John Stones #29 Waiting patiently for bae to play, hoping today is our lucky day

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mimimithis

mimimithis

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Just Drive said:
Thanks for that! :)

Is Jack ok??


Wow, that’s beautiful! ❤


Fuming. Poor Jack. Was nice to see his shirt lifted up, though.
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That kick must have been painful, what was Collins thinking?? No need to go that hard. But he seems fine, and the right lower abdomen, apart fom abdominal muscles, has no vital organs which could potentially be harmed. He might not be able to flex his abs for a few days.

Ah, Stones. He's being talked about quite a bit by the German comm today, he's heaping praise on him.

Love Manuel, he's really good.

cobette said:
Disney Springs is a shopping area with restaurants and bars. It's very pretty! We're going to a bar called City Works I think, there's so much choice though and I want to go somewhere we've never been! I will probably switch again before we leave!



This is stunning!



I have a soft spot for JJ!

I think baby has been a bit hesitant at winning the ball back today 😬 am I being too harsh?
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Ooooh, that sounds lovely! I hope you enjoy, and that you have a lot of sun and good times, especially also discovering new things. New things are my weakness.

A little, but then he still goes in and does his job, and he has Manuel to help him out right behind him.
 
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mimimithis

mimimithis

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Just Drive said:
🤣 I work with a couple of Spaniards whose middle names are Martin (pronounced “Marteen”).
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Martín can be both, definitely. I can just hear Americans trying to pronounce it, tho 😁😁😁 For Germans, it would be Martin, with the accent on the a, so a whole different kind of wrong. Or, if you live here in Bavaria, it'd be Maaarrrddin
 
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mimimithis

mimimithis

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cobette said:
They are sexy tho aren't they!? I reckon I could watch the game in this bar. They have Newcastle game on.

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This looks so good!!!

Starttheline said:
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I like this one, it's like they're doing an interpretive dance
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This handsome boy. 🥰
 
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rasperryripple

rasperryripple

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cobette said:
I've rebooked for later this morning just for you 😘 it does look amazing, I've wanted to try the vanilla bean French toast for years!



Please can he come hold in me those arms whilst he fucks me!? Thanks for sorting.

@mimimithis I have missed you this week. Hoping for a peaceful weekend for you x



I am feeling a bit frustrated because things have been much more sedate than usual! Having to cater for mum not really being a Disney person. Should step up a gear when she leaves and actually get on some rides!



I love this man more than anything in the world.
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Enjoy and please take pictures 🥞
 
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V

Violetroselily

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mimimithis said:
Sorry for the long wait, @Violetroselily , the last two days have been madness. Long post ahead.


Pregnancy

With pregnant patients, we don't use radiation on her stomach/pelvis, so no x-rays and/or CT scans, unless it's vital for survival. Any woman in the age range of teen upwards to about 50 will be asked about a possible pregnancy before an exam with ionising radiation, and it will be written down on her patient file and signed by the patient, so we cannot be made criminally liable for using radiation on an unborn without proper indication (again, the only indication to do so is if the patient is at imminent risk of death without the proper diagnostics, and even then we're really restrictive). Now, if we need to x-ray a female patient (also young male ones), we always use lead shielding on the pelvic area, unless it's the pelvis/hips we need to x-ray. In CT, that isn't possible, but the scattered radiation is lower the further the scan is away from the uterus. There are also formulas to calculate the organ radiation dose of the uterus, which our physicists will do for young patients with trauma CT scans, for example.

MRI, since we use magnetic waves/resonance, and not radiation, is generally the safer method, and can be used as an imaging diagnostics for pregnant patients. There are restrictions here, too, while not forbidden by law, it's not recommended to perform exams on a pregnant patient during first or third trimester. First, because the organogenesis is in full swing, which means the first three months are used by the cells to build the little human, form the organs and the skeleton, and the general shape - magnetic resonance could potentially disrupt the forming of organs, or lead to the cells making "mistakes" for a lack of better words, which could potentially lead to deformations or missing organs. Third trimester, because the magnetic resonance gets the hydrogen atoms to swing, since the fetus is inside a giant water bubble, so to speak, the water will start moving around it, and it could be a cause for early labour.
When we perform abdominal MRIs on pregnant patients, the babies look so funny in the individual slices, but you cannot show that to patients, they could be left distraught.

Here's an MRI of a pineapple instead.


Now, the one exam that is generally considered safe is the ultrasound, where we can see the fetus, and yes, the bigger it gets, the more it can obscure any organs which lay around it, so we need to always move our probes to get better angles and try to figure out a way around them. Funny thing is that the fetuses don't really love the feeling of ultrasound waves, and usually will turn their backs, so you get the funniest arse shots of them, on purpose. We try not to let exams take more than a few minutes, because the fetal movements might upset the patients, too, and they're the ones who should feel comfortable during the exams.



Situs inversus

Funny you should ask that, I just had a patient come in for an exam last week who had what physicians call a complete situs inversus, which means that all of their organs are mirrored, so where normally the heart would be on the left, and the liver on the right, it's exactly the other way round. There are also incomplete forms, where just the heart might be mirrored or just the liver and spleen.

I know @cobette had a laugh about you using ER for a reference, but it was actually one of the most medically accurate shows on TV (here's looking at you, House MD), along with Scrubs.

Ionising radiation dose limits

There are laws about how much radiation any person - medical or not - is allowed to be exposed to. There's ionising and non-ionising radiation, so with rays or particles vs. e.g. electromagnetic fields. Ionising radiation can be due to natural radiation exposure (both terrestrial and cosmic) due to our environment, food or even the air (e.g. radon) as well as natural UV radiation (light), or due to medically applied radiation.

There are government agencies which take care that the laws are upheld and renewed every few years. For us in Germany that's the BfS, the Bundesamt für Strahlenschutz (federal office for radiation protection), for you in the UK it's the HSE.

Radiation - HSE

HSE provides information on ionising radiation and non-ionising radiation. Looks at radiation hazards in the workplace and how to control them.
www.hse.gov.uk www.hse.gov.uk

The Ionising Radiations Regulations 2017

These regulations revoke and supersede the Ionising Radiations Regulations 1999.
www.legislation.gov.uk www.legislation.gov.uk

As medical professionals, especially as radiologists or radio techs, we wear so called EPDs, electronic personal dosimeters, on our bodies, usually on our lab coats or scrubs, which continually assesses the amount of radiation we are (or could potentially be) exposed to. Pregnant colleagues will wear an additional one, which measures the exposure for each day, and they'll have to write down the amount for each day worked.

Our exposure limit is set to 20mSv a year, which is a lot (in comparison a chest x-ray in 2 views is about 0.02 mSv), and our individual organ doses 20mSv for eye lenses and 150mSv for extremities, for example. In reality, however, our dosimeters show an amount of 0 mSv radiation exposure due to all the protection measures that are built into our institute/exam rooms (e.g. lead lining in the walls, lead glass shields in angiography) or which we wear to protect ourselves (e.g. lead gowns, thyroid protection, lead glasses, gloves etc.).

Pretty examples of x-rays:
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What made you want to specialise in Radiology? Did you consider any other specialisms?
At what point do you specialise? Do you have the equivalent of foundation years in Germany?

Do you ever debate what type of imaging to use? Is an MRI ever the first port of call, or would you always do something else first? Why do MRIs take so long?
 
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