At the end of the day falling asleep and resting has a lot to do with ones emotional well being. It was a busy day yet again and the end of the shift and all the work done came with a sense of accomplishment. Still there was some unease and drifting away through the stages of sleep wasn’t happening as quickly as it usually does. Has my caffeine consumption finally caught up to me? Is my circadian rhythm shifting?
No time to ponder that as my phone began to vibrate jolting me from the beginning stages of drifting off. I read the number and as my tired mind put two and two together I answered.
“Hi. I’m (so and so) we have a patient that is being transferred from another hospital. She has been suffering from abdominal pain and the OB needs to rule out…”
“You need me to come in and do a scan… Alright I’ll be there in thirty minutes.”
The only really important emergency that requires our attendance at this time of the night is pregnant appendicitis. Normally with anyone else if they wanted to they could do a CT scan that can tell if the appendix is inflamed and about to burst. With a pregnant female this is not an option for obvious reasons. Radiology is loath to expose the unborn fetus to ionizing radiation. An MRI is safe for the unborn child especially as it gets into the second and third trimester. The risk if there is any, is diminished by the fact that the mothers health is also important.
I got there quite quickly. Living close to the hospital has its advantages. I’m mostly awake but still kinda tired. I start up my machine and go through the QC procedures to make sure it all runs. While I turn everything on and get ready for everything to load one of the night time techs finds me and hands me the requisition. The duty rad finds me and explains the situation again. This woman is being brought here from another hospital because we have the specialist care to take care of the mother in her condition. We can also perform the test.
They got the patient to me quite quickly. She was in obvious distress and was accompanied by her partner. I tried to put her at ease. I tried to put them both at ease actually. I explained the test as lightheartedly as possible. She was worried about freaking out inside the machine. I reassured her that it would be fine.
With her husband/boyfriend’s help we got her onto the table. It took some time to attach all the equipment and adjust her to be comfortable. When it was time to slide her in some error came up. The machine wouldn’t do what it wa ssuplosed to. She was beginning to be uncomfortable. Damn it.
I ran over to the other scanner and booted it up just in case. It takes at least fifteen minutes for it to start up. I reset my scanner in the meantime. I had to take some of the equipment off of her. The pressure of the anterior cool was becoming uncomfortable. I removed some of the wedges that had her slightly decubitus. We readjusted and the reset worked. I put all the equipment back onto her and proceeded to scan.
There are a lot of breath holds and we were looking at various things that could be causing her distress over and above the appendicitis. She overcame her anxiety and complied with the scan procedures. At one point someone came into the control room.
“Hi. I’m her mom.”
“Ma’am with all due respect I need you to leave.” Pointing my finger towards the exit while still focused on the screen. I need to think about what I’m doing. I can’t have her in here.
The rad came in and we discussed what we were seeing. It’s not appendicitis but something that may still require intervention. They have a lot to think about. As we finished the scan and transferred her to the stretcher we had to wait for the porter who was transferring someone somewhere in the hospital. The woman’s drugs started to wear off. She began crying. It’s hard to hear that sound that timbre. They wanted to take her to emerg themselves but they can’t and really shouldn’t. I finally relented and took her out into the hallway where the porter caught up to us and took her the rest of the way.
I closed up shop and went home now more tired than ever but still half awake.