My eyes are burned by the fluoro

Finally, something happened that was worthwhile to blog about. My clinical placement at Westmead started yesterday.

There are six guys altogether at Westmead, including me. We're all in the same awkward position; technically, we're second-years, but we really only have first-year knowledge. Plus the assignments that we have to do really screws things up a little bit.

It was the usual show and dance. We rock up, get kicked in the teeth with all the OH&S and emergency regulations and get the standard tour around the department. This being my second time at Westmead, I had a good idea of where all the departments are located. The radiology department is full of right angle turns and intersections, so you best bet is you're lost is to turn randomly and if it's a dead end, go back and take another path. Personally, during my first visit I spent a ridiculous amount of time simply walking to the other departments, using the tea room as my reference point. So I can always find my way to and from the tea room.

I've been working in fluoroscopy since the beginning and will stay there until the end of the week. Fluoroscopy is basically real-time x-ray imaging. Occasionally, patients will swallow some barium contrast to show extra details. Apparently that tastes really bad because a prison inmate was supposed to get x-rays of his throat and he puked on the barium and refused point-blank to drink any more. And he was supposed to swallow it two more times.

Fluoroscopy is pretty good in that, there is only a handful of ops in the morning and there is plenty of time between ops to have a break. Some ops can take well over an hour and the other radiographers there brought books along to pass the time. Unfortunately the time can work against you. Today, there was a patient in for an op on his small bowel. Twist number one: he has MRSA. Look it up if you don't what it is, but it's bad. During the op, we injected contrast into his system. As it made its way through the bowel, we gave him three booster shots of contrast to ensure it would reach the whole bowel. Which leads onto the second twist: he shat himself. He wasn't in the best of shape, so the booster shots actually worked against us in the end. It soaked through all the layers of sheets and reached the foam mattress. Plus he has MRSA. So we had to disinfect everything with copious amounts of hospital-grade disinfectant. This sort of shit doesn't happen often, so it was bad luck for us.

I also go to sit in on an ERCP prcedure. ERCP stands for Endoscopic retrograde cholangiopancreatography, and it combines fluoroscopy and endoscopy to treat problems in the pancreatic duct systems. It's pretty simple actually, you turn on the real-time x-rays when the doctor tells you to, and you take an x-ray when the doctor tells you to. And it has 20 minutes gaps between ops. The bad thing is that the doctors always seem to speak softly, so you have to concentrate like hell on listening to the doctor. I had a go at using the system during an actual op and there is nothing worse when you miss the doctor's words and he has to repeat them. That happened to me several times and each time I felt like a complete dill.

Well, the clinical is only two days in and I have 28 days left. Now off to bed to rest. I can't remember the last time that I had to stand with no place to sit for 7 hours.