Saturday, August 22, 2015


Uploaded W-10 to a lap top as an experiment.  It is always gutsy to upload a new OS to a computer.  It is SLOW.  Like a Blue Whale!.  It takes more time to load than my oatmeal can start burping in the microwave!.  It has moments of flatus.  Lemme clarify:  It pauses, "honks", then resumes a bowel movement somewhere on a silicon chip, then resumes, like nothing ever happened".  Problem is, I am 15 minutes without a cursor, and cursing.  It Sucks.  Peace, TJW


If I were a fife player, I would pipe a merry tune.  My wife will be back at work, soon. (help me Ian Anderson).  My wife is much better.  My post is about my wife's battle with health care, and insurance, and long waits to see a Doctor.  Our health care insurance does not cover acute life saving meds for DVT.  I will not mention the the drug.  We are making way, though.  She will wreak havoc in the clinic she works at as a nurse on Monday.  My Wife, has been a pent up bull for many weeks.  Having DVT, and a PE is nothing short of scary to me as her husband, but scary as shit.  Discussion:  a DVT is a clot in a major vein in the body.  When the clot breaks off, it flows through the right atrium of the heart to the right ventricle, which pushes it up into the main pulmonary arteries (left or right).  It can then clog a blood vessel that allows for oxygen transfer in the lungs.  This may cause shortness of breath.  Which my wife endured.  She promptly presented herself to the ED and was treated.  She was hospitalized for an ordinate amount of time.  

Alas, many of the tests, and procedures are not covered by our measly insurance.  But our health care system worked for us.  My Wife still lives, and works.  The key is "works".  Many catastrophic health care situations leave a spouse unable to work.  Consider a heart attack, when a spouse cannot work.  Consider me, and my family lucky.  My wife is already passing out gifts to the needy people in our community today.  She love's to help people.



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.


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



Saturday, May 16, 2015


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 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.


Sunday, March 8, 2015


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.  :)