Renewing Licenses .

Renewing licenses should happen more frequently and made sure the test is up to date. Even though these tests are annoying and inconvenient they are important to the patients. Keeping up with the new procedures and regulations are very important to the patients it makes them feel more secure in the hands of someone who has kept up with new rules. Also these tests that renew licenses help keep new safety procedures which will always insure the safety of the patient and technician. Another good positive factor that comes from renewing licenses is keeping up on new technology that comes out almost every two months. Which also ensures the safety of the technicians and most importantly the patient.  

The prices of doing an x-ray are getting ridiculous now a days. One x-ray on just possibly a leg or arm can cost $200-$500. Which is completely outrageous when someone just needs a small x-ray like that to be done. I mean seriously don't hospitals get enough money from other things like surgery or even staying long at a hospital can rack in a lot of money for hospitals. A more complex radiology procedure like a CAT Scan or MRI is possibly acceptable for $200-$500 because those take up a lot of energy and resources but a simple x-ray should not be that expensive. A more appropriate price would be maybe in the $100's range just because their are such a simple procedure and use up as much energy or resources as another radiology procedure. My own personal experiences can provide evidence for this considering in the past I've had multiple x-rays, CAT Scans, and MRI's and they have all been expensive for my parents to pay for. However, if the x-ray cost was decreased it would help decrease all totals. Anything can help now a days.

New Aprons .

New lead aprons should be made in x-ray rooms. The aprons now used are out-dated and loosing their protectiveness against radiation. Most hospital only get new aprons in once every two years because they're supposed to be so protective. However the truth is they loose the protectiveness they possess after a good useful year. Yes. they still protect you from the radiation but not as good as they did when the hospital first got them in. In my opinion new technology should be made to make them last longer and be more affective. For one I know in our developing world the technology is available. Also, they should be made to cover more secretly over whatever should be cover during the x-ray. For example, make the covering more snug and cover only what should be covered. Hopefully new technology will come out soon and hospitals can stay current on protective wear for x-rays. 

Missing Fractures .

In radiology sometimes the x-rays miss fractures on bones. This normally happens because the focus elements are out of wack or someone has set the kVp levels differently to what the intended amount is for the certain body part. Missing these fractures is a serious matter because you can miss important fractures on person that would affect them later in life or sooner then later. Also by missing fractures your aiding in the doctor misdiagnosing the patient which is not good for the patients health at all. A fracture being missed is slightly common because small fractures can be so small and barley noticeable that technicians think it might just be scatter or fog on the x-ray. Scatter or fog on the x-ray happens when the film has been mishandled or the lighting was off and can appear on the film looking like a fracture. Although this is what can happen on an x-ray it's still the technicians fault because if they think it may be scatter or fog they but their uncertain then they should re-take the x-ray to be certain. Doing more preventative steps like these will help in not missing fractures and help the doctor correctly diagnose the patient.   

CR and DR .

The old way of taking a x-ray is using a darkroom but now there's Computed Radiography and Direct Radiography. Computed Radiography is where a phosphor plate is used to capture image and not film or cassette and then a laser reader scans image to be able to view it more clearly. Direct Radiography is where the image is directly made into an electrical signal and then it's put into the computer and ready to be read. Although DR is very expensive, wired directly, and limited movement for this reason CR is more common. These two forms of taking an x-ray are becoming extremely helpful in recent years helping radiologist getting images quicker. Also these ways help reduce the amount of radiation.  

Burns .

In radiology getting burned is unfortunately common. The proper name for getting burned is by definition called erythema which means reddening of the face and skin. These burns hurt pretty bad it's equivalent to getting second or third degree burns depending on the strength of the burn. Getting burned is more uncommon then common however because now radiologist's and radiology technicians know better the amount of exposure to give each patient. Also there are guidelines to not getting burned which are called ALARA which means As Low As Reasonably Achievable. The four steps to this are all exposure has benefit, all exposures use ALARA, dose levels should remain below maximum allowed for certain procedures, and always follow ten commandments. The ten commandments are basically the principles for every radiologists. The first is understanding radiology control meaning time, distance, and shielding. Second is do not allow familiarity to result in false security. The third is do not stand in the primary x-ray beam. Fourthly always wear protective apparel when not behind barrier. The fifth one is always wear a radiation monitor. Sixth would be never hold patients (exposure). Seventh is protect patient if needed. Eighth commandment is use gonadal shield on people of child bearing age. The ninth one would be examination of the abdomen use every protection necessary. Finally the tenth commandment is always collimate. To follow all these guidelines and protections is to ensure safety to the patient and you.

