What Do You Mean I'm a Third Year?!

Definitely how I feel when it comes to university work!

Stardate: 93312.32

I realise I have been very non-existant on this blog as of late, but I've had a lot going on, and I completely forgot to write a post. After my mammography placement block, it was just a matter of getting my assessments completed and filling in our portfolio examinations, so I ended up returning to CT and similar departments. Following that, I had one exam resit (yay for reduced Summer holiday time) and lots of part-time work shifts. Oh, I also visited Dubai, too.

Now the realisation that I only have 10 months left until I graduate has finally dawned on me... I am terrified! That's barely any time, and soon enough, I'll be applying for jobs. I have suddenly lost the ability to do remember anything about x-rays... *sobs quietly in a corner*.

This year is when we have optional modules, as well as the compulsory ones:

• Our Research Project (AKA the dreaded dissertation)
• Professional Practice (the placement module)
• Diagnostic Imaging Technique
• Pathophysiology
• Preparation for Practice
• 2 optional modules, of which I chose a Focused Practice module and Advanced Medical Imaging Systems
•  and finally the elective weeks in June.

I have some idea on what my dissertation will be, but I'll try to avoid thinking about it again until it's mentioned in a lecture... just to be on the safe side. Especially after looking at how many essays we have to hand in this year, the above gif works wonderfully. This year is going to be... hard. As for my electives, I've been playing with the idea of going abroad, or spending some time in a CT department... as I can't do anything Forensic related until I graduate. I'm not ready to be a full-blown adult yet...!

Either way, I apologise for the lack of posting, I will pick it back up as soon as the semester starts next week!

LLAP!

How To Not Be Awkward in Mammography Departments

Fact: No-one enjoys having a mammogram. No-one!

Stardate: 93085.08

I've gone pink for this post, (I know it's not October, but for this post I wanted to give a quick nod to the Breast Cancer Awareness organisation, Pink Ribbon) so if you have trouble reading it, I do apologise! I have also dedicated this post to my amazing and brave Auntie Mich, who kept me motivated to keep this blog going way back when I was just starting out!

It was the one placement I was openly dreading. After already having done radiography for nearly two years, you'd think I was already okay with seeing humans undressed in most ways, shapes and forms. No matter how many times you tell patients they can keep their underwear on, there's always one who didn't hear you... Apparently, I was not fully prepared.

I have to admit, despite having heard and been taught about Mammography, I'd never taken an active interest in the modality, nor fully looked into it. But once I'd looked into (aka Googled) the basic physics of mammography equipment  to refresh my memory post-exams (e.g. ultrasound, mammography units), I started to warm more to the subject than I had previously. The other plus side post-graduation wise: men currently can't do the job, so there is less competition for job applications (although I don't agree with this, from a work gender-equality angle).

Mammography is basically low energy x-rays that image the breasts. It's most well-known for its being an early detector of breast cancer, by finding masses or microcalcifications. I spent time in both screening clinics, where women who fit the criteria are checked every few years for any changes; and assessment clinics, where women have attended their GP after having found a lump, for example. 

So last Monday after having arrived at the department and been shown around, I witnessed my first mammogram, and couldn't help but look everywhere in the room, except at the body parts being examined. Eventually, I had to buck up and pay attention, or last week's block was going to go pretty slowly for me.

Every patient I saw examined was happy for me to stand in the room and have everything explained to me, and some even explained instead of the mammographer, which was a new experience! But this did put me more at ease, as being a student I'm used to doing the 'Student Shuffle' (basically constantly moving out of everyone's way) and being quiet when not in the general radiography or CT departments.

Once I'd followed a few women through from their mammograms to their ultrasound, I started to gain more interest and look in more detail at the images. I particularly enjoyed helping one of the consultant radiographers (yes, you read that correctly, we can become consultants!) with an ultrasound guided biopsy, where I was shown different types of tissue structures within the breast that would be going for testing.

I also got to spend one morning sitting with a doctor while he ran a clinic. It was interesting to see the other side, watching the pre-assessment, and then seeing how the imaging side was requested and for what reasons.

However, with Mammography, you will eventually come across sad news at some time or another. A number of the patients I saw examined at the department had already had a mastectomy (breast tissue removal surgery), and some images I was shown for comparison and to help me understand breast anatomy, displayed what were cancerous masses. For me, this was quite a tough experience (hence why I've never considered Radiotherapy), and it hammered home how beneficial Mammography is as a department. Even for a small number of men.

From what I've witnessed, being a mammographer, is a very intimate job. During the examination, you will be in the patient's personal space, and the procedure can be difficult and uncomfortable for patients. It's a difficult job to do, putting apprehensive and worried women at ease, and if they're upset, you have to be the type of person who knows how to handle that situation kindly and professionally. Not only that, nothing can be missed off the image, because something small could be hiding in that one area not included, so you have to be skilled enough to make sure you've gotten everything on the receptor. There is also a chance to be a breast sonographer, giving you a little more autonomy in your work.

