Owww - Poor Bone Density!!!
This is old age - be careful - it can sneak up on you at any time.
So, old person + slip and fall = Complex fracture through the distal left femoral metadiaphysis, displaced posterior to proximal femur, multiple free butterfly fragments*.
Something really weird happened today.
You know that person in school that nobody liked? The one who came to school in smelly clothes and their parents were drug addicts or something?
I saw that person today at work.
Only now we're all grown up and adults. Only....she's still stinky and fat and....I think she might use drugs.
It was really weird.
Thankfully, I don't think she recognized me.
This 80 y/o won't be doing the conga anytime soon.
Comminuted left hip intertrochanteric fracture.
Medial superior and inferior pubic rami fracture.
60-year old woman fell backwards off of a 6 foot high stone wall.
Trimalleolar fracture with dislocation pre and post films.
Caution: Falling Children
Another kid that fell from an extreme height. This one fell off of a backyard zip-line, that her Dad built. Awww that's so sweet. Only he built it TWELVE feet in the air. Accident waiting to happen.
I turned cast into a verb. Is that OK?
This case -here -of a woman who had an x-ray and discovered 23 needles in her body, makes me sick. Investigators believe her grandparents inserted the needles many years ago. They were trying to kill her, so her parents could have a baby boy.
Check this site out - X-ray photos
It's very disturbing, but amazing.
or these - Funny x-ray pictures.
This one is a little bit too realistic - 3d accident
Today I felt like monkey bread, in that everyone wanted a little piece of me.
Or maybe like Brad Pitt in his underwear.
Or a million dollars.
Anyway- I was very busy.
We were (of course) short staffed and swamped with old people. Every holiday it's the same way.
"Grandma, what! you look so old! I can't believe you've aged in a year! When did that happen!?!"
"And Grandpa you banged your knee four weeks ago and it's bruised? Your old skin hasn't healed rapidly like my young healthy skin!?! That can't be! To the ER we must flee! With the entire family! All 50 of us."
So....when we have actual sick, DYING patients, the faux sickies (semi-sickies) get upset that they have to wait and their 50 relatives complain and argue with the million other relatives in the waiting room and the fighting spills out the front door and the police come and arrest everyone and finally - - - - there is peace.
OK it wasn't quite that bad.
At one point I was the only tech in the hospital (the other person was out to get lunch). I was in the recovery room doing post op xrays on a hip and ER called with a stat port chest on a baby. I hung up and anesthesia called for a port chest for line placement.
It was that kind of day.
Everyone wanted everything STAT.
And everything was portable and none of the patients could stand or move themselves.
Honestly, I had a really great day.
It was fun.
I love crazy.
So, here's something new.
I had to look this up.
The Rad read this as "post maxillary LeFort BSSO".
A quick google -"Surgery to the maxilla is carried out at three levels named after a French Surgeon René Le Fort.
The Le Fort I osteotomy involves separating the maxilla and the palate from the skull above the roots of the upper teeth through an incision inside the upper lip. The maxilla is fixed in its new position with titanium screws and plates. Surgery time is around three hours. The operation is frequently carried out with the mandibular Sagittal split osteotomy when it is termed a Bimaxillary Osteotomy.
Bimaxillary osteotomies take around five hours to complete and may be carried out in conjunction with chin surgery and liposuction/liposculpture. On occasions bone grafting is required in the Le Fort I osteotomy to ensure bone healing and union across the bone cuts. The graft is frequently harvested from the hip. Bone graft material may be harvested from the chin or lower jaw in bimaxillary cases – leaving the hip intact.
Cosmetic improvement is startling for those individuals requiring these procedures, and with proper planning it is unusual for patients not to be delighted with outcome.
Interesting.....gross, painful, but very interesting.
Ouch.
NPO 4 U!!
I'm getting really sick of x-raying little ( 7-10y/o) kids injured in contact sports. This little boy was playing tackle football and he was wearing all the right protective equipment. It wasn't a pick-up game in someones backyard.
His parents were surprised that he had a broken femur. "It was just a little kid. (that tackled their son and broke his femur)" the dad said.
When you go to a Mighty Midgets' (or whatever their team is called) game and there's an ambulance and paramedic crew parked on the sideline it indicates that this might be a dangerous sport.
This is the fifth femur fx on a child under 10 that I have done in the last 2 months.
I'm so excited. League sign-ups for the local archery club are next week. Because of the old job, I worked on league nights, I couldn't sign up. But this year I can sign up!!!
My bow is strung, my fletchings are glued and my nocks are tight. I'm ready - and I hope the next time I post Robin Hood, it's means I've actually shot a robin hood* (like that will ever happen!).
I made a Shepard's Pie last week. The recipe's from the Sunday's At Moosewood cookbook. Every vegetarian should have a copy. The book is divided into regional sections - vegetarian recipes from Africa, British Isles, Italy, China, Mexico, ect. ect.
I used a prepared tofu "sausage" instead of the frozen, shredded tofu called for in the recipe and pre-packaged mashed potatoes, because they were free with a purchase at the grocery store.
Tofu Layer -
Tofu "sausage" 16 oz pkg
1 large onion chopped
2 med carrots sliced
1/2 cup celery sliced (or any root veg. of your choice, parsnips,beets,ect.)