Outdated CT Procolos .

Outdated CT protocols are a widespread problem in radiology right now. In a hospital you could have a brand new CT scanner, but the protocol could still be outdated and imported from a previous unit. For best possible imaging new scanners need undated protocols so they can be optimized for reduced radiation does levels that are available today. There have been many advances in the world of radiology with CT scanners but many practices are not taking full advantage of this. If a practice were to take full advantage they would see there are many dose-reduction tools available for today. The best thing is today's new advances allow for reduction in radiation exposure yet still allowing for high-quality imaging.

Nuclear Breast Imaging In Radiology .

Doing a nuclear breast image, some experts say, may increase a woman's risk of developing radiation-induced cancer. A single breast specific gamma imaging (BSGI) or position emission mammography (PEM), which are both forms of nuclear breast imaging, have a lifetime risk of a woman getting radiation cancer then if she were to have annual screenings of mammography starting at age 40. BSGI's and PEM's, which have been approved by the FDA, have been promising in detecting cancer, yet both have an injection of radioactive material to the patient. BSGI by definition means using a high-resolution gamma camera allowing mild compression of the breast, also includes a nuclear radiotracer which gets absorbed more quickly by cancerous cells. In PEM, radioactive material is absorbed by the body to measure metabolic activity and determine presence of disease.

MRI For Evaluating Knee Pain In The Elderly. Yay Or Nay?

Knee pain in the elderly has been very common for as long as anyone can remember. It is most common in those of fifty years and older. Studies have shown that the most likely cause of knee pain in the elderly is Osteoarthritis or OA rather the pain being acute or chronic it's still extremely painful. Using a MRI on knee pain like this has positive and negative results which has physicians bickering back and forth about weather or not to use it. Starting with the positives, using an MRI on knee pain can pin-point exactly what is the cause of the pain is in the patient and there is no "if", "and's", or "but's" on the diagnosis. Nevertheless there are negatives about using MRI's on knee pain. For instance using it causes overuse of expensive imaging, delay in diagnosis and treatment when waiting for the images to be processed, inconveniences to patients, and increases health care costs. All in all using an MRI for elderly knee pain is useful but to a limit. I feel as though it should be up to the patient if their doctor has told them the cause of the knee pain and they want to be more sure then request a MRI if not then just stick with what the doctor is telling you. I came to this conclusion because looking at the negative aspects tells me it would be more beneficial if you don't utilize the MRI when most likely all that is wrong with an elderly persons knee is OA.

Molecular Imaging .

Molecular imaging or MI is gaining respect in the U.S. As of right now it's extremely popular in Europe however some in the U.S. feel it's risky and unneeded for most procedures. The use of MI is very risky, difficult to understand, and heavily regulated. The vast majority of physicians here feel it will open new ways to the future of personalized medicine and boosts imaging research and open new ways to better funding. The main focus of MI as of now is cardiovascular diseases to see if using MI would be more useful in evaluating diseases of the heart. The most common reason MI is gaining popularity is because imaging is much clearer for a doctor to diagnose. Also a MI image is presentable in less then 30 seconds and is less stressful on the body. As I see the most useful part about MI is a doctor can clearly and easily screen two completely separate targets at the same time. I personally hope doctors in the U.S. make MI more permanent because it can help find a disease that could not be found in other tests. However, because of the limitations on MI I feel that using this method should be a last resort, to only be used if other tests have been done to try and diagnose someone and they failed that is when a MI should be used.    

Mammograms .

Mammograms are one of the most important things to women health. Sadly some mammogram programs are taking heat from financing and people saying, to save their own department, that mammograms are not that needed. I would like these people to still say that mammograms are insignificant when they need one because of a possible lump under their breast or their wives breast. Recently mammography advocates were judged being told that programs for mammograms are not as important and the recommended age for women to receive a mammogram should be raised to 40 to 50 years of age when really mammograms for women should be at age 20. The reason mammograms are at such risk is the funding for hospitals is being cut. For instance, in New York funding for state hospitals was cut in 2009 by $3.5 million. It's sad to have to see a program for under privileged women to get mammograms for a reduced price is going to have to be completely cut from some hospitals when it's such an importance. "The prolonged U.S. recession has put mammogram and other cancer screening programs at risk for closure." - Donald A. Berry, PhD 

Women In Radiology .

