Hello,
Thought I best come and update this before it didn't happen at all. I've been meaning to all week! This week I have been in CT for the whole week and I was right to be apprehensive. Just as I thought it was not my cup of tea at all although over the course of the week I went from absolutely hating it to finding it bearable. As with most things in life it depends on the people you are surrounded by as to whether something is enjoyable or not doesn't it? That being said, CT just really didn't float my boat but at least I know that now and it's something I learned about myself.
Ok, so in CT you are really working as part of a team. At least two radiographers are always present because you administer a contrast (Optiray 300) which is typically 100 ml and I think (although I could be wrong) is primarily iodine based. Depending on what you are examining there may be a delay between injecting the contrast and taking the images so you may do two or three series of images, i.e before contrast, soon after injection and then another after a ten minute delay depending on what you are looking at whether it's blood flow in the heart and the course of the aorta or whether you are looking at the kidneys and the ureters. The reason for the delays and different timings for injecting contrast and taking images is also so that when looking at blood flow you can look at arterial and venous phases.
Sorry if I am talking more gibberish than usual today, I am kind of taking notes for myself to jog my memory if I need to look back and think about what I have done and what I learned this week and to be honest some of it I need to double check on the accuracy. So anyway, most of the examinations I saw were for CT head, high res chest, thorax, abdomen, pelvis, triple phase kidney and CT urography. They seemed to be the ones that appeared continuously but I also saw one or two shoulder examinations and an exam that looked at blood flow all the way down into the legs.
I always used to think CT was nice and peaceful and quite a relaxed environment as whenever I've had to go down there to help with a PAT slide or pass on a message all you ever seem to see is the radiographers sat behind the lead screen drinking coffee and having a relatively easy life compared to the rest of the department but looks really can be deceiving. Having spent a week in there I would say it has been the busiest of all the different modalities I've been to the past two weeks. It is extremely hectic and as you would expect you get patients in all kinds of states.
There are ward patients and outpatients to get through and then you get emergency patients being sent round from A&E or other sources who require urgent referral for CT. From what I remember I think most of these were head scans and after a few days I was able to get patients onto the table and position them. At first I felt like a fish out of water not knowing what I should be doing (or not doing), not wanting to get in the way but feeling like I was sticking out like a sore thumb and a total nuisance because I felt like there was little time to deal with students.
Thankfully though one of the mentors was fantastic and seemed to take pleasure in taking students under their wing and getting them involved so that was brilliant when they were working and to be honest it was their guidance that got me through the week. Otherwise I'm not sure I would have learned anything at all as this was one of those situations where you felt like you were a bit of a dogsbody, not really getting to see or do what you were meant to be there for in the first place. Again, thankfully it doesn't happen too often because it can be soul destroying. From previous experience I've found that if you keep trying to make an effort and don't let people knock your confidence too much then you will normally find someone who as I say is happy to take you under their wing and to help you to make the most of the time and get good experience.
It's not normally like this but I think it was just due to the stressful and pressured environment in CT, and as we all know, everybody reacts differently to stress so I just took it on the chin and got on with it. I was sure glad to see Friday and the end of my block of placement though! Unfortunately though I've come down with yet another cold and feel like death. I started feeling ill Thursday night and was worried I wouldn't be fit to go in yesterday but as I just had a bad throat and felt physically fit I went in. Wish I could say the same this morning though. I feel like hell and it's on my chest already. I hate this time of year, I have only just got over my September cold and horrific chest which I thought I'd got under control but apparently not! Sorry, I'm being whiny again. Maybe it's the flu jab I had last week, maybe I just got unlucky and picked up something before it became effective, who knows. Am due to go back to docs for a check on my bad chest that I thought I'd sorted anyway so I'm sure it will be short lived.
Ooops.....seems like I got a bit side tracked there. So what did I actually do in CT this week? This week it's been predominantly getting patients in to change, checking ID, doing preps for the scan whether it's water or a work-up with 25 ml Gastrografin (iodine based again I think). This is all to do with improving image quality from what I'm told. Also had to remove and replace the contrast in the injectors, prepare the room, remove cannulas and act as an assistant when the radiographers were cannulating and doing any other random jobs that popped up. Like I say, the week got better as it went on and I went from loathing it to finding it bearable once I understood what was expected me but I realised CT just isn't for me. Again, I didn't like that you don't speak to the patients an awful lot although there is more interaction than in MR.
There were two things this week that will stick in my mind though. I had a patient collapse on me while I was trying to help them up. Neither of us were hurt and they collapsed back onto the table without being at a great distance so I felt a bit shaky and upset after that. I don't know why exactly but I did. It wasn't a pleasant experience but my mentor was pleased with how I handled the situation so that was re-assuring. The other thing was another patient who came for a ct colonography/virtual colonoscopy which I forgot to mention before. My first impression was that they were going to be very difficult to deal with and quite awkward. With this procedure the patient is injected with Buscopan to relax the bowel, a catheter with a balloon inside is inserted into the back passage and inflated and then the images are taken. I can't remember if contrast was used. I think it was for some and not others.
Anyway, there was a delay while we waited for the doctor who does the procedure so while we waited I stood next to the patient while the lay on the scan table and struck up a conversation. I noticed they were nervous and holding an awkward looking hand which was just suspended in mid air not directed at anything or anyone so I grabbed hold of it which they seemed to appreciate, and we just talked. It's weird but I felt very protective of them because they seemed so vulnerable so I held there hand and talked to them as long as I could before I had to stand behind the screen and rubbed there hand and back/shoulder when they needed the re-assurance that they were okay and would be looked after and let them squeeze the life out of my fingers. I didn't mind though, I knew I was doing good and to be honest I think that was the highlight of my week. I really think I made a difference t that patient and they were so thankful afterwards I was touched. So after that I made a point of trying to go up and talk with patients any time I saw there was a bit of a delay or they were left in the room on there own, even if it were momentarily.
I realised that a lot of the patients are anxious and they are scared. Quite often a friendly face and a bit of re-assurance is all they need and they didn't seem to mind students at all. Some seemed to quite like them in fact and seem genuinely interested in how you're getting on. A lot (or the majority from what I saw) have been diagnosed with cancer and some were very ill indeed but you would never know it because they still offered a smile and were pleasant even though they were so ill. I must admit I was surprised by it and once or twice when maybe I may have inadvertently asked them a daft or sensitive question in striking up conversation and not realised it until maybe they told me about their history etc but they didn't mind, they seemed to appreciate my efforts to stand and talk with them for a while. It made me realise that sometimes I over think what I say to patients and forget that they appreciate company and conversation just like anyone else and it doesn't change because they have become a patient. So actually, maybe I learned more than I realised this week.
Also had my end of placement de-briefing with my clincal tutor and it seems I am doing well thus far so I hope I can keep going. I've got all the details I need now for my case study so can get on with the write-up between now and next placement. Overall summary of this placement from my perspective is that it was a long hard slog. There were times I felt like giving up and there were times when I'd never been so upset and disheartened at placement (has never happened before and I hope it never happens again) to times when I've been so happy with it all (how I'm progressing, what I've seen, done and learned) but like I say this one was a toughie. So time for me to get up, have a coffee and some toast and see if I can get my hands on some more cold and flu rememdies.
Have a good weekend if you're reading this :)
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