Road to Radiography

I’m back in the outpatient imaging center for a couple weeks during this clinical rotation, and I have made some more progress.  After many months of clinical assignments and wondering if I would ever get a chance to comp a skull exam, one finally came up this week, and I knocked it out on the first try.  The only oddity of this comp attempt was that my patient was a 6-month-old, and I had to have another tech in the room to hold my patient after I positioned him and aligned the tube.  The patient diagnosis was Plagiocephaly, which is something else I had never heard of.  I was just excited to get the chance to perform the exam for the first time. 

I also got my first chance to do a master comp on the Barium Enema exam today.  Everything went perfectly as far as the images were concerned, but my marker managed to get coned off one of the images.  Unfortunately, that is a show-stopper.  I’ll get more opportunities to do this, but I really wanted to get it done on this particular patient.  The patient was ‘average’ in size, which makes the imaging process a lot less difficult.  I don’t get the luxury of average sized patients in very many of my fluoroscopy exams.

I have been doing the upper GI studies solo with the radiologists lately, and I’m pretty comfortable with those.  There isn’t really much to them… I just gotta get that BE comp and I’ll be quite happy :)

Tags: 4th Semester, Clinical by John Setzler
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Since today is Halloween, a few of my fellow students decided to get into the spirit by dressing up for the occasion. Chelsea, our favorite Elvis fan pictured above, brought out the wicked gothic witch costume. When our instructor arrived, she sent out for McDonalds breakfast for everyone and then we finished our lecture on mammography. Two of my classmates decided to dress up like our instructors, which was quite entertaining…

Amber tried to pull off the Angie look with some amount of success… Paul, on the other hand, went after the Bruce look…

It’s a little difficult to appreciate Paul’s effort unless you can see Bruce beside him. Bruce doesn’t teach on Fridays, so we decided to have a field trip out to Bruce’s house for some mid-morning trick-or-treating…

Paul has Bruce’s favorite delicacy in his shirt pocket… a vending machine honey bun…

Wendy doesn’t have to work very hard to pull off the Sara Palin look…

It was an interesting Friday to say the least…

Tags: 4th Semester, RAD-211 by John Setzler
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I finished my operating room special rotation this week, and I really enjoyed it.  It was an interesting change of pace from the normal grind of radiography work.  The operating room work all involved either portable or C-arm procedures while surgery was in progress.  I worked with one of the hospital staff techs for three days during this rotation. 

I think the two most interesting procedures I was involved with were both endoscopy procedures rather than surgical.  The first of the two was a bronchoscopy procedure where the scope was placed down the trachea into the right and left mainstem bronchi, and from there into the further subdivisions looking for various items.  The only thing I didn’t like about this procedure is that I didn’t really know what the patient’s condition was and what the doctor was looking for.  It was interesting to watch the biopsy process during this procedure though.  Several were taken from various locations within the bronchial tree. 

The second procedure was another endoscopy procedure called a retrograde pyelogram.  The patient had a rather large kidney stone that needed to be removed.  The urologist performing the procedure was expecting to use a laser lithotripsy procedure to remove the stone, but it didn’t happen unfortunately.  I was looking forward to seeing it.  When the stone was located with the scope, they attempted to grab it and pull on it a little, and when they did, the stone broke into three pieces, and they were able to remove each of them individually without using the laser to break it up. 

Some of the other procedures I got to work were a lumber expansion, a cervical laminectomy, a hip replacement, a retrograde cystogram, a hip pinning, and a bunionectomy.  The bunionectomy was rather interesting because I was close enough to the surgeon that I could watch exactly what he was doing during the procedure.  Watching the bone being shaved off with a saw made my own foot hurt :)

I met some nice people during this rotation also.  I had a couple of surgeons who didn’t mind giving me insight into what was going on.  They knew I was a student and were happy to talk with me.  It did occasionally feel strange to me when a surgeon would start a conversation with me while the surgery was in progress.  Those moments did make me more comfortable in the environment though…

Tags: 4th Semester, Clinical by John Setzler
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The fall break is over and I’m back to the grind once again.  My new clinical rotation is in an outpatient center.  My first three days back in clinical this week have been a little challenging for some reason.  My x-rays were good with a couple exceptions that bothered me just a little bit.  After spending 8 weeks in ortho, there are quite a few common x-rays that I simply haven’t done, and getting back to those in the outpatient center has made me have to think a lot about each image once again.  Out of all the x-rays I did this week, the only re-takes I had were on chest x-rays.  I’m almost to the point of doing all chest x-rays on men with the 14×17 IR turned crosswise unless I can see light on both lateral margins of the chest.  The re-takes I did this week were all on RA chest x-rays of male patients where I had clipped a lateral margin of the lung.

One of the x-ray rooms at this site has a system that I also find difficult to use.  My very first clinical rotation in the program was at this same site, but I didn’t get to use this particular equipment at that time.  I’m having to learn how to position and align this particular tube and table.  It doesn’t detent easily either, so I plan to spend some time working on that issue on my next visit to the site.  I won’t be at the outpatient center next week because I have a short special rotation in the operating room at one of the local hospitals. 

The worst thing that happened to me this week was that I lost my Moleskine notebook that I used to keep track of my procedures and other notes that I take in clinical.  I lost it sometime around lunch time on Monday.  I use this notebook to record all of my procedures along with the patient medical record number for my logs that I have to turn in at mid and end of the semester.  I usually transfer this log information to the computer after each day in clinical, so I only lost 6 or 8 procedures that I had done before lunch time on Monday.  I had other very useful notes about positioning techniques written down in that notebook as well, so I’ll have to re-write that stuff in the new replacement notebook. 