Women in the field of all radiology departments is at a all time high for demand. Every day more women are being staffed by hospitals. The number of women entering the medical field alone has reached 60% and in Europe its at 70%. Out of the 60% in the United States there are 22% of women entering various fields in radiology. Some are saying that if women start to take over the radiology work force more that working practices and attitudes will have to change in order to retain skilled female radiologist. I find this insignificant that they would have to change anything considering women are already in the field and doing just fine now. Although some female radiographers do agree with this saying, "...women in general should be developing a thicker skin and stop trying to be a perfectionist and try to start making the work place more professional." A downfall is there will be 60% female radiologist students and actually only 25% will go through with it and complete training. Unfortunately women even at radiology conferences are still being undermined by men in the department seeing as how men are more frequently asked to be a speaker then women. At a recent conference in 2008, fifty six of the invited speakers were male and only five were women. Even though after the conference it was found that there was a shift and more likeness to the women speakers. Hopefully people will take to this movement of more women for radiologist will be seen.

Prenatal Imaging .

"Bad news" is defined as "any news that alters a patient's view of the future for the worst". Sadly few pediatric radiologists are trained with communication skills that are seriously necessary to provide optimal care to the expecting parents. Pediatric radiologists are the people who interpret ultrasounds and are ultimately the person who will have to tell patients and their partners the outcome of the ultrasound. Communication process is extremely difficult when telling patients a fetal abnormality has been diagnosed. Key clinical and ethical features are most important when making conversations with pregnant patients in the challenging setting of fetal abnormalities. The emotional toll on the radiologist in these types of prenatal health-care conversations are very uniquely challenging. Normally radiologist tell the doctor the "bad news" and it's the doctor to tell it but recently radiologists are the ones to deliver unsettling news and yet they don't have good training to deal with what to say or what the patient will say or do. This problem needs to be addressed and is a big reason why I myself do not want to be a pediatric radiologist and deal with ultrasounds and the emotional baggage one can keep after working in that field for so long.  

Morbidly Obese .

 Americas skyrocketing numbers of the morbidly obese is causing a huge problem for all of radiology. Recent government study showed 5 percent of adults in the United States are classified as morbidly obese which totals out to about 9 million. Morbidly obese is defined as 50 to 100 percent or 100 pounds above a persons ideal body weight. Sadly in the world of radiology size does matter. Doing a CT or MR for a 200 pound patient is completely normal and a standard procedure but a 400, 600, or 800 pound patient causes radiologist to have trouble interpreting the image because of poor image quality. Radiologist have noted sheet charts when sent back to the doctor saying that they had "procedural limitations" due to a patients body or excessive weight translating into the patient was too large to fit into the CT or MR machine. Even when a morbidly obese patient is able to squeeze through a CT gantries or MR bores the images turn out strikingly fuzzy. CT units weight capacity is 450 pounds which is a likely weight in the morbidly obese therefore they cannot fit because this 450 pound capacity is including the table which the patient is laying on. When the patient cannot fit it takes radiologist and doctors to a conclusion to do surgical exploration which was used years before CT scans existed. This is a way to an alternative but is costly on the patient and takes a longer time. This takes a huge emotional toll on the patient as well when their told that basically they're too big to fit inside the machine which causes great stress. Lucky since this study came out about how many morbidly obese patients there some models of CT and MR machines are being made-over to hold a greater weight capacity of 800 pounds instead of 450 pounds. Yes, these new machines being re-done are a benefit to the morbidly obese the new machines are rare to see in a common hospital and are spread out over the country to few hospitals so a morbidly obese person would most likely have to travel if they really needed a CT or MR done.

Education In Radiology .

