Wow

I honestly can't believe that the semester is almost over!! It seems like I just got started!!

So I've been working dayshift in CT this whole week and I'm feeling pretty good about things. The more I work, the more confidence I gain. (Duh!) Yesterday I got to do an AIF which is something that I hadn't done in probably 3 months (at least) and I remembered everything I needed to do and had a great study! Earlier in the week I did a dreaded head angio and got a compliment from the vitrea tech who does the reconstructions about how great it was! Yay me!! Today I got to do a chest angio which I think is probably my favorite exam. It's the only angio study that we get to reconstruct ourselves and I love to do it!! All the other angios are sent to the vitrea and there are only 4 people in our department trained on that equipment. Thanks goodness I'm not one of them!

We also have a new protocol that started this week concerning a soft tissue neck with contrast. We are supposed to start the scan above the ear and end it at approx. the level of the carina. Well, when I trained in CT over the summer the protocol was that the scan ended at the sternal notch. I will remember that for the rest of my days because the very first soft tissue neck I did, I did not get all the way to the sternal notch, a fact which the two techs supervising me did not notice, and our head radiologist called to point it out to me. I was so embarassed and wanted to crawl in a hole. You would have to know and work with this doctor in order to understand just how small and insignificant he can make you feel! Though technically it wasn't my fault since at the time I didn't really know what I was doing anyway! Anyway, back to the new protocol, I did a neck with contrast today and luckily just happened to get down far enough because I thought I only had to go to the sternal notch! Sternal notch is forever drilled into my head and it's gonna be hard to change! Oh well... live and learn I guess! The study was beautiful though!

I am loving dayshift because there is such a huge variety of exams being done. It seems like the last few times I worked in CT on seconds that all I ever did was stone protocols and heads! Not that I mind those, just gets a little monotonous sometimes!

Well, hope everyone has had a great semester!!! Merry Christmas and Happy Holidays!!

Dayshift!!! Yay!!

So I just found out yesterday that for the next month or so I'm going to be working some dayshift!!! Yay!! I'm a full time second shifter but thanks to someone on first shift having surgery I get to fill in AND be in CT full time!! Well, for a little while anyway!! I don't care though... I'll take what I can get! And I'll get to finish up my clinical time without having to stay late!

By the way, I ROCKED a head angio tonight!! They still make me super nervous and I almost threw up after I finished it but everything turned out great!! I'm getting more and more confident which is great! I still sometimes feel like I have mush for brains when I leave work because I'm thinking so much!! But it's great... I'm really glad I let my supervisor talk me into cross training!

Not too exciting...

So it's been a while since I've posted anything new and that's only because I haven't done anything too interesting in quite some time. I did have a patient that I had to chase down through the hospital and into the parking lot because his IV had not been removed! It was pretty interesting to say the least!

It seems like the only exams I've done in the past few weeks or so are heads and abdomens! I had just gotten really comfortable with chest angios and now it's probably been a month since I've done one! Oh well. I'm getting ready to get a lot of time down there because the regular 2nd shift CT tech is going on vacation and I'm filling in for her. Yay! Sometimes I feel like I'm going to drive someone crazy asking a million questions but I guess I would rather do that than screw something up!

I'll write again soon when I have more interesting things to talk about!

Head Angios

Okay, so I'm not sure how everyone else feels about them, but basically, I LOATHE head angios. I know, I know, they are a relatively short exam to performed but for some reason, I just don't like them. Here's my reasoning behind this.

Two weeks ago on a Friday night, it's about 10 p.m., almost time for me to go home and a Head Angio pops up. Okay, so I haven't done one of these since I was still in training which had been more than two months prior to this night. Well, I got the patient, started the exam, everything was fine. I don't know how everyone else was trained but I was taught to set my ROI tracker in the ascending aorta and set my HU to 120 and let the scan start on it's own when the contrast reaches this point. Well, I did this and for some reason, I don't know if it was because the woman was absolutely tiny or what the but tracker actually read some streak artifact from the contrast that I think was actually in the vena cava and started the scan waaaaaayyyyy too early. There was absolutely no contrast whatsoever anywhere in the brain. The only thing I could do was restart the scan. There was probably about a 15 second timespan between the end of the first scan and the start of the second one but it was enough that the entire scan was contaminated. I was very disappointed. Though I didn't receive a call from the radiologist and the girl who did the recons the next day said it was fine. I was still mad because it wasn't an ideal scan. Oh well.

So, needless to say after that experience, I was none to keen on doing any head angio that popped up. Well, low and behold, Tuesday night an ER doctor orders one!! EEEKKK!! I had the other CT tech that was with me, who I graduated from x-ray school with, show me how she does them. Instead of using the tracker system, she sets the ROI between C3-C4 and watches for the internal carotids to blush. Once this happens, you manually start the scan. So this is what I did and after a few seconds of panic when I didn't see the blush as quickly as I thought I should, I got a beautiful scan! Yay!!

I still hate them though!! About the only angio study I feel fairly secure in doing is a chest!! I guess that just comes with time!

