Rockin' Boobies

I totally rocked the Mamms on Monday.
Perfect pictures, even with difficult patients. (oooo, I can't lift my arm, ow ow ow)
The processor ate two of my MLO's, but other than that everything was great!

I've realized that I just have to suck it up and use more compression than I was previously comfortable with. Every job has it's little tricks. Every machine is different. Every patient is different.
But I think I've finally beaten the sucky machine!

Happy March

Happy March!
I turn 25 this month. Boo.

It's depressing. If I live to be 100 (ha,ha, not likely) 1/4 of my life is already over.

But really, I should look at it as 1/3, because statistically I'm more likely to only live to 75.
Sad.

I thought this article about hormone related side effects was interesting. I see anecdotal evidence of this when I'm doing mammograms on women that have taken HRT in the past. Their breasts are very firm and hard, so it's much more difficult to get adequate compression. We all hate doing HRT pts.

However, the worst are women with breast implants. We draw straws to see who has to do those.
One woman came in to the dept. and was suprised at how difficult her mammogram was now that she had breast implants. Her surgeon told her that mammograms would be easier now that she had the implants, because there 'wasn't as much breast tissue'. -Not true!

As you can see from these pictures.
First, standard mamm views are taken with moderate force to the breast and implant.



Then, implant displacement views are taken. The implant is pushed back against the chest wall and the breast tissue is pulled forward and compressed. Imagine a half empty tube of toothpaste. Just like pushing the toothpaste toward the cap, we push or squeeze the implant toward the chest wall. There are double the views(x-rays) = more time and more times compressing the pt.

Dump Run

I had my first dump 'n run a couple nights ago.

The front desk calls,
"Do you know about a pt. Xxxx, that's a direct admit to CT?"
"Um, No?" I want to say, 'Why would anyone be admitted to CT?", but whatever, the front desk wouldn't know that, anyway.

I warm the scanner up and wait. About 40 mins later 3 EMTs come racing into the dept. with an unconscious elderly woman on their gurney. They're shouting some stuff about low blood pressure, V-fib, O2, something, something - and they rush past me into the CT room.

What I see is a cyanotic old lady actively seizing.

I follow them into the room, "Um, she's having seizures.", I say.
They roll their eyes at me, like duh.
"Yeah, that's why she's here.", one of the EMT's says, while they're moving the pt. on to the CT table.
"Has the ER nurse looked at her?", I ask.
"No. Direct admit to CT.", the EMT says, while they're wrapping up their stuff and heading out the door.

OK - So here I am alone with a cyanotic, seizing old lady. The ER is on another floor. In fact the only other depts. on my floor are housekeeping and HR. They're all gone for the day anyway. There isn't any crash cart or even a blood pressure cuff in our dept. Not like I would know how to use one, right? Actually, for a Rad Tech, I'm very good at taking blood pressure by palpation. Thank you EMT training. Anyway, back to my story. Thankfully, the ER nurse came to my rescue and with her help I tried to scan the pt.'s head. CT and seizures don't really work well together. After the third try we gave up and the ER nurse took the pt. upstairs to be admitted to, get this, a real hospital room, where they gave her some nice Ativan. And I finally got the CT done.

Later on I went up to the pt's room to do a CXR and EKG and the pt's Dr. popped in.
I hate this Dr. Deeply, deeply dislike him. If I were dying, and he was the only Dr. that could save me, I would rather die.
I have the pt's chest uncovered to do the EKG and the Dr. waltzes in, flinging the door open and not shutting it. Granted, she's unconscious, so she doesn't know that her boobies are exposed to the world passing by outside, but gross!
I shut the door.
The Dr. snaps on a glove, "Well, as long as you have her gown open, I'll do a breast exam!" He proceeds to vigorously squish her sagging, floppy breast tissue. "Her family's very worried she might have breast cancer."
She's 88 y/o and unconscious. Hmm, breast cancer may not be her worst problem right now. Then the Dr. grabs my hand, "Here feel this! I think it's a lump. What do you think?"
Eww! I do mammograms, but I DO NOT grope unconscious old ladies!
So I say diplomaticlly, "I feel some tissue, but I don't know what it is."
He snorts, "Well, it feels like a lump to me."