Despite the lack of another knee-jerk reaction towards an pandemic of the Swine flu, this flu season will most likely be huge due to the lack of education or most likely, the lack of applying education. Patients in our facility refuse to wear blue masks.
I work in a hospital where daily I'm seeing Mexicans carrying masks. Not wearing, carrying them. All day long these miracle masks help prevent the spread of the H1N1 (Swine Flu) virus. I see them tucked in back jean pockets, top shirt pockets and small children chasing their masks around waiting rooms. Kids like to pretend they are mini parachutes. The parents nearby totally oblivious to the problem.
As offended as many may be by this comment, it is just a fact that I only see dark skinned immigrant appearing people walking around with masks. Sure I'll occasionally see a white person (who knows, could be German or Australian) wearing a mask (yes, actually wearing). But those individuals are clearly patients currently under chemotherapy.
Two recent incidents in my department. I took their Chest X-ray and after excusing them from the exam room, the patient proceeded to remove their mask as they walked out the door and to return back to their doctor's office. Another removed her mask in order for her to cough outside of her mask. Nice.
We've had numerous deaths in our hospital due to the Swine flu. Even pregnant women have been delivering babies who have confirmed Swine flu already. As much as I hate to say it, they are mostly Mexican or Hispanic.
In addition to not wearing their masks, they also do not cover their mouths when they cough. But that's not just a Mexican issue, it's apparent with all races. I've never seen so many people walking around, adults mind you, coughing straight into the air, no head turned to the ground, no cough into the shoulder, not even a hesitated raise of the hands as if to not catch the cough in time. I find myself holding my breath after "drafting" behind some patient in the halls only to have them cough full force straight ahead of them.
Try this experiment sometime; around 2 hours until sundown, sit across from somebody who's back is turned towards sunlight. In just normal conversation, you can see fine mist droplets flying from the person's mouth 4 feet across from you. A cough or sneeze carries those droplets at least 2-3 times further than the normal speaking distance.
None of these people are going to change, nobody is going to stop them and we will end up having the biggest flu season anyone has seen in awhile. Nothing will be done until numerous people will begin to die in the thousands. Nothing preventative outside of this year's flu shot is currently being done to prevent this from becoming a bigger problem.
I'm not sure what the problem is. Is it staff that do not speak Spanish in order to inform the patient not to remove the mask while in the facility and just merely hand them the mask without instruction? Or is this just pure ignorance as to how the mask provides a barrier for the spread of germs and spores.
Who knew covering your cough, limiting yourself around crowds, and washing your hands frequently could be so difficult to follow.
Saturday, September 19, 2009
Saturday, August 22, 2009
Doctors Quick To Blame X-ray Techs, Again.
Okay, you knew it was coming. I've been sitting idle on this blog for quite some time. Now I'm finally moved to voice my opinion, a rant if you will. In the past few months I think I've let my Radiology followers down with guitar postings and more personal life reflections. So here it is.
I work in a facility that has an Urgent Care. For some reason, these doctors have complete confidence in their nursing staff to triage patients for x-rays. Double overlapping orders like "Right Finger" and "Right Hand", "Left Wrist" and "Left Hand". Basically really have no clue as to what will show the area of interest. We get orders all the time requesting "Shoulder, Elbow, Wrist, Hand". That translates to 3 images for the shoulder, 4 images for the elbow, 4 images to the wrist, and 3 images to the hand. That's a grand total of 14 shots of radiation to the body. Little do they know, they've just missed anything that might be broken in the humerus (between shoulder and elbow) and the forearm (between elbow and wrist). But don't ever bring that up because that might get thrown in there too if the ordering nurse is second guessing herself. We hardly ever get just a humerus and forearm ordered. This would show the entire humeral shaft, show a portion of the shoulder and two views of the elbow. Then the forearm order will overlap studies by providing views of the elbow while still visualizing the wrist and entire forearm. If anything, the ordering nurse should resort to this if he or she is doubtful as to what's visualized.
When x-raying a body part, there is a certain amount, criteria if you will, regarding the total area to be visualized. Outside of that perimeter may be considered as irresponsible use of radiation. The larger the beam, the more amount of radiation being used. Because of billing reasons, we are required to stay within the boundaries of which to image a body part. Outside of those boundaries are considered fraud, seeing more on an image than what's considered standard (translation if more than half of another body part is shown on an image then you took two exams for the price of one.)
