This thing I refer to as My Life

A lucky day! In addition to everything taking place on the OTHER blog, I am one of the two second year residents that gets to start moonlighting...in my second year! Yeah! Extra income while I study!

The plan is to induce tonight! (Or rather, early tomorrow morning depending on how you want to look at it.)

I know some people may not fully understand what I do and what the breadth of radiology is about, but I think this is a good all-encompassing example. And, just to pat myself on the back a little more (and the patient too for that matter), I was told that in my career, 99% of my biopsies will be much easier than this one, and I hit the target on the first attempt! I'm still a little high from this one, can you tell? Break out your metric ruler so you'll understand this a little better...So, here's the scenario: First, as a radiologist, you have to be able to interpret the image below. You sterilize the skin surface and then numb the skin with lidocaine. (I'm assuming you have done all of the paperwork already, because that is not interesting to write about.) You have a 1.3 mm diameter 15 cm long needle that you need to place 12 cm's into a patient and try to stay within a single CT slice, which is 3 mm. You want to traverse the back muscle and the psoas muscle to enter a mass that is surrounding patients abdominal aorta. If you go too close to the bone, you may hit a lumbar artery which will bleed significantly. If you go too wide, you will hit bowel that may require surgery to repair. If you go too deep or at the wrong angle, you could hit the abdominal aorta which will cause significant bleeding and could cause death. Oh, and somewhere in there is the ureter and the inferior vena cava, but you really cannot tell where they are exactly. You need to get your needle in the mass so you can get a sample for the pathologist to figure out what it is, so the oncologist knows what kind of chemotherapy to use. Oh, and did I mention that you're wearing two pairs of latex gloves and that you're supposed to stay within one 3mm slice? Right, I did mention that last part. (You may need to click on the image to enlarge it.)

Today, I used a CT to help me take a 15 centimeter spinal needle--> stick it 12 centimeters into a patient's back--> through the back-strap muscles--> through the psoas muscles--> into a mass surrounding the abdominal aorta --> and then suck cells out while moving the needle back and forth without actually hitting the aorta!

If you're not sure, the word you're looking for is YIKES!

I'll try to post a picture of it, if I can get one. In the mean time...Cross Post! (That means go look at the other blog, too.)

Okay, we've got an interesting up date. We're going to keep this blog here the "private one" and the more general stuff will go in a public blog. We'll see how long both keep going and I'll try to cross-post to let you know to go look at the other one. So, provided you know how to spell my name, go to www.myfirstnamemylastname.com and enjoy!

As we were leaving the American History Museum yesterday, we saw this...


Before we went into the Museum, We had the nice parking spot on the mall. How often do you look through your car and see the Washington penis...I mean Monument?




And, finally, it's time for a tummy update....(This is from today)


And, if that wasn't enough, here's a movie of Richie moving around...