Category Archives: Ultrasound

Sweet and Sweet Caffeine

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I had a good weekend at work.

Not only because there was a time change that meant my 12 hour shift was actually only 11, and not only because I had a great book that I thoroughly enjoyed, and not even only because I met some great new friends… because I also had the pleasure of meeting some amazing patients.

I scanned a patient this weekend that was sweet as could be, looked to be probably 42 or 43, and enjoyed talking.  I spent probably more time than I should have out in the hallway with her, talking about life and how we perceive it.  We talked about not knowing the true trials other people are going through, and only being concerned with our own.  I told her about Layla Grace, and how it opened my eyes to the difficulties that other people face, and how they can touch our lives if we let them in.  She told me about her children, and her grand children, and her work.  She also told me she was 58, and it blew me away.  She looked AMAZING.  Our conversation really got me thinking.  I really enjoyed meeting her.

I scanned another lady that had had multiple previous exams, and made another snap judgement.  She was overweight, covered in tattoos and I figured she was probably a drug seeker.  Then we started talking.  She asked me about the picture of Ronan on my badge, and we talked about kids.  She told me that she was told she would never be able to have kids, and her little boy is her miracle babe.  We talked about the love of parenting, and how it’s the truest, purest form of love.  We talked about people who don’t want kids, and how we wished we could fully show them how amazing it is to be a parent.  We talked about family size, and infertility, and the joys of pregnancy.  We talked for much longer than the elapsed time of the exam and when she left to go back to the Emergency Department, I was a little sad to see her go.  I told her it was really great to have met her, and I had enjoyed talking to her.  She said the same, and to take good care of my sweet little boy.  I smiled for quite a while after the exchange.

I scanned a sweet old lady that was deaf as a post.  She couldn’t have been more than 60 pounds, and I all but lifted her from the wheelchair to the bed.  She would ask me questions loudly, and, unable to hear the answer, just assume I had said what she wanted.  ”How longs it gonna be?”  ”ABOUT 15 MINUTES,” I told her.  ”Oh okay.”  ”Help me burp,” she asked me.  So I stood there, patting her back while she curled up, trying to burp.  Her ribs protruded out so far, I felt like I was abusing her.  ”I just can’t get it out!” Later on, she’d ask me, “Are we about done?” every two or three minutes during the exam.  When she was all finished, I sat her up and told her we were going to move back to her wheelchair.  She said, “Just let me sit a minute!  They’re going to take me back up right away, right?…” She paused for a moment, then held her arms wide open.  ”…Give me a hug.”  I gave her a hug, and she squeezed me tighter than her frail frame suggested was possible.  She patted me on the back, and said “You’re sweet.  Ok, lets go.”  She was confused and suffering from dementia, but she was sweet as could be.  Her hug made my day.

I also had caffeine.  It really made a huge difference in my night shift.  For the first time, I had just as much energy at 4am as I did at 8pm.  I even danced around when a good song came on.  I don’t know how I’ve lived without it for so long.  I know so many people who have multiple, several caffeinated drinks a night… I was flying off of half a Coke.

Last, but not least, I read an amazing book this weekend.  The whole thing.  I couldn’t put it down.  I’d love to write a review on it, so I’m not going to get into too much depth here.  But it was Tales from the Trips, by John Cave Osborne.  Fantastic read.  One of the best parts of my whole weekend.  More on this later.

So nice to write a positive post about work.

Ultrasound Resonates: The Father.

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I didn’t have a chance to sit and write yesterday, but this has been on my mind.

Sunday night was one of the worst nights I have ever worked in my entire career.  I did over 20 exams in a 12 hour shift, and I was fully exhausted by the time I was ready to come home.  I can hardly remember faces of most of my patients, let alone stories about them.  They all seem to blur together.

However, there is one fellow that stood out.  He was one of the last exams I did on Monday morning.

He came in through the ER with severe chest pain.  The ER, of course, did a full Heart Attack work up, and then sent him over for a gallbladder ultrasound when everything was negative.  As I was scanning him, he told me about the last time this had happened.  He said that he had a stabbing pain in his side, and that it was too uncomfortable to ignore.  “I woke up in the middle of the night feeling like someone was sticking a needle in my left side.  I told my wife, and she said it was just indigestion, and told me to go back to sleep.  So I did.  The next morning, I woke up and it was worse.  She still thought it was indigestion, and she told me, ‘Go to the hospital if you want.  It’s indigestion.  I’m going to work.’  I called my daughter and had her take me to the hospital.”

He went on to tell me that they admitted him to do some tests, and he ended up spending the night.  After all the cardiac tests were done, the doctor came in the following morning and said, “You passed the stress test with flying colors.  Your heart is working.  But we’re prepping you for surgery in 2 hours.”

