigation, the aspiration and the fluidics of that machine that breaks up the cataract. Both feet and both hands. And my hands are hovering right above the patient's face. And then your neck has to be extended enough that you're looking through the microscope and able to see everything. The surgeon is sitting at the patient's ear. So right eye? I'm sitting by your right ear. Left eye, we switch the room around, move the pedals and sit on the other side.

We cleanse the area around the eye with antiseptics again to prevent infection. And then we put a sterile sheet over your face and open just the area for the eye that we're going to work on. We put a metal speculum, a little holder, in between the eyelids so that if you would happen to fall asleep during your surgery I'll still be able to do the work and continue on. And then we make two very small incisions into the eye. We gently open the front of the capsule of the cataract in a perfectly round fashion. And then we use a phacoemulsification hand probe which pulverizes and aspirates the debris from breaking up the cataract. So we remove the hard, nut-like aspects of the cataract. Then we use a different hand-piece to tease out the sticky bits leaving the capsule of your own tissue open, clear and intact. Then we fold the lens implant and put it into the capsule and let it unfold in place. Then it's just a matter of removing some of the gel that we had used to smooth the entry and exit of instruments in and out of the eye.

We inject a little bit of antibiotic into the eye, make sure the wound is secure, and take away the drape. And then we put a few more drops in, put a protective shield on the surface of the eye and take you to the recovery room. And within about 20 minutes you're able to get up and go.

The eye is a moving target. there is nothing at all that paralyzes or stills the human eye. So we need to just talk you through it and make sure that you are kind of playing our game to hold still and to look straight up at the light. When you're looking through the microscope, the view is so magnified that the tiniest of movements looks large which is very helpful in what we need to be doing. But also it's a problem if the patient is moving because even one millimeter is too much. There's not a lot of wiggle room within the anterior chamber of the eye. There's between two and five millimeters of depth we have to work within.

Microsurgery!"

Walking through cataract surgery video interview with an ophthamologist

Amy E. Weber, MD


Fish fresh from Jersey's Atlantic Ocean trucked to farmers market in Chestnut Hill

Fresh jersey fish
A New Jersey van packed with fresh Atlantic seafood did a brisk business its first time out at the Chestnut Hill Farmers Market last Saturday. They plan to come every other week, alternating with the market they do in Bryn Mawr. Justin Hetrick introduced eager new customers and your correspondent to the fresh fish operation. "We are called Local130 Seafood [A large patriotic painting on the side of the van shouts it out] We are out of Asbury Park, New Jersey. The "130" stands for the amount of New Jersey coast line. All the fish that you see here today, with the exception of halibut which comes from New England, is coming right off the coast daily. Sea scallops out of Point Pleasant. You know Barnegat Light, Long Beach Island? We are Asbury Park, only 20 minutes from Point Pleasant and we can go the day they come in off the boat and get everything fresh that day. There’s a fleet of commercial boats that run out of there. Arguably, I think it’s the third largest port in New Jersey next to Barnegat Light and Cape May. They go out in all kinds of weather to catch us the fish that we need. We are pretty lucky and blessed to have that. Nothing here is ever frozen. Nothing that we sell in the shop is frozen. We pack it fresh and we put it on ice so it keeps the temperature nice and cold without ever actually freezing it. So it’s still soft to the touch. Here are some of the information cards that I didn’t put out yet - we have skate wings, the black sea bass, sea scallops, weakfish, fluke, A lot of people know it as flounder but we like to call it fluke. The only thing I don’t have a card for today is cod.” Watch video interview of fishmonger
at Chestnut Hill farmers market in Philadelphia of fish caught fresh from Atlantic Ocean here.


City crew grinds tree stump

Workers grind tree stump

A severe storm earlier in the summer uprooted a large maple tree on our street and it fell on the roofs of our neighbors’ houses. Some weeks after the tree was cut down and removed, a city work crew and contractor Scott’s Tree Service arrived to grind down the stump. City worker Ed Jardell described how the stump is ground down in sweeping back and forth passes of the grinder’s large rotary blade. The machine takes off more or less two inches at a time depending on the species and hardness of the tree and whether there is any sponginess or rot. Watch video of Philadelphia City crew grinding down the stump of a maple tree uprooted by a storm


City workers grind down tree stump

Stump grinder
A severe storm earlier in the summer uprooted a large maple tree on our street and it fell on the roofs of our neighbors’ houses. Some weeks after the tree was cut down and removed, a city work crew and contractor Scott’s Tree Service arrived to grind down the stump. City worker Ed Jardell described how the stump is ground down in sweeping back and forth passes of the grinder’s large rotary blade. The machine takes off more or less two inches at a time depending on the species and hardness of the tree and whether there is any sponginess or rot. Watch video of workers grinding down tree stump and interview of worker describing process.

