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Wednesday, November 22, 2006

3 LBS ...........................;)

Now this is a show I can watch. I like to watch the medical shows, I don't know why, I would think that when I got home I would like to leave work behind me. The thing is these characters on the shows are always doing crazy things we could never dream of doing in real life. I don't know if you have ever seen Grey's Anatomy but this show is so Dramatic. I love it, but it is not real. Another show that is very entertaining because of the brilliant acting of Hugh Laurie. He is a one man show in House. The only complaint about House is that they exaggerate allot. The MRI machine need I say more.................. If you are an MRI tech or have had an MRI you will understand how ridiculous they make themselves look when they are doing MRI's. The time that I am thinking about is when they had a 600lb patient that had to be done even though he exceeded table weight limit. They were too worried that they might get sued if they didn't try to do the patient. MY GOD, give me a break. I would be more concerned about breaking a million dollar piece of hospital equipment that can not be replaced over night. But that is enough, I do like the show.............really. Now, I want to talk about 3 lbs. Albert Einsteins brain only weighed 2.74lbs . He also had no sylvian fissure his parietal lobe was one. this show is good and I am hooked. It is on at 10:00 p.m. on Tuesday on CBS. The show Is about 2 Neurosurgeons and how they deal with patients differently. It has one Doctor who is very straight forward and ready to cut away, while the other is more emotional and willing to listen to patients needs before he makes his decisions as to what type of treatment is right for them.

I think It has the makings for a great series if they stay focused on whats important.

Monday, November 20, 2006


The lab test indicated abnormal lover function.
The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried immediately.
Exam of genitalia reveals that he is circus sized.
She stated that she had been constipated for most of her life until 1989 when she got a divorce.
The patient was in his usual state of good health until his airplane ran out of gas and crashed.
Rectal exam revealed a normal size thyroid. (Long fingers?)
Between you and me, we ought to be able to get this lady pregnant.
A midsystolic ejaculation murmur heard over the mitral area.
The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.
Both breasts are equal and reactive to light and accommodation.
She is numb from her toes down.
Exam of genitalia was completely negative except for the right foot.
The patient was to have a bowel resection. However, he took a job as stockbroker instead.
When she fainted, her eyes rolled around the room.
Examination reveals a well-developed male lying in bed with his family in no distress.
She has no rigors or chills but her husband says she was very hot in bed last night.
She can't get pregnant with her husband, so I will work her up.
Whilst in Casualty she was examined, X-rated and sent home.
The patient states there is a burning pain in his penis which goes to his feet.
On the second day the knee was better and on the third day it had completely disappeared.
The patient has been depressed ever since she began seeing me in 1983.
I will be happy to go into her GI system, she seems ready and anxious.
Patient was released to outpatient department without dressing.
I have suggested that he loosen his pants before standing, and then, when he stands with the
help of his wife, they should fall to the floor.
The patient is tearful and crying constantly. She also appears to be depressed.
Discharge status: Alive but without permission.
The patient will need disposition, and therefore we will get Dr. Blank to dispose of him.
Healthy-appearing, decrepit 69 year old male, mentally alert but forgetful.
The patient has no past history of suicides.
The patient expired on the floor uneventfully.
Patient has left his white blood cells at another hospital.
Patient was becoming more demented with urinary frequency.
The patient's past medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.
She slipped on the ice and apparently her legs went in separate directions in early December.
The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary oedema at home while having sex which gradually deteriorated in the emergency room.
Patient has chest pains if she lies on her left side for over a year.
He had a left-toe amputation one month ago. He also had a left-knee amputation last year.
By the time he was admitted, his rapid heart had stopped, and he was feeling much better.
The patient is a 79-year-old widow who no longer lives with her husband.
The patient refused an autopsy.
Many years ago the patient had frostbite of the right shoe.
The bugs that grew out of her urine were cultured in the Casualty and are not available. I WILL FIND THEM!!!
The patient left the hospital feeling much better except for her original complaints.

SilverHawk™ Plaque Excision System

This is the future, FoxHollow Technologies Inc.'s SilverHawk catheter is one of the hottest selling new medical devices on the market and has sent the company's stock surging since it went public in October 2005.

Titusville, Fla. (July 14, 2006)— Parrish Medical Center (PMC) recently started doing a new procedure to help fight peripheral artery disease (PAD) using the SilverHawk™ Peripheral Plaque Excision System and SilverHawk™ Cutter Driver — devices that remove the plaque that commonly blocks arteries and interrupts blood flow.

Since March 2006, Radiologist Joseph Flynn, D.O., and the Interventional Radiology department at Parrish Medical Center have been successfully performing this procedure. Dr. Flynn is continually advancing his knowledge to bring cutting-edge technology to the North Brevard community through advanced classes and seminar training. Other Interventional Radiology care partners are Tammy Flannery RT(R)(CT)(CV), Jennifer Rice RT(R), Julie Cook R.N. and Cherie Clark R.N. The SilverHawk is inserted into the patient's groin through a small puncture site and moved through the artery to the site of the blockage. The tiny rotating blade is activated and the doctor advances the SilverHawk through the vessel, shaving plaque from the artery walls as it moves forward. The plaque is collected in the tip of the device and completely removed from the patient's body. Plaque excision typically is performed as a stand alone therapy without requiring additional procedures such as stent placement. Multiple lesions and multiple arteries can be treated with a single device. A number of multi-center and single center studies have demonstrated promising early clinical results in a range of patients from those with mild leg pain to those with critical limb ischemia.

