To cut the long story short, a couple of us ended up at a friend’s place at night, when his dog, whom he left shut in at home for the whole day started bounding towards us at the speed of lightning.
after a bit of sniffing and jumping around, he tried to jump onto everyone. i was seated holding my knees on the floor when he managed to burrow his head in between my arm and knees and started to nibble on my arm. I pushed him away and continued to watch the tv. But, that stupid dog (I must say out front that I am a dog-lover) started to jump infront of me with his paws on my knees, trying to burrow his head in between them.
That was when he started his dry humping. With the leg of my pants.
Stupid dog.
Now i’m scarred for life.
May 3, 2008. dailies, {#^@! *&. No Comments.
tired.
sick.
pain.
stress.
sian.
unexplainable motivation towards becoming a taitai.
February 21, 2008. Radiography and Work-related stuff, {#^@! *&. No Comments.
It was a week of unhappenings again at the hospital again. I can’t seem to shake off the suay streak. maybe things will be good next wk onwards~
first day was the Queen’s birthday, yeay~ God save the Queen! the only reason i’m happy is probably becos we get to miss one day of clinicals since its a public holiday.
second day was spent in General department as usual, since no roster was up yet. Happy news was that Jon was the liason this time, not Anthony. But still the first day in general was again, plagued with mistakes.
1. Miscentering of a stage B clavicle. Too medial with too little collimation.
2. Mispositioning of a stage B pelvis. Patient was oblique due to the pain, image came out slightly rotated with slight exclusion of the tip of right hip replacement. AP Pelvis revealed left pubic rami fractures. 2 hip replacements were seen, but request form stated there were NO medical devices. O_o attempted inlet and outlet views, but didnt manage to get a very nice outlet view cos the bucky and the tube were at their maximum range. Chopped the iliac crests a little. =\
3. Scanned a cassette with a radiographer’s initials when it was she who handed the form to us. But becos of some problems, the chest xray was slightly chopped at the costophrenic angles. She was not very happy about having her name on a substandard chest xray, seeing that she’s one who actually do a rib projection with a filter.
And she said “Why is my name on this xray when I didn’t even supervise it?”
I owned up saying, ” because you handed the form to us, I scanned it with your initials on it.”
Then, she started going on to me about how to position properly, the cassette was placed in the wrong orientation, and how resolution is better when it is done landscape compared to portrait on digital systems, to which i still don’t understand. Pixel size should be the same lengthwise or widthwise, with differing matrix sizes for different cassette sizes isn’t it? Does she mean that the pixels are not squares? Can someone correct me on this? I’m totally clueless.
The point was, I was assumed to be the one who made the exposure. Not the first time during clinicals, which was quite sian. Is this what work life is about?
Third day i was rostered to the Computed Tomography (CT) room. saw 2 rainbows on the way to work that day =]
1. first case of the day was a quite a damper. the patient had 1 accompanying doctor, 2 nurses and altogether 3 radiographers. During the slide, the foley catheter was pulled out accidentally when it got caught onto something and well, urine spilled all over. really all over. over the scanning couch, over the pat slide, over the bed. And cos the scanning couch’s mattress was slightly indentated in the middle, there was literally a river of urine in it. -_- everyone had fun cleaning after that.
2. Inpatient case of abdo/pelv scan. A radiologist questions why consent was not obtained for inpatient for use of contrast as a protocol, which sent him and the radiographer into a wild debate. Atmosphere wasn’t too good in the room.
3. An inpatient for a abdo/pelv again, this time radiographer went through the possible risks involved. Radiologist scheduled for cannulation was doing an interventional procedure somewhere else, and another registrar was called in to do the cannulation. She hooked the side port of the cannula to the power injector, which of course, led to the port exploding cos of the buildup of back pressure during injection. Nothing was wrong with the patient, apart from having sticky contrast media running all over her arms. But because the patient started raving around during the scan, it had to be paused and all of us rushed into the room to see what went wrong. And just a second before that happened, Radiographer Evan just pointed out that the pressure at which the contrast was going in was particularly high.
