Road to Radiography

 

During today’s clinical, I got my first confidence boost.  I performed my first x-ray!  I had a 72 year-old female patient who was in for a chest examination.  Working under the direct supervision of an RT, I positioned the patient for a PA and then Lateral x-ray.  Both of the images came out well with no problems.  The CXR is the only procedure I feel any amount of comfort with at this point, because it’s the only positioning we have been over in lab so far.  I was lucky today in clinical because there were quite a few chest exams, and I had the opportunity to observe several before I attempted one myself. 

I also observed a UGI exam on a 19 month-old male, which was quite an experience.  This particular exam was very difficult because the child did not want to let go of his mother in the exam room.  As soon as the staff attempted to place the child on the table, the expected fit followed.  With the mother at the child’s side, two RTs held the patient by each arm while a third held his feet to help keep him in position.  It was a struggle throughout the entire process, and the radiologist didn’t get everything he really wanted, but he thinks he probably has enough for an evaluation.  Oddly enough, it wasn’t too difficult to get the child to drink the barium.  We put the barium in his own cup, and he drank some of it on his own.  We were unable to get him to drink while he was on the table though, and had to resort to a syringe to inject the barium solution into his mouth.  That seemed to work ok. 

I took the test for my second module of Medical Terminology last night and made a 98 on it.  I’m out of school on Monday for the Labor Day holiday, but I’ll be spending time over the weekend and on Monday to start preparing for my first test in Intro to Radiography & Patient Care.  That test is gonna have a lot of material on it. 

I also have to go to the Health Department tomorrow for my second round of Hepatitis B vaccinations…  another shot! 

Tags: 1st Semester, Clinical by John Setzler
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Today’s lab was a lot of fun. We started out by getting checked off on our film processing requirements for the semester. Since we won’t encounter film requirements in any of our clinical sites, we aren’t going to spend a lot of time studying that technique. We will be doing it in our lab from time to time, but beyond that, digital seems to be taking over. Being in the dark room was interesting. It’s challenging to get the film out of the film bay in the dark, even though the safe light (red) is on. I think if I had been in the darkroom with that light for about 10 minutes or so, I would have been able to see a lot better. I wasn’t in there long enough for my eyes to adjust to the environment.

During the second half of lab, we did some experiments to show the effects of scatter radiation. Under normal circumstances, scatter radiation is the ONLY radiation that radiographers would be exposed to. We should never be exposed to the primary beam. When radiation is applied to a patient, one of three things will happen… 1) it will be absorbed in the body 2) it will be transmitted through the body or 3) it will be deflected by the body. The deflected x-rays create what we call scatter radiation.

We placed a dummy skull on the x-ray table for this test. We put the image receptor in the bucky under the table and another receptor vertically on the table beside the skull, but outside the collimation area on table. The object was to see how much of this film placed outside of the beam area got exposed by scatter radiation. When we collimated to the entire skull and made a picture, the film to the side was heavily exposed by the scatter radiation. On the second test, we collimated tighter to only expose a 5×5″ area of the skull. The smaller collimation area didn’t expose the film nearly as much as the larger. On the final test, we placed a piece of the rubberized lead protection on the bottom half of the film cassette beside the skull. In that result, there was no visible exposure behind the lead protection area.

This experiment was a simple demonstration of scatter radiation and why we need to protect ourselves from it. Scatter radiation has lost a lot of its energy, but the cumulative effects of it can be harmful. During the class before lab, we discussed the inverse square law, which wasn’t completely new to me. In photography that law is used in a studio environment when using studio lighting. Changing the distance between the light and the subject has an almost identical effect in photography. The intensity of the light (assuming the power doesn’t change) follows the same rules as x-ray.

Tags: 1st Semester, RAD-110 by John Setzler
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Michael Vick gets sacked by the Carolina Panthers defense in a game in Charlotte on December 4, 2005 - Photo by John M. Setzler, Jr.

We had our first test today in the Radiographic Procedures class. I spent several hours last night preparing for it, and it paid off for the most part. I missed 3 out of the 75 questions for a grade of 96, which I’m happy with. I should have only missed one though. Somehow, I managed to get the Trendelenberg and Fowler’s positions mixed up. I knew the positions, but I have no explanation for why I didn’t get them right on the test.