Personally, I'm not completely sold on Mammography myself. If I had to say what I enjoyed the most, it would be the ultrasound examinations and biopsies, as I could 'see' more on those images, than on the plain film ones (a slightly odd situation for an undergrad radiographer). I wouldn't mind going back for another week, but right now, it's not something I could see myself going towards once I graduate. I can see why it's an appealing job to some, and don't get me wrong, I found the diagnostic side of it and the variation interesting, but all day and every day would be breasts. And I don't think I'm ready for that just yet!

This week I'm in the Paediatric department witnessing all sorts of examinations. But, more on that in my next post!

LLAP Guys!

Ps. I hope you've all gone to see Jurassic World... 

Managing Placement Assessments, and CT in (Dino)Nutshell!

How I feel handling all my different placements and assessments...

Stardate: 93066.03

I apologise, as this post is a few (ahem... five) days late. This is once again because of part-time work, and placement in a different hospital due to the department I'm in this week (more on that in my next post!)

As I'm now in my "Summer stretch" of placement blocks, second year clinical assessments are now creeping up on me, rather ominously too, as they're not easy to pick appropriate patients for! And as you have so little time in each department, due to rotations, every moment there is precious. No-one ever said second year was easy... Including me!

So far, I've passed my CT head and Extradepartmental Chest X-ray (Mobile/Portabe) assessments; so only three more to go! To celebrate passing my CT assessment, I decided to dedicate this post (briefly) on CT, and also went to see 'Jurassic World'... my inner child was incredibly happy (so was the grown-up, because Chris Pratt; 'nuff said.) It's amazing, I highly advise everyone to see it.

So, about CT, or Computed Tomography! Most people have heard of, or at least have had, a CT (or CAT) scan. For Leeds university students, CT is a department we visit, to further our understanding of extradepartmental modalities, that involve medical imaging. CT scans, use a 360-degree x-ray beam to create a 3D image, using a number of imaged slices taken from a large series of two-dimensional images, to visualise the internal structures of the body, without having to cut open the patient! CT has plenty of applications, including the detection of abnormalities, as well as diseases, such as cancer, inflammation and trauma etc.

There are a multitude of advantages to CT over the usual 2D medical radiography. It doesn't have the issue of superimposition (organs/tissues lying over each other), allowing structures to be assessed, and allowing the area of interest to be studied in detail. CT also has a high-contrast resolution, meaning that tissues with even the slighest difference in density can be distinguished from one another. Finally, CT images can be viewed in various ways, or "planes", allowing any exisiting pathology's position to be pin-pointed.

Non-medical uses of CT include discovering flaws in industrial parts before they are used, and to identify the existence of any oil, water or gas etc. in structures.

I find CT an interesting department to look into once I've qualified, as they're used quite often in forensic radiography for virtual autopsies, which I'm thinking of writing about for my final-year dissertation. Being able to see all the internal anatomy without it being superimposed onto itself is great, as it makes spotting abnormalities that little bit easier... but not by much for the inexperienced!

And that is basically CT in its barest form! This week I've been in the Mammography department, so I'll have a more in-depth post coming up regarding the Breast Screening process, and a little on the modified equipment.

Final Note: GO AND SEE 'JURASSIC WORLD'. Think I made that clear enough...

LLAP Guys!

So It's Been 5 Months, Eh? Let Me Tell You About Cardiac Cath Labs...

How I feel looking in the mirror now I have to get up early for placement...

Stardate: 92967.34

Well, aren't I just the worst blog owner? But in all fairness to myself, I have been entirely swamped by being a student radiographer. My placement in January got incredibly hectic, I've worked so many shifts at my part-time job, and then there's these evil little things our lecturers call 'exams' that recently came and went... But, finally I'm back on placement, so I'm going to be right back on track with this blog. I mean... I'm sure you've all missed it, right?

Now, if any of you readers are prospective students or currently a first year at the University of Leeds, let me give you another bit of advice... Second year is freaking hard. I have never felt so mentally drained in my life! And I've worked as a full-time supervisor in retail...  

Don't get me wrong, I still love my university and the course, because I know it'll be worth it in the end. Our lecturers do an amazing job, but there is just so much to cram into your head, you'll be begging June to come faster so the May exams are over. And I thought the January exams were tough! Never have I been so wrong...

But it's not all doom and gloom! Hooray! 

So, what are Cardiac Cath Labs, you ask? Well, in the UK, a Cath(eter) Lab is an examination room containing diagnostic imaging equipment used to visualise the arteries and chambers of the heart for treatments or investigations. They're staffed by a multidisciplinary team such as cardiac consultants, cardiac physiologists, nurses and radiographers. 

