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  • A little professionalism, please?

    I've been having gallbladder issues recently. In January, my gastro doctor had me go in for an ultrasound. Didn't come up with anything abnormal, but that didn't rule out a gallbladder problem, it just meant that I didn't have any gallstones (which is good, 'cuz from what I've heard, gallstones are hella painful sometimes). So my doctor ordered a HIDA scan. From what I understand about the procedure, it's some kind of nuclear scan-type thing that measures gallbladder functionality. Or something. I'm not really sure, and the particulars aren't something I really cared about. As far as I'm concerned, if my doctors think I need it done, I'll go ahead and do it.

    The staff at this particular location of (Local Hospital) Diagnostics aren't the most professional, but it's the location closest to my house. And, apparently, the only one that isn't actually in the hospital that can do stuff like HIDA scans. I'm used to a degree of not-super-professional-behavior, 'cuz let's face it: laid back people are usually a bit friendlier, and sometimes medical procedures are scary. The woman who did my HIDA scan, though, takes the cake for worst person I've dealt with there.

    She wasn't mean. She wasn't rough. She didn't have an unpleasant demeanor. All's good, right? Nope. Let me explain the generals of the procedure so you can kind of get an idea of what I was going through this day.
    • It's a fasting procedure. I couldn't eat for… I can't remember how long, but it was first thing in the morning so I hadn't eaten in over 12 hours.
    • A gel-type thing gets injected and it kinda "highlights" your organs. Or something.
    • That's when you kinda have to wait an hour to let the gel do its thing.
    • After an hour, you go back in and they take pictures and see if the gel has gotten where it needs to go.
    • In my case, the gel had gotten to my gallbladder so I then had to lay on a table for an hour as another substance was administered and more pictures were taken.


    I've been to this place a few times, so I don't know what they have on file and what they don't. I was taken back into the procedure room and asked to verify my name, so I did. I'm not sure about what kinds of radiation/etc, if any, are involved in this procedure, but I'd imagine that it may not always be pregnancy safe. I'm not pregnant, there was no chance at the time that I could have been pregnant, but I was not asked if there was a chance that I could be. It's probably a good thing that I didn't really have to worry about that, though, considering she actually explained nothing to me, including risks.

    She also didn't ask me if I have any allergies. I do, actually: to a couple different medications. I... don't know that that information is in the paperwork I filled out for them. Even if it was, most people double-check for safety reasons. Nope, she didn't ask. She set me up with my little IV-thingy in my hand and sent me back out into the waiting room. As I sat there, reading my Cosmo and waiting for the time to pass, my wrist started to get really, really itchy. I looked down. Oh, hello there, Mr. Reaction Hive-and-Rash. Since it's only a small area of my wrist being affected, I don't say anything and assume that's just a side effect of the highlighter gel stuff. Things have side effects, after all.

    During this time, my mom comes to wait with me since this procedure could take as long as four hours. I tell her about my reaction, and she recommends that I let the tech know about it when I go back in. Which I do. My exact question was "I had a bit of a rash show up when I was in the waiting room. Is that normal?" She responded that there wasn't usually a reaction to the gel, and that I probably just had a sensitivity to the tape holding my IV connection thingy in.

    (Red flags went up here. I've had that kind of bandage tape applied to my skin before for various reasons. Never had a reaction before. Plus, that's not a typical reaction to tape. But hey, she's the tech, not me.)

    She starts to scan me to see if the gel has gone through yet. It has, so I'm now her captive audience... for an hour. During this time, I get to hear about the following:
    • She was putting her dog down that afternoon (I think she talked about that for a good twenty minutes)
    • Her pressing need to know all about this weight loss regimen I'm on
    • How hungry she was
    • Other tidbits of her life, her boyfriend, and whatnot


    Okay, yeah, small talk. Some people do that. I do that. I generally know not to talk about putting down my pet to a total stranger.

    Remember how I said I hadn't eaten for a long time by this point? Yeah, I was starving. So her talking about how hungry she was was... obnoxious, but something I could relate to and tolerate. UNTIL...

    She pulled out a box of crackers. And started eating them. Okay, I get it, you're hungry and it's not like you have a back room you can just dash into. But you know the nature of the test I'm having. Why would you eat in front of someone who has not eaten and cannot yet eat? Why are you eating in a medical procedure room?

    I couldn't get out of there soon enough, believe me.

    Thanks for letting me rant.

  • #2
    Um, ok, I've seen my share of doctors and had my share of medical procedures, but I've never seen technician/nurse/doctor/whoever eat in the area where a medical procedure was going on.

    That's got to be a big no no. There are chemicals and things, and god forbid you get crumbs in somebody's wound or something. You could cause contamination of samples or infection. And saliva on your hands? Don't even get me started.