Anyway, the point of all this information leads me to my next point. Doctors like to use words like "they" when describing something when things go wrong. When "they" is used when describing a wrong order, the patient interprets "they" as "x-ray", the people who took the pictures, never the idiot nurse who's not aware of anatomy. I performed a wrist exam on this elderly man a few days ago. I did the 4 required views and sent the patient back to the Urgent Care. About a half hour later, this patient returns with their wife for a forearm exam. I kindly mentioned, "oh, so you're back for more x-rays"? She replies, "the doctor said that you should have included more of the arm" and points to the middle of the forearm. Rather than go into a whole blame game with the patient, who really doesn't want to hear excuses but to just find out what's wrong and go home, I calmly mentioned that we are required to only x-ray so much and that it's not up to the x-ray tech to determine how much of an area, mentioned also about the exam is like a prescription, I can only do what's ordered. I'm fast so they were in and out quickly, all that really mattered to them anyhow.
But I can see how people can get things twisted around with a word like "they". I'm sure the provider said, "oh, they were supposed to get more above the wrist" could have implied that the nurse ordering the initial exam forgot to order a forearm with the wrist. Now you can see where the problem is.
The problem is that our Urgent Care nurses have been given the thumbs up to check patients in, ask them where it hurts, and then send them off to x-ray, BEFORE THEY HAVE BEEN SEEN BY THE DOCTOR! So we get lumbar spine orders when it's clearly a case of constipation. Orders for shoulder/elbow/hand x-rays for numbness and an hour later the patient returns with a Cervical spine order (don't get me started on the oblique orders for MVA patients). Or even better, an elbow and wrist order with comments stating, "show entire radius and ulna" only to call the doctor and be told, "I can't find the proper order, can't you just open the beam up and show me the whole forearm?" Yet time after time after time, WE the tech are portrayed as the idiot, the staff to point the blame to when something goes wrong. In some ways it's very similar to high school clicks, one group views they are the most important to the hospital. But let's face it providers would be BLIND without x-ray.
I work in a facility that has an Urgent Care. For some reason, these doctors have complete confidence in their nursing staff to triage patients for x-rays. Double overlapping orders like "Right Finger" and "Right Hand", "Left Wrist" and "Left Hand". Basically really have no clue as to what will show the area of interest. We get orders all the time requesting "Shoulder, Elbow, Wrist, Hand". That translates to 3 images for the shoulder, 4 images for the elbow, 4 images to the wrist, and 3 images to the hand. That's a grand total of 14 shots of radiation to the body. Little do they know, they've just missed anything that might be broken in the humerus (between shoulder and elbow) and the forearm (between elbow and wrist). But don't ever bring that up because that might get thrown in there too if the ordering nurse is second guessing herself. We hardly ever get just a humerus and forearm ordered. This would show the entire humeral shaft, show a portion of the shoulder and two views of the elbow. Then the forearm order will overlap studies by providing views of the elbow while still visualizing the wrist and entire forearm. If anything, the ordering nurse should resort to this if he or she is doubtful as to what's visualized.
When x-raying a body part, there is a certain amount, criteria if you will, regarding the total area to be visualized. Outside of that perimeter may be considered as irresponsible use of radiation. The larger the beam, the more amount of radiation being used. Because of billing reasons, we are required to stay within the boundaries of which to image a body part. Outside of those boundaries are considered fraud, seeing more on an image than what's considered standard (translation if more than half of another body part is shown on an image then you took two exams for the price of one.)
Anyway, the point of all this information leads me to my next point. Doctors like to use words like "they" when describing something when things go wrong. When "they" is used when describing a wrong order, the patient interprets "they" as "x-ray", the people who took the pictures, never the idiot nurse who's not aware of anatomy. I performed a wrist exam on this elderly man a few days ago. I did the 4 required views and sent the patient back to the Urgent Care. About a half hour later, this patient returns with their wife for a forearm exam. I kindly mentioned, "oh, so you're back for more x-rays"? She replies, "the doctor said that you should have included more of the arm" and points to the middle of the forearm. Rather than go into a whole blame game with the patient, who really doesn't want to hear excuses but to just find out what's wrong and go home, I calmly mentioned that we are required to only x-ray so much and that it's not up to the x-ray tech to determine how much of an area, mentioned also about the exam is like a prescription, I can only do what's ordered. I'm fast so they were in and out quickly, all that really mattered to them anyhow.
But I can see how people can get things twisted around with a word like "they". I'm sure the provider said, "oh, they were supposed to get more above the wrist" could have implied that the nurse ordering the initial exam forgot to order a forearm with the wrist. Now you can see where the problem is.