Typical examinations that occur in Cath Labs include:

• Coronary catheterisation
• Coronary angioplasty or Percutaenous Coronary Interventions - used to treat stenotic (narrowed) coronary arteries
• Transcatheter Aortic Valve Implantations - the insertion of an artificial heart valve using catheters
• Pacemaker implantations
• Electrophysiological studies - e.g. mapping of the heart to locate heart abnormalities
• and Cardiac ablations - a procedure that is used to scar small areas in the heart that may be causing a heart rhythm problem.

I managed to see a good range of procedures this week, but the most interesting I saw was probably the PCIs, as radiographers have a large role in the team. PCIs usually use a femoral (leg) or radial (forearm) artery to access the coronary arteries of the heart. Then through a 'sheath', a guide catheter is pushed to the opening of the coronary artery; this allows contrast (x-ray dye) to be injected into the artery. The size of the artery is then assessed to select what size balloon catheter will be used. The guide catheter is moved to the stenosis (narrowing), so the balloon catheter can inflate, forcing any 'plaque' to compress, and the arterial walls to expand.

I also saw a TAVI which involved a large team, and plenty of contrast to check the valve's operation. I watched as the valve was prepped, and the one I was lucky enough to see was made from hand-sewn strips, and formed from pig pericardium (a double-walled sac that contains the heart)! It's amazing how small the valves become before they're inserted, and then you get to see them deploy to their full size around the old valve site. Seeing the valve outside the body made me appreciate how much magnification is used in fluoroscopic imaging!

Unfortunately, there isn't too much I can say, as I only went to Cath Labs for 3 days, and it went by so quickly! And as a radiography student, we can only do so much in that department with our basic training. It seems I need to get used to the early mornings and placement again!

Next week I'm working the Late shifts over the weekend, but this time, not as a radiographer assistant, but as a student. So I'll probably have plenty to talk about!

Once again, sorry for the long delay, but I'm hoping to keep on track once more!

LLAP!

Ultrasound - Not Just Babies!

  An ultrasound scan for the thyroid gland.

Stardate: 92672.31

Last week saw me in the hospital's various ultrasound departments: general, obstetric, paediatric and vascular. Despite my initial reservations and disinterest in ultrasound, I actually really enjoyed my week there. At first, I tried to read up on basic anatomical appearances, and how ultrasound images were produced, including the physics and which transducers (probes) were used for which examinations etc. But I'm going to leave that for another post... 

From my basic understanding, I started to get the hang of it all, and could get my head around what position the transducer was in when I observed examinations. I even got to have a go in some departments, where I managed to scan a kidney, my own thyroid gland, and finally an abdominal aortic aneurysm (AAA).

In the general department, the examinations are mainly musculoskeletal and some gynaecological procedures. Obstetric is the most famous ultrasound department, as it's where a multitude of women go for their pregnancy dating, 12-week and 20-week scans. Usually the 20-week scan is an anatomy check, as well as to check the sex of the baby (if the parents want to know what they're having). Paediatric is of course the children's department of ultrasound. And finally, Vascular is where all the circulatory system investigations occur.

Anatomy on ultrasound scans takes a little bit longer to get your head around than general x-ray anatomy, but once you've witnessed a few scans, you start to recognise certain structures and their appearances. If I do take anything away with me from my week, it is that fluid always look black and veins, in comparison to arteries, are compressible. Which is how sonographers test for DVT (Deep Vein Thrombosis).

As ultrasound has such a wide range of examinations and procedures, I couldn't really pinpoint one I wanted to talk about in detail that would fit into this post nicely, so I'll possibly put one up soon after some serious consideration! There were plenty I witnessed where I wouldn't mind looking further into them.

Out of all the departments I visited, the most interesting I found to be was Vascular, but each department has its own intrigue. Being placed in ultrasound has certainly changed my attitude towards the modality, and I actually wouldn't mind going there again. Some students find it boring, but if you ask plenty of questions and try to look into image production and anatomy before you go, there's less chance you'll be confused, and will be able to identify what you're actually looking at!

This week I'm in A&E, but I'm working alongside the first-years, so now I have to look like I actually know what I'm doing! I've also started my radiography assistant job, so you may start seeing posts about doing part-time work alongside the course cropping up!

LLAP guys!

References

1. Diagnostic Ultrasound Scan, n.d. photograph, viewed 25 January 2015 <http://www.ultrasoundnow.co.uk/wp-content/uploads/2012/01/shutterstock_82853839.jpg>.

The January Exams Episode

January exams are over it seems...

Stardate: 92647

I know, I know, it's been forever since I made a post... well, nearly two months anyway, if I'm not mistaken. But I do have an entirely reasonable excuse why. During this last week, I have been studying like a demon for my three January exams that snuck up on me over the Christmas period. Apparently, being a second year is hard. No, I mean it. Really hard.