Speaking of the notebook, if you aren’t familiar with the Moleskine, I highly recommend checking them out.  I find them to be the perfect companion for notes in the clinical environment.  The only problem I have with them is the cost.  The real Moleskines are $10.95 each at most places where you can buy them.   After using several of the real Moleskines, I stumbled across a clone version of them at Walmart made by a C.R. Gibson called “Markings” that are half the price of the Moleskines.  By some standards, $5.50 is still expensive for a pocket notebook like this, but I, more than happily, pay the price because I like the notebooks.  I think if you try one you will never go back…

Tags: 4th Semester, Clinical by John Setzler
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Tomorrow (Wednesday) is my last day of clinical before the mid-term break. I’ll be finishing up my ortho rotation and moving into an outpatient imaging center starting on October 20th. This outpatient center is the same site where I had my very first clinical rotation, so I’m sorta excited about going back there once again. Hopefully the staff technologists will be able to recognize some amount of improvement in my skills.

Looking over my list of comps that I can still get, there are a few that I might be able to pick up at the outpatient center. I have all 15 comps that I need for this semester and one additional to carry over to next semester, so I’m good to go in that arena. Here’s what I hope to get in the second half, and the barium enema is a MUST while I’m at the outpatient center:

Ribs (required)
Barium Enema (required)
Orbits (elective)
Cystography/Cystourethrography (elective)
Pediatric Abdomen (elective)
Esophagram (elective)

I’m not sure if I’ll get all or any of these with the exception of the barium enema. I was told I’d get rib exams at this site. I don’t see very many of those, so hopefully I’ll see some soon.

Tags: 4th Semester, Clinical by John Setzler
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I finished up my second-shift rotation last Wednesday and it was fairly successful. I picked up four more of the required comps I need for graduation, which just leaves six more on the list. I hope to get a couple more of those knocked out this semester also.

I’m going back to the orthopedic office for one more week before the mid-semester break. I’m going to try to pick up a nerve block comp on Tuesday, but this is going to be a short week in clinical. Tuesday will be my only full day, so hopefully I will be able to get it then.

We’re doing skull work in the positioning class this week, so I’ll need to put some time into that before Thursday as well.

Tags: 4th Semester, Clinical, RAD-211 by John Setzler
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I’m seeing a lot of sports injuries on my second shift rotation. I had three different patients tonight with padded football pants. One of them had the worst femoral fracture I have seen in my experiences. His fracture was down at the condyles, in the thickest and most dense portion of the femur. I think he ended up in surgery later in the evening. One of the others had a fractured radius down near the wrist, and I can’t remember the exact injury on the third patient. Once again, most of my patients on second shift were younger people.

I am enjoying the second shift rotation.  I’m beginning to get the hang of modifying procedures to accommodate a trauma patient who can’t get into a standard position.  I just think these routines may take a little more practice before the intuition on my part begins to solidify. 

The people I’m working with are excellent as well.  One of the techs that I mostly work with is very helpful and a good teacher.  His willingness to teach us is making this an excellent experience. 

I was also able to claim last night’s trauma cervical spine as a comp, so that was also a nice addition to my requirements.  Hopefully I’ll pick up a couple more required comps before my second shift rotation is over…

Tags: 4th Semester, Clinical by John Setzler
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Today was my first day of second shift rotation.  One of the first things I noticed was that most of the people coming in for x-rays were younger folks.  I had lots of ankles, feet, and hands, with a few spines and chests as well.  I did manage to get the pediatric chest comped this evening as well.  I should have gotten my cross-table C-Spine as well, but I had to reshoot it because I coudln’t see down to C7.  I’m not sure how difficult this shot will be to get in most cases.  I could not suppress the patient’s shoulders enough to make C7 visible, so I had to shoot a Swimmers to get it. 

The only out-of-the-ordinary thing I saw tonight was a patient who had swallowed a battery.  It was sitting in her stomach.  I guess that battery might pass on it’s own, but it may also involve surgical removal at some point.  I don’t know how long a battery casing will last in the GI tract.  The chemicals inside the battery would certainly be dangerous if they leaked out into the GI tract.  An alkaline battery such as a Duracel or Energizer contain zinc chloride and ammonium chloride, as well as manganese dioxide. 

This second shift rotation has an upside and a downside for me.  The upside is that I can sleep later than normal since I don’t have to be in until 3pm.  The downside is that I’m missing out on work opportunities and my paycheck for September is gonna be quite short.  Send in your donations now :)

Don’t forget to check into the chat room if you get a chance :)

Tags: 4th Semester, Clinical by John Setzler
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I start my two-week second shift clinical rotations on Monday. I’m hoping to pick up a few of the required comps I need during this time. Out of the 10 required comps that I still need, I might be able to pick up these if I’m lucky:

• Ribs
• Humerus
• Skull
• Paranasal Sinuses
• Trauma Cervical Spine
• Portable Abdomen
• Trauma Shoulder (Scap-Y/Trans-T)
• Pediatric Chest

I still need two more elective comps also, and I might be able to pick up some of those on second shift as well.  Here are a few of the possibilities I might encounter:

• Sternum
• Upper Airway Soft Tissue Neck
• Scapula
• Facial Bones
• Orbits
• Zygomatic Arches
• Nasal Bones
• Mandible
• Pediatric Abdomen

I would love to come away from this special rotation with at least 4 or 5 comps in the bag.  Hopefully it will be productive…

Tags: 4th Semester, Clinical by John Setzler
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Greetings to everyone…

I set up a chat room for Radiography students if anyone is interested in participating.  It’s free and open to the public.

Radiography Student Chat

Feel free to stop by and hang out…

Tags: 4th Semester, Miscellaneous, Websites by John Setzler
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