Saturday, August 1, 2015

DVT, A Personal Diary

My wife came into the kitchen last Tuesday saying her calf was hurting.  I told her that he miniscule varicosities can be painful.  We both went to work.  I get a call at my place of business, which is a small hospital in south Texas.  I see that call is from my wife.  I was sitting at the front desk of the X-Ray department.  (Yes we call it X-Ray in south Texas), other places call it Radiology....and since we have CISCO phones, I saw it was my wife calling.  Cell phones do not work in our hospital.  Probably for a reason.  Too many people would be playing candy crush or angry birds.

She was at a large hospital in Houston in the ED.  I almost had a technicolor bowel movement.  She told me she had a pulmonary embolism.  Her O2 SATS were 82% on admission.  The did a leg U/S, and a chest CT.  Great. 

Problem was the source of embolism was her peroneal vein in her left leg.  Atypical!

Darn, Heck, and H-E-double L!

I clocked out, and went to lend a feeble hand in her admission process:  Wheeling her up to the fourth floor into a private room. (Nice)  And we got her some food.  My wife is a nurse, and is not a typical DVT patient.  She is lithe, active, and determined to have her way.  She gave me a list of stuff to bring from the house.  The list included pink slippers, a favorite pillow, toothbrush, comb etc.  I went home to gather things up and grabbed our son and gave him the news.

"Mom had SOB, and palpitations, and pain in her calf.  She has a blood clot in both of her pulmonary arteries" 

"What" said my son?

I explained it to him, and he shed tears.  I told him it would me OK.

We sprung her from the hospital, and she immediately started going through the discharge bills.   She found she was charged for two units of whole blood which she did not get in the IV.  Her OP prescriptions hit us like boulders: Coumadian, and a shot form of low-moleculoer weight form of heparin.  The shots would cost $275 a week.  Insurance did not cover it.

My wife is home now, and the doctor bills are mounting.  She has a pulmonologist, a blood doctor (Haematologist), PCC, and an endocrinologist. 

My wife is a nurse, and she is pissed off.

Discussion:  Most DVT arise from the above knee veins.  Her DVT is strange.  the peroneal veins are typically small veins that run on the inside of the calf, but they are deep veins anyway because they are accompanied by an artery.  Hat's off to the Sonographer that grabbed this one.  Sadly, many poorly trained sonographers do not scan the PTV's, or the peroneals.

She is doing well.

Sorry for the lapse in posts. it has been an interesting summer.

TJW

Sunday, June 14, 2015

Ultrasound Sonography, version Two, Sonographers Blog.

I have been away dealing with family issues. When you have a wife and a family, all stuff goes wrong at some point.  I have been away from my Blog for a bit dealing with wills, and my older Mother and Father.  We are getting ready for them to be dead.  Such is life.  I need new glasses.  I need to see with my profession.  I am a Sonographer.  I depend upon my eyes to help patients.  I will schedule an eye examination this week. It pretty much sucks to get old.  Thank You all for reading my BLOG.  I love you!  BTW, the web site SONOWORLD is no longer free.  You must pay them a fee to read anything.  LOL.  I will not pay them a fee.

I understand that ultrasound microscopes have value.  Here is a link

http://search.sidecubes.com/?category=Images&p=1&st=nt&ic=1&q=ultrasound+of+cancer

Blessings

TJW

Saturday, May 16, 2015

BONES

Bone fractures occur.  I hate to say it, I am getting old, and I had a rib fracture.  It hurts to this day.  I pray for the wonderful people who fall down and injure themselves every night and day, and end up in the ED for medical care.  They are in horrid pain, I know.  I have had a fractured humerus, toe and rib.  Pain pills are not a long term answer..  I have long known a fractured rib hurts like Satan's breath.  Perhaps we can help the older people with a Sonogram of the bone.  X-Rays by Roentgen are great, but an ultrasound can be efficient.  Here is the article  TYVM  SonoWorld, andd SCIENCE 20


A study of portable ultrasound in detecting the presence of minor fractures in patients showed that 85% of patients with a fracture confirmed by X-ray had injuries detected through ultrasonography.

You'd still want a radiographer to rule out fractures but emergency clinicians could rule in fractures using ultrasound images, they conclude.

Ultrasound is a high pitched sound wave generated at a frequency of more than 20,000Hz in air, though the frequency changes depending on the density of the objects through which it passes.