We had three exams, one for Research Stats (this module, ladies and gentlemen, I kid you not, is pure evil. Sauron himself probably would have agreed), Chest Commenting and Anatomy. No matter how much I tried to get my head around Research Stats, it would not sink in, and I have the horrible, foreboding feeling that I've failed the exam. Commenting by far was the exam I was most confident for, and Anatomy I tried to write loads and draw as many diagrams as I possibly could! All that, and I also had a Physics essay to hand in at the start of the assessment week. So, with all that, I'm knackered.

But now that it's all over, I get a nice weekend to myself, (even after doing a quick shift in my new job as an radiography assistant - woo!) where I don't have to think about anything. That is until Monday rolls around, and the early mornings begin again... you guessed it, placement is here again!

This time around is a 5-week block. I'm in ultrasound, A&E, CT, fluoroscopy and finally orthopaedics. So yes, I'm going to be nice and busy. I'm looking forward mainly to CT, as it'll be a new experience for me. But I'm having to start thinking about the dreaded assessments, which will be:

• GI Tract with contrast
• Circulatory/Renal/fluoroscopy examination with contrast
• MSK non-ambulant
• Extra-departmental chest x-ray (e.g. a portable)
• CT Head without contrast 

We'll see how it all turns out. But at least ultrasound will be slightly more relaxed than some other departments anyway. Hopefully they're nice to me on my birthday this Wednesday...

I'd better start looking at how ultrasound actually works...

LLAP!

Smile for Second Year!

How I currently feel in specialised modality departments.

Stardate: 92458.79

I realise it's been a while since I posted anything, but I've been ridiculously busy, so I decided to wait until my first block of second year placement as a student radiographer had begun before making anything worthwhile reading... that and I've been using precious hours as nap time...

The first set of lectures were just a bombardment of anatomy, and believe me when I say we learn a good deal more than just bones! Thankfully, it's my strong subject, but alongside Anatomy is Imaging Science (or Physics), Imaging Technique and Research Methods (queue the 'Psycho' theme). I've suddenly realised that my home away from home is the Healthcare Library, and copious note-making (seriously, it's ridiculous how tall my pile of notes is) accompanied by rivers of green tea is helpful. And as that wasn't challenging me enough, attending four martial arts classes a week while being captain of the university Taekwondo club certainly assured I learned to appreciate weekends in a whole new light. I've forgotten what sleep is.... again. 

This year, I'm in a completely different Trust for placement, so aside from getting used to new radiographers, specialised modality departments (such as CT), different shift times and learning which direction I'm supposed to be going in, I've also had to brush off the cobwebs cluttering my radiographically-trained brain in order to not look completely useless!

For my first week, I was placed in Vascular, which involves angiography, an imaging technique that visualises the blood vessels using contrast agents. You also get to live in scrubs for a week. One of the examinations I saw this week was a cerebral angiogram (within the brain's vessels), that displayed 6 aneurysms in the patient's brain. These were treated with endovascular coiling, which involves inserting a guided catheter (small wire) into the femoral artery (in the thigh/groin area), which aids a microcatheter into the aneurysm. This coiling promotes blood clotting within the aneurysm, eventually sealing it and reducing the pressure.

But my favourite experience this week, happened to be during an endarterectomy, which is the surgical removal of plaque from an artery. This examination can be quite slow for radiographers, as they are only needed for a small part of the procedure. Luckily, my supervisor knew the surgeon taking the case, asked if I could observe the procedure. The surgeon agreed and basically explained everything to me as if I were his student. 

Throughout this procedure, patients stay awake but are anaesthetised. An incision is then made over the blockage site (in this case the femoral artery), and the blood flow is re-routed using clamps. The artery is then opened, and the plaque removed. As student radiographers don't go into dissection rooms, I was amazed to see how big the femoral artery is in 'real life'; about the thickness of your little finger. It was brilliant to be able to understand what was actually going on, instead of just aiding the radiologist, who inserted a shunt further up the artery, to 're-inflate' the artery, to prevent the artery staying narrowed.

Overall, this week was really interesting, although I've been told many students find Vascular placement quite boring. I think it is what you make of it, and I did my best to get involved as much as possible, for example changing contrast, patient moving and handling etc. It's also a good time to learn some vascular anatomy, such as the various branches of the internal carotid artery. You also get to see a 3D spin, which is a pretty cool radiograph of the skull that does almost a 360 view, with contrast to help visualise the cerebral vessels. Check out this Youtube link for an example: http://www.youtube.com/watch?v=0gWmehOhRGs

Next week I'm in Main X-Ray again, so I'll get to refresh what I learnt from first year (and maybe get a head-start on my portfolio). Hopefully I'm not too rusty!

LLAP guys!

My First Conference - IAFR Annual Conference 2014

A look into the pack we were given today at the conference.