Peripheral arterial disease affects more than 30 million people worldwide, and while it can strike anyone, it's most common in people over age 65. Untreated, PAD can lead to difficulty in walking and, in its most severe stage, gangrene leading to leg amputation. Also, people who have PAD often have arterial blockages in other parts of the body and are, therefore, at greater risk of suffering a heart attack or stroke.


DR. Gary J. Fishbein, (of The Dayton Heart Center), crossed the occluded distal ATA using a 0.035" angled Terumo Glidewire® and a 4 French straight taper Glidecath. A 5.5 French SilverHawk™ catheter was advanced through the occlusion, with a total of 6 cutting passes made. Again the results were excellent: the previously occluded ATA was left with 30% residual stenosis and improved collateral flow to the peroneal. There was now straight-line blood flow restored to the foot. It was not felt to be technically feasible to cross the long occlusion in the peroneal artery, so the intervention was stopped at this point. There were no complications with the procedure. Hemostasis was obtained with a Closer AT. Read more here.....

Sunday, November 05, 2006

The Pituitay, Empty Sella, & Ruptured Aneurysms

The Pituitary is such a small part of the brain, about the size of a pea, and yet in controls so many functions. Its main function is to control the release of hormones throughout the body. The Pituitary is is conected to the hypothalmus by nerve fibers. There are several hormones that the pituiatry control the release of:


Melanocyte-Stimulating Hormone (MSH)

Gonadotropins: Luteinizing and Follicle Stimulating Hormones

Adrenocorticotropic Hormone (ACTH, corticotropin)

Growth Hormone (Somatotropin)

Follicle-stimulating hormone

Empty sella syndrome occurs in patients when spinal fluid is found within the space created for the pituitary. The most common cause is a large openening a membrane which sits on top of the pituitary. When this opening is large, the spinal fluid pressure is forcred down onto the pituitary and flattens it out within the sella. In most cases, the pituitary functions normally as evidenced by normal thyroid functions, normal tests of adrenal function, normal somatomedin-C levels, and regular menses. Some patients have empty sella syndrome as a result of other processes such as neurosarcoidosis pituitary tumors that have degenerated, etc. Rare patients have a congenital empty sella and a coexisting pituitary tumor.

Pituitary tumors are associated by function.Usually by what hormone they release.Pituitary adenomas are the fourth most common intracranial tumor after gliomas, meningiomas and schwannomas. The large majority of pituitary adenomas are benign (not malignant) and are fairly slow growing. Even malignant pituitary tumors rarely spread to other parts of the body. Adenomas are by far the most common disease affecting the pituitary. They more commonly affect people in their 30s or 40s, although they are diagnosed in children as well. Most of these tumors can be successfully treated. Pituitary tumors can vary in size and behavior. Tumors that produce hormones are called functioning tumors, while those that do not produce hormones are called nonfunctioning tumors.

Pituitarary Apoplexy Can occur When An Aneurysm near the pituitary ruptures. This can cause bleeding or hemorage in the pituitary . Pituitary aneurysms can be enough to cause symptoms and they often include headache, nausea, visual loss, double vision and altered mental status. Most patients also have undiagnosed hormone insufficiency prior to the apoplectic event. In patients with such symptoms, the diagnosis of pituitary apoplexy is best confirmed with an MRI of the brain with special attention to the pituitary. Conditions to consider when trying to establish the diagnosis of pituitary apoplexy include ruptured intracranial aneurysm, meningitis, brain stem stroke, cavernous sinus thrombosis, intracerebral hemorrhage, temporal arteritis and ophthalmoplegic migraine headache, but typicaly pituitary apoplexy is a condition that develops over hours to several days, typically resulting from hemorrhage and/or infarction of a pituitary macroadenoma.

Treatment for pituiray tumors

Wednesday, November 01, 2006

Brain Aneurysms

The Brain is an amazing thing but when things go wrong it sure gets scary. When a person has an aneurysm they can go for years without knowing it. It is only when they start to experience new symptoms that they start to wonder what is going on. Some of these symptoms include loss of feeling in the face or problems with the eyes. Immediately before an aneurysm ruptures, an individual may experience such symptoms as a sudden and unusually severe headache, nausea, vision impairment, vomiting, and loss of consciousness. I have a friend at work that came in with several of these symptoms one day and now she has 2 aneurysm clips in her cerebral arteries. She had the clips put in at Shands in Florida. There are other methods including embolization coils to fix aneurysms. Many MRI centers will not scan a patient with a Aneurysm clip in their brain, but will scan a patient with embolization coils. CTA's of the brain are another great way to see the cerebellar arteries at little risk to the patient. Science has made diagnosing aneurysm much easier than ever before, and advancements in surgery have made it possible for people to recover from a very scary diagnosis.


MRI Nueroarm Video