Tuesday, April 15, 2014

Healing Bones With Ultrasound

Here is a great article, and something I have prayed for a long time.  Healing broken bones.  Let me be specific:  speeding the healing of broken bones.  In 2004 I tried something stupid.  I tried to learn along with my family the precarious art of roller blading.
I failed.  I fell and broke the surgical neck of my left humerus, and required 3 surgeries, including bone grafts from my pelvis.  Needless to say the recovery was full of the usual drooling in an arm chair watching day time TV which is why our cats and dogs go crazy when you are at work.  No wonder they like the fuzz toys we bring them home from the store to cut down on the Prozac we medicate them with.  My wife and son were great in coddling Daddy while he healed.  I had a non-union fracture though,and required surgery to harvest bone from my ischium (Part of the pelvis bone rich in hemopoetic tissues).  This required further convalescence, as you may guess, and the physician finally ordered a "TENS unit".  This awkward magnet was strapped on my shoulder for weeks and was advertised to deliver magnetic waves to heal the bone.  Though I have no scientific evidence  it did not work, it was a hassle.  Bulky and uncomfortable, I am convinced my surgeon did better work than this device.  Perhaps the article I will post a header to will show us what ultrasound will do in the next few years.  I do not condone this device, nor am I being paid to promote it because I have not used it. It looks promising.


MISSISSAUGA, Ontario--()--Bioventus, a global leader in active orthopaedic healing, today announced that the next generation of its market-leading1 EXOGEN® Ultrasound Bone Healing System – including new compliance features and a healing progression Performance Guarantee – is now available in Canada.
“The release of the new EXOGEN device is exciting news for those of us who treat fractures on a regular basis. This technology has become a very useful tool for fracture treatment. The new Performance Guarantee is unprecedented and provides reassurance that Bioventus stands behind its product”
EXOGEN® – the clinically proven treatment for indicated* bone fractures – is a medical device that helps fractured bones heal.
  • EXOGEN uses safe, effective low-intensity pulsed ultrasound to help stimulate the body’s natural healing process2
  • It has an 86% heal rate for fractures not healing on their own3
  • EXOGEN offers 38% faster healing of fresh fractures4
Thanks Sonoworld and Exogen

Wednesday, March 19, 2014

Medical Mistakes And Ultrasound

My apologies to all.  My family and I have recently moved to a new home.  We are living out of boxes for now, but my industrious wife and child are correcting that issue, though, I still cannot find my scrubs.  I will post this while my dog look's for my scrubs (I gave him a scrub shirt with my scent, he is a blood hound).  This issue I have today is an important one: medical mistakes.  This has haunted medical professionals ever since the practice of medicine was discovered and refined (over 2000 years).  Most lay people think medical mistakes involve wrong medications given to patients.  While that is probably true, other mistake happen.  An example is the wrong knee being replaced with a prosthetic.  Or the wrong blood is given to a patient causing holy YOU know what in the ED.  Ultrasound is becoming the standard of care in such situations like trauma to the chest and abdomen, and line placement both in the ED and in the CCU and ICU.  Insurance companies recognize this and are setting up fee schedules that encourage the use of ultrasound in many instances.  Ultrasound is becoming a wonderful tool both to eliminate errors, and insure that the patient get's the best quality of care at a "Somewhat" affordable rate.  We will yet see what the health care reform does with the wonderful tool we call diagnostic medical ultrasound.  Here is an excerpt and the link.

As a result, many leading hospitals, such as Christiana Care, are using ultrasound guidance to insert central venous lines, since the technique has been shown in several studies to greatly reduce rates of this complication—or even to prevent it entirely—compared to inserting the central catheter needle “blindly.”
Ultrasound at the bedside can also improve diagnostic accuracy and is increasingly used in ERs for the FAST (focused assessment with sonography for trauma) exam, a test to rapidly check trauma patients (such as car crash victims) for signs of internal bleeding. 
Because ultrasound imaging doesn’t expose patients to ionizing radiation, it’s now the preferred diagnostic test for appendicitis in children, as well as checking people of all ages for kidney stones, adds Dr. Sierzenski.
Thank You Lisa Colier Cool and Yahoo


Friday, February 14, 2014

Smokers Now Offered Abdominal Aortic Aneurysm Screening

Sorry my friends, I have been offline for a few weeks with the flu.  Well, I am back at the helm again with some more shocking news.  Smokers are at risk of arterial disease.  Specifically, abdominal aortic aneurysms.  We have known about this for years.  Smoking does nothing good for you.  The interesting thing is that many states in the USA are making POT legal.  POT has more heart stopping ingredients than tobacco.  Well the US government is stepping out once again to limit the use of tobacco products while condoning the use of POT.  We Sonographers have long looked for triple A's in our practice.  We love to find them before they bust.  There is a CPT code for the screening.  I look for them on any routine belly exam.  Most liberals would like to to see tobacco crops destroyed, unless you are Al Gore.

Message to Sonographers?  Look for those triple A's  Here is a link to an article

The U.S. Preventive Services Task Force (USPSTF) is recommending routine one-time screening for abdominal aortic aneurysm (AAA) in men aged 65 to 75 years who have ever smoked in updated draft guidelines published online in Annals of Internal Medicine.
Clinicians should offer selective screening on a case-by-case basis for men in the same age group who have ever smoked, the draft guidelines state. If finalized, the recommendations will replace previous USPSTF guidance on the topic from 2005.e.