    Granted, I'm not a medical professional. But this is what my instincts are telling me. I think your instincts are right.
    "If you pray very hard, you can become a cat person." -Angela, "The Office"

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    • #3
      Oh, please tell me this was a lab that starts with a Q, because I have had horrible service there. Most has been general snarkiness and surliness, but my last visit was the very last.

      My doctor was trying to investigate the reason for my hypertension and she sent me for a blood draw and a 24 hour urine test. I went in and the lab tech looked at my paperwork and said that I would have to stop taking my meds for three weeks before they could do a blood draw.

      Seriously? I was in an ER three weeks previous for palpitations that actually scared me (I had no idea what was going on at the time and my being scared about them actually made them worse) and put on clonidine for my hypertension. Then placed on other drugs which helped lower the blood pressure. Do you want to send me back to the ER? Because I'll be more than happy to send you the huge bill that results from it.

      She then told me I needed to walk around to get my blood going. Again confused about this, but DaDairyDruid and I walked around the square and back so she could do the damned blood draw.

      Then they harassed me because I didn't go to the lab first thing Monday morning (I did my 24 hour urine test over the weekend), because they didn't open their doors til 9am.

      I told my doctor about it and she couldn't believe it. Since then she's sent me to the lab affiliated with the hospital and I remind the nurses if they accidentally give me the wrong lab paperwork.
      Random conversation:
      Me: Okay..so I think I get why Zoro wears a bandana
      DDD: Cuz it's cool

      So, by using the Doctor's reasoning, bow ties, fezzes and bandanas are cool.

      Comment


      • #4
        The tech threw a bit of a fit that I took my medications that morning even though it was a fasting test. I'm pretty sure taking my meds wasn't gonna hurt it, considering I took them... with water, which is pretty much universally allowed as far as I'm aware.

        It wasn't a lab with a Q, although I'm kinda glad it wasn't 'cuz I've had less than awesome experiences with them, too.

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        • #5
          I do HIDA scans. Usually 3 or 4 a day. So I'ma geek out here for a minute. Grab the popcorn, kids, it's a long one.

          Quoth retailsweetie View Post
          From what I understand about the procedure, it's some kind of nuclear scan-type thing that measures gallbladder functionality.
          Yup.

          Quoth retailsweetie View Post
          A gel-type thing gets injected and it kinda "highlights" your organs. Or something.
          It's basically radioactive saline. For a HIDA scan in particular, the tracer is tagged to make the body think it's what is used to make bile, so the liver sucks it up and turns it into bile. That bile then (should) flow into the gallbladder. The radioactive component is what allows us to see it with the scanner.

          Quoth retailsweetie View Post
          • That's when you kinda have to wait an hour to let the gel do its thing.
          • After an hour, you go back in and they take pictures and see if the gel has gotten where it needs to go.
          • In my case, the gel had gotten to my gallbladder so I then had to lay on a table for an hour as another substance was administered and more pictures were taken.
          Sounds like their protocol is a bit different than ours. We usually image every 15 minutes, though it the gallbladder is visible we can fudge it to every 10. The second set of images is to watch the gallbladder contract. That other substance is Kinevac. It's an analog of cholecystokinin, which is a hormone your body produces naturally when you eat. It contracts the gallbladder so the bile can go do its job. There's a normal range of how much it's supposed to contract.


          Quoth retailsweetie View Post
          I'm not sure about what kinds of radiation/etc, if any, are involved in this procedure, but I'd imagine that it may not always be pregnancy safe.
          Just to be safe, I ask every female if they're pregnant. Even the ones who clearly can't be. It's gamma radiation and very little at that, so it would probably not be dangerous for a pregnant female and her baby. However, if a pregnancy test came back positive, we wouldn't do the test. Just in case.

          Quoth retailsweetie View Post
          She also didn't ask me if I have any allergies. I do, actually: to a couple different medications.
          I admit it, I forget to ask this question sometimes. Since our tracers and even supplemental meds are analogs of something the body naturally produces, we really don't give people anything they could be allergic to. Usually. But I'll get to that.


          Quoth retailsweetie View Post
          She set me up with my little IV-thingy in my hand and sent me back out into the waiting room. As I sat there, reading my Cosmo and waiting for the time to pass, my wrist started to get really, really itchy. I looked down. Oh, hello there, Mr. Reaction Hive-and-Rash. Since it's only a small area of my wrist being affected, I don't say anything and assume that's just a side effect of the highlighter gel stuff. Things have side effects, after all.

          <snip>

          My exact question was "I had a bit of a rash show up when I was in the waiting room. Is that normal?" She responded that there wasn't usually a reaction to the gel, and that I probably just had a sensitivity to the tape holding my IV connection thingy in.

