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.~

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!

Head Lines

Headline from a newspaper: "Queen Mary Having Bottom Scraped".

Made me laugh.

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.

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.

Tree Jumper

This is what happens when you're 9 and you jump out of a tree.
And you land on your shoulder and break your clavicle.
The 1st one is the angled shot.

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!

Watching You

The Manager wants everyone to take a 20 min. walk outside.
So we go outside.
After skipping around the cement urban sprawl on Friday, I had a lovely pink sunburn.

Drunk guy with his head swaddled in gauze, like a mummy, talking to Diabetty tech.

DG: You better do a good job.
Diabetty: Oh, we always take good x-rays!
DG: Well, I know where you work, so you better do a good job.
Diabetty: You know where we work? Yeah, I guess you do.
DG: Yeah, I know where you work, because I live a block away. Sometimes I watch you guys.
Diabetty: ................um......?

I will NOT be taking a stroll outside/around the hospital anymore!
He might be watching.

Monday Joke

Too tired today.
I was in Mamms again.
I think I have the meanie machine beaten. Finally. The lead tech. checked my work and said I did an "excellent job". Good....but I still feel bad using so much compression. :( Oh, well, it's kind of funny, not a single woman complained about the compression.
At my old job everyone complained about compression - before we compressed them. Then they would say "oh, that wasn't so bad".
Strange.

OK I have to get up super early tomorrow so here is a funny joke:

Did you know diarrhea is hereditary?

No, Really?

Yeah. It runs in your genes!

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!!

X-ray Cartoon

Here's a cute cartoon about x-rays!

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.