Sunday, August 28, 2016

Off Topic, Advertising

The internet is bold, old, and dripping with sarcasm, and every other human emotion.One thing I hate is advertising.  It is everywhere you look, or hear.  I am off topic but, I can stand it no longer.  Here is my list of hated ads.  Not in order, but with equal vitriol.

1  Learn More (yeah like we are really interested)
2  Save (spend)
3  Just (like.....really?)
4  Only 19.95  (Bullshit  Try 25.36)
5  Hurry!  (why?)
6  New  (aren't they all new?)
To be continued  TJW

New Small Town

I have not been online for many reasons, the first is that my wife has been ill.  She is recovering.  She had DVT and a PE.  I have changed jobs from one small hospital to another wonderful place in south Texas.  I am warming to the small community slowly as I am only part time for now.  They make great food, and make friends slowly because of the small knit community.  I have a Toshiba machine that I use to take care of my patients.  It is great with the upgrades.  (Xario)  My bitch with this machine is that it is bulky and very hard to take portable.  I prefer to go portable for in house patients, or ER patients.  I am getting cranky in my back as I approach 60 years of age.

Thank you all for following my posts  I will continue


Thursday, April 7, 2016

Ophthalmic Nerve Sonography: Update

I need to restrain myself.  I have encountered an article which may contain truths, and half truths.  I will try to explain.  The measurements of the ophthalmic nerve for non-invasive evidence of increased intracranial pressure was pioneered by NASA and the Russian Space agency because of issues with astronauts and cosmonauts returning to earth with blurring eye site, and other signs of neural impairments due to the time spent in micro gravity. This has been known for many years.  It is known that micro gravity causes an imbalance in the CSF in the brain and spinal column of astronauts, which can result in strange effects.  These effects, specifically on intracranial pressure have been studied well by many countries participating in the ISIS.  The use of non-invasive ocular ultrasound was demonstrated many years ago, by measuring the diameter of the optic nerve using and ultrasound probe sending sonic waves to image the optic nerve through the closed eye-lid.  I will cite a couple articles:

ISS Science for Everyone
Science Objectives for Everyone 
The Vision Impairment and Intracranial Pressure (VIIP) project examined the effect of long-term exposure to microgravity on the structure of the eye along with change in distance and near vision of crew members before and after they returned to Earth.
Science Results for Everyone 
I can see (less) clearly now. Many astronauts experience poorer vision after flight, some even for years after. A number of studies have looked for causes and distinct physical changes in the eye itself have been found. MRI scans suggest that pressure changes in the brain and spinal fluid caused by weightlessness may be partly to blame. Many astronauts do not show these effects, though, and more advanced imaging techniques may be needed to understand the role of changing brain pressure in microgravity. This in turn will help researchers assess vision problems and develop ways to prevent them.  

This was published 5-13-15

Thanks NASA/gov

Next is a breaking article TODAY!

Breaking News: Ocular Sonography Detects Intracranial Pressure

SoRelle, Ruth MPH

This is so interesting that science journalists lag so far behind the times.

Faced with a patient in the emergency department who might have increased intracranial pressure, Kristi Koenig, MD, reaches for one of her most valuable tools — the ultrasound machine — to rule out the possibility that forces are building inside the skull.

Thanks Live Science

Monday, April 4, 2016


Most people consider uric acid a nasty lab value associated with gout, and arthritis.  Many people associate it with eating meat,specifically red meat.The early symptoms of gout are linked to a painful great toe, in many cases.  Uric acid build up in the blood can also cause kidney stones.  Many ultrasound examinations are ordered because of renal colic caused by a kidney stone dislodged in to the ureter causing blockage, pain, and sometimes the death of the kidney.  Ultrasound can pick up hydronephrosis, or blockage of the kidney or ureter, but is not very sensitive for finding the source of the blockage.

Here is a short essay courtesy of Live Science regarding the basics of uric acid.

A byproduct of the body's metabolism, uric acid is a human waste product that most people never think about.
But for some people, uric acid can cause painful medical problems such as gout and kidney stones.
To understand what can go wrong with uric acid, you first need to know where this chemical comes from — purines. The purines that break down to form uric acid are nitrogen-containing compounds found in the cells of all plants and animals, including humans.

Thanks Live Science

Sunday, March 13, 2016


This is a topic I have talked about in the past.  It is exciting.We are now exploring ways to locate, and treat tumors using the MRI machine and US.  The MRI can locate the lesions, and US can treat them.  The secret?  Nano particles which oscillate and release kinetic energy in the form of heat in response to ultrasound.  This thermal energy can destroy a tumor, and spare the surrounding normal tissues.

Thermal ablation with magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive technique for treating fibroids and cancer. New research from UC Davis shows that combining the technique with chemotherapy can allow complete destruction of tumors in mice.


Saturday, March 12, 2016


I will not post much of substance tonight.  I am weeping.  TJW

Saturday, March 5, 2016

He We GO!

I will post a great link to an article I can love.  I learned a bunch from this article.  Blessings, all  thanks for visiting.  TJW.