          (Red flags went up here. I've had that kind of bandage tape applied to my skin before for various reasons. Never had a reaction before. Plus, that's not a typical reaction to tape. But hey, she's the tech, not me.)
          Typically there are no side effects to the stuff we use. However, it could have been a reaction to a preservative or something else in the cold kit used to make the tracer. The radioactive component, Technitium, is actually a metal, so if you have a metal sensitivity, it might have been that. We actually had someone react to Cardiolite the other day. She had a rash all the way up her arm that hadn't been there that morning. So we had to call the pharmacy and let them know. They'll run tests and make sure there was nothing nasty in the kit that could explain it.

          Though if the itchy and rash was confined to just the area around the IV site, I'd be more inclined to suspect the tape. Even if you've used it without issue before, we develop sensitivities over time. I have a sensitivity to certain types of band-aids that I didn't have when I was younger.

          Quoth retailsweetie View Post
          Okay, yeah, small talk. Some people do that. I do that. I generally know not to talk about putting down my pet to a total stranger.
          Uh, yeah. That's weird. I will admit to having some conversations in front of patients that we probably shouldn't have, but never with a patient.

          Quoth retailsweetie View Post
          She pulled out a box of crackers. And started eating them. Okay, I get it, you're hungry and it's not like you have a back room you can just dash into. But you know the nature of the test I'm having. Why would you eat in front of someone who has not eaten and cannot yet eat? Why are you eating in a medical procedure room?
          Ok, that is a HUGE no-no. Absolutely no food or drink in clinical areas. That's a rule for everyone in the hospital, not just Nucs. Now do I sneak a drink of my coke every now and then when there's no one else around? Sure. But I sure as heck wouldn't put anything near my mouth when there are radioactive materials and biohazards lying around. That's really stupid.

          Quoth retailsweetie View Post
          The tech threw a bit of a fit that I took my medications that morning even though it was a fasting test. I'm pretty sure taking my meds wasn't gonna hurt it, considering I took them... with water, which is pretty much universally allowed as far as I'm aware.
          That depends. If you drank enough to contract the gallbladder or if one of your medications did, that would royally screw up the test. Li'l Sis once had a gallbladder ultrasound and the morning of the test she spaced and had one animal cracker and a sip of water before she remembered she was supposed to be fasting. That was enough for the ultrasound techs to not be able to see her gallbladder. For a HIDA scan, non visualization of the gallbladder usually means surgery to take it out because it's not working and causing problems. So if you have a test that's specifically looking at something to do with digestion, it's better to call and ask.
          Last edited by jedimaster91; 03-23-2013, 01:31 PM.
          I am no longer of capable of the emotion you humans call “compassion”. Though I can feign it in exchange for an hourly wage. (Gravekeeper)

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          • #6
            ugh. when i'm *very hungry* talking about food usually annoys the hell out of me

            that was inconsiderate, and to be honest somewhat unprofessional in my opinion

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            • #7
              Quoth retailsweetie View Post
              The tech threw a bit of a fit that I took my medications that morning even though it was a fasting test. I'm pretty sure taking my meds wasn't gonna hurt it, considering I took them... with water, which is pretty much universally allowed as far as I'm aware.

              It wasn't a lab with a Q, although I'm kinda glad it wasn't 'cuz I've had less than awesome experiences with them, too.
              I have checked and double checked with the lab I use now and I've been told that taking water with my meds will not mess up my lab results. There is a reason they ask for this info. The lab tech you had was a moron. I'd definitely talk to your doctor about not going back again if you can help it.

              I've also heard other people have had bad experiences with Q lab.
              Random conversation:
              Me: Okay..so I think I get why Zoro wears a bandana
              DDD: Cuz it's cool

              So, by using the Doctor's reasoning, bow ties, fezzes and bandanas are cool.

              Comment


              • #8
                Quoth jedimaster91 View Post
                Though if the itchy and rash was confined to just the area around the IV site, I'd be more inclined to suspect the tape. Even if you've used it without issue before, we develop sensitivities over time. I have a sensitivity to certain types of band-aids that I didn't have when I was younger.
                Another possibility is that it's not exactly the same tape that has been used without issue.

                Other examples of sensitization:

                One theory regarding penicillin allergies is that they originate with the consumption of small quantities of impure penicillin (i.e. mold).

                Poison Ivy is a sensitization reaction - some people are initially unaffected, but after repeated handling of it, they start having the same reaction that most people do.

                People building composite aircraft need to wear gloves/barrier cream at all times when handling the "goop", otherwise they can become sensitized and break out in a rash when handling it. Once they start to react, it's game over - even with PPE, there's still enough exposure to cause problems, but proper PPE for a non-reacting person is enough to keep them from becoming sensitized
                Any fool can piss on the floor. It takes a talented SC to shit on the ceiling.

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