This Week

I saw something I'd never seen before last night and thought it was worth mentioning. I went to get a patient for a chest without last night. It was ordered on a 30 something year old woman in the ER who hadn't even had a chest x-ray yet so I was a little curious as to why we were doing the exam in the first place. Her history only said shortness of breath. I don't know how it is at other facilities but MOST of the time at ours, a chest x-ray is the first step. Well, it turns out the exam was actually ordered on the wrong person! This happens at least once a day in our ER and we techs spend a lot of extra time hunting down correct patients and orders!

Anyway, it turns out the exam was actually supposed to be ordered on a 50 something year old man who was complaining of pain in the center of his chest. He had in fact had a chest x-ray prior to the ordering of the CT and the report mentioned a peritracheal and hilar fullness and recommended a CT chest with contrast. It turns out the patient was allergic to contrast! When I finally got the correct patient scanned I saw a pericardial effusion! It looked huge to me!! I have never seen one before! The CT report stated that it should be checked again in 3 months so I assume it wasn't too bad... but I think that explains why the patient's chest was hurting so much!

Can't believe September is almost over!

Well, I can't believe it's fall and September is almost over! How did everyone survive the windstorm? We had several HUGE branches fall in our driveway and on our garage but didn't sustain any major damage. We were without power for 72 hours though! I tell ya, you don't realize how much you take electricity for granted until you don't have it anymore!

Nothing very exciting has been happening in CT as of late. I got more time down there than usual this week, x-ray, for once, was well staffed and I got to spend a whole extra night down there making three days this week instead of just two! Yay! Though it seemed like the whole night was nothing but routine heads and of course the token really intoxicated guy who gave us all a good laugh!

The one really interesting case I did see took the form of a kiddo that was less than 2 years old. He had a huge mass on the side of his neck that was red and really horrible looking. A soft tissue neck with contrast was ordered and after 3 failed IV's and two trips back and forth between CT and the ER, I finally managed, with the nurse applying pressure to the IV, to hand inject 10 mL of contrast. The scan of course wasn't that great but it was enough to determine the mass was either an abscess or swollen/infected gland. Let me tell you I have never seen anything like it!! The knot was almost as big as the baby's head!

I have also been very frustrated lately about the fact that some patients don't feel it is their responsibility to inform health care professionals of their entire medical history. I personally feel that if I was allergic to CT contrast, and had horrible reactions to it, that I would let my doctor know as soon as I was told the exam I was going down for. Maybe that's just me though! I can't tell you how many people come down for exams, Chest Angios in particular it seems, that end up having to have a Lung Scan done instead. It just seems to me that a lot of time and trouble could be saved if perhaps the ordering physicans would ask about contrast allergies before ordering exams! Oh well.

Another gripe (I have quite a few this week) is that no matter what, it seems like nurses will argue with you about the size/location of IV's needed in order to power inject. I feel like a need to make a gigantic, neon, flashing sign! Though for some reason, I still feel like that wouldn't be enough! I really sometimes want to tell them we aren't arguing just for the sake of arguing, it's how things have to be done!

Well, I guess that's all for now. Hope everyone is having a great Fall so far!!

What a night!!!

Wow! Last night was a killer!! We were absolutely slammed from the time I walked in at 3:00 until I left (an hour late) at midnight! I worked most of the night in x-ray but did get in a few hours of time down in CT so I would mention the interesting case I saw.

I'm not sure how much we're allowed to say on here because of HIPAA and everything so I won't mention the circumstances surrounding this patient's injuries, but I got to see something I'd never seen before. The patient's orders were pretty routine... I guess you'd call it our "trauma panel", a head and c-spine without and a Chest, Abdomen, and Pelvis with. I did the head and c-spine with no problem and as I was watching my CAP images come up so I could do delays, something caught my attention. I don't know how other scanners are, but after our scans are finished the images flash by at the top of the screen and something funny in the liver caught my attention. I wasn't really sure what I was seeing, though to me it kinda resembled how atrophy looks in the brain. Well I called the other tech (who's been doing CT for about 8 years now) over to take a look and it turns out it was a lacerated liver! Pretty cool! Well, not for the patient I guess but definitely something I'd never seen before.

I'm back in CT tonight so we'll see if anything interesting happens!!

Let Me Introduce Myself...

Hi, my name is Brandy Johnson and I am starting my first semester here at USI. I graduated from Owensboro Community and Technical College's Radiography Program in May of 2006. I started working at Owensboro Medical Health System in 2005 as a Tech Aide in the Radiology department and was offered a full time job as a Rad Tech right before graduation.

I currently work 2nd shift and just completed cross training in Cat Scan. I have to say I like it so much more than I thought I would! Cat Scan is a completely different world than regular x-ray. It took me completely out of my comfort zone and threw me headfirst into a whirlwind of new information. For the first few weeks I was afraid my head was going to explode from everything I was learning! I feel pretty confident with most exams but I have to say Chest Angios still make my hands shake!! It's so great though because I feel like everyday I'm learning something new!

Now, some more about me... I've been married to my husband David now for two years. We have a black lab named Zoey who we treat like our baby. We bought our first house here in Owensboro almost a year ago and like to spend our free time hanging out with friends and family including our 7 nephews!! We also like to do home improvement projects, the next of which is going to be putting tile down on our bathroom floor! I say "we" but mostly it will be David doing the work!

Anyway, enough blabbering for now. I'm looking forward to getting started this semester and want to wish everyone the best of luck!