In today’s lab, we started positioning. The first positions we studied were for chest examinations. We practiced the upright PA chest and the left lateral chest. I volunteered as the demonstration lab rat for our instructor, and then I got to watch the process being performed on another student in the class. After the demonstration, we practiced on each other for the remainder of the lab period. I believe I could perform this examination on my own. The only part of it that we don’t get to practice is setting up the exposure. That will happen in clinicals.

My second day of clinical is on Thursday, and I’m looking forward to it :)

Tags: 1st Semester, RAD-111 by John Setzler
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This is a “Tobacco Hornworm” that I just happened to notice munching on my cayenne pepper plant while I was watering this afternoon. I couldn’t pass up the opportunity to make a quick photo of him…

I took my first test on Friday. This was a Medical Terminology test, which is the online portion of my RAD-110 class. I wasn’t sure what this test would look like or what to expect at all, but it wasn’t too bad. It was all multiple choice, matching, and fill in the blank. The test was made up of 100 questions in total. I made a 98 on the test. I got tripped up on, what I consider to be, a trick question, but after looking at my incorrect answers in detail, I can see where I went wrong. I can’t post the details of what I missed here yet, because I’m sure everyone hasn’t taken the test yet.

I have another test coming up on Tuesday in my Radiographic Procedures class. I’m gonna have to put some serious time into that one starting tomorrow… I’ll let you know how that one goes when it’s over. I always hate the first test I have in a new class. I won’t really know what to expect on future tests until I’ve had my first one. After that, it shouldn’t be so difficult. I just have to be over-prepared for the first one…

 

Tags: 1st Semester, RAD-110 by John Setzler
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Today was my first day of clinical.  I will be working a 6-hour clinical on Thursday’s for the rest of this semester.  I didn’t get to actually do anything other than observe today.  I did get to help with the preparation of a sterile field of equipment what was being used in an arthrogram though.  That was interesting since we just discussed that in class yesterday.

My first observation of the day was a thoracic vertebrae exam which is commonly called a T-Spine.  The first view the radiographer made was the AP view with the patient lying on his back on the table.  The second and third views were lateral views with the patient lying on his side with one image made on each side. 

My second observation of the day was an upper GI exam using fluoroscopy.  This exam was interesting to me also, because I have had one done on me before, but I obviously wasn’t able to watch the imaging screens.  The patient was given a substance like Alka-Seltzer to create gas and bloating in the stomach, and then a barium drink to make the esophagus, stomach, and duodenum visible for the process.  The physician observed the barium drink going down the esophagus and into the stomach, while several images were made (in erect position.)  The patient was then put in a recumbent position and multiple images were made while the patient was rotated and put into several other positions.  Of all the exams I observed today, the most images were made during this one.

The third exam I observed was a lumbar vertebrae exam with flexion and extension views.  This exam was very similar to the t-spine procedure, but there were some additional images made with the patient in the erect position with extension and flexion images made from both sides.

The fourth and fifth exams were hands and feet.  In these exams, the image cassette was placed on top of the table rather than in the bucky.  The had exams were done in the AP and PA orientations.  The foot exams were done in the AP and lateral orientations. 

The final exam I witnessed today was an arthrogram, which was also done using fluoroscopy.  This was the exam where I helped the radiographer prepare the sterile field for the physician.  I didn’t envy this patient very much.  He got a contrast injection into his shoulder joint (between the scapula and the humerus).  The physician gave an injection of anesthetic before this injection, but it still looked like a potentially painful situation :)  I don’t believe any images were recorded during this process, because the patient was having his imaging exam done in MRI.  This process was just in preparation for that. 

The day seemed to go by rather quickly.  Six hours didn’t seem like much.  There were a few slow periods during the day, but they weren’t too bad.  My clinical coordinator stopped by as well.  We were told to expect her to pop in occasionally, but we never know when she is coming.  I suppose those visits will become more of an event once I start doing things under supervision and on my own. 

There is another student from my class at this same clinical site, so I’m not there by myself as a student.  My clinical partner knows a lot more than I do though.  He works in a radiography department.  He knows how the computer systems work and how to do quite a lot already.  I expect that he will be a great source of aid for me during my infancy in this program. 

