Sunday, December 30, 2007

Prison, not a healthy place to be

Greetings gentle readers.
First off some business. My previous BLOG was on YAHOO. I cannot post there anymore for some reason. Go to YAHOO and search the YAHOO tool button search engine for me, gallgizzard.
Next: My Blog here is hard to find. it is Please do not put a period between the www and the S.
And finally, the pic on the left was taken by me during the evacuation of Houston, TX during Rita. My family and myself stuck in traffic with thousands of people on highway 59-N. We made it as far as Bush Airport (22 miles from my home). It took us 18 hours to make it this far.
We turned around at this point because we were low on gasoline (Petrol), and our pet's were in danger of dying. It was a hot day as you see.
One other note: I am having format issues. My line breaks are not showing up well on the blog. I know how to write, but this blog engine is not treating me nice. I apologize for the un-organized posts. I will send a note to, but they are all off flying ultralights and drinking silly stuff at the moment.
Here is my post:
" COALINGA, Calif. — When any of the 5,300 inmates at Pleasant Valley State Prison begin coughing and running a fever, doctors do not think flu, bronchitis or even the common cold.
They think valley fever; and, more often than they would like, they are right.
In the past three years, more than 900 inmates at the prison have contracted the fever, a fungal infection that has been both widespread and lethal.
At least a dozen inmates here in Central California have died from the disease, which is on the rise in other Western states, including Arizona, where the health department declared an epidemic after more than 5,500 cases were reported in 2006, including 33 deaths. "
Gosh, this editor is nasty, I cannot get a paragraph break in here. I am so sorry! Help me Google!
This writer wants to state that people should be wary of closed places. This includes nursing homes, sports centers, malls.. anywhere people are crowded around. This new disease (maybe not new, perhaps ancient) is a fungus. I would be willing to entertain other comments on this. Perhaps there are other sonographers who have some findings to share. Echo, abdominal ultrasound findings. Let's see how this disease presents on ultrasound.

Saturday, December 29, 2007

Thyroid Patient

Greetings Gentle Readers,

Yes, this is the same ole' Gizzard posting. I have a quick story to tell. I had a young student a few years ago attend one of my classes on abdominal ultrasound. We cover everything in the belly, then some. The "then some" involves discussions about small parts, thyroid, and testicular imaging (another post to come). In day five we cover superficial sonography to include masses , lymph nodes, muscular tumors, and thyroid sonography.

As usually happens, the students scan each other in the lab on the great machines we have, and damned, if I was looking over the shoulder of the neophyte when I spotted a heterogeneous lesion in a students thyroid gland. I say "no big deal"to the person on the gurney, and no big deal to all who gathered rapidly (my utterance rang like a monastery chime in a mountain retort in the Himalayas). DING DONG!!!!!


Medical Dilemma. It looked like the throngs of unwashed hanging about after a car bombing. But these people could hear! BONG BONG!

One word of advise to junior sonographers, never say OMG or WOW in front of a patient. They will look at you with the eyes of lasers (and my cat) and say "What did you find?". Many patients watch the eyes of a sonographer instead of the screen which they think looks like a snowstorm (1965 TV set on channel 2).
Gizz Note: did you know that it was once thought a tornadoe could be predicted by listening to the pattern of white noise on a TV set? Please look that one up for me folks.

I proceeded to tell the group about the mass seen on the screen with attention directed to it's grey-scale features, all the time smiling and tapping my toes lightly.

By the literature, the vast majority of lesions in the thyroid gland are benign processes, and should cause little concern. I preached this to the audience who gave me the "fish-eye". I counseled the student who's thyroid lesion was clearly presented on the screen not to worry, but consult her doctor when she returned home. I always say this when ever an abnormality is seen in the classroom setting. I told her I am not a doctor and that it is up to her physician to decide what to do.

Sure enough, I get an E-mail the next week from this student telling me she did visit her physician, and they DID perform a biopsy and it WAS cancer. Wow, if I had any schnapps at the office, I would have taken a sip. I told her to stay in touch and God Bless.

It does not end here. She showed up a year later to take another class, and I got big huggz when she strode into class. Alas I do not always remember names, but I do remember faces, so I accepted the bear hug she dealt me.

I asked her about the surgery, and she said they did a total thyroidectomy. "They removed it all and gave you radiation chemo?" I asked

"No, they did not give me any chemo...."


