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!

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!!

Diaper Up

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.

Full Moon

Whoa!
This Saturday I broke the department record for most x-rays done by a single person in one shift.
The previous record was 17. I did 22!
My previous best was 15, but now I'm the new record holder!
And I didn't have to call in my back-up person.
Although, I did call her in on Sunday.
We had 2 traumas come in at once and I decided I couldn't do everything.

This week-end I did 52 patients total in 3 - 8 hour shifts. I think the total for all shifts was well over 100 patients. Plus I answered a million phone calls, refaxed ultrasound paperwork to the radiologist( the US tech couldn't get her paperwork to the right place, ever), entered all the orders for each exam (plus the CT and US exams) and made exam copies for patients.

What a week-end.

Drive Away

This is a new one-

ER nurse- "Patient X in bed 3 won't be over for their x-ray. They have to drive their wife somewhere. We'll call you when they get back."

Hmmm, I guess the husband's night sweats and chronic cough weren't worrying the wife very much. She still wanted her ride 'somewhere'.

The patient showed up 45 min. later. I made my student do the x-ray.
Better they get TB than me.

Gimme Gimme

This little 3 year old child had a tantrum and pulled a candy machine over. It fell on their leg and broke the femur in two.

Ouch!

Mister Twister

Older man water skiing. Hmmm, ouch?
I know! I know! My lateral sucks! But he wouldn't even let me touch his leg, so I worked with what I had. Next time...more tube angle. And if you don't know what I'm talking about....these pics are perfectly AWESOME!!

Cracked Up

Man vs. Truck.

Truck wins.

I'm pretty proud of my nice cross-table laterals. This was ordered as an ankle, but I decided to do more of a Tib/Fib after I saw how much damage there was on his ankle. In the last pic you can see that there are some spiral fractures. I've seen fractures like that spiral from ankle to knee.

For a 20-something he has horrible bone density. Too much soda? More calcium!

I also did an AP Tib/Fib, but I'm too lazy to copy it.

Light Bulb

If you have a fake hip and you stand on the edge of your bathtub to change a light bulb ---- you WILL slip and fall. The final result will be painful:

Ring Ring

Yes. This is my butt.

This is also the phone that I carry around while I'm working. People call me on it and tell me to do stuff. Sometimes I listen to them.

A favorite, never gets old tech joke:

Hey! Your butt's ringing!

Getting Old

This is such a neat x-ray in real life, but unfortunately it doesn't copy very well.
The pt was an 86 y/o cancer pt. She had absolutely no control over her arm. When I lifted her arm to position it, it flopped around like a wet noodle.
I also did an external rotation, but that did NOT copy at ALL. And it was so gross looking too.

Ding Dong

Look at how small this newborn is! That's my HAND it's sitting on.

(and NO I don't have giant hands!) It was so tiny!

However, look closely at its chest: Bell shaped. That's a sign of Down Syndrome. Sad.
Upright Abd of a newborn.

In Control

I think it's strange that 3 months ago I sat sweating, praying, on the edge of my seat, waiting for my interview in a new department AND NOW I'm in control of that department.
I worked my first 4 day week-end by myself. Thurs. to Sun.
I'm not following anyone around anymore.
It was interesting.
Very, very busy.
Exciting.
Boring.
Gross.
My very first patient on Thurs. painted the walls, floor and x-ray table with vomit.
It smelled like hamburger.


I had this funny little conversation with a nurse on Sat. night. The ER was packed and I was working on one patient and a nurse brought over another patient. The computer was slower than a 92 year old on ice. I'm trying to work fast and get done with the first patient, so the nurse can go back to the ER with him, but the computer is Too Slow!!
She's breathing down my neck.

Then she starts walking around looking for something and she finally comes back to me and says: Are you here all by yourself?
Me: Yeah.
Nurse: Well, that's strange.
Me: Uh, on a Sat? Evening? I think there's usually just one person.
Nurse: Yeah, but don't you need a license or something to run the machines?
Me: Uhhhh.......I've been a tech. for 5 years.
Nurse:...............oh, never mind.

Should I be insulted?

Wiped Out

Thursday (today) we did 18 fluoro/interventional pts. I was doing or assisting in almost every case. PLUS I did 3 In pts, 2 girls from a MVA and 4 other ER pts. All 7 of the ER pts were on backboards, so everything was cross table. Knees, c-spine, l-spine, ect. Ugg.
And 2 of the in pts were kids. So sad....little cancer kids with bald heads.

I'm having a hard time letting the students do stuff. It's really tough. Either I end up jumping in and doing everything or I let the student do it, but I forget that I'm supposed to stand there and watch them. I end up walking away to do some paperwork or answer the phone. Then I run back when I remember that they're "just" students. Aaaaaaaaa!

Some of the techs are really rude to the students. Even though they're students they're still HUMANS! Do unto others as you would like done to you.
Please.
It's embarrassing to watch them belittle the students. It just makes them look incompetent.

Well, I've collected a couple really juicy, grusome stories during this last week........... but I'm waiting for people/media to forget about them. No HIPPA lawsuit for me thanks very much!

X-ray Vision

.
This is very strange.