I was shocked!  This guy was relatively thin, healthy appearing, didn’t smoke… I asked him what kind of surgery he had.  They did a double stent in his heart, and then took him into an endarterectomy surgery on his neck – he had had a greater than 95% blockage of his left carotid artery.  It was then that I noticed the massive scar on the side of his neck.  I jokingly asked him if he has let his wife forget about it yet.  He chuckled and said, “She’ll never live it down.  But today, when I said my chest hurt, she was out in the car before I had a chance to pull my pants on!”

I finished my exam relatively quickly, and had moved him back out into the hallway, but continued to chat with him.  He was telling me about his daughter and how she was interested in becoming a Sonographer.  He asked me questions about how to get into the field.  I cant exactly remember how we got on to the topic, but he then started telling me about how he’d had a stroke, and it took them weeks to find it.  He said it started out with severe headaches, and seeing seven or eight doctors for it in the course of a month.  Someone finally put him on a steroid and a pain killer for it, and whenever he took the medicine, he would have seizure-like activity on one side of his body.  At that point, one of his doctors finally decided it was worth their time to do some diagnostic testing, and found that he had had a major stroke to the back of his brain.  He went through months of rehab and has been on blood thinners ever since.

Around that time, the transporter had arrived to take him back to his room, and even though it was on his paperwork, I couldn’t believe all of the medical problems he’d had, so I asked him how old he was.

He said, “I’m fifty-five this year,” Dad.  And for the last 24 hours, I couldn’t stop thinking about you.  This poor fellow is sitting in the hospital trying to find out what’s wrong with him, and all I can think about is you.

Ultrasound Resonates – Sweet Innocence.

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BABY_3It’s no surprise that during the course of my work, I meet young girls that are having babies.  Babies having babies.  Little things that are too young to know how to get the oil changed in their car, and yet they’re about to bring life into this world.  It scares the living crap out of me.

Last night was no different.  Now, this was not the worst case I’d ever seen.  My patient was 18 years old, which is ripe and mature by the standards of my hospital.  And, to be completely honest, I fully expected this to be her second or third pregnancy, which is also common as cake.

I rolled my little patient into the room, and had her get up on the bed for me.  I had to move her IV pump from the wheelchair to the bed post, and those things weigh almost as much as I do.  I said, under my breath, “This isn’t going to be fun.  Ugh.” as I started to un-attach the pump.  She looked at me with terror in her eyes and asked, “What’s not??”

I chuckled and said, “Don’t worry, hun.  I just have a really hard time moving these pumps.  They’re heavy.  Your ultrasound isn’t going to be bad at all.”

Her relief was immediate and not just a little comical.  I had already figured out that this little girl was terribly innocent, and not terribly bright.

As she laid down on the bed, she said, “Look how swollen my feet are!”

They were.  They were sausages.  Her toes were like little Vienna snacks attached to her pork feet and ham-hock ankles.  It was disturbing to see on such a small girl.  She couldn’t have been more than 5 foot 2, perhaps 120 pounds at 35 weeks pregnant.  I asked her, “Have you had a high blood pressure?”

“Yeah.”

At this point, I had started scanning, and had seen that her baby looks great.  There was plenty of fluid, measurements were on time, and the kid was active – kicking and turning all over.  As I’m showing her where the baby is laying, and what parts are sticking out of her belly, she quietly asks me, “Do babies that are born at 35 weeks survive?”  I could hear the fear in her voice.

“They do, sweetie!  Almost every single one of them do!”  My heart was aching for her, and the absolute terror she had of her baby dying.  “They have to go to the NICU for a little while, but then they are okay… Are they worried the baby is coming?  What’s going on?”

“They’re maybe going to induce my labor tomorrow,” she told me.

Hmm.  Swelling.  High blood pressure.  “How high has your blood pressure been?”

“It’s been about 190 over something.  I don’t really know.  It’s come down to 160 though.”

My eyes flew wide open.  “Have you been having headaches?”

“Really bad ones.”  I could tell she had no idea.  Her blood pressure, the headaches and swelling all pointed to pre-eclampsia.  They weren’t taking the baby because they were worried about the baby… they were worried about momma.  And the sooner they got that baby out, the better.  I told her that it was a good thing that they were thinking about inducing her labor.  She shouldn’t be afraid.

She was quiet for a moment, and then asked, “Do they let mommas see the babies when they are in the NICU?”

I was speechless.  My eyes even started to tear up.  This poor, sweet, clueless girl was about to birth a child – HER child – and all she could imagine was someone coming and taking it away to an unknown corner of the hospital, and keeping it.  I can’t imagine the fear that was in her heart, or how badly she wanted to hold on to being pregnant, despite what it could mean for her.