Thanks Clinical Advisor

Tuesday, January 21, 2014

Appendicitis: Ultrasound And Multi-Modalities

I have always been an advocate of using ultrasound in the diagnosis of appendicitis.  In children, the use is a first defense.  Sure we can get lab work, and search for McBurney's sign.  I think the use of CT scanners is a burden on the patient's financial resources in a time of health care reform chaos.  We should learn to use ultrasound as a valid and very useful (and economically conservative) way to help out in acute and chronic situations.  The use of these big machines like CT and MRI are more useful in other situations.  There is nothing better than a good surgeons touch, but it is expensive at 3:00 am.  Though I will not volunteer to pull call at a hospital, or doc-in-the-box (too old and cranky), I would argue that up and coming sonographers put the scrubs on and go out to look for these lesions which are common.  I made my own DX of appendicitis 21 years ago with clinical and sonographic means.  I saved my own life with the help of a great surgeon.  He told me I was at the doorstep of death.  Yes I imaged my own appendicitis, though I do not remember.  Friends at the hospital I worked in said you were wise to come in and present as an acute patient.  They later told me I was a nasty patient.  I would hate to see a child suffer what I suffered, and not be treated correctly.  Here is an article that melds diagnostic imaging with the wonder tools a medical doctor has.  Peace TJW

FRIDAY, Jan. 3, 2014 (HealthDay News) -- A clinical pathway combining the Samuel's pediatric appendicitis score (PAS) and selective use of ultrasonography (US) has high sensitivity and specificity for diagnosing appendicitis in children, according to a study published online Dec. 30 in Pediatrics.


Thanks Doctors Lounge

Friday, January 10, 2014

Self Directed U/S testing?

Really?  You manufacturing people want to market to people with no formal ultrasound experience?  Is the CES on LSD?  Probably.  The Consumer Electronics show is in full swing with many drunken people spilling drinks and gadgets all over Vegas.

One thing that worries me is Tom Cruise like people that have an ultrasound machine to look at the baby hour by hour in the womb.  Or worse.  Many seniors will look at the gassy upper abdomen to look for abnormalities they are not trained to look for.  They may even use one of the small machines and look at the heart and say "Mable I am Dying"  Like Redd Foxx did in an old TV series Sanford and Son's. Here is a link that makes me worried.  Happy New Year.  Look out all!

Personalization: Putting the "Me" into Medicine
More than 70 percent of respondents are receptive to using toilet sensors, prescription bottle sensors or swallowed monitors to collect ongoing and actionable personal health data. Sixty-six percent of people prefer a personalized healthcare regimen designed specifically for them based on their genetic profile or biology. And 53 percent of those surveyed said they would trust a test they personally administered as much or more than if it came from a doctor.

Though this article did not mention ultrasound specifically, I am  wary of these issues.  Perhaps I missed a sentance

Here is the full link.  Blessings all


Wednesday, December 25, 2013

Merry Christmas All

This sonographer is celebrating another Christmas with family.  We ventured out of Houston during one of the worst storms in American weather to travel up to north Texas to visit my mom and pop.  They are both in the mid eighties.  They are as well as you can be when you are that seasoned.  We made it up in 10 hours due to the ice storms plaguing Texas last Friday.  It was rough.  My Daddy took us out to dinner on Saturday night.  We ate steaks at a restaurant in Wichita Falls, Texas.  McBrides is a wonderful place to go if you crave mesquite broiled cow.  We ventured down on Sunday morning to visit my mother and her husband.  Not all families stay together as many of you know.  We were met with ribs, and brisket, and warm rolls and the usual array of veggies and salads.  Mom made some pies.  I am not a person that likes sweets, but I will eat what my mother cooks.  The outside temperature in the wee hours (8 am) of monday was 27 degrees F.  We loaded up and shoved off at 11:00 am.  Smooth sailing till we hit Houston.  Always a nasty place for cars and trucks (Mostly big ass trucks....Why do people drive them now with gas so high)?  I guess they make more money than I do. This morning I was woken by my wife's pekinese dog opening packages under the Christmas Tree.  I kid you not!

The dog found his chew toy in a box, and managed to get it out.  It was squeaking at 7:30 AM. and he had also managed to open other boxes. My wife posted the video on here facebook account.  My wife and son soon came down to enjoy the usual Christmas festival of spreading paper all over the living room to see what Santa left us.  I got some wonderful dress pants.  My son got his new HD TV for his bedroom. (I had nothing to do with that gift).  My wife got muk luks(spelling).  Boots that are warm.  I have a new wide screen monitor for my computer.  My old Samsung monitor was gently going to the grave.  Thanks Samsung for a flat screen that lasted 12 years.  My son gave me a new computer keyboard because I tapped on the old monitor to wake it up.  He thought I was making noise on an old keyboard.  Old monitors need to be tapped to life.

Today is a balmy 53 degrees F.  My son got some cash, and he will use it to buy a new skateboard.  I think he is great.  He is athletic, and has so many GF's, He must be careful lest he gets molested.  He is a smart looking gentleman!

Anyways.  Be blessed all.  I am now an ultrasound contractor.  I will travel anywhere to see patients or provide education.  I am hoping 2014 will be a better year for business.  Contact me if you need some help in the ultrasound business.  Merry Christmas.  Be safe.  TJW

Wednesday, December 18, 2013

God Bless You All. Merry Christmas. Here is Krampus. A German Legend. Off Topic

This is Krampus.  He is the Anti Santa Claus  He is nasty and is a Germanic favorite for many years.  I post this because my wife who is a nurse likes to do the Krampus march in Houston.  We could not go this year because the weather was bad.  We wanted to go.  Conditions were unsafe to travel down town.

On another note, be safe in your travels.  Do not drink and drive, and do not piss off the TSA people.  They are already pissed off at themselves. Police are pretty mad nowadays also.

Be well prepared to celebrate the birth of Jesus Christ.  Blessings to all.  I will post many things in the New Year.  TJW