Stardate: 92305.32

Prepare for a long post...

I have to admit it, I am knackered. Due to a 5.20AM start to get a train at 6.34AM to Middlesbrough, and getting home at 7.40PM, I have had one heck of a long day, but I think it has definitely been worth my time. I don't know many undergrad students who attend conferences, but I certainly think that we should. I met so many new people, gained a lot of information from qualified radiographers, their views and advice, and I also learnt a good deal about the new and upcoming future developments in radiography (mainly forensic imaging). It's definitely motivated me to attend more conferences in the future! 

The morning started with a talk from Her Majesty's Senior Coroner in Sunderland, Derek Winter, who spoke about the role of a coroner and the role of post-mortem CT. For those of you who are unsure, a coroner is an independent judicial office holder appointed by a local authority, that investigates deaths that have been reported to them, if they have reason to suspect the death was violent or unnatural, has an unknown cause, or the deceased died in prison, police custody or another type of state detention (Ministry of Justice, 2013). His presentation explained that CT imaging is considered to be one possible way to reduce the number of autopsies in Britain, which is 2-3 times the rate of comparable countries. Post-mortem CT (PMCT) is also more cost-effective than an autopsy, but is a developing field, and has certain limitations. Certain faith groups are keen to avoid autopsy, as are bereaving families, in these cases CT virtual autopsies would be favourable.

Our next talk was then on Multi-Phase Post-mortem CT Angiography, which has been a major research project at the University Centre of Legal Medicine in Lausanne-Geneva. This presentation informed us of courses available to radiographers, as well as the current developments and benefits of MPMCT Angiography. In Lausanne, the forensic radiographers carry out examinations and cases themselves, including incisions and cannulations, which usually requires training, but gives these radiographers more autonomy in their practice.

After a well-needed coffee break (I was beginning to nod off from being tired!), the subject turned to Non-Accidental Injury and Physical Abuse cases in children. I had the chance to actually meet one of the speakers (Dr. Amaka C Offiah) prior to her talk, as I took the same train as her from Darlington to Middlesbrough, and we also shared a taxi. A national expert in radiological research into child abuse, and the first woman to be appointed as the Royal College of Radiology Roentgen Professor, she is well-known within her field and her talk was excellent and incredibly informative about the pitfalls in radiological diagnosis of physical abuse in children. Her presentation highlighted many key areas within this subject, and how to avoid future issues from arising within departments.

Our final talk was on ballistics, which highlighted and identified different bullet types, gun 'anatomy', trajectory and basic witness statements on forensic radiography ballistics. It was quite an interactive and entertaining way to end the day!

The members of the IAFR (International Association of Forensic Radiographers) were all very welcoming, and happy to answer questions, and I also got to speak to a few recent graduates of the Masters course at Teeside.

Overall, I thoroughly enjoyed my day, gained a CPD (Continuing Professional Development) certificate, and got to speak to the Forensic Radiography Masters course co-ordinator, who re-assured me about the content, and applications process.

For anyone interested, I've posted a link to the IAFR website for you to have a look at :3

An added bonus: I even managed to watch Doctor Who without nodding off. So now, I'm off to read my Stephen King book until I fall asleep! I'm too tired to pay attention to 'Once Upon a Time' tonight...

LLAP guys! Told you it would be long....

The IAFR website: http://afr.org.uk/

Radiographers to Gain Prescribing Rights?

Could prescribing rights be on the horizon for radiographers?

Stardate: 92257.58

So, I was browsing the SoR's website last night, and came across one of their news posts that caught my eye, regarding radiographers and prescribing medication.

In July 2009, a report was published presenting the findings of the Allied Health Professions (e.g. radiographers, physiotherapists, podiatrists etc.) prescribing medications. Currently, there is 'supplementary' prescribing training available to experienced and expert radiographers. These radiographers use PGDs (Patient Group Directions) - specific written instructions for the supply and administration of medicines - for analgesics and anti-emetics that may be required before, during or after procedures. Contrast agents are also managed with PGD.

In order for a radiographer to undertake supplementary prescribing training, they must already be highly advanced, and their employer must have identified a need for a supplementary prescribing role. They undertake the same training as nurses and pharmacist independent prescribers.

There a few arguments raised that back up the need for independent prescribers within the Allied Health Professions, for radiography:

• radiographers are experts in drug interactions with imaging contrast media
• they could manage unexpected side effects, and only liaise with other medical professionals if clinical emergency
• invasive procedure patient need could be better supported by independent prescribing

The report concluded there is strong evidence supporting a progression to Independent Prescribing for radiographers, but less than for physiotherapists and podiatrists. You can read the full report below (link in references list).

But recently, the Society of Radiographers has posted a news update (19th August) stating that ministerial approval has been received, meaning that proposals put forward by the movement (AHP Medicines project) will be taken to public consultation later this year.