I set her straight, told her that it was still her baby, and she could spend every waking moment in the NICU if she wanted to.  I gave a little mini-PSA about how important it is to breastfeed premature babies, and told her how much every nurse in the hospital would help her if she tried.  And then I sent her back to her room, hoping for the best for her and her baby.  Hoping that everything would turn out okay.  Hoping, really, that she was more ready for what was about to come than she seemed.

Ultrasound Resonates is a way for me to share stories of my experiences in ultrasound.  Privacy and HIPAA will always be protected in these stories, but they are really a way for me to share an accounting of the people that touch my life through my work.


Ultrasound Resonates: Snap Judgments

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As you may or may not know, I am a Diagnostic Medical Sonographer.  That is just a huge mouthful of words that means that I do ultrasound.  I have to admit to you, I used to be lucky enough to work in the field of my passion: Obstetrics… pregnant mommies.  But since the birth of my child, and the overwhelming desire to stay at home with him as much as possible, I have taken a job as an Ultrasound Technologist in a busy hospital.

Ultrasound Resonates is a way for me to share stories of my experiences in ultrasound.  Privacy and HIPAA will always be protected in these stories, but they are really a way for me to share an accounting of the people that touch my life through my work.

Last night was a busy shift.  It had been slow nearly all day, but as soon as all of my day-time co-workers punched out, the Emergency Department punched in.  Within fifteen minutes, there were several ultrasounds in the queue, and my evening help wasn’t scheduled to come in for another hour.  I sent for a few of the patients, knowing that by the time transport got them to me, I would no longer be scanning solo, and I got to work.

When you’re busy and behind, it’s very easy to get frustrated by the exams that are ordered, and the people that you get used to seeing in the ED.  We call them “Frequent Fliers.”  Some of our most common customers are young pregnant women who are mistakenly told by their friends that if they go to the Emergency Room and say they are in pain, they will get an ultrasound and find out the gender of their child.  We HIGHLY DISCOURAGE this practice, mostly by completing OB ultrasounds without ever showing or telling the mother what the results of her exam are.  We point out very clearly from before we even touch her with a probe that we are not allowed to talk about the ultrasound, and that the doctor in the ER will tell her what the exam showed when she returns to her room.

One of the transporters dropped off an ER case for me, and left.  I glanced up at the camera and saw a young woman in the hall with her husband waiting.  A quick check of her ER chart told me that she was about 10 weeks pregnant with abdominal pain.

And then I did it.

I made a snap judgment.

I immediately assumed she was one of the young ladies that came to the ER to see her kid.  I instantly found myself upset at her for wasting my time, and coming to the hospital when she could have just stayed home.  I wasn’t rude or mean to her when I brought her into the room, but I wasn’t exactly warm and compassionate either.  My snap judgment had made me curt, even cold towards her.  When I had her prepped, I started asking her the routine questions.

“When was the first day of your last menstrual period?”

She told me.

“Which pregnancy is this for you?”

‘This is my tenth.”

SEE?!  There, I was RIGHT.  My snap judgment was RIGHT.  She just cant stop having babies.  I bet she does this every time.  Just keeps coming back to the hospital.  I bet she keeps having abortions.  I see it all the time.

“And how many children do you have at home?”

“Seven.”

Seven children?  Holy crap.  Who wants that many kids?  How many of those are accidents?

“Ok.  So you’ve had two miscarriages or abortions?”

She paused.  “… No.  I had a baby last year that died at 4 months old of SIDS, and 3 months ago I had a miscarriage at 18 weeks.”

…

Wow.  Take a breath here, Mandy.  That’s some heavy stuff to go through.  No one deserves to have to deal with that.

“Oh no, I’m so sorry.  I can’t imagine how difficult that was.”

She then proceeded to tell me what was going on, how she’d been feeling pain for a few weeks, and assumed when she went to her OB appointment that they would tell her she had a urinary tract infection.  When they didn’t find anything, she started to worry.  With her recent history, her mind just wouldn’t rest.  And I could completely empathize with her.  I even had tears in my eyes as she spoke.  Every night when I put Ronan to bed, I worry that he wont be there when I wake in the morning.  It’s a very REAL fear that she has already lived.  My worst nightmare has been her reality.

From that point out, things were different.  We talked, we laughed, and I found out that she is actually an amazing person; a loving mom, a caring wife and a hard working nurse.  She told me about her seven children at home, and how each one of them was planned and lovingly awaited.  She told me how all of them got their names.  She said how they have partners that they help take care of and get ready in the mornings, and about how when they go to the grocery store, people always come up to her and compliment her on her well behaved children.  She could tell me things about every single one of them, each one as precious and amazing to her as the last.

Last night, I found out that she was the kind of mother that I want to be.  When she left my department, I had nothing but respect for her.  While I didn’t get to tell her anything, I let her go with the peace of mind knowing she was about to find out her baby was ok.  And I found out that my snap judgment was dead wrong… as they almost always are.