Say What?!?

I love the new voice recognition transcription.

Soooo funny.....

Sometimes you have to wonder what the Dr was trying to say.

Add a Dr with a lisp or accent and it's hilarious.

Actually ER notes:

~

This 17 year old uterus fell in a hole today.

~

Patient brought in a brief video tape of the accident and it looks like the colon was behind him and took him and the patient fell forward.

~

This 20 near all was seen by myself a week ago.

~

It feels like I would patient Mark got kicked in nuts.

(the pt's name was Ronald -so???)

Anything Else?

Actual conversation with a patient:

Patient - "I'm cold. Why is it so cold in here? Are you cold? Why is this bed so hard? Do I have to stand up? This is taking too long. I can't stand up. I want another warm blanket. Where's my friend? Can my friend come back to my room now? You want me to stand up? How long will this take? Where's the nurse? Can I have a warm blanket now? How come these beds are so narrow? Do you have a bigger bed? Where's my friend? Why is it so cold? Ohhhhh, I'm sooooo sick. cough cough"

Too Much?

Is it too much to ask, that when a pt is pregnant you tell me before I do the x-ray?

Or don't even tell me, just check the box next to pregnant in the chart, I do check the chart before every patient.

Or don't bother, I know you're too busy to click on a tiny box.

'Cause I look like a retard when I ask the patient,
"Any chance you might be pregnant?"
"Yes, I'm due in 4 weeks (like duh)."
"Does the Dr. know that you're pregnant?"
"Yes, he knows (again duh!)."

I'm sorry! YOU ARE FAT! I can't tell if you are carrying a baby in that belly or a submarine sandwich! Sorr-y!

Throat Ca-chunk

Ok - try this: Take a drink of water. Do you hear a noise in your head when you swallow? No? Try it again. Bend your neck to the right, to the left, down, across. Yes? You can hear a noise?

THAT'S NORMAL!!!!!!!!!!!

I did a video swallow (dumbest exam ever, next to VCUGs) today on a 30-something woman with the history of: chunking noise in head when swallows.

Yes. Really.

What did the Rad. tell her?

He said, "Huh, yeah I have that too. You're not crazy, there really is a noise. It's the cartilage in your neck. (Thank you for your money, have a good day.)"

She also had foot weakness, post-nasal drainage and sinus pressure. Really? A video swallow? Why?

Well, I like my job (and money) so come on crazy faker patients. Can't you think up any other imaginary symptoms?

~On a side note: I randomly picked up the optical space age thermometer today and took my temp. It was 100.1F

And I felt fine.........but I had a fever, so I had a perfectly good reason to go to the ER.

I took it a couple more times and it was 100.0 and 99.8

Oh, well I had better things to do than sit in the ER waiting room for 3 hours.~

Dark Angle

I'm a little burnt out, so I took a vacation from blogging. Why am I burnt out you ask? After only one year at this new job?
Well, I guess it's hard to be stretched in so many different directions. Starting Jan. 1 we saw a 50% increase in patient volume. The ER added more Dr.s and nurses. Did Radiology staff more people? No. They decreased the staff on each shift. Why?

Oh, that's easy - the hospital sold the radiology dept. to a private company.

We are no longer hospital employees, although we work in the hospital.

Strange? Yeah.

But now FINALLY!!! they've realized that we NEED more staff, so now I can breath and relax a tiny bit. Instead of one person doing 25 patients (unconscious, MVA, combative, drunk, bleeding), now 2 people share the load. And all the fun phone calls, order entering, processing and generally fire putting out of running a department.


~

Another reason I'm burnt out - I've x-rayed every single dead morgue patient we've had in 2009.
What are the odds of that happening? We get a lot of deaths and I work .8, so I'm not there all the time.

But I've had every single suicide, MVA and still born.

Part of me likes it and the other part is disgusted that I admitted that.

It's awful to see a man's body ripped open like a too full garbage bag, but unique because I'm the last person to x-ray them, too see into and through them.

When I was a kid, and I crossed a street, I would always stop in the middle of the road and touch the center line, because I thought no one else had ever touched that exact spot and so it was unique and special.

X-raying dead people is some what the same, in a way, unique.

Snap Crack

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*.

*Butterfly fragment - a wedge-shaped shard of bone from the shaft of one of the long bones. This injury occurs at the apex of the fracture force and is a subtype of a comminuted fracture.

Past Flash

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.

Chop Chop

Amputation at the 2nd and 3rd digit.

Ouch. Again, another victim of a circular saw attack.

Conga Line

This 80 y/o won't be doing the conga anytime soon.

Comminuted left hip intertrochanteric fracture.
Medial superior and inferior pubic rami fracture.

Fall Back

60-year old woman fell backwards off of a 6 foot high stone wall.

Trimalleolar fracture with dislocation pre and post films.

You can see on the medial side where the fibula was sticking through her skin.

Falling Children

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.

Radius Fracture

This kid never complained or cried. Very brave. I gave her extra stickers.

Casted up nicely.

I turned cast into a verb. Is that OK?

Failed Infanticide

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.

Very Strange

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

Pressure Cooker

I canned vegetable soup.

And Peach/Mango/Passion fruit marmalade.

And Sugar cookies!

Monkey Bread

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.

NPO U

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!!

Contact Sports

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.

Robin Hood

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!).

*The term "Robin Hood" refers to splitting the shaft of an arrow already in the target with another arrow.

Shepard's Pie

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.

Cover with mashed potatoes, dot the top with butter and bake at 400 degrees for 15 to 20 mins - until top becomes golden.

If I made in again I wouldn't bother with the tofu "sausage". I used portabella mushrooms and they are 'meaty' enough.

Wii Mii

I'm addicted to Wii. It's sad, but true. That's my mii hanging out with Mario and Princess Peach. I got a gold on every level in Mario Cart and they took a commemorative picture.

This is the first video game I have ever played and I can see why people become addicted.

"Just one more game. Ok. One more. Now just one more...."

Well, excuse me, now I have to get back to Rock Band.

The Wii is calling.