Radiographer Nicole sprayed contrast all over herself while reloading the power injector for the second scan, so naturally she was not very happy. Registrar who connected the cannula was no where to be found. Everyone was quite pissed.
CT Machine started showing signs of hanging, as it scanned for 2cm in the scout film and stopped completely. the scans have to be replanned. And it continued to appear for the following few cases.
4. Cardiac scan for calcium scoring. Seeing that it was an ECG-gated scan, plus becos of the high amount of contrast that was going into the patient, radiographer Nicole pointed the possibility of terminating the scan halfway to the scheduled radiologist. He was not very impressed by the new 64 slice CT machine, seeing that it was actually a few months old. They agreed to continue with the scan after much consideration. Scan went on smoothly.
5. Machine finally broke down for good during a sinuses scan. Patient had to be moved upstairs for the scan. Congestion in the waiting area was a major headache as no patients are allowed to be upstairs along the corridors. One of the radiographers had to become the porter for the day, moving up and down with every single patient.
6. A couple of diabetic patients who had no case notes, and no accompanying nurses. Had to call up their clinics to make sure they had stopped their medication as they require intravenous contrast again. Didn’t help when patients themselves had no idea which medication they were on. but it all got through in the end.
Fourth day at CT again
1. Hope was on the machine getting repaired before lunchtime so that the hectic transporting of patients could stop. But it failed us again on the second case, reverting everything back to square 1.
2. Patient with allergies to contrast but doctor requested for the scan to go ahead. Gave antiemetics before contrast injection but patient still vomitted. poor guy, he was literally all jittery during the injection.
Fifth day at Angiography suite
1. first case was delayed for 1 hour, as the radiologist was unavailable.
2. trouble with paperwork, patient not registered.
3. Saw 2 rare cases that are rarely seen in Sillypore, well i haven’t seen it being done so far. then again, i haven’t seen much. heh.
Ablation of Varicose Veins (ultrasound-guided) No idea why it was don’t in the angio suite when no angio was needed. The staff from VNus was there to guide the procedure and use of the Closure.
Sclerotherapy of Cystic Hygroma in supraclavicular fossa. cool stuff. Didn’t know there was such stuff.
On the whole, the week looks like its getting better. hopefully next week will be good. Think its portables next week, need to wake up 5 plus again =_= and take walks up to the ICUs.
June 16, 2007. Radiography and Work-related stuff, {#^@! *&. No Comments.
Its officially over. Last paper was as exciting as the last with repeated sample mcqs again, with a slightly surprising decision of choice of topic asked for the 30 and 20m essays.
enough of digress, and onto the Radiology 101.
Roomie and I were curious why penile implants are considered health hazards to patients having MRI scans, as it was stated in the notes, that ferromagnetic penile implants can induce heating, with spontaneous overinflation. so we giggled, googled, and tadaa~ even though this paper didn’t answer our questions, it was still an interesting read.
An excerpt from the paper
Radiological assessment of penile prosthesis: the role of magnetic resonance imaging (direct link to article)
Ignacio Moncada Æ Jose´ Jara Æ Ramiro Cabello
Juan Ignacio Monzo Æ Carlos Herna´ ndez
World J Urol (2004) 22: 371–377
DOI 10.1007/s00345-004-0427-7
Abstract (excerpt)- Penile implants offer a dependable way of restoring erections in virtually all motivated patients. The satisfaction rate among both patients and partners using these devices is high. However, too often, urologists do not present this option with the same authority as other treatments. The reason is fear of complications and lack of expertise in managing them. Although they are not very frequent, complications may be catastrophic.
The most significant postoperative complication associated with the implant surgery is infection of the device, which is quite frequent, but some other important complications are distal and proximal perforation of the albuginea, SST deformity, ‘‘S-shaped’’ deformity of the penis, erosion of a component, and mechanical malfunction of the device.
