Many of my female followers have probably already had a pelvic ultrasound (US), this week I had another one. I thought it would be a good idea to introduce/refresh about this test. It had been years since my last, in my case this was done to follow a medical condition. If you have ever had a pregnancy, you are familiar with this safe (no radiation exposure) and painless procedure. This simple investigative tool is used to exam other parts of the body, including the heart, blood vessels, liver to name a few
How It works: sound waves are bounced off our internal organs – ‘pelvic US’ – ovaries, uterus and bladder – showing not only shape, size but how blood flows to the organs. No menstrual flow can be occurring for this test.
Actual Test: There is no restriction to eating or drinking but you are told to drink at least two 8 oz glasses of water one hour before test. You must hold your urine, no bathroom stop on way into the sonographer’s room. The full bladder moves female organs into view and provides a solid contrast image.
A clear warm gel will be applied to your abdomen, then a slight pressure as the ‘transducer’ (a microphone like small long device) as is applied to your abdomen especially the lower.
Dependent on why the test was ordered the transducer may be covered with a plastic sleeve and placed 2″ – 3″ into your vagina during the exam. As you can reason this offers a view, a different angle that can assist in making or identifying a problem.
Typical time for this study is about 30 minutes, mine took 22 minutes and included the vaginal viewing.
FYI: Sonography technicians train for 16 – 20 months and are supervised by the radiologists (medical imaging physician). There are many training programs but not all however accredited by the Commission on Accreditation for Allied Health Education Programs. There are many certifying organizations; those that pass the American Registry for Diagnostic Medical Sonography can use RDMS after their name. Several states require licensure after completion of an examination. There are over 50,000 in the US (Bureau of Labor Statistics). As always whenever someone is involved with your well-being speak up if you feel any aspect of your exam is not ‘right’!
It is well-known many cancers are caused by radiation exposure, even the sun radiation cause skin cancer the #1 cancer in the US. Medical radiation exposure is your responsibility! Every wonder what happens to all the radiation you receive when you have ‘medical imaging’ tests for such things as broken bones, stomach pains, headache, heart disease? Sadly it accumulates in your body! If you want to calculate how much you have in your body, check out the website calculator by The American Society of Radiologic Technologists – it is user-friendly.
Some tests expose you to small amounts others too much more. Radiation, harmful rays of ionizing energy, cause not just skin cancer but blood and other cancers result from our bodies being dosed. Before you have another test read this useful patient info.
Before you agree to exposure to these harmful rays ask “what difference the results would make in your care’.
DocHandal tries to bring you the latest research findings that docs like herself read and use. This blog hopes to share some and guide you to reading more, after all it is your body guys!
American Heart Association Guide for Improving Cardiovascular Health at the Community Level, 2013 Update*This study looked at 26,902 men, ages 45 to 82, free from cardiovascular disease and cancer at the start of a 16-year study. Researchers found those who skip breakfast or eat late at night could be at increased risk of developing coronary heart disease. Specifically for this study male health professionals were used. They freely admitted they regularly skipped breakfast, and were found 27% more likely to die while those who ate late at night had a 55% increase in cardiac death.
Important to note it did not appear to matter how frequently they ate a day.
REsearchers caution that, these associations appeared to be mediated by BMI (body mass index), development of hypertension, hypercholesterolemia, and diabetes over the years of the study.
FDA just (August 9th) approved the first rapid finger stick Human Immunodeficiency Virus (HIV) test that not only reveals if you have antibodies to HIV -1 or 2 but if you only have the virus (i.e. you have the antigen p-24)! In this 20 minute test the presence of the virus can be found 12-26 days after exposure. Prior to this 4th generation test one would have to wait till your body made antibodies – anywhere from 20-45 days after exposure. Note: this test however does not distinguish between antibodies to HIV-1 vs. HIV-2.
Now health care professionals have a quick tool that can independently distinguishes in a single test HIV antigen from HIV antibodies. Early infections yield antigen positive while only when the body starts fighting do HIV antibody develop.
Why this is a ‘big deal’ is you could be walking around undiagnosed spreading HIV infection because your body has not made antibodies. NOW infection can be recognized, treatment, and prevent spreading HIV infeon. At this writing the Centers for Disease Control and Prevention (CDC) estimates that in US each year approximately 50,000 people are infected with HIV. Of the more than 1 million people living with HIV, approximately 20% have not been diagnosed.
