Road to Radiography

This is the first time since I started this blog that I have skipped any school days when it comes to writing entries here.  After the Thanksgiving break, I just decided to take a couple days off of the blogging so I could focus on the tasks I have at hand.  We don’t have any tests this week, but I have two next week and at least two more before our final exams.  That being the case, I’m going to be covered up for the next three weeks or so.  I have clinical tomorrow where I am going to do my best to get at least one more comp completed.  After thinking about it, I am going to talk to the techs and see if I can’t get them to help me get my KUB, Erect Abdomen, and Portable Chest completed as soon as possible.  I really need to get these knocked out because I’m most likely going to be in an orthopedic office on my next rotation in January.  I’m really looking forward to that because I’ll have completed my lower limb lab tests before I go there.  I hope to complete a lot of master comps when I find my way into the ortho office.  This lower limb study is dragging out.  We have completed the actual training on it, but we can’t test off in lab until exam time, because it’s our final exam in lab.  We can’t knock it out early, so we get to simply practice it in lab until mid December.  The pace of the positioning class seems slow sometimes, but in a case like this where we are getting a LOT of practice time, I should be able to easily ace the positioning test.

On a side note…

I was out photographing a high school wrestling match last night, and I was witness to a rather severe injury.  It appeared that one of the wrestlers received a severe dislocation of the scapulohumeral joint.  His shoulder was a complete mess and I thought I could see the lump on his shoulder where the head of the humerus was trying to protrude.  They didn’t move him from the wrestling mat until the EMS people arrived.  I felt bad for the kid receiving that kind of injury, but I would love to see the x-ray.  Even though I’m working in a hospital environment right now, I’m not seeing a lot of trauma, especially more severe examples of it. 

Oh well… such is life… I’ll be back tomorrow to talk about any comp advancements I should make at clinical… ;)

Tags: 1st Semester, RAD-111 by John Setzler
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I just wanted to take a moment to let you know about a rather nice bargain I was introduced to this week.  If you are using the Microsoft Office software suite, or any part of it as a student, Microsoft is offering a promotion where you can purchase the Microsoft Office Ultimate 2007 software suite for $59.95.  Here is the link to the site:

The Ultimate Steal

This is a legitimate offer from Microsoft, and I have taken advantage of it myself.  I have been using Microsoft Office 2000 since it was first introduced, so I think now is a good time to upgrade.  The end-user license agreement also allowed me to install the software on my home desktop computer as well as my laptop system. 

Tags: 1st Semester, Miscellaneous by John Setzler
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Tomorrow is our written test on the lower limb anatomy and positioning techniques.  I started studying for this yesterday, but I still feel overwhelmed with the amount of information I need to know in the morning.  I’m going to be grinding on this until the wee hours of the morning in hopes of getting a great score on the test.  I need a good grade on this one since I got an 84 on the last test.  I’m going to keep things short today and keep on studying.  Tomorrow is my last day this week before our Thanksgiving holiday.  I get the rest of the week off, including clinical day…

Tags: 1st Semester, RAD-111 by John Setzler
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Today was clinical, once again.  I’m really growing fond of Thursdays and starting to look forward to next semester when I’m in clinical 2 days per week instead of one.  I’m still stuck at 2 of the 4 master comps I need for this semester, but I’m on the edge of a couple comps.  I have all the pre-comps completed for the KUB, Portable Chest, and Pediatric Upper Extremity.  I am struggling with portable exams right now.  I may need to ask one of the techs to spend a little extra time with me on those.  I have made a couple attempts at comping the portable chest and haven’t gotten an image that I’m totally satisfied with to turn in for a master competency.  These portable exams are difficult.  I’m still making progress though.  I’m getting a few pre-comps here and there, so the comps will start to come more quickly.  I really wish I could start pre-comping my lower extremity exams, but we won’t test off in lab on those until December unfortunately.  I have done a lot of foot, ankle, and knee exams, and I’m quite comfortable with those, but I can’t count them as pre-comps yet.  I suspect that I’ll be rotating to an ortho office in January, so I should get a ton of opportunities to comp upper and lower extremities, as well as the spinal exams.  We start learning the spinal stuff at the beginning of January, and those exams are very common everywhere I go. 

I did a foot and ankle exam on a patient today who was complaining about pain in her foot, and her ankle was visibly swollen, but not extremely swollen.  When I looked at the radiographs, I immediately noticed a bone spur that was hook-shaped and approximately 1.5cm long, with the hook pointing toward the toes.  I don’t know if that was the cause of her problems, but it certainly didn’t look comfortable. 

I’m glad I get to sleep in tomorrow…

Tags: 1st Semester, Clinical by John Setzler
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Our Patient Care & Intro to Radiography lab today consisted of a 3-hour round-table discussion about ethics in healthcare.  We were presented with lots of scenarios regarding ethical decisions that we will be faced with in this field.  A lot of these scenarios were based on situations where the patient asks you questions that you can’t really answer easily.  Here’s a summarized example of one of the scenarios:

Mrs. Smith shows up in the radiology department for a post-op abdominal x-ray.  She starts asking you questions like “What do you think of Dr. Jones (the surgeon) because I have heard he’s not so great and that he has a history of leaving surgical instruments inside patients?  After you do her abdominal x-ray and view the images, you see a hemostat and a couple sponges that were left behind in the patient’s abdomen.  You show these images to the radiologist and he requests lateral views to go along with the AP views you have already made.  When you return to Mrs. Smith, she wants to know why you are having to do different views and what is wrong that you are having to do that?

