Spring, 2012

Spring, 2012

Even though we are well into 2012, it feels like a new year for North Carolina Ultrasound Society as we begin planning for our next Annual Symposium to be held March 22-24, 2013 at the Grove Park Inn in Asheville, NC. This is traditionally one of the favorite venues for our meeting, so MARK YOUR CALENDARS NOW! Great information and spring in the NC Mountains – how can you top that!!!!  

Our 2012 Symposium was a HUGE success with lots of favorable feedback regarding the speakers for this year’s meeting.

Subclavian steal syndrome (SSS), is a constellation of signs and symptoms that arise from retrograde flow of blood in the vertebral artery, due to proximal stenosis or occlusion of the subclavian artery. The arm may be supplied by blood flowing in a retrograde direction down the vertebral artery at the expense of the vertebrobasilar circulation. This is called the subclavian steal.

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Throughout our careers as diagnostic medical sonographers, we will witness several anomalies, some congenital while others are not. The following case study involves a uterine anomaly some women may never know they have: uterine didelphys. This patient was referred to a maternal-fetal-medicine practice from an outside study for a uterine anomaly. The exam ordered: OB 1st Trimester with nuchal translucency (NT). The patient is a 33 year old white female; gravida: 2.

Uterine anomalies [Figure 1] are grouped into six classes according to their “prognosis for future fertility and their surgical correction” (Hagen-Ansert, 2008). The six classes include: Class I - segmental müllerian agenesis or incomplete canalization; Class II - unicornate uterus; Classes III: uterine didlephys; Class IV - bicornuate uterus; Class V - septate uterus; and Class VI - related to diethylstilbestrol (DES) exposure while in utero. (Hagen-Ansert, 2008).

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I was scanning a 30 week fetus, having difficulty trying to get a nice 3D face image for the mom. I said, " I cannot see the baby because the legs are over the face." The patient replied, " That's how I got myself in this situation to begin with."

Ultrasound uses high frequency sound waves to produce images of body structures such as organs and tissues. Obstetric ultrasound is the well recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non- medical fetal ultrasound is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication.

Advancements in ultrasound technology have made 3-D and 4-D imaging available. Some entrepreneurs have capitalized on this improvement in image quality, and today keepsake fetal ultrasound boutiques are available in many states. These “entertainment ultrasounds” are carried out without a physicians order. A 3-D or 4-D keepsake ultrasound image or video can be produced for any expectant mother who wishes to see her baby and can afford the cost of the session, which is typically not covered by health insurance.

Who would have thought that black, white and shades of gray could make a difference in someone’s life?  The phenomenon of sound that is so high one cannot hear allowing a mommy and daddy to see and know their baby is healthy before she’s born is astonishing.  Formulas of physics applied and coupled with modern technology has aided in preventing heart attacks and helping to diagnose life-threatening conditions that could not have been seen before.  This is a day in the life of an Ultrasound Technologist!

As an ultrasound student learning this technology has been amazing, but one of the things that have impacted me the most is the patient.  The first day I stepped into the hospital to begin work, my mind was trained to properly perform exams, use the functions and controls to maximize image quality and think through the scenarios necessary to help the doctor diagnose disease. I was ready!

I confidently walked out to the patient waiting area and called for my patient.  As she stood up and walked down the hallway with me, I couldn’t help but be reminded of my mom.  As we began the exam, my heart broke as I saw cancer spread throughout her abdomen.  My educated mind knew the reality was that she had a short time to live!  As we talked throughout the exam, she reminisced of stories and fond memories.  She shared with me that her son drove ten hours just to come and take her to this appointment and that he was waiting for her in the waiting room.  After her exam, as we took the walk back to the waiting room, my mind and heart were completely shifted from thinking about buttons and knobs to what is most important in life-those whom we love!  When we arrived at the waiting room, her son stood up and she was just so proud to introduce me to him.  I shook his hand and said, “we’ll always be there for our momma’s, won’t we?”  His reply was a smile and sincere “absolutely!” Sobered and humbled, I walked down the hallway back to the exam room to start the process again and prepare for our next patient.

As an Ultrasound Technologist we are actively present in people’s defining life moments.   We have the unique privilege to share in the high points of their lives when a mother and father see their child for the first time.  We’re also there when a mother has cancer spread to a degree that is unalterable.  Every patient is someone’s mother, grandfather, child or spouse.  The reality is that some day that patient lying on the table could be my loved one.  As I approach each exam, I’m reminded of this reality and am encouraged to help my patient to the best of my ability, as I would hope someone would do for my loved ones! 

One of the most challenging aspects of being an ultrasound technologist is caring for each patient in a healthy way.  Every day we may see patients who are dying as well as see patients who are about to give birth and have great joy.  There is a roller coaster of extreme emotions that must be kept in perspective.  It is a terrible thing to be emotionally hardened in these life circumstances!  It’s also a terrible thing to carry your patient’s burdens and life circumstances on your shoulders.  At the end of the day, I’ve learned to look back and know that I’ve genuinely cared for each of my patients physically and mentally. As I clock out for the day, I leave these extreme emotions at the door and go home to my family to hug my wife and play with my son and be the best husband and father I can be.

Tomorrow I may see a mother who has been bleeding and she needs my help to know if her baby is ok, a man who has been doubled over in pain and is worried he’s had or is about to have a heart attack, a newborn who has been vomiting for days and is losing weight because he cannot keep any nutrition in his body and a patient with Hepatitis C and cirrhosis of the liver who needs me to help drain the fluid out of his abdomen so his body won’t shut down. I’m going to be there to help them. This is a day in my life as an Ultrasound Technologist!

Chris McSmith
Cape Fear Community College
Sonography Program
Class of 2012