BACKGROUND: Being injected with the HIV virus can lead to Acquired Immune Deficiency Syndrome, or AIDS. This virus damages your body’s immune (defense) system – by destroying CD4+ T blood cells which are key to fighting diseases. At present there are two types of the virus- HIV-1 and HIV-2. HIV-1 is worldwide while to date HIV-2 is mostly in West Africa, although increasingly HIV-2 is being reported cases in Europe and North America.
Care very much what children eat in ages 3-5! A recent study followed over 1,000 pre-school children watching their diet and behaviour around foods. Testing of blood lipid levels were also done specifically looking at the ‘bad’ lipids (LDL cholesterol, apolipoprotein B) as well as the ‘good’ lipids ( HDL cholesterol and apolipoprotein A1).
“The eating behaviors subscale included whether children were allowed to decide how much they ate, whether they ate while watching television, the number of meals they ate per day, the presence of gagging or trouble swallowing while eating, and whether the child is not hungry at meal time because of frequent drinking,” according to the study.* Parents completed questionnaire to make determinations of behavior risks.
The study revealed at an early age an association between diet and behavior leads to high levels of ‘bad’ lipids. This can predisposing to later risk of cardiovascular disease.
*CMAJ (Canadian Medical Association Journal) June 17, 2013
Seems nowadays you can’t get out of office visit, ER or hospital without one or many tests. Seems many of my colleagues never touch the patient but order tests including cardiac catheterization to biopsy.
Anytime you are subjected to a medical test presume there is a reason and those results are important. Yes often they are ordered in the name of prevented care adlib mammogram, colonoscopy, ECG and the like.
You should know why any test is ordered, exactly how will a result mean to how you are cared for. There are tests that are ‘nice to know’ but not necessary for good medical care. So since you are the one being exposed to radiation, needles and tubes – speak up – ask till you understand. Don’t be shocked if then the test is not ordered!
I have long said never get an ECG (EKG) without asking for a copy to keep in your wallet or take a photo of to have in your smartphone. Please take a few minutes to go to DocHandal’s (iTunes) podcast channel “Listen Up” and listen to the podcast titled ‘Healthy Wallet”. You may have to pay for personal copies however if your medical records are being sent to another medical care provider there is no charge. Transfer of medical information between caregivers is part of ‘continuity of care’, something that is required by law.
Finally patients are freely given a DVD/CD of their imaging study -for example an Ultrasound or CT scan. So why get a copy of medical tests? Take it to appointments often you need to take this to the ordering medical provider who may get the written reports later than your copy of the test/study. Many capable physicians are able to interpret and actually prefer to interpret the imaging study rather than just rely on the report.
It is your health, body and you are responsible for it!
When a negative ‘surprise’ (or abnormal experience) occurs after taking medications or using a medical device – you can easily take action. Means are available and include bedsides the obvious of calling the pharmacy or medical subscriber – you can ‘go to’ the FDA! The FDA website (medwatch) is a plethora of information with plenty of research and you can also report your concern.
Examples of concern include:
it occurs to you that there might be a problem with the quality of the drug, product or medical device
often you were taking a drug that worked then you were switched to a different manufacturer (usually a generic company) by the pharmacy or your insurance plan only to have it not ‘work’
experience a reaction you believe to be a side effect – new symptoms or worsening symptoms after taking a drug or using a medical product/device
took a drug, or used a medical device incorrectly and it may have had a negative/unsafe effect for you.
Know there are many ways for YOU to address any of the above possible concerns:
-anyone can call the FDA at 1-800-332-1080 or go to their help website.
If you are researching or want to know about a specific drug or device – your source should be ‘medwatch’ – a free ‘.gov’ site of the FDA. Here anyone can have access to info about such things as tobacco products, cosmetics, including veterinary products it is a great ‘go to’ site. Want to know about foods and especially current recalls and outbreaks this site is the way to find out. I was glad to see also covered was ‘dietary supplements’ – we all take so many of them.
Check this site for those hospitals in your area deemed centers meeting the AHA standards for treatment of heart problems including failure, AFib (an arrhythmia) and resuscitation as well as stroke. ‘The American Heart Association and American Stroke Association recognize the hospitals for their success in using Get With The Guidelinesto improve quality of care for heart disease and stroke patients. This list is current as of May 15, 2013. It is updated monthly’.
‘Continuous quality improvement’ so end result is measurable patient health. The AHA program sets guidelines for medical personnel, offer clinical tools provides mechanism for reporting tracking and patient management tools. Workshops and webinairs for staff and patient education materials for outreach programs are also available.