"All Things Considered, May 3, 2008 · This past week, the Transportation Security Administration introduced new security measures at Baltimore-Washington International Airport, including a controversial "whole-body scanner." The scanner provides guards with an image that strips away a traveler's clothing, revealing everything that person is carrying — and their naked bodies. TSA spokesperson Christopher White shows Andrea Seabrook how it works."

"Wired-Nice Bombs Ya Got There
A scanner the government is testing for airport screening reveals much more than meets the eye to be comfortable for most passengers.

Susan Hallowell, director of the Transportation Security Administration's security laboratory, sacrificed a large measure of her own modesty Wednesday to demonstrate the problem.........read the rest here"





More examples from the walk through x-ray airport scanners.

The machine:

I already get enough radiation at work, I don't need more when I go on vacation!

As for the "back scatter radiation" that they use- what do people think radiation is? Calling it backscatter radiation makes it safer? I should try that with pts : "Today we're using sweet rainbow foofy x-rays!" All radiation produces scatter and I don't really want my thyroid caught in a small box with a handful of "back scatter radiation".

Ok, ok I'm sure it's harmless. But I have questions....What about pregnant women? Will TSA preform preg. tests on travelers who don't know their LMP?

Which preg. woman will sign up first, to sue TSA for malpractice, because of birth defects in her baby, that she attributes to a walk through x-ray screening she had on her way to Hawaii when she didn't know she was pregnant?

Run Run

Today I ran and ran and ran. The End.

Juuuuuust kidding!

I was in fluoroscopsy/interventional today. Following around 3 different techs. Work started at 7:30am with 12 patients. Apparently this is a slow day. At the old job we did at the most 1 (yes, ONE)fluoro case a WEEK. And, as I usually worked evening shifts on the fluoro days, I haven't done a BE, UGI, VCUG, ect. for a loooong time.

Not that I missed it much.
People can keep their anuses and various bits to themselves, thanks much.
But it's part of the job.
And I wanted this job, at this big fancy hospital, so much.
The Rad was so nice. He talked to the patients! He explained the procedures! He was a normal person!
Amazing.
By 8:30am, when the pts start to arrive, there are 3 more add ons. By the end of the day there will be 2 more. Total pt exams =17
I assisted with 1 thoracentesis, 1 paracentesis, 1 abd mass biopsy, 3 UGIs (one on an 8y/o), 1 VCUG(where I was peed on) and 2 ERCPs.

I also watched a student x-ray a partial amputated thumb. She was hoping to test out on it, but couldn't remember how to do the oblique so I couldn't sign off on it for her.
I also did a lot of other minor things-like running around and getting things, finding people, transporting equipment, and running and running.
We didn't stop for lunch until 10 min. to 1pm.
Our next pt was at 1pm, so we had 10 min. to eat.

While we gobbled food, The Manager came up and asked in a passive/agressive manner if JCAHO allows us to eat in our dept. I'm guessing.....NO. Whatever, I'm the new employee, just following the others lead!

I have tomorrow off!!

I Suck

I hate, hate, hate my new job!

After yesterday, where I did a post-op knee in recovery ALONE (even though I didn't know where the recovery room was or what their protocol was!! I like to jump in and try not to drown) and a port-a-cath placement in surgery ALONE(with 2 students, but that totally counts as alone). -longest sentence ever!

Anyway after yesterday, I thought I was pretty hot stuff! Rockin' the new job no sweat.
I hit a wall today. Crawling over this wall, called Mammograms, took all day!

I used to be really, really good at Mammos. No pain, pts would thank me and request me to do their Mamm the next year. All that is over....

The machine at the new job is really, really old. More than 13 years. I'm used to a new machine that does everything for you except comfort the pt. This ugly, stupid piece of junk that I will have to use every single week, is a real wham, bam, thank you ma'am piece of crap. I like to do the compression slowly - it's not so painful that way.
Sucky machine has 2 speeds - off and super fast.

I was apologizing to pts all day long!
A mammo is NOT suppose to be painful.
At times I almost wanted to give them the number of my old job, just because they have a better machine and I felt so bad for the pts getting squished.

This is how my day went: I love this job....oh, mammos no problem....holy crap what is this thing!?! that's your mammo machine?!?! No Way! No way!..... Ok well, that didn't look too bad let me try one....ok I suck....no I really suck....I hate this job.....I really hate this job....now I want to kill myself....will this day never end?....oh, that wasn't too bad....wow! maybe I've beaten this!....No, I suck....stupid machine...Wow! good mammos! finally!....Sorry lady, I'll wrap your breasts up and you can tuck them under your arm.....She needs new boobs, but I got good mammos....Ha, Ha!....I'm outta here!

X-ray Cartoon

Here's a cute cartoon about x-rays!

Eyes Up

We do a lot of pre-MRI screening x-rays.
Our protocol for any metal grinders or metal workers are 2 waters views. One with the eyes looking up and one with the eyes looking down.

You have to wonder about the person who discovered that MRI's and metal don't mix.

"Mr. Jones in a few seconds we'll start your MRI."
"Argh, my eyes! I'm blind!"

Tech writes in notebook: Note to self---pre-screen pt.s for metal in eyes. Metal+MRI=Bad!