2 Tbs veg. oil
1/4 tsp thyme
1/2 tsp coriander/cumin seeds
pinch freshly ground black pepper
1 Tbs lemon juice
2 Tbs soy sauce
Saute the onions, sliced vegetables, and spices in the oil until the onions are translucent. Stir in the tofu, lemon juice, soy sauce, and black pepper. When heated through, remove from heat and set aside. Place this first layer in a well greased 9x9 inch baking dish.
Potato Layer
Use pre-packaged mash potatoes (like me) OR
4 large potatoes, peeled and cubed
3 Tbs butter
1/2 cup milk
salt to taste
Place cubed potatoes in saucepan and cover with lightly salted water. Bring to boil, simmer until potatoes are soft. Drain - saving hot potato water to use in gravy. Mash potatoes with butter and milk. Salt to taste. Set aside.
Mushroom Gravy
2 Tbs veg. oil
1/2 lb mushrooms, sliced
3 Tbs soy sauce
pinch black pepper
1 1/2 cups hot potato water
2 Tbs corn starch dissolved in 1/2 cup water
Heat oil in a skillet, stir in mushrooms, soy sauce and black pepper. Saute until mushrooms are tender. Add 1 1/2 cups hot potato water and bring to a boil. Slowly stir in cornstarch mixture and cook at a low boil, stirring continuously, until gravy in clear and thick.
Pour mushroom gravy over veg./onion layer in baking dish.
This patient fell 15 feet from a roof and broke his radius and ulna. Another tech did the x-rays (and hung this first one upside down).
The bones are so crushed that this lateral looks almost like an AP.
So I took my cats to the Vet today.
Did you think this post was about Veteran's Day? :)
Catty, the 8 y/o, is doing fine, but Saveta, 15 y/o, has all the symptoms of hyperthyroidism. Ugh. They took blood and urine and now I'm waiting for the Vet to call with the results. He said he would probably prescribe pills for her and see how she reacts to them. She also has an icky tooth that needs to come out.
I hate the idea of giving her pills everyday. She is a cat. Just a pet...but still. She runs around and plays with her toys. She doesn't act sick.
I've had her since I was 10. I watched her birth and was the first person to touch her, so I guess it's hard to think about her dying, because she's a part of my childhood. And a part that hasn't really changed - cats don't get wrinkles!
Nicely dislocated finger on a 50ish woman. "Caught finger in sweater and fell over onto hand." Ouch! It looked really messed up from the outside too. I felt like telling the woman to take a pic of it with her cell phone. She could show it to her friends. The 4th digit was almost perpendicular to her other fingers! So weird.I Love Dr. Horrible!!
I just stumbled upon this funny, funny video on hulu.
Dr. Horrible's Sing Along Blog
The singing is great and Neil Patrick Harris is such a cutie.
But I want more! Another episode - more, more, more!!
On your mark-get set-GO!
Tomorrow is a BIG fluoro day - 24 pts and counting!
Keep your fingers crossed for me that it's better than last week!
Hello Saw! Goodbye Finger!!
This guy partially amputated his finger on a circular saw. "I stopped paying attention for one second!" he said. 
Saturday was a dislocated elbow night. Two in one night - how often does that happen?
This pt was very, very drunk. They gave her 8 of morphine and she was still writhing around on the cart. She also threatened to murder me if I touched her elbow and it hurt her. I couldn't really do a lateral (or an AP or anything that looked right), but I tried and she didn't kill me, so fairly successful.
This next pt dislocated and fractured his radius. He also wanted to kill me. The student I was working with said he looked like he was going to punch me when I was positioning his arm. Hey- if you come to the ER, you're in a lot of pain and you want x-rays done, it might hurt. Boo hoo. Would you rather not know what is wrong with you?
He wouldn't let me move his arm for the AP, so the x-ray below was done with tube/film angle magic. I was pretty close to AP all things considered.
Then I spent an hour in surgery workin' the C-arm.
And ta da- post op films. Looks a lot better, right? (ignore the yellow arrow-it's not pointing at anything)
I had a really awful day today. It was a fluoro day, my first in over a month, and it really sucked. We didn't have a ton of patients, but I kept making mistakes, embarrassing myself and saying things I shouldn't say out loud.
I did one gigantically stupid thing (erase part of a pt's digitally archived exam) and tried to make up for it the whole day. Everyone was really nice to me and supportive, which makes me think that they are probably ripping me down behind my back (that is what they usually do).
And to finish off the day, on my way out, I tripped over a box in the hallway and looked like a retard.
Bad. Day.
Last night at work I put a diaper on a little old lady with explosive diarrhea. Fun. Fun.
When she tried to stand up for the x-ray she grabbed her rear end, "Oh, oh it's coming out again!"
Me - "Ok. Well, I have this diaper-sort-of-thing(that is a diaper). Should we use that?"
Her-"Ok. I guess so."
After the x-ray she went to sit back down, "Oh NO! It's really coming out now! What should I do?!?"
A very pungent stink starts to fill the room.
Me-"Well....hmm....I don't really have anything to clean you up with here....hmm."
She rode back to the ER sitting in her stinky diaper.
I felt bad for her.
I know this post is a little late - it's the middle of Sept., but I wanted to show off some of my garden........again.
Cheddar Cauliflower
Squash
Royal Golden Melon - It grew twice as big as this and turned bright orangy-gold. Mmmm and so sweet too!
Veronica Broccoli
Lincoln Peas with clotted cream
Purple Cauliflower
Kale, Cucumbers, ect.
Watermelon-growing