Here is a snippett.

aced with a patient in the emergency department who might have increased intracranial pressure, Kristi Koenig, MD, reaches for one of her most valuable tools — the ultrasound machine — to rule out the possibility that forces are building inside the skull.
Dr. Koenig, the director of the Center for Disaster Medical Services and a professor of emergency medicine at the University of California, Irvine, School of Medicine, said ultrasound is a powerful tool for diagnosis in the emergency department. “In this case,” she said, “we can rule out elevated intracranial pressure. The ultrasound is a tremendous -triage tool with high sensitivity to detect people who need more monitoring.”
GallGizzard Note:  These findings were discovered many years ago.    Blessings  TJW

Saturday, February 27, 2016

The world is going ape S++T over the Zika virus.  Good reason.  Sonographers must be aware of the ultrasound ramifications of this disease.  Microcephaly.  The BPD, and head circumference is essential now.  We do not know how this disease will progress, or whether it is related to genetic issues.  Let's have a heads up now in the ultrasound community!  Here is a recent link:

"Zika virus disease (Zika) is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected. Once a person has been infected, he or she is likely to be protected from future infections."

Thank You CDC.


Health care as we know it has a dirty, dark side.  We all know it.  It is evident from the way we treat our indigents patients and can be traced to the white house.  I will post something I found on the net.  Something I found disgusting. I hope this issue is resolved soon.  Health care is something that comes from the heart of people who care for others that are sick.  It should never involve predators looking for a fix for a nasty fascination. 

"An ultrasound technician has been accused of going well beyond the scope of his clinical duties by fondling a patient’s breasts after she underwent an examination of her liver at Touro Infirmary last month.
Police arrested 43-year-old Gretna man Emmet Collins on a single count of sexual battery in connection with the incident. Collins’s attorney said he believes his client will be exonerated.
The woman told police that she had just finished having an ultrasound on her liver about 5 p.m. on Jan. 19 when the technician assisted her into her bed, made her lay back, removed the blanket from her chest and began fondling her breasts. The woman told police, according to the warrant, that “as the technician was doing this, he smiled, which made it seem awkward.”

Thanks Matt Sledge

Note:  there is no mention of the ultrasound technician being registered.

Be well, TJW

Saturday, February 20, 2016

Just Ducky

I took this photo last year.  It is grand, and you may want to click on it.  It is a JPEG, and the Blogger had issues with uploading it it because it was so large.  You can see ducks flying out of the way of a thunderstorm.  I tend to be a photographer in the moments when I am not tending to patients, and driving.  So many things are happening in U/S.  I do not think robotics will take over the ultrasound world.  There are too many variables in diagnostic ultrasound.  Just some thoughts on a Saturday afternoon.  Let's talk about the issues of robotics?  Shall we embrace this technology?  I think not.  It will always be up to a human to perform a sonogram, and interpret it it for the radiologist, or cardiologist. These doctors just put a rubber stamp on what we think.  My thoughts, TJW

Saturday, February 6, 2016

The Presurfer: Pholisma Sonorae: A Strange Looking Flowering Plant

The Presurfer: Pholisma Sonorae: A Strange Looking Flowering Plant

This a strange, like the late Paul Harvey liked to say.  My buddy Gerard likes to post very interesting things on his blog  He and I share links.  What caused me to cross-post this link is the word "haustra"  In the medical world the haustra are organelles that help the intestines absorb nutrients in the intestine.  Explore the link to discover more.  TJW

Sunday, January 31, 2016

I Hate Hospitals

Hospitals are like fast food restaurants.  They offer nothing but BS to a patient who is in pain, or worse.  I have to reveal that most hospitals rely on the people they employ. doctors,nurses, X-Ray Techs, and even sonographers.   We all function as a unit.  If critical care breaks down, the patient suffers.  Many small hospitals charge them discharge them.  For CT, X-RAY LAB, and over paid doctors who sleep most of the time in the ED.  Our senior Administration in Congress and the White House are WRONG!  LETS VOTE FOR TRUMP!


Saturday, January 30, 2016

Routine Ultrasound Testing For Pregnant Women Is Not Good

I have always advocated that prenatal ultrasound has some unintended risks, but people still want to see the fetus in the uterus. I hate doing OB ultrasound because the ultimate question is: What is the sex of the fetus?  But the doctors still order them, to keep the family happy. 

Here is a link for you all to chew on.

(NaturalNews) It is common for a pregnant woman to undergo several routine ultrasounds during her 40-week pregnancy. What many don't know, and despite what popular medical and government websites state, ultrasound scans have never been proven safe for pregnant women or babies and aren't recommended for routine use and non-high risk pregnancies.


I have had some issues with our family of late.  My wife and I are getting more mature, and I have posted her battle with a PE and the persistent issues of growing older. I had a birthday yesterday.  So did my son.  We were both brought into this world on the same day.  My wonderful wife will take us out today for a Mongolian BBQ lunch.
Fear Not!  I will continue this BLOG until I die.  Like David Bowie!

Now, on to issues of business.  Here is a nice one for you.

Former school teacher Moira Rogers was diagnosed with breast cancer two years ago. It quickly spread to her bones, causing unbearable pain in her arm.
"I was so frightened and my life just seemed to be sort of shortened," she said. "When you're feeling the pain, you know you have cancer, and you think about cancer, and there's just this big C-word envelops your life."
She found new hope from an innovative treatment being developed at London's Royal Marsden Hospital.

Here we find yet another wonderful use of sound.  Let me post the resource:

Thank You CBS  TJW. 

Welcome Back my friends to the show that never ends, (Emerson Lake and Palmer) 1973