Marker Placement

Greg's 46th Birthday

I’m working on comping my L-spine and C-spine routines right now. My positioning technique is good, but I’m running into problems with marker placement. In my last clinical rotation, I learned one way to do it, but I’m being taught a different way at my new clinical site. Actually, in my last two clinical rotations, I have used the same marker placement technique for the L-Spine series. I had been taught to use my left marker on every image, which makes sense. My mind wants to use the right marker on the RPO, but consistency wants me to use the left marker, as do the people I have been working with in clinical. At my current site, they prefer that I use the right markers on the AP Sacrum, AP L-Spine, RPO, and LPO views and then switch to my left marker for the lateral and the L5-S1 spot. I had another shot at the L-Spine comp today, and the only error I had was a clipped marker. My positioning was fine, so I expect to get that comp completed this week. My positioning on the C-Spine routines has been good also, but I’m clipping markers there too. I have to get more aggressive with my marker placement on those. I always have my marker on the bucky, but I end up losing it when I collimate. I’ll get it sorted out :)

Fireworks and Test Prep

I survived my first week back to school for the summer term. My schedule this summer is the most difficult I have had so far where time is concerned. I’m going to have to make some changes in my personal routine to cope with the additional time in class and clinical. That will take a little getting used to.

The video clip here is from the fireworks show at the Hickory Crawdads (Single-A minor league affiliate of the Pittsburgh Pirates) baseball game on Friday night. I’m still having fun with the video camera :)

I have my first test in RAD-122 on Wednesday, and it covers a good bit of material, but I think I’m going to be ready for it… hopefully. This instructor is the department head and his test questions are often quite tricky. I got my first B since I started back to school in his RAD-121 class during the spring semester. I was close to an A, but didn’t quite make it. My average was somewhere between 91 and 93, but I don’t know exactly what it was.

I’m out of school today for the memorial day holiday, but I have my normal clinical rotation tomorrow…

Technique Charts

Old Harley

One of our areas of study during the first week of the summer semester is technique charts. One of my objectives this semester is to start building a reliable technique chart. In order to do this, I want to measure the thickness of some body parts that I’m imaging and record the exposure technique that goes along it whenever I come across exposures that I think are really good. This will start to give me a baseline to use whenever I’m not using automatic exposure controls. My first hurdles to this project were that no one knows for sure what the screen speeds or bucky grid ratios are at my clinical site. I discussed this with my instructor and he recommended making an assumption that we’re using 200 speed screens an 10:1 grids, which would fall in line with what’s in use at the other facilities I have be in so far. Today when I returned to clinical, I started looking for the calipers so I could measure some patients, and there are none to be found. Without those, I can’t begin to start making any real sense of techniques. I sent an email to my instructor to ask if I could borrow a set of our calipers from the lab for a couple weeks. Hopefully he’ll allow me to do that since we don’t use them in the lab. The thickness of our phantoms never change :)

I didn’t run into much of anything intriguing at clinical today. I did learn that refuse from a barium enema can smell particularly foul, especially when the patient’s large intestine was not cleaned out to an optimum level before the study was started. I had to clean up a floor in a dressing room where a patient had ’spilled’ some barium, and it about knocked me out.

I got my first precomp on a barium enema today. I’m looking forward to getting some fluoroscopy comped this semester…

New Clinical Rotation

The Mailbox

Today was the first day in the new clinical site, and I hit the ground running with an 8am double contrast barium enema. There’s an old saying that I like to remember occasionally that says: “Eat a bullfrog first thing in the morning and nothing worse will happen to you for the rest of the day.” I guess the same holds true for getting the barium enema out of the way early…

I’m really going to like this clinical site. I worked with two techs today who were excellent, and they both seemed to be interested in helping me with my goals. That’s always a good feeling. I expect that I’ll be able to get a lot of work done here during the next 10 weeks.

I actually got my first opportunity to comp a T-Spine today. I made two perfect images to get the new semester’s comps rolling. The only thing I didn’t care for on this exam was that this site prefers T-spines to be done on the table rather than standing. When we learned the spinal routines in class and lab, we were taught that these exams could be done either way, but in my past experiences, even though they are limited, I believe that its easier to do T-spines erect, especially for the lateral. My T-spine patient today was in for a follow-up for a T12 compression fracture. I’m also curious as to why the doctor would not want a coned-down view of the T-11 / L1 area. I did several T-12/L1 junction images when I was in the ortho office last semester.

I’m planning to start getting my pre-comps and comps on the fluoro studies this week. They do a good bit of fluoro here, and I have a lot of that stuff left to get comped.

I’m back to lecture and lab tomorrow, so I’m signing off… I have a lot of reading to do :)

We’re Underway

Clay Wedding

As the photo may indicate, I’m going to be tied up for the rest of the summer it seems. The way our summer semester works is just a bit outside of the norm. Instead of the regular 16 weeks, we have a 10-week semester. During this 10 weeks, I have two classes plus clinicals. Our RAD-122 (Radiographic Imaging II) is held during the first five weeks and the RAD-131 (Physics) is held during the second five weeks. In a nutshell, we’re covering 16 weeks worth of material in a five-week period twice during the summer term.