The problem is that our Urgent Care nurses have been given the thumbs up to check patients in, ask them where it hurts, and then send them off to x-ray, BEFORE THEY HAVE BEEN SEEN BY THE DOCTOR! So we get lumbar spine orders when it's clearly a case of constipation. Orders for shoulder/elbow/hand x-rays for numbness and an hour later the patient returns with a Cervical spine order (don't get me started on the oblique orders for MVA patients). Or even better, an elbow and wrist order with comments stating, "show entire radius and ulna" only to call the doctor and be told, "I can't find the proper order, can't you just open the beam up and show me the whole forearm?" Yet time after time after time, WE the tech are portrayed as the idiot, the staff to point the blame to when something goes wrong. In some ways it's very similar to high school clicks, one group views they are the most important to the hospital. But let's face it providers would be BLIND without x-ray.
Thursday, August 13, 2009
The Fergussons
I've been spending my time searching for old photo albums. One of my finds was this picture taken in Canada in 1973. This image produced an explosion of memories about my grandparents. My grandfather passed away in 1998 from complications due to lung cancer. He once told me that he had smoked since he was 16 and didn't stop until he was in his 70's. My grandmother was diagnosed with Alzheimer's Disease in the late 90's. She may have had it before 1999 but my grandfather kept it pretty well hidden from the rest of the family. Mind you, that generation learned to keep immediate family issues hush. When my grandfather died, we found out pretty fast about grandma's condition and placed her in an assisted care facility. It was when their house was being sold that my mom obtained personal belongings from my grandmother. This is the first time I've ever seen these albums. It's brought laughter and a lot of sadness to realize they are not here with us anymore.
One album in particular caught my attention. A simple trip to Canada in 1973. My grandfather was born in Albany Canada and later moved to the US. They meant everything to each other. Married in 1970 (my grandfather divorced from a previous marriage, and my grandmother a widow) they appeared to be inseparable. He was the only grandfather I knew. My own grandfather died a year before I was born, taken by leukemia in his late 40's.
My grandfather always spoke his mind with the usual catch phrase at the end, "are ya with me?" He may have seemed like he was annoyed by my lack of planning, but you knew he was telling you because he cared.
My grandmother was very simple, almost unaware of what's going on in the world. She definitely was from the "man takes care of everything" generation. With her big silver wig, sharp features and those cool Ray-Ban "cat eye" sunglasses (back in the 60's and early 70's), she was always dressed to the 9's for every occasion.
I have cousins, grandchildren from my grandfather's previous marriage. They all lived in Seattle, Washington at the time. When I was 12 or 13, my grandparents invited me to fly up and visit. I never grew up with any brothers or sisters so visiting my cousins was like the best thing ever. I loved being with my cousins, they were never thought of as step family. Some of my best vacation memories are with my cousins.
During the flight, I remember grandpa putting on the disposable earphones (you'd plug into your armrest and there was a dial to select preset stations), turning the station to his favorite Lawrence Welk music. Grandpa stuck his nose in the air, swaying back and forth in his seat while snapping his fingers to the beat. Of course I couldn't hear the music, but I could tell what he was listening to. I used to get stuck watching The Lawrence Welk Show whenever I'd spend the night at their house. I'd usually just lay on the floor and pet their golden labrador, Candy.
They had a place down in Corona Del Mar, a beach getaway. I'd spend the weekend with them every so often. Around 5:00 PM, we'd leave to go to a place called The Quiet Woman. Grandpa would joke around and say, "Okay Dave, let's go to the Headless Woman. Grandma would quickly correct grandpa and say, "The QUIET Woman Alec,...the QUIET Woman". I've shared that story with my own daughters and every once in awhile I'll take Pacific Coast Highway through Corona Del Mar on my way to Laguna Beach, and point out The Quiet Woman to everybody. Of course everybody in the car responds, "The Quiet Woman Alec, The Quiet Woman".
A favorite dish that was served on weekend visits at the beach house would be barbecued swordfish. It was sooooo good. In fact, after finding these pictures of my grandparents, I decided to extend grandpa's summer tradition of occasionally serving swordfish to my family and friends. I know I'll think of my grandparents every time I grill it up. I miss them very much. I miss grandpa's wisdom. There have been so many times I wanted to call him up and ask his opinion or advice regarding something. I miss watching him build things in his garage at the beach; clocks, airplanes, and other around the house repairs. At the time, you never picture life without them...are ya with me?