The first week of class is now complete.  This semester, I have no class or clinical on Fridays, so I’m off tomorrow.  I’ll get to sleep just a little later tomorrow, but I plan to take advantage of that free time to continue my reading and studying.  My first test in this program will probably be on Tuesday, so I need to be over-prepared for it until I get a grip on what will be expected from me at test time.  I’ll also have a medical terminology test (online portion of RAD-110) available to me tomorrow, so I’ll probably try to get that out of the way as well.  The medical terminology portion of this class is basically a self-study self-paced class, but I can’t afford to fall behind in it. 

Tags: 1st Semester, Clinical by John Setzler
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Canyon de Chelly, Arizona - May, 2007

Photo by John M. Setzler, Jr.

 

My first week of classroom work is over. Today, some of the things we have been talking about started to sink in just a little. In lab, we spent some more time playing around with the x-ray machines. I’m feeling comfortable with positioning the machine, cassette, and using the collimator. My photography background is proving helpful already also. We talked about how film is exposed and processed, none of which was really new for me. X-ray film and camera film are very similar. The intensifier screens in the film cassettes emit light when activated by an x-ray beam, and that light exposes the film the same way light exposes film in a camera. The processing of that film is also basically identical to normal film processing.

I still have a lot of reading to do. I think once I get all the reading done and my lab workbook exercises finished, I’ll be right where I need to be during the first week.

Tomorrow is my first day of clinical (RAD-151). Everyone in my class is pretty nervous about this because we are all basically ‘deer in the headlights’ right now. We don’t know anything and won’t really be doing much of anything but shadowing for our first 2 or 3 weeks. We aren’t allowed to pre-comp anything until we have been tested on it in lab. In reality, I think that’s a good thing because we won’t be doing anything ‘blind’ in clinical. How much hands on work we get to do in clinical in the early weeks will really depend on who we are working with and their predisposition to be ‘helpful’. Our instructor told us we would generally encounter two types of radiographers in clinical… 1) the ones who are really helpful and 2) the ones who forgot that they were once students. I’m hoping I get paired with the first… Clinical is the meat of this entire program, and I’m very excited about the process and experiences that wait for me there. I already know that all of those experiences won’t be butterflies and bunny rabbits, but I’m ready to go :) I think the clinical experiences will also provide me with a lot of good material for this blog.

Tags: 1st Semester, Clinical by John Setzler
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I survived the second day, and I got to park a little closer to my building today. I think the Tuesday/Thursday attendance level is probably lower than the Monday/Wednesday/Friday levels at the school.

RAD-111 - Radiographic Prodecures I

Today’s class continued where yesterday’s left off. The lecture covered some basic principles of patient care in the x-ray environment, including neonatal, infants, toddlers, children, and adults. We also discussed image quality factors, which seemed a little out of place since we haven’t really looked at any real images yet.

We had our first 3-hour lab session today also. We spend about 45 minutes looking at the x-ray machines and learning how they move in relation to the table and the upright position. We spent the rest of our time just experimenting with the movement and then most of us used the leftover time to study, read, and work on whatever else we needed to do.

I think I need to spend some more time reading in the textbooks.

Tomorrow, I have classes and the lab for Rad Intro & Patient Care between 10am and 4pm. I’ll also expect parking issues again tomorrow… we’ll see what happens. I also need to get the paperwork done for clinicals since my first clinical is Thursday. THAT is one part I’m really looking forward to.

Tags: 1st Semester, RAD-111 by John Setzler
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Augusta GreenJacket’s Bobby Felmy makes a head-first dive into third base against the Hickory Crawdads - Photo by John M. Setzler, Jr.

I started my journey along the Road to Radiography this morning as my fall semester classes began at 10am. My community college has a record enrollment this semester with just over 5000 students. THIS was the first problem I encountered when I arrived at school this morning. I’m glad I got to campus about 20 minutes early, because all the parking lots were stuffed full. As the case would be, I found a parking spot, but it was on the far opposite side of campus from my classes. I guess it’s about a 1/3 mile hike from where I parked to my building. That’s not so bad normally. I can use the exercise, but it was 93 degrees when I got to school. During my last two semesters, I had classes at 7am, and parking was never an issue. I usually arrived on campus around 630am and had my pick of prime parking spots. Despite the huge parking hassle, I still made it to class with about 5 minutes to spare. I have a rolling book bag, so the trip across campus wasn’t that bad… just hot.