We jumped right into the imaging class today. We had nearly 6 hours of lecture covering technique chart development, automatic exposure control, and radiographic film. We didn’t quite finish the section on radiographic film, but we’ll be finishing that up in class on Wednesday and having our first test next Wednesday. Oddly enough, we’re out of class on Monday for Memorial Day.

I start my summer clinical session in an outpatient center tomorrow morning at 8am. Tomorrow is going to be another one of those really long days for me. My clinical runs from 8 until 3:30 and then I have to go to work around 4. I have one sports photography assignment at 4pm and another one at 7pm, so it will be around 10pm at the earliest until I find my way back home. Days like that make it very difficult to get any useful studying done. Luckily, I have a long weekend to make up for it before my first test.

As of this time, I haven’t organized my documentation for this clinical session yet, but I intend to do that this evening. In the next day or two I’ll have my goals list for the summer clinical in order. I already know that I’m hoping to get a majority of my fluoro comps completed. I’m very happy with the opportunity to be in an outpatient center at this point because we just finished up our fluoro stuff in lab at school at the end of the spring semester, and I’m ready to start working on comps for those procedures.

Hopefully I’ll be back tomorrow night at some point to post some preliminary thoughts on the new clinical site…

During the Break

I’m a little over half way through my two-week break before the summer semester starts. I have enjoyed the time off so far, and I’m looking forward to the rest of the week as well. Last week, I visited the Kangaroo Conservation Center in Dawsonville, Georgia. The above video clip shows some of that place. It was really interesting and there are over 300 kangaroos on site, as well as other Australian wildlife.

When I start back to class next Monday, I’ll be taking Radiographic Imaging II (RAD-122), Radiographic Physics I (RAD-131) and my third round of clinicals (RAD-171). My clinical rotation will be in an out-patient imaging center and I’ll be in from 8-330 on Tuesday and Thursday, and from 8-12 on Fridays for the duration of the 10-week summer session. I have all of my books ready to go. I purchased “Digital Radiography and PACS by Christi Carter and Beth Veale” on Amazon.com and saved about $8 from the school bookstore price. I also purchased “Radiologic Science for Technologists by Stewart C. Bushong” used on Amazon.com and saved about $50 from the school bookstore price. I purchased the workbook that goes along with this book new from the school bookstore earlier this week. Fortunately, my total book cost for the summer semester was about $110 with the savings I got from Amazon and buying a used book. I’ll probably start reading in these books tonight or tomorrow to get a jump start on the semester. I don’t have a syllabus for either class yet, so it would be hit and miss as to where I should start. Maybe I should just enjoy the break :)

Here’s another video clip from the trip to Georgia… This is the Fountain of Rings at Atlanta’s Centennial Olympic Park…

Here We Are…

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Friday is our last day of the semester. I loaned my camera to our head cheeze to snap this photo of my class when we attended the pinning ceremony for the graduates last night. One of our students played hookie from the pinning ceremony so there are only eight of us in the photo. One of our students in this picture is also playing hookie from clinical tomorrow so he can go fishing.

A little bit about this group…

First row - Left: Duggan - experimental remote controlled airplane pilot…

First row - Center: Amanda - hair dresser extraordinairre…

First row - Right: Wendy - YouTube model (my positioning videos) and she sucks cause she’s going to Mexico over the break…

Middle row - Left: Jason - hookie-player who is feared by fish in 5 counties…

Middle row - Center: Amber - Newlywed (i think during the break)

Middle row - Right: Chelsea - Elvis freak and the youngest member of our troop…

Back row - Left: Joan - The one everyone wants to sit next to at test time…

Back row - Right: John - by far, the sexiest member of this class, the best photographer, the best blogger, and an inspiration to all…

Not pictured: PAUL… he shouldn’t have played hookie :)

I’ll be back in a couple weeks…

Winding Up

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Wow… it’s been busy lately around here. I haven’t forgotten about my blog here and I really hate that I haven’t been able to post more regularly. When April rolls around, my work schedule gets very busy. That, on top of the school schedule, doesn’t leave me much time.

I’m in the middle of my final exams for the semester. I took the finals for the RAD-112 class today. I had the positioning exam which consisted of the GI tract and the urinary/biliary systems. I made a 99 on that exam. I also took the written exam which was cumulative from the entire semester. I’m not sure what I made on it yet, but I think I did well. I needed to make an 87 on it to get an A in the class for the semester. I should have reached that mark. Tomorrow, I have the cumulative written exam for the RAD-121 Imaging class and the final lab exam for that class as well. My grades in RAD-121 aren’t as high as I had hoped they would be, so I may end up with my first B since I returned to school this semester. This may be the semester where I stop having to worry about maintaining a 4.0 GPA. It’s nice, of course, to have a 4.0, but losing it won’t be the end of the world.