The first dilemma in this scenario is how to answer Mrs. Smith’s first question about performance issues with the surgeon.  It’s really a no-win situation for the tech.  Lengthy discussion about this issue didn’t really lead to a definitive answer either.  If you agree with Mrs. Smith, you are possibly guilty of slander.  You also can’t easily tell her that Dr. Jones is working in her best interest and that he’s a great surgeon.  You also can’t tell her that you saw a hemostat and sponges in her abdominal x-rays.  There are some reasonable solutions to providing a response to her second set of questions though. 

These situations are just difficult to handle.  As a tech, our ‘tongues’ should be sort of ‘tied’ here, but you can’t just ignore a patient’s questions.  Learning how to deal with this is part of the learning process…

Tags: 1st Semester, RAD-110 by John Setzler
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We started learning the physical positioning of the lower extremity in lab today.  We covered these procedures:

AP Foot

AP Oblique Foot

Lateral Foot

Calcaneus (Axial)

Calcaneus (Lateral)

AP Ankle

Ankle (AP - Mortise)

AP Oblique Ankle

Lateral Ankle

AP Tibia-Fibula

Lateral Tibia-Fibula

I think I’m going to create an Excel Spreadsheet on positioning technique for my own use in studying, and I’ll probably share it via this website as well.  I’m planning to use the following columns:

PART/VIEW - FILM SIZE - TT/BUCKY - CR & DIRECTION - POSITIONING TIPS

I’m not sure what the best way to break this down will be… maybe I need to add some columns… your suggestions would be appreciated :)  If I come up with something I like, I’ll go back and add all my previous positioning to it, and continue it throughout my program…

Tags: 1st Semester, RAD-111 by John Setzler
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We continued our study of lower limb positioning today in the RAD-111 class.  We have covered from the toes to the distal and mid femur in the book so far.  We’ll start the physical positioning process on those tomorrow in lab.  I don’t think we are actually going to practice toe positioning in lab though.  We will need to know those for the written test though.  There are a lot of positions to deal with in the lower extremity, and I’m not exactly sure how I’m going to memorize all this yet.  We’ll be tested on Tuesday of next week and I’ll have to have ‘mental’ knowledge of all of it by then.  Our last written test in the positioning class was my worst grade so far this semester.  I got an 84 on that test, and I’m confident that it was because of the number of positions and detail we had to cover.  This unit has even more positions, so I guess I need to start working on my strategy for learning all of it with a high level of confidence.  I think I’ll make another chart of all the lower extremity positions and work from that.  I’ll probably try to post that list here over the weekend…

Tags: 1st Semester, RAD-111 by John Setzler
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My day in clinical got off to an interesting start.  Just as I came in and got my lab coat on, one of the techs told me to come to come with her for a portable chest.  I followed her to the ER and we just stopped.  I asked her where the patient was, and she told me that he was coming in an ambulance and would be here any minute.  When they rolled the patient in, I knew I was in for an experience, because the paramedics were still doing chest compressions on him.  The patient was flat lined and had been that way for 30 minutes or longer.  After they got him in the code room and had him tubed, we did our chest x-ray.  His eyes were open, his body was cold to the touch, his stomach was very bloated with air, and his skin was starting to show signs of cyanosis.  We left and went back to the radiology department…

About 45 minutes later, we got another call from the ER to come do a chest x-ray, so we went back.  The patient who had been ‘dead’ was now on a ventilator and had a heartbeat.  I was amazed.  Whether or not this patient survives is still up in the air.  If he does survive, I assume that some amount of brain damage will have occurred after being flat lined for that long.  The paramedics were not sure how long he had been down before they got to him.  The patient was air lifted to another facility for further treatment…

I guess this is a scenario that I’ll get used to eventually :)

Tags: 1st Semester, Clinical by John Setzler
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Well, I did not win the chili cook-off, but I ate some chili and a good time was had by all :)  Maybe next year…

We had a great lab today in our Patient Care & Intro to Rad class.  The clinical instructor from our school’s respiratory therapy program came to teach us about oxygen therapy and how to deal with patients who are on oxygen.  Rad techs often have to deal with patients who are on oxygen, so knowing how to connect and disconnect the oxygen, as well as the masks is rather important.  We don’t remove the oxygen masks and lines from a patient unless it’s absolutely necessary though.  We sometimes have patients come through the department that are on tanks that need replacing though, so being able to do that is critical.  So we learned about the various types of oxygen delivery devices and how they work, and how to install regulators on tanks.  The final item we learned is how to calculate how much time is left on a tank at a given flow rate.  I’m glad we had this instruction, and now I feel confident working with patients on oxygen. 

I’ll lose a little time in tomorrow’s clinical.  I’ll be leaving 90 minutes early because our instructors are taking us out for lunch.  I do hope to get at least one more comp tomorrow though :)

Tags: 1st Semester, RAD-110 by John Setzler
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I just spent the last few hours working up a large pot of some good red chili.  I sampled it and it’s not bad.  I love chili, but to be quite honest, chili doesn’t get REALLY good until it’s been frozen and reheated.  I’m not going to be able to freeze this batch for the chili cook-off because I have to take it to school with me tomorrow.  If I think about it, I’ll take my camera with me to school tomorrow and shoot some more photos…

Since we have no classes today, it was a good day to cook a little…

Tags: 1st Semester, Miscellaneous by John Setzler
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