Career day features sound engineer, pet groomer, funeral director and more

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Career day pet groomer
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Career day sound engineer motion
 And concert sound engineer Barbara Adams wowed students when she told them she once worked with Kanye West (before he became famous). She talked about what her job is like - lots of heavy lifting and much more. And to illustrate the science of sound and hearing she disassembled a speaker. Students excitedly bunched around to see the diaphragm pulse to Michael Jackson's "Beat It."
 

Keep those safety goggles on! prevent eye injury, vision loss

Eye doctor safety goggles power tools vision
“I was wearing safety glasses and I just took them off for a moment when ...” Ophthalmologist Amy Weber says that is the moment when traumatic eye injury resulting in vision impairment or total and permanent vision loss too frequently occurs. In an eye practice where the staple is treating maladies of the elderly such as cataracts, glaucoma, macular degeneration and diabetes, Weber expresses sadness that so many preventable injuries in the younger are not prevented. She commonly treats, and may operate on, the homeowner who had just taken off safety goggles to inspect a stuck weed whacker, the plumber who, wanting a better look at a pipe overhead, takes off goggles while still using a power saw and the parent who took a moment to wipe some sweat away while observing their kid’s paintball game.
 
 
 

Thai food truck serves Thai tacos New Year's Eve


Selling roses in heavy traffic

Selling roses heavy traffic
Jason Cohen sells roses, 3 for $6, on a narrow island dividing the noisy, rushing north and south bound traffic on Stenton Avenue. For several years, an amiable elderly man from Mali known to your correspondent as Joseph, sold flowers at this busy location where Bethlehem Pike branches off from Stenton at Paper Mill Road. The flowers come from a wholesaler in Glenside and the vendors generally get dropped off in the morning and picked up in the evening. Cohen, from South Philly, has been selling flowers for a few years mostly in center city and came out to where Chestnut Hill borders Springfield Township about a month ago. Before that, he was making rolls in a bakery but it wasn't for him or he wasn't for them. How does he weather the 8 to 9 hour-long days? “I’m a people person so I just talk to people.” Watch video and interview of vendor selling roses in heavy traffic here


Huge machine lays asphalt street

Huge pneumatic paver lays asphalt street

Watch video and interview here. An operator high atop a pneumatic asphalt paver was assisted by two "back men" (otherwise called a screed or back end operators) at the rear of the machine on a little platform slightly above street level and by a crew of about 10 holding rakes, "lutes"and shovels laying down new street "mat" in northwest Philadelphia, Chestnut Hill. One back man who has been with the streets department since 1997 explained how this new half a million dollar computer-enabled paver is much superior to the 1996 model he originally worked with. He can monitor the job on a 7 inch display as the paver lays down what appears to be a couple inch thick layer of hot steaming asphalt and smoothly seam in a new section to an existing one, in automatic or manual mode turning the levels. It's important to regulate the speed, depth of material and and create a proper crown proper sloping down to the curb edge for rainwater to drain off. And a good back man, he says, makes less work for the foot crew who finish off the leveling work.


Vet with PTSD dog carries flag on solo walk for fallen comrades

Vet walks for fallen comrades

Watch video interview of Iraq war vet on long solo Memorial Day walk with PTSD dog. On Memorial Day, Iraq war vet Bobby Caroselli, gears up and takes a trek to commemorate his 28 fallen battalion comrades until he can walk no further. One arm and shoulder cradle the pole upon which a large American flag is hoisted while the other hand firmly holds the harness of his PTSD German Shepherd, "Corporal." He is outfitted in a camouflage flak vest, as is his dog, and his backpack bears the names of his fallen mates. He served in the army infantry during the 2007 surge and, only 19 at the time, he says he grew up fast. When asked about his combat experience he relates only that he had "seen enough." He remembers his buddies fondly and, recalling their humor and imaginative pranks, a smile comes over his face. Your correspondent struck up a conversation with Caroselli after he had paused near the war memorial atop the Water Tower Recreation Center fields. He and Corporal then resumed their solitary Memorial day march under gray, drizzly skies, the red and white striped flag flapping and snapping smartly behind.