Clinical has been going well also. My current clinical site is, by far, the best I have seen so far. This hospital environment is staffed by the best techs I have met so far. Each of them is extremely qualified, and most of them have been very helpful to me in my efforts to learn this trade. My requirements for this semester were to log 300 procedures and 22 master competencies. I have logged over 500 procedures and managed to collect 34 comps. The extra comps I have accumulated will carry over to the summer semester, where I’m required to get 15, so I only need 3 more to get to that mark. My summer semester clinical rotation will be in another outpatient center. I should be able to get started on my fluoroscopy comps and pick up a few others as well during the 10-week session. I’ll be in clinical for 2.5 days per week this summer.

I’m also at a point in my program where I’m starting to think about where I would like to work when I graduate. So far, I have been in the hospital, outpatient center, and orthopedic office environments. Each of them definitely has its good and bad points, but I’m not sure where I want to go yet. Part of me wants to go into the hospital environment because of the large variety of procedures I would see there, including trauma, OR, and special procedures. The other part of me wants to work in an orthopedic office because of my personal interest in sports medicine.

This is my last week of school for the semester. I’ll finish my exams and clinical this week and then get two full weeks off before diving into the second round of the imaging class and then the physics of radiography. I’m going to enjoy a little time off…

Looking Ahead

Hickory Crawdads - Miles Durham

My second semester of Radiography school is coming to a close, and I find myself thinking about what I want to do with this education when I graduate in May of 2009. In my first year of clinical rotations, I have worked in an outpatient imaging center, two hospitals, and one orthopedic office. Those three environments pretty much cover the complete spectrum of x-ray work.

I see certain advantages of working in each of these environments. What I need is some feedback from people who work in the field and other students who have spent more time thinking about what they want to do with their education in radiography. If you read this blog, please take a few minutes when you get a chance and let me know what your opinions are on the subject of the various working environments for radiographic technicians.

Pediatrics and Spanish

Centered

I had a really interesting experience again today in clinical. Just as my day was winding down, we had an order come through for a 4-year old child. The order said that the child had fallen down some stairs, and there were a LOT of x-ray requests on the order… Chest, Ribs, Pelvis, T-Spine, and L-Spine. That seemed like a lot to me, but I’m just a student and don’t know much :) I’m fairly confident that when this sort of exam comes up on a child this age, there is some type of concern about abuse, and the doctors are probably checking for that. We set up for the exams and I went to the lobby in Radiology to get the patient.

Once I got to the lobby, I found out rather quickly that I had a challenge coming. The 4-year-old patient was waiting with his mother and younger brother, and none of them spoke any English. I have been learning Spanish, but I’m FAR from conversational. One of the most important Spanish phrases I have learned is “Yo soy un estudiante de Espanol.” Telling them that I’m a student of the Spanish language should let them know that I probalby don’t know much, but I intend to try. So, I introduced myself as clearly as I could and tried to start a conversation with the 4-year-old. That part went fairly well. He told me his name and age without much problem. Since his mother was holding a much younger brother who was sleeping, I asked the child to come with me while his mother waited behind, which wasn’t received with as much interest as the name and age exchange. I told him that all I wanted to do was take his picture and that it would not hurt. I held out my hand and said “conmigo” (with me), and he held out his hand and I took him to the x-ray exam room. I showed him the x-ray equipment and moved it around some, trying to describe what he was seeing and what we would be doing (in my best elementary Spanish). At this point, I really believe I had gained his trust quite well. He wasn’t complaining. At this point, I did need some assistance from the other techs to help hold the child in position. This is where we normally run into problems with children, and we expect it. Being held in an unnatural position by strangers in a strange environment will carry its on type of psychological trauma for a child that age. Luckily, he did very well with minimal crying and practically no struggle. When we were finished, we re-dressed him and I took him back to his mother and brother in the waiting room. The child had a big grin on his face when his mother asked him if he liked getting his picture made… He told her he had fun!

This is not some sort of huge success for me, but I was happy with the outcome. Pediatrics is one specific area I have considered in the future, and experiences like this one, even though it’s rater rare, reinforce that for me.

I do intent to further my studies in Spanish in the future as well. I started taking Spanish at the school last year, and I completed two semesters of it before I gave it up. I really enjoyed the class and the teacher was great as well, but the learning pace was painfully slow. I decided to give the Rosetta Stone software a try, and I’m really enjoying that so far, even thought I haven’t had a lot of time to spend with it lately. I guess that is one drawback of taking the self-paced learning as opposed to a classroom environment. The strict schedule of the class would keep me more on track and not allow me to push it aside. I would not, however, have time to take the classes while I’m in the radiography program between those class/clinical hours and work. That being the case, I’m going to work my way through the Rosetta Stone program and then re-evaluate what I want to do with my Spanish education after I graduate from the Radiography program. I think being conversational in Spanish would be very advantageous to me in this field…