One of the Society's professional officers, Christina Freeman, is highly involved in the project, and stated that independent prescribing would "bring radiography in line with other AHP, like physiotherapy, and increase opportunities to develop practice in areas such as emergency, unscheduled and cancer care."

I believe it would be a great opportunity to advance a radiographic career, and give insight into other clinical areas of expertise that radiographers rarely experience, and give the profession more autonomy with patient management. There is a long way for the project to go, but it is currently big news within the profession's future!

Who knows, in 10 years time I could be prescribing people medication... jeepers!

LLAP!

References

1. Department of Health. (2009). Allied health professions prescribing and medicines supply mechanisms scoping project report. Available: http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103949.pdf. Last accessed 27th August 2014.
2. Society of Radiographers. (2014). Radiographers move a step closer to gaining independent prescribing rights. Available: https://www.sor.org/news/radiographers-move-step-closer-gaining-independent-prescribing-rights. Last accessed 27th August 2014.

First Year Finale

That feeling when you've finished your first year successfully.

Stardate: 92252.42

It's been a while since I wrote a post, but let's just blame that on trying to finish my case study! So, after a good 11 months, my first year as a student radiographer is finally over! There's been stress-fuelled all-nighters cramming for exams, early mornings waiting for the bus to placement in the rain and piles and piles of lecture notes and textbooks to hike through. It's been a whole new experience. The course is definitely intensive, but it'll be worth it in the end.

In two weeks I'm off to the IAFR's Forensic Radiography conference in Teeside, and I know it sounds a little sad, but I'm actually excited for it, seeing as it's my first conference. I've even planned a smart-casual outfit, so I don't look like an out-of-place student.

But for now, I'm just enjoying my time off, spending time on my PS3, participating in Parkrun's and earning a little extra money from my part-time job here and there.

Here's looking forward to the new academic year!

LLAP!

Cardiac, Cages and Conferences

An example of an Ilizarov apparatus on the tibia and fibula.

Stardate: 92138.26

So, this week I'm in Cardiac, Mobiles and Theatre. For a Monday, the cardiology department on the x-ray front was pretty slow. I helped out on some portable x-ray examinations in (surgical) recovery and also on the ICU. As the focus (funnily enough) in Cardiac is of course, the heart, you see chest x-rays in abundance here. 

But for the majority of the week, I have been placed on mobiles and theatre, and one thing I finally got to see, was a surgical procedure involving the fixing of an Ilizarov apparatus to a patient's lower leg, due to bone bowing caused by osteogenesis. After seeing so many in A&E clinics, it was interesting to see how they areactually done. 

Ilizarov cages (as I call them), are used to lengthen or reshape limb bones, to treat complex fractures, or non-unions of bone. They are named after the orthopaedic surgeon, Gavriil Abramovich Ilizarov.

The top rings are fixed to healthy bone by tensioned wire (Kirschner wires), allowing weight-bearing force to be transferred through the external frame, to bypass the fracture/injured site. The force is then transferred back to the healthy bone through the bottom ring. The structure therefore acts as a 'bridge', where the middle rings hold the bone fragments in place.

For bone lengthening/reshaping, the affected bone is surgically fractured, and the cage is attached. During recovery, the fractured bone will begin to heal. This process is slow, and the rings is adjusted using the network of nuts, increasing the spaces between rings. The adjustment is done four times a day, moving the fracture apart 1mm per day. This allows significant lengthening. 

The procedure I was present for was quite short (2 and a half hours in all), and the only thing that bothered me was probably seeing the wires about to come through, due to the wires pushing the skin outwards. The rest was fine. The sound of drills doesn't bother me, nor does blood or the sound of a mallet breaking a bone... on purpose (with good reason)!

Aside from that, mobiles has been quite quiet, so while surfing the internet, I came across an event that caught my eye: the International Association of Forensic Radiographers Annual Conference that's being held at Teeside University. Luckily for me, this event was open to students (with a student discount!), and after a long look at my funds, I decided I was definitely going. I've been told by friends on other courses who attend conferences that they're good for networking and experience, so how could I say no?! The topics that are going to be included on the day are:

• Update to the new Coroner & Justice act
• Post Mortem CT Angiography 
• The radiographer as researcher
• Pitfalls in NAI and follow-up imaging
• Radiological detection and interpretation of internally concealed illicit drugs
• and Ballistics

So on September 13th, watch this space! It might actually be interesting!

Next week is my guided study week, so unless something incredibly life-changing happens, I'll post again when I'm back on placement in screening. Due to me only having my case study to be getting on with now most of my portfolio is complete, I'm off to London for a few days to see my grandfather, and hopefully sit in on some cases at The Old Bailey. Murder trial anyone?

LLAP!