       There are three missions in the field of education for radiology they are education, research, and delivery of clinical services. The educational field is in danger for radiology and is a growing problem, the two greatest challenges is money and time management. In the last five to ten years benefit of clinical activities has dropped dramatically due to reimbursement from government, private insurers, spiraling technology, and regulatory costs. Faculty members unfortunately do not have enough time to prepare for a teaching seminar because they are pushed to the limit trying to maintain their expected roles in their own departments with the hospital. Medical schools were once devoted to the educating of medical students but now they're complex organizations that focus more on research and clinical businesses then on educating feature radiologists. Being that faculty members are forced to do more patient throughput personal contact with students and teachers is limited which creates a problem when the student is trying to learn and has questions yet the radiologist has his obligation to the hospital and patients. There is a desperate need for new methods of instruction, knowledge acquisition, and assessment. 
       Lucky a new possible solution to this growing problem is simulation tools which are just now being accepted in medicine. These new tools provide very structured method for the delivery and measurement of an educational objective. Another plus is the new tools reduce costs buy substituting very expensive radiologists who would be the teacher. Also can reduce the need for faculty members to engage in repetitive and time consuming teaching of simple skills. Examples of the new tools would be anesthesia and sedation simulators and well designed ultrasound simulators (UltraSim and MedSim). I am unbelievably happy to see this new improvement considering I myself will be enduring a career in radiology I'm glad their fixing the problem before I get to my program of study.

MRI Burns .

       MRI burns are becoming more and more likely which is not a good thing one because of the obvious reason it's burning people and the second reason is it costs hospital unnecessary amounts of money because then the hospital must pay for damages to the patient. Due to the most recent MRI burns doctors and other professionals are trying to figure out what is causing these recent burns but it's hard to determine what the cause is because so many things are normally not safe to bring close to a MRI magnet. In my findings there actually is no master list on what not to and what can be permitted in the MRI suite basically because it would take a huge team of specialists to create such a list plus the amount of effort to keep the list current would be simply unimaginable. I don't know about some people but me being a person who has had multiple MRI's it's very unsettling to see that researchers won't take the time to create this list because it would simply "take up to much of their time". Okay let me see you specialized researchers get in a MRI tube and I will tell you "oh by the way I didn't take the time to find out for your safety what you may have on that would cause a magnetic burn". 
       Recently a blanket was kept over a child when he needed an emergency MRI and he received second degree burns. Doctors said there may have been a metallic layer in the blanket. Although the blankets manufacture said that there's absolutely no evidence to say the blanket is at fault even though the blanket did contain aluminum in it. The scary thing is that even metal that's non-ferromagnetic, which is metal that absolutely can not be put through a MRI machine, can become an electrical conductor. I believe this is more than enough reason to create such a list to where it clearly states what can and can not be allowed in a MRI tube. Certainly I hope this problem is resolved before I enter a hospital because that's a little concerning that some poor child could be burned because he's wearing his favorite shirt that shouldn't be in the MRI tube but he has no idea. Plus anyone including myself could be injured. 

The Problem of Image Rejects/Retakes .

 This issue of image rejects/retakes is a major problem within radiology. The main problems with this is it can occupy unnecessary resources, expose patients and radiographers to unnecessary ionizing radiation, and indicates suboptimal quality management. Image reject/retakes mostly happen because of incorrect operator competence as in positioning, type of film, and incorrect organ coding. Unfortunately the product of an image reject/retake that is not immediately recognized can lead to a misdiagnosis. In addition to problems with the reasons of image reject/retake in mobile radiography equipment exposure faults which can lead to more unnecessary radiation exposure and equipment malfunction. After a image reject/retake is taken there are three steps that should be taken although if the image was taken correctly this would not be necessary. First, the new image that will need to be taken is going to have to be done within a reasonable time as not to worsen the condition. Secondly, a report of what happened should be understood and known by radiologist and radiographers. Finally, the cost of proposed corrective actions should be taken into account any useless actions certainly should be avoided.

 Thankfully there is recently new technology to radiology which is known as "digital revolution" or basically going totally digital. The digital revolution has made a drastic change in the percentage of image reject/retake from 10-15% down to 3-5%. Decrease in percentage of image reject/retake is a helpful outcome of more education and training which is a consequence of lack of knowledge from radiographers and their digital skills. If only a new educational training program on digital skills was a six month requirement, maybe that's something to work on in the radiology profession. I'm almost positive that such a program would make image rejects/retakes go down from 3-5% to 1-3%. Also a great new value for decreasing the problem is equipment and operator performance programs is a great idea for improving as well. An added bonus to going completely digital is it's also economically rewarding and in this day in age is a very good thing. 