RAD-110 - Rad Intro & Patient Care

My 10am class is taught by Bruce James. The first day of class is never very difficult. We received the course syllabus and photocopies of all the physical and immunization records that we turned in before classes started. One of my clinical sites requires all that information, so I need to make sure I get it delivered to them around mid-September (makes a mental note to add that to his calendar). The RAD-110 course also includes Medical Terminology, rather than having that as a separate class. The Medical Terminology portion of this class will be conducted online, and it’s basically self-paced and self-taught with the textbook we purchased and the tutorial CD ROM included with it. Bruce stressed that staying on schedule with that program is important. Bruce’s MO for teaching is using PowerPoint presentations. All of the presentations are available online, so I need to go download those so I’ll have them on file here for study purposes.

Today’s class discussion was “Infection Control & Aseptic Technique.” For the most part, this discussion was terms and definitions, along with discussion of the Cycle of Infection.

RAD-111 - Rad Procedures I

My 11am class is taught by Teresa Fletcher. The first part of this class was much the same as the previous class. We received a syllabus and discussed the course schedule. Teresa also uses PowerPoint presentations, but as far as I know, those aren’t available online. She gave us printed copies of them. I need to make a note to ask her if we can get digital copies of those. Today’s lecture in this class was also a lot of terms and definitions dealing with body positioning and planes. The great thing about this lecture is that very little of it was new. Most of it was covered in my Anatomy & Physiology classes from the last two semesters.

Half of my class has the 3-hour lab for this class on Monday (today) and the other half has the lab on Tuesday (tomorrow). I’m in the Tuesday group, so my Monday is rather easy with a 10-Noon schedule.

Daily Objective:

I have a lot of free time today since I’m not working tonight. My objectives for today are to get the online orientation and biography completed. I also want to work through the first week’s assignment in the Medical Terminology book. I have reading assignments from both classes that I will start on, and I’ll make my study flashcards for everything that we have covered so far.

Tags: 1st Semester, RAD-110, RAD-111 by John Setzler
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Angel Trumpet - © 2007 - John M. Setzler, Jr.

 

Over the summer, I found an interesting new website system called NING.COM.  This system allows individuals to create social networks similar to Myspace and FaceBook, but the networks are setup for people who have common interests in mind.  I created one for Radiography Students that I thought might be a fun and entertaining way to meet other people who are in Radiography School.  This network is an excellent place for collaboration and discussion of the topics that we will be learning as we progress in our studies.  The link to the site is:

http://radiography.ning.com

If you are a Radiography student, you might be interested in joining this site just to see what happens.  I just launched the site tonight, but I’ll be inviting my own classmates to join when I see them on Monday.  I think it would be great to have a lot more people on the network as well.  It’s free, and it could be a lot of fun and a GREAT resource if enough people got involved in it…

I hope to see you there :)

John M. Setzler, Jr.

Tags: Websites by John Setzler
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Patient Care in Radiography: $56.00

Introduction to Radiologic Sciences and Patient Care: $58.00

Merrill’s Pocket Guide to Radiography: $29.25

Medical Terminology: A Programmed Systems Approach: $90.75

The Radiography Procedure and Competency Manual: $37.25

Textbook of Radiographic Positioning and Related Anatomy: $146.00

NO PICTURE AVAILABLE

 

Radiographic Positioning and Related Anatomy Workbook and Lab Manual: $74.00

This list ends the REQUIRED texts for my classes. I’m not sure if these books are good for multiple semesters, but I’m sure that some of them are. The Grand Total with tax on the required texts is:

$525.64

Additional items that I purchased while in the bookstore:

Mechanical Pencil: $3.50

Extra Lead for Mechanical Pencil: $2.00

Extra Erasers for Mechanical Pencil: $1.25

Four Sharpie Highlighter Pens: $4.00

Bantam Medical Dictionary: $7.50

Academic Year Day Planner: $4.50

1″ 3-ring zipper Binder: $16.25

Three wirebound notebooks: $10.50

Accessories Total:

$52.97

Grand Total spent at the bookstore today: $578.61

In past classes, with a few exceptions, I have been able to sell my books back to the bookstore at the end of the semester for up to 50% of what I paid for them new. These books, however, will remain in my library for reference. I also kept my Anatomy & Physiology book ($168.00) from the two semesters of that class I had last year.

Thank God for Pell Grants!

 

Tags: 1st Semester, Preliminary by John Setzler
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