"My Doctor did not want me to have Iodine 131 therapy because I told him I wanted children."

Here I must say dear readers, that most thyroid cancers which are deemed virulent, or aggressive are followed by radiation treatment consisting of a couple pills of a very radioactive form of iodine. This treatment requires the patient to be cloistered for at least 2 days in isolation because of the high levels of radiation emitted by the iodine (mostly beta rays which do not penetrate far). Clothing, food, tissues, bandages, all personal effects must be tossed after this form of chemo.

The idea here is to treat any remaining cancer cells with radiation. Iodine is taken up specifically by thyroid cells, thus is the best chemo agent for the task as it will hunt out aberrant thyroid tissue like a blood hound seeks an escaped criminal.

Here the story resumes. I say to her "Would you like for me to scan your thyroid bed for any thing extra?"

Of course you have figured out I found another mass. It was removed, and she did have radiation chemotherapy, only after delivering her healthy baby son.
By the way, the image you see above is one of my feline buddies I inhabit the house with. She just got a shower, and she is not pleased. And Yes, I will post her to lolcats.



Wednesday, December 26, 2007


Greetings gentle readers,
Tis' the day after Christmas, and all through my house, all the cats were purring, I could hear nobody grouse. I drove home yesterday from the in-laws alone because today I must get back to work. I am going to see some patients, though I doubt it will be busy because most people will be out exchanging gifts, or tryying to put together the new what-cha-call-it for the kids. I will pick up my family on saturday.
My kid got an amazing assortment of things from St. Nic, but the toy I was enthralled with was the motorized radio controlled car with a working video camera on it. He used it yesterday to check out all kinds of things on the sly to include the bathroom, the christmas tree late at night in hopes of catching Santa's visit, and of course he had to check up on everybody else. The good thing is, the car cannot open doors. Think PRIVACY folks.
In other news, I am still tweeking this forum (I changed the style) and I will be adding some "Elements" to include a feed-back page and other things.
As I prepare to see patients near NASA (an hours drive from me), I leave you with a link I hope you will visit,0,4740879.story (Courtesy Chicago Tribune)
This link will take you to a very sweet story about an old man and his devotion to caring for animals which I thought you may like.

Sunday, December 23, 2007

Working out the kinks

Greets Gentle readers,

It is Christmas weekend, and yes I am going to do as much work on this BLOG as possible while taking care of family and freinds. This is a Sonographers BLOG as titled so lets get right down to it. I am a Sonographer. What the heck is that?

I perform ultrasounds.
Let's define a Sonogram. Its a medical testing procedure that lets us evaluate your unborn baby (DUH) and a lot of other things too. I specialize in Cardiac scanning, Vascular imaging, Internal Med, and I perform OB-GYN procedures. I am board certified in all the above.
Who certifies me? Am I a Doctor?
No I am not a physician, I am certified throught the ARDMS (American Registry of Diagnostic Medical Sonographers).
So why should I care?
Simple, ARDMS Sonographers are the best of the best. They have demonstrated competance through intensive testing to know human anatomy, physiology, and pathology. The boards are a TUFF! I am glad I am through with them. I must continue my education by posting 30 category 1 CME's every three years. I will say that is a minimum number, and should be raised. The field of ultrasound is changing every day, and we Sonographers should be on top of every change by staying in touch with avenues of education.
Oh! Did I mention I am an educator?
Yes, I teach medical ultrasound. I teach in Houston Texas. Please come down for a visit
More about that in future posts.
For now, I wish you a Merry Christmas and Great New year in 2008.
Here are some links for fun! (All G-Rated for the family!) (Ooops Dr Schwab can get R Rated once in a while)
And the always funny.... (My cat was on there last week)
And here is one you will LOVE (Thanks Gerard)

Saturday, December 22, 2007

Merry Christmas from the Gizz!

Greets gentle readers,

As you know, I have had a hard time with my previous BLOG. I have "dun it down". I will continue a presence on Yahoo, but it will be a small one. This first post is to establish a presence on Google Blog.

My family and I are headed out to a small town in south Texas for Christmas today. We do not look forward to the traffic and drunks. Please know that I will be posting more on this blog that has value than my Christmas trip. To my freinds, Merry Christmas. GO NASA!

I will continue to post things that are of value to the world.

God Bless you all!