References

1. Ilizarov Apparatus, n.d. photograph, viewed 17 July 2014 <http://upload.wikimedia.org/wikipedia/commons/thumb/f/f6/Ilizarov2.jpg/640px-Ilizarov2.jpg>.

The Finals Countdown!

"So Emily, do you feel you're ready for your final exams?"

Stardate: 91935.01

Well, I'm back in lectures again for two weeks, after returning from my short Easter break (I'd say holiday, but as I was mostly revising and working, I'll refrain from doing so!) My first-year final exams are now looming ever closer, and despite revising every day, passing all the mock exams, and even printing off an A3 skeleton, I still don't feel ready. 

We've only got four exams, the longest of which being Physics at two and a half hours, but luckily they're spread out over four days, so I don't have to cram for two subjects at once beforehand. We've got two exams for Musculoskeletal Anatomy, one for Imaging Technique and one for Physics. I'm feeling confident for the Anatomy exam, as this is the one that, for now, makes the most sense. Physics on the other hand (see above image), well... writing pages and pages of notes has helped, but as far as 12-pulse bridge circuitry and rectifiers are concerned, I'm done for! You cannae change the laws of physics Jim, unfortunately...

Thankfully, a good chunk of some exams are MCQs (Multiple Choice Questions), and as long as you've done some reading around and understood the basics of the module, you should get most of these right, which usually can get you to the 40% pass boundary. Following those are the long answer questions, which range from 10-20 marks. 10 mark questions apparently only need about a page of writing, and 20 is two pages (...Wha?) So, my aim is to write as much as possible (within the relevant parameters anyway), and hope for the best!

After the exams are done with, we're back off out on placement again, but this time it'll be for 11 weeks! How will I survive 11 weeks of no Taekwon-do, nor a constant internet connection?! Do I risk taking my PS3, or shall I take boxsets upon boxsets of DVDs? Oh, decisions, decisions...

Mayhem in March

When people ask you about mock exams; applies to both preparation and execution!

Stardate: 91796.42

As you may have noticed, it's been quite a while since I last posted (and it has been ages, because I was on placement last time!) This is generally down to mock exams having been placed over the last two weeks. We had our exams in Musculoskeletal Anatomy, Medical Imaging Science, and Diagnostic Imaging Technique. 

I would like to say I was happy with my results, and I will, but I'm a picky human being with a funny little brain, and I know I definitely could have done better. So I'm happy, but not satisfied with them (to be fair, I haven't had one set of results back yet). I was surprised when I concluded that I found the physics exam the least terrifying!

They weren't so terrible in retrospect, but the only thing to remember about radiography exams is: write as much as you can that's relevant to the question! I lost marks for assuming I didn't need to write something down. If you've learnt it, write it down and talk about it! Also another handy tip is to definitely keep on top of your revision. It soon builds up if you don't!

Anyway, since I've managed to free myself from revision, as a 'reward', I've been reading some radiography journals to pass some time (when I'm not watching Star Trek, or Doctor Who). Two articles caught my eye in last month's (Feb 2014) issue of the journal Radiography. These were very different in content, but interesting reads.

The first was about using cross-sectional imaging in virtual post-mortem examinations. This appealed to me, generally because it's to do with Forensic Radiography, which is the field in which I want to continue my studies. The second was about professionals' experiences of imaging in the radiography process. I may have mentioned it before, but if you haven't already, signing up to the SoR is very beneficial for (prospective) radiography students, as you can access journals and articles, and loads of information which can give a nice scope of the field.

Soon you'll be hearing more from me again, as I'm back on placement next week! I'll be in A&E for one week, clinical skills for two, and a screening room for another. So there'll be plenty to get on with, and hopefully I'll have interesting things to feed back!

LLAP and reverse the polarity of the neutron flow!

References

1. Matt Smith Filming His Final Scene, n.d. photograph, viewed 11 March 2014 <http://static.fjcdn.com/comments/Matt+Smith+after+filming+his+final+scene.+Leaving+the+TARDIS...for+_76a0889eed211250bf3e27e7c154b0c1.jpg>.

Happy World Radiography Day!

Source: http://www.sor.org/about-radiography/world-radiography-day

Stardate: 91459.52

Firstly, as you may have gathered from the above picture, today is World Radiography Day. Today marks the anniversary of the discovery of x-radiation by Wilhelm Röntgen in 1895 `. The day is basically to help promote radiography as a career and to increase public awareness. It's also of course for radiographers to show how proud they are of their profession!

Because it was World Radiography Day, I decided it would be the opportune moment to ask one of our lecturers (who also works as a Forensic Radiographer) how you would go about getting into Forensic Radiography post-registration. Unfortunately, not many places allow it to be chosen as an elective, so I would need to start asking around and finding out about it now, in order to get as much information on it as possible. Membership to the IAFR (International Association of Forensic Radiographers apparently costs a bit now, and there aren't too many people to ask, but luckily I have my lecturer and one of the radiographers on placement who is also a Forensic Radiographer too.

