First day doing what I came to do

We woke up this am without water. After finding Philbert we were back in business at least for the morning. He is a very helpful person to have around. very pleasant and calm, a real delight.

Abdullah (KHI Driver) along with two dentists who are working with KHIpicked me up in his Corolla . We dropped them off at the school and went on the CHK.

So much for the misconception that the ultrasound units weren't being used!! I worked with Dr. C in the morning. I love working with Radiologists who have been working for a long time. They know what's important and what's not. @ 8:00 am we started the first study with probably 7 of the radiographers. By the beginning of the 3rd we were down to 1 and then a young primary care physician came to work with us the remainder of the day. He requested & I lent him the materials from Jim Baun to study for the afternoon and evening.

We scanned using a small Siemens unit. No recording device of any type. A secretary sitting at a table close by wrote out the reports as the exam was performed. We scanned a real variety of cases throughout the day (Abdomens, Pelvics, Scrotals, Peds Abdomens, baby heads, Obstetrical, Musculoskeletal, Thyroid). I was showing, demonstrating and moving at what I though was a pretty good clip. After about 8 or 9 studies in the next hour, the tolerant and calm Dr. C took over scanning. I was scanning too slow and the patients were backing up. By the end of the scanning session @ 1:00 pm we'd seen 43 patients. I can tell you, , , , , , I've now seen it done. From two until 4:00 we slowed way down I gave reports to a different radiologist and a senior Radiography student helped with interpreting (French & Kinyarawanda) and making sure I got the paper work done. We only did seven exams in the last two hours of the day. That made a total of 50 patients between 8:00 & 4:00 and included a 1 hour lunch.

Dr. C told me that it's not uncommon for him to scan 60+ just in the morning. There was a very high percentage of pathology. It took longer for the patients to get swapped out than for the scanning. There was quite a large group of patients who came from a TB/AIDS clinic. These patients ranged in age from 50's down to kids barely out of diapers. The primary question of concern being the possible presence of enlarged peri-aortic lymph nodes and any other sequella of TB. I saw a pathology I'd not seen before (except in books), calcifications within the spleen as an effect of TB. It was quite dramatic, but alas no images for case studies as there were no images ever recorded.

I'm trying to keep an open mind as I consider how I can be most helpful in furthering the practice of sonography. There is no possible way for the systems that I'm familiar with to scan the number of patients they are having to see. It is efficient, in that the Radiologist sees every study because he does every study. The Radiologists are quite proficient at scanning are very knowledgeable in sonography but the radiographers have no experience at all. The patients are receiving reports at the completion of the exam which they hand carry back to the attending physician. I'll wait a while to try and get a bigger picture before I decide where I can be most useful in the evolution.

Miscommunication: so I didn't meet up with my ride when expected. After standing on a corner for 40 minutes waiting, I walked to a store about a mile away to get a new Webcam. The Logitech seems to be the only casualty of the trip. After purchasing that, I got a ride on a mototaxi. Ten minutes on the backside of a 100 cc motorcycle, weaving through traffic, beeping all the way, trying not to fall off and wishing I'd put my bag around my neck instead of loosely over my shoulder, , , and for the thrill, , , , only $700 Rwandan Francs ($1.40). It turned out they had gotten there after me and waited almost 30 minutes thinking I was late. Gotta love a cell phone - but I hate to get one for just 8 weeks.

No water when we arrived home but someone went to bring some to us. I got out my earlly birthday present, a new Electric Autoharp with Keys for D & E (Shaloy got it for me from "The Harp Doctor"). Tuned it up and played for about an hour but quit before 9:00. Ike says that's when he goes to bed and I dont' want to be rude.

By the way I love getting comments.. . It lets me know that somebody is reading the blog.