This is a very interesting video. This could be our future....
Recently, patients have been asking me about the significance of "bear down" and what that exactly does to the exam. A Venous Reflux exam can be tedious if the patient does not know how to properly "bear down". I tell my patients to "bear down" like they are having a bowel movement. Many of them look at me weird and simply say "What does that do"?
The calf muscle pump is critical in maintaining venous hemodynamics and the purpose of this exam is to know if the calf muscle pump is working effectively. An effective calf muscle pump consists of three things: 1) veins as reservoirs for blood collection 2) the contracting muscles of the legs, and 3) competent valves maintaining unidirectional blood flow. Therefore, when the calf muscle pump is effective, blood moves toward the heart resulting in a decrease in venous pooling, decrease in venous pressure, and an increase in venous return.
Hopefully my patients know why it is important to "bear down" during the exam. I am craving some dark chocolate I think I might need some energy boost!
Happy New Year everyone! I want to congratulate Manny Gracia for passing his Boards. Manny is a recent graduate from Chicago and was the blogger for the 2011 SVU Annual Conference in Chicago. He inspired me to create this blog. Best of luck in your future Manny!
I cannot believe it is January already, where does the time go?? Soon, I will start performing renal artery exams in my lab and although they are the toughest, I am still looking forward to it. The renal arteries can be challenging, but that makes it more intriguing for me. Time for some hot coco I am brutally cold! Why does Jersey have to be like Siberia!?
I cannot believe it is December already, I have been in my externship for over 3 months now. A week from now I will be in New Orleans for the SVU Board of Directors Meeting. It will be my first time traveling to the beautiful city of NOLA and I'm very eager to attend the meeting and see everyone again. I have not seen them since June when the Annual Conference in Chicago took place! NOLA is famous for its festivals such as Mardi Gras and of course the Sazerac cocktail that I will be indulging upon arrival! I will be roaming through Bourbon, Magazine, and Frenchmen St. to discover the nightlife NOLA has to offer, perhaps I might need to pack a hangover remedy....tomato juice and tabasco?? BYE JERSEY
Travel season is starting time to get out the suitcases and start packing...
New Orleans here I come!
One thing about this profession is you must be aware of your posture, having the proper ergonomics is crucial when performing the different types of studies. Unfortunately, I am only 5 foot 2 and most of my patients will be bigger than me considering I am the size of a walnut. When performing bilateral exams, I tend to use my right hand since I am right-handed. I make sure I adjust the bed properly and I always tell my patients to move more towards me so I avoid from reaching over too far over the patient. This also avoids extreme flexion or deviation of my hand, awkward posture, or discomfort. The last thing I want to develop from my job is back pain or carpel tunnel syndrome. Off to watch Rachel Zoe, my inspiration for new wardrobe. “Style is Personal but Taste Isn’t" - The Rachel Zoe Team
After a month living here, I have discovered some great coffee houses. My favorite is Chez Alice Cafe & Bakery, along with Small World Cafe and The Bent Spoon. I like to enjoy my hot chocolate with my Mac in front of me as I type away. I have come to realized that in coffee shops you will come across some very interesting people. Although my Mac always keeps me occupied I try not to send off "I'm busy" vibes because I enjoy meeting new people that can share an experience that I have yet to encounter. When I stumble upon someone for the very first time, I tend to look at their hands. I believe hands tell all. Observe the fingers of someone's hand perhaps they can tell you something that you may want to know....
Which procedure is better? Both procedures have their benefits and I am proud to announce that in my lab we are going to start performing Radiofrequency Ablation (RFA). If you are not familiar with these two terms they are used for the treatment of varicose veins (bulging veins). They both are noninvasive and catheters are used to get to the abnormal vein in order to close it up. With RFA, there is usually less pain post op and less bruising than with laser ablation. RFA is typically the preferred method because it is generally associated with less discomfort. Both techniques are fairly fast and they are incredible improvements over the traditional vein stripping. With that in mind, if you or anyone you know have varicose veins, you know which treatments are commonly used. Oh the joy of aging :) Is it Friday yet?
I am still not used to the long hours Monday-Friday, perhaps wearing compression stockings will help. I would like a masseur hopefully my mentor can hire one. As I am observing all kinds of vascular studies, and learning the new equipment that is being used here at the vascular lab, a case that stood out was a patient who was getting a carotid exam. I noticed that their right vertebral artery had a to-and-fro waveform or retrograde flow. When that situation arises you automatically should scan the brachiocephalic or innominate artery to check for stenosis. The diagnosis for this patient is subclavian steal syndrome (SSS). It is narrowing or occlusion of the subclavian artery. Off to watch the Real HouseWives of Beverly Hills...hasta mañana!