   

The Beginning .

Who Am I ?

My name is Kalegh and I live in Columbus Ohio. My favorite color as you might notice is green. I was born in Columbus, Ohio however I've lived in Bozeman, Montana and enjoyed it especially the snowboarding scene was my favorite I miss that very much. I have been all over the country there's probably only a very few states I haven't passed through or visited. I live with my father here in Columbus but my mother lives in Columbus, Georgia basically Savannah, Georgia though. I have four cats two of them live with me (Scarface and Alice) the other two live with my mom (Cookie and Bubba) and I have one dog (Maggie) who lives with my mom and I absolutely love and miss dearly. I attend Columbus State Community College.I will be doing the radiography program there and hope to be done with the program and school in general in about two and a half years. I enjoy hanging out with friends and going shopping is my favorite thing to do although it doesn't work out very well when I have no money to spend. Once I do get my program finished and finish school I really would like to work with children at Nationwide Children's Hospital  mainly because I can do my job while having fun and goofing around with kids which will also prepare me for having my own children. I also hope to soon make it to Europe and travel to get experience in the world if I had to choose where I would like to visit in Europe it would either be Rome or Italy. Also I hope someday to make it out of Columbus but would also not like to be too far away from my family.

What I Know .

Radiography is a very interesting field. People think its just taking x-rays but its much more. Radiography consist of x-rays(of course), MRI's, CAT Scans, and ultrasounds. In radiography you need to know what type of film to use for each different part of the body. I'm also aware that x-rays were created in 1895 in Germany. Luckily for me I'm aware that the department for radiographers is good right now and hospitals need them and in this economy that's a good thing. A good thing about being in radiology is that if you don't want to work in a hospital for example if that type of environment is too much for somebody that you can work in a small doctors office or most hospitals have off campus offices that are less stressful as well. Although if you wanted to be a x-ray tech for a veterinarian office and take x-rays of animals that is something entirely different and would require different types of training as in how to handle animals if they become excited.

What I Do Not Know   

Radiography is a hugely developed field and therefor there are some things I do not know. As of right now I'm not familiar with the different types of sizes of film and positions quite yet which is very important. Also I do not know how much radiation is put out every time I would be taking a x-ray. One thing that is a mystery to me would be the fact if there's an emergency as in a hazardous emergency do I take the x-ray and encounter the infected or would a hazmat official be interacting with the individual. The probably most important thing I do not know is what type of field I want to actually go into because each one is so different there's so many pros and con's about each field. 

What I Hope To Learn 

I hope to learn and understand the patients more and how to interact with them when I know something is seriously wrong with them. Also I want to know what kind of challenges radiographers encounter. Which is mainly what I will be exploring in my blogs. Because to understand this profession that I'm very passionate about I need to know the challenges and problems I may be coming face to face with.

Three Interesting Facts About Me  

• First you would never guess just by looking at me but I love rock music my favorite radio station I listen to in my car is The Blitz. Also I regularly attend rock concerts with my dad. My favorite one I think I've seen so far is the concert in 2008 with Avenged Sevenfold, Shine Down, Saving Able, and Buckcherry. The most rewarding thing about this concert is that I was able to see The Rev play before he died at that concert and I got to see him play at Rock On The Range before he died in 2009.

• Secondly I have lived in a different state Bozeman, Montana. It was a great experience to see how others live in a different state for example the culture there is so different then from people who live here in Columbus, Ohio like people there are so much more down to earth and EVERYTHING is about waiting for ski and snowboarding season which I shared while I lived there. Although I tried this on my mom and considering my mom is a teacher it didn't work out so well but some of the students parent's will yank them out of school for the day just to go skiing or snowboarding for the day either because the season just started or the season will soon be over.
• gelato shop where the Jersey Shore cast worked and we also saw Dash the Kardashian sisters clothing store in Miami. One thing that was funny to us was a guy at an intersection tried to sell us drugs by acting like he was advertising jet ski lessons we almost didn't know what to do considering this man was trying to sell us drugs in the middle of the day but we just hurried n crossed the street.