As long as I can pick their brains and gain some hints and things to check out, I'll be okay. According to my lecturer, if you put brie, pork and liver in a box somewhere warm, leave it for a fortnight, then open it up, once you've stopped throwing up, you'll then know whether you want to be a Forensic Radiographer or not. But, despite that, the work is interesting and fun. I still like to think it is for me, even if that does sound unpleasant!

Aside from that, spread the love for Radiography! All of it thanks to Wilhelm Röntgen.

Two days until I move to my placement site...

LLAP!

References

1. Society of Radiographers, 2013, photograph, viewed 8 November 2013 <http://www.sor.org/sites/default/files/images/wrd_2013_logo_web.jpg>

My First Clinical Placement Visit... The Walkthrough!

Definitely how you feel when you finally get out on placement and do something useful!

Stardate: 91438.12

Evening everyone! As you all know today was my first clinical placement visit. After a mad dash to the train (after the ticket collection machine crashed on me) I collapsed on the train's floor, knackered already from waking up at 5.45. The rest of the morning's travel schedule went as planned, and we got to the hospital at least 20 minutes early, which is always a good start. My friend and I were down on the rota to be in mobiles and theatre, and at first we were at little nervous as it was our first day, but really I had an amazing day.

I started off by watching a general chest x-ray, as no surgeries were scheduled until later, but then one of the radiographers came to take a student down to the theatre room, and typical me, I was straight in to volunteer! So I walked down to theatre, and was shown where to get scrubs (I picked blues naturally, I'm not sure I'd have worked/liked the pink ones) and got changed into them. Important fact: scrubs are incredibly comfy, you won't want to change out of them! At first, I put the trousers over my uniform ones (like an idiot), but I was soon set straight! Hair nets were next (these I do not like), and finally the surgical masks. I was given two lead rubber aprons: a skirt and a top, and honestly they are so much heavier than they look!

Once that was all sorted, I was shown how to use the C-Arm and what radiographers working in orthopaedic theatres have to do. I watched some fluoroscopy procedures and I began to watch a bone graft from hip to ankle, but unfortunately, I fainted. 

No, I wasn't grossed out, I didn't feel sick, and I was sufficiently hydrated and fed... I was just too hot. This was the result of having to wear two lead rubber aprons, the lack of a cooling system and the claustrophobic like feelings induced from wearing all this as well as a surgical mask. So I had somehow managed to completely overheat and fainted. I was even considerate enough to go into a corner of the room first, so as to be out of the way! As I hadn't hit my head,  I only needed to be taken to recovery to my 'stats' checked. My BP was fine, but my temperature was shockingly high until I had a drink and cooled down. In the end I retrieved my surgical clogs and made my way back to general x-ray to have lunch. I was pretty eager to go back, but just to be safe, my tutor decided it'd be better if I worked on mobiles for a while.

I watched one mobile case, a patient that had just come out of surgery and was a little too groggy from anaesthesia, and then I was shown how to take a lateral chest x-ray. My clinical day ended with me watching a ureteroscopy over in Urology. And this time, I didn't faint!

Overall, I really enjoyed my time on this placement. Everyone was really willing and ready to tell you everything about anything, and I saw a lot more than I expected to see on my first day.

I can't wait for next Thursday now!

LLAP

References

1. Eleventh Doctor 'Who Da Man!', n.d. gif, viewed 31 October 2013,<http://i1231.photobucket.com/albums/ee517/bubblemaddie/random/tumblr_lq97tjzqCA1qbj6cco1_500.gif>.

The End of the Beginning!

I have broken one of my own "rules" and instigated a photo being taken... of myself!

Stardate: 91429.8

I'm now onto Week 5 of my course, and on Thursday (yes, Halloween) I will be off out on my first day of clinical placement (it's only for one day, but the big 3 week placement is looming closer!) Am I nervous? Maybe... okay, yes. (Mainly because as I've said before, us newbies pretty much know absolutely nothing!

Yes, we've had some basic clinical skills drilled in, such as Moving & Handling, Basic Life Support, and Basic Positioning and Patient Care Techniques, but I am wondering which of my fellow students have actually managed to retain all this well enough to not blank on the first day!

Our comfortable start of semester lectures are starting to get more complex (but not difficult, just more interesting... apparently we cannae change the laws of physics), everyone's starting to tire out faster, books are starting to be loaned from the libraries (not that I hadn't started that as soon as I got to Leeds, mind) and we're all (I'm sure) getting nervous for our first real placement. 

For my first "introductory" day on placement, I'll be working on Mobiles and Theatre. Fitting for All Hallows' Eve, one believes. Here's hoping it isn't too... horrifying! 

(Dammit Jim, I'm a student radiographer, not a comedian!)