THANKS Science20

Been Gone For a Few Days.

Sorry, I have a family, and I have issues.  I think everyone knows what it is like to prepare for deaths.  My Mom and Dad are in the 80's.  We have been going around with the bottom feeders (attorneys).  Enough.

Upper extremity U/S is great at ruling out CLOTS!

Shoot I have known this for years, and so have many of the great doctors I work with are great.  Here is an article from www.sonoworld.com to put this issue at rest.  Thanks Sonoworld!


Single whole-arm ultrasound can rule out upper-extremity deep vein thrombosis with a lower rate of repeat screening than a multi-step strategy using clinical scoring and D-dimer testing, researchers reported.
Ultrasonography has largely replaced venography for the diagnosis of upper-extremity deep vein thrombosis (UE-DVT), despite the absence of diagnostic management studies showing the practice to be useful for determining which patients need anticoagulation therapy, researcher Michelangelo Sartori, MD, PhD, of S. Orsola-Malpighi University Hospital, Bologna, Italy, and colleagues wrote online May 11 in JAMA Internal Medicine.

THANKS SONOWORLD, and JAMA

Sunday, March 8, 2015

GO-PRO FOR THE FAMILY

My wife bought a basic go-pro for the family.  We are debating how to use it.  My thoughts are in the washing machine for a real view of how clothing is washed.  It is water proof.  Be safe  TJW

Get a go pro for the family, at least to document any car wreck you have for the insurance adjusters.  Russians do.  :)

NURSES ARE GODS

I am usually a very scientific, dry humor blogger.  I never show my humor in my posts, but being married to a nurse I will break my Draconian rules at least once.  As a sonographer, I deal with many people who are in pain, ill, or just looking for some opiates.  I have had my share of accidents on the examination table.  Sonographers deal with the ill patient like nurses, but on a limited basis.  We do not respond to the call bells, or deal with 12 hours of "I need my PAIN SHOT".

Sonographers are in awe of the God we call a Nurse.  Here is a post I hope you all share.

Do you remember what weekends are? Are you so immune to undesirable body fluids that you no longer have a gag reflex to suppress? Can you hold in a pee for hours, if your hectic job requires it? If you answered yes to all three questions – you’re probably a nurse.
Now, everyone thinks they know what a nurse is: the romanticised versions on Grey’s Anatomy probably help form the disastrously erroneous illusion they’re all sex-mad bimbos. Let’s be straight, though – if there was one thing the nurses in TV and movies wouldn’t be interested in (if they portrayed the profession realistically), it’d be sex.

Thanks to Nina Cresswell, and www.whatculture.com

 http://whatculture.com/offbeat/13-problems-only-nurses-will-understand.php


Thursday, March 5, 2015

Sorry To Be Out

Out Of The Office

I am sorry, I have a family.  I will begin posts again after a family issue is resolved.  Many of you have kids and know what happens when we have issues with kids.  We get distracted.  For days, weeks, months.  I am beginning to come back to the blog to take care of the insatiable appetite of my buddies on this topic of sonography.  The topics are many.  I have much work to do.  I will not make posts at work because it is not allowed. Employers frown upon blogs.  So Be It.

I have a few topics to post, as a Sonographer.

The lion is a funny, but a real thing that a taxidermy person made poorly.  I l love it!

I cannot find the link to credit the person who took this picture. 



Bats.

They send out ultrasonic pulses where prey is in space. This is basically what bats do.  They use echolocation for the food with sound.  The pulses are ultrasound.  They tend to find a meal with ultrasonic waves of energy. Sound waves. Like we use our car horns to tell another person to move at a stop sign.  They have misshapen ears, and crazy noses, and they are for echo locations.  The noses and ears are for the radar of the prey they feed on.  Insects are primary, though many feed on fruit, and some on cows for blood.

” That’s how the science podcast Invisibility recently described Daniel Kish, a blind man who taught himself how to navigate by echolocation. But their description slightly misses the mark. While both humans and bats can paint visual landscapes from echoes, the pointy-eared flyers possess a stark advantage: ultrasonic sound."  

Interesting:    Many humans who are blind use clicking noise they generate with the tongue to find a way around.  Bats do it.  Humans should be able to adapt.  And they have.  This is interesting article.

Here is the link  TY
 http://www.popsci.

Blessings  TJW