Tuesday, June 30, 2009
2009 StewMade "70's Appliance Guitar" Avocado Burst.
I was trying to capture all the 70's "ugly" in this guitar. But it turned out to be a little more tasteful than I expected.
Friday, June 12, 2009
The Old Toshiba is Finally Digital: Siemens DR.
It's finally here and fully functional. A big long awaited change. I thought I'd really miss the old Toshiba room, but this new DR room is amazing.For those who don't was "DR" is, it's basically a direct capture x-ray room. Instead of using x-ray cassettes (special designed film holders to rest the part being x-rayed) you place the part in a large sensor area and the image shows on a flat screen monitor within seconds. No need to run back and forth into the room to change out these cassettes. I review, highlight and send immediately to whoever needs the exam. Doctors can see these images within seconds.
So no more lost films, no more film jams, no more processor chemical smell and doctors don't have to wait for their films to be delivered by doddling patients who decide to stop by the coffee cart on their way back to the doctors office.
Very cool.
Tuesday, May 26, 2009
Finally Found A Decent "Point and Shoot."
After agonizing research and reading every camera review under the sun, I finally found a great P&S digital camera; the Olympus Stylus 1020 10.1 megapixel camera.
It's a step up from what I had before (Olympus Stylus 720 7.1 megapixel) and read many raved reviews regarding this camera. The zoom is INSANE! I'm not sure what new technology they put in this camera (I thought it had the clarifying "motion blur correction" that my 720 had) but now I can zoom 7X and not get a blurry picture (something my other camera could not do). Plus all the familiar menus and a few new ones to add, that keeps this camera in the quick to use category.
I like how you can switch from normal to fine and also alter your shadows prior to exposure. Edit features feel like you're at the will of the camera, not much control. Think of it more like a auto improve function; you're not sure what it's correcting but it does seem to really improve images if they are a shy too dark or too contrasty.
I'll probably still get a SLR digital camera for more serious camera shots. But for a grab and go to Disneyland or family BBQ, this camera is perfect. Oh, and I saved about $80 by purchasing on ebay. I paid about $174 when major stores were selling for $279 or a little less.
Tuesday, April 28, 2009
Not The Best Week for My Daughter.
My daughter's birthday was yesterday. I got a phone during the middle of the day from the school nurse saying that she didn't feel good. She had a headache and stomach didn't feel very good. Since the Swine Flu virus is going around, the nurse showed me that they all received a memo regarding the outbreak and recommended that I take her home.
She was asleep when I went to pick her up and had a low grade fever. I gave her some OTC medication and of course she perked up after about an hour.
We had planned to go to Disneyland after school but her illness canceled that. Around 4:00 she asked when we were going to Disneyland. Once I told her we weren't going, she freaked out crying and begged me to still go. Then she screamed "this is the worst birthday ever" and ran off to her bedroom. Of course the Tylenol wore off and she was feeling sick again.
Tuesday, she comes home from school complaining of flea bites all over her body. We just washed her bed sheets the night before so It thought this was odd. She complained that she itched all over, pulled up the back of her shirt and thousands of red dots were all over her back. I said, "chicken pox". We went online and looked up images of flea bites and they looked just like her back. So it's flea bites, right?
Wednesday, the school sends her home because she and 4 other students in her class were sent home also....with the chicken pox! So my daughter will be staying home this week with no soccer because of her chicken pox and sore ankle from an injury 2 weeks ago. So now on top of this Swine Flu pandemic scare in the news and all that has happened, my poor daughter has just about had it with illness.
She was asleep when I went to pick her up and had a low grade fever. I gave her some OTC medication and of course she perked up after about an hour.
We had planned to go to Disneyland after school but her illness canceled that. Around 4:00 she asked when we were going to Disneyland. Once I told her we weren't going, she freaked out crying and begged me to still go. Then she screamed "this is the worst birthday ever" and ran off to her bedroom. Of course the Tylenol wore off and she was feeling sick again.
Tuesday, she comes home from school complaining of flea bites all over her body. We just washed her bed sheets the night before so It thought this was odd. She complained that she itched all over, pulled up the back of her shirt and thousands of red dots were all over her back. I said, "chicken pox". We went online and looked up images of flea bites and they looked just like her back. So it's flea bites, right?
Wednesday, the school sends her home because she and 4 other students in her class were sent home also....with the chicken pox! So my daughter will be staying home this week with no soccer because of her chicken pox and sore ankle from an injury 2 weeks ago. So now on top of this Swine Flu pandemic scare in the news and all that has happened, my poor daughter has just about had it with illness.
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