Complications
Buckling of cylinders as seen in MRI was a strong predictor of persistent pain. Statistical analysis of the data using the odds ratio indicated that buckling was associated with a 300-fold increase in the probability of persistent penile pain compared to the absence of buckling (P<0.0001 Fisher’s exact test). The sagittal view provided the best image of the
buckled cylinders (Fig. 1) although the coronal view was also helpful.
Figure 1: Buckling of one cylinder of prosthesis (sagittal)
Figure 2: Buckling of one cylinder of prosthesis (coronal)
Buckling of cylinders is not the only pathological situation which can be assessed with the help of MRI. Infection (Fig. 3), fibrous sheath around the reservoir precluding the complete deflation of the prosthesis or around the Resipump in Mark II prosthesis (Fig. 4), SST deformity or hypermobile glans (Fig. 5) are among other pathological findings.
Figure 3: Penile edema and sepsis. Figure 5: Hypermobile glans.
Figure 4: Fibrous sheath around Resipump in a patient with a Mark II penile prosthesis.
For Radiographers,
T1 and T2-weighted images are obtained with a pelvic surface coil using the spin-echo technique for tissue contrast, with the prosthesis in the flaccid state and then in the inflated state after activating the pump mechanism. Sagittal, axial and coronal views are normally obtained in every case in each state. In addition, oblique views are occasionally obtained. Penile length from pubis to glans may also be measured with the help of
MRI in the flaccid state and after full inflation of the prosthesis.
MRI provides good definition of the tunica, cylinders and prosthesis reservoir in each projection during flaccidity and erection. The pump is less clearly defined, probably due to its metallic parts.
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Its been declared officially, we have a natural disaster on hand! the storm is bringing Ozzie is long-awaited supply of rainwater, even though inefficient damps and catchment areas are at fault. to date, we braved 2 storms to get to school for the papers, once to get to Vincent’s for dinner, have a combined record of 3 spoilt brollies from the wind, wet clothings and more wet clothings, and 10 numb toes on my feet.
couldn’t sleep last night because of the furious vibration and rattling of the windows and frame from the wind. only managed to catch 2.5 hrs before the paper. and now, i really swear, the wind is really really intent on ripping our bedroom windows off. quite scary actually. x_x
June 9, 2007. Radiography and Work-related stuff, dailies, {#^@! *&. No Comments.
I am so freaking mad, upset, pissed, *inserts a dozen more negative emotions.
1. Radiographic Practice Paper
The 1 hour long paper, which includes 20mcq, 1 compulsory essay, and 2 choose 1 essay question was totally what sinGARpoleans would describe as cheeken feet. But, I’m just super irritated by the fact that i’m gg to get a grade based on my writing speed, not what I know. ok, ok, fine, yea, if tat’s the case then everyone can get As. But I’m just irritated. So i’m here venting my frustrations away on the keyboard, when i have another Sonography paper (1 hour also, if you’re interested) in less than 14 hours. Whatever, ANGRY!!
2. Radiographic Practice Assignment
The grade wasn’t too bad, but falls short of what I expected. i dunch rikez. The marker scrawled comments in red all over my work. It would really help if I could actually read it, rather than trying to appreciate the artistic sense in it. And it didn’t help when my roomie actually pointed out that 2 words in the comments read “lousy, lousy”. T_T I should just go and hide in the toilet for the night, and bury myself with ultrasound images while taking in the smells and sounds.
3. Hotdog
My hotdog didn’t explode in the oven today. I like to eat exploded hotdogs.
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tell me what else can happen, huh, huh, huh. this sem is really not the sem for me. All the stuff that has happened.. I feel like i’m a transplanted organ (ectopic kidney) being rejected by the big Aussie oie oie oie (patient). This place is really not for me.
what else. want come, everything all come together lah. 來吧！
June 4, 2007. {#^@! *&. No Comments.
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