Strange Socket In Hospital

[JohnW2]

A few years back I had a kidney stent fitted, via my groin. A group of people in attendance, none wearing anything special by way of protection, and watching the progress of the stent insertion on screens. I wondered at the time, and since, quite what system they were using to view the progress of the stent along my artery. Some undergoing similar, have reported been able to actually see the screen, and progress themselves.

Fair enough, but ....

Would that be X-rays? I was laid on an operating table, which seemed to be inflated, and warmed, maybe with water.

If they weren't wearing lead aprons, it would not have been X-rays - I would guess probably ultrasound? Did they hold any oprobe/sensor against your body?

 

[JBR]

Are you talking 'now', or 'back then' ?

What you describe is obviously the ideal, and how it very often is. However, I was thinking/talking mainly about manipulation of pacing wires within the heart. As you imply, it very often only required a fairly small number of seconds of screening, in short bursts, to get that done. However, sometimes the wires were stubbornly reluctant to go where one wanted them to go, so one had to do a lot of 'fiddling about', under more-or-less continuous screening.

I can't remember whether the machines told them this, or whether they had some sort of 'stop watch', but the radiographers were constantly aware of the accumulated amount of screening time, frequently updated us on that amount, and started becoming increasingly 'concerned' if/when the total got to more than a minute or two.

Back then.

As it happens, I have had a pacemaker implanted, nearly three years ago now. Yes, they used screening (which I asked to watch, and was permitted to). I suppose they had to occasionally have a quick look to ensure both leads had ended up in the correct places.

 

[Harry Bloomfield]

Fair enough, but ....

If they weren't wearing lead aprons, it would not have been X-rays - I would guess probably ultrasound? Did they hold any oprobe/sensor against your body?

I didn't notice, and they had a sheet up, hiding what they were doing. As said, I couldn't see the screens either.

 

[JohnW2]

As it happens, I have had a pacemaker implanted, nearly three years ago now. Yes, they used screening (which I asked to watch, and was permitted to). I suppose they had to occasionally have a quick look to ensure both leads had ended up in the correct places.

Indeed but, as I said, it's unfortunate sometimes a lot more than a 'quick look' if the pacing wires are reticent to go where they need to go! In some senses, it's like fishing cables through voids and stud walls (when some imaging system might help) - i.e. they 'get stuck somewhere.

If you had a ('permanent') pacemaker implanted, I presume that was done in an operating theatre of 'catheter lab', where there was probablyt a fixed image intensifier, so a 'mobile machine' probably not required.

I was talking abut the insertion of temporary pacing wires, as an emergency, usually in Coronary Care Units or ITUs (ICUs in modern parlance ), and sometime even wards - so that's when the mobile machines were needed.

 

[JohnW2]

I didn't notice, and they had a sheet up, hiding what they were doing. As said, I couldn't see the screens either.

Fair enough. My point was that although an X-ray source is 'at a distance' to do an ultrasound scan (like they do on pregnant women) one has to actually hold a probe against the skin.

However, as I said, if they weren't wearing lead aprons then I would imagine that either they were crazy (and not worried about being sacked) or else the imaging was being done using something other than X-rays - and ultrasound is about the only obvious alternative that comes to mind.

 

[Harry Bloomfield]

However, as I said, if they weren't wearing lead aprons then I would imagine that either they were crazy (and not worried about being sacked) or else the imaging was being done using something other than X-rays - and ultrasound is about the only obvious alternative that comes to mind.

That is why I was curious, as to what was used. I've seen similar examples in TV programs, X-ray type images on TV screens, but staff appearing to wear normal theatre type clothing, during the op..

 

[JBR]

If you had a ('permanent') pacemaker implanted, I presume that was done in an operating theatre of 'catheter lab', where there was probablyt a fixed image intensifier, so a 'mobile machine' probably not required.

I was talking abut the insertion of temporary pacing wires, as an emergency, usually in Coronary Care Units or ITUs (ICUs in modern parlance ), and sometime even wards - so that's when the mobile machines were needed.

Oh yes, it is a permanent pacemaker. I was assured that it should last at least 13 years before replacement.
Yes, it was a fixed (well, movable) X-ray tube above the table (actually, it may have been below with the image intensifier above, I don't remember now).
In any event, I'm still here so I assume it's working well!

 

[JBR]

That is why I was curious, as to what was used. I've seen similar examples in TV programs, X-ray type images on TV screens, but staff appearing to wear normal theatre type clothing, during the op..

I think it's usual to wear lead-rubber protection underneath their green theatre dressings. The lead protection could transmit infections.

 

[JohnW2]

Oh yes, it is a permanent pacemaker. I was assured that it should last at least 13 years before replacement.

They usually (but not always!) last for at least as long as they are meant to

Yes, it was a fixed (well, movable) X-ray tube above the table (actually, it may have been below with the image intensifier above, I don't remember now).
In any event, I'm still here so I assume it's working well!

Now I'm a bit confused. If there were a bit of machinery 'above you', that does sound like X-rays, but I still find it very hard to believe tat any of the staff would then have got anywhere near it with appropriate 'PPE'. Maybe @darreng1983 has some thoughts ?

 

[JohnW2]

I think it's usual to wear lead-rubber protection underneath their green theatre dressings. The lead protection could transmit infections.

I've just realised that I've been getting you and Harry mixed up, since you bothed offered personal anecdoses about 'screening', When Harry wrote:

A few years back I had a kidney stent fitted, via my groin. A group of people in attendance, none wearing anything special by way of protection

... I assumed he meant that literally (i.e. at all) but, as you say, in a situation in which the staff were wearing 'theatre gear', there could well be lead aprons underneath it.

BTW, nearly all of the theatre clothing these days is blue, rather than the ('traditional') green

 

[Harry Bloomfield]

I assumed he meant that literally (i.e. at all) but, as you say, in a situation in which the staff were wearing 'theatre gear', there could well be lead aprons underneath it.

Unless the 'aprons' were very thin, and very light, that was not the impression I got. It was a tiny, cramped, basement room, with around six people in attendance. Had there been a radiation risk, I would have expected them to minimise those in the area. Some seemed there to simply socialise.

 

[JohnW2]

Unless the 'aprons' were very thin, and very light, that was not the impression I got.

They are neither thin nor light I still imagine that, unlike JBR, your screening was by something other than X-rays, probably ultrasound.

 

[Harry Bloomfield]

They are neither thin nor light I still imagine that, unlike JBR, your screening was by something other than X-rays, probably ultrasound.

Except, I don't remember the US head being used, nor any of that lub they use. I was quite curious at the time, and since, about the viewing method, so I was paying attention to that.

 

[JohnW2]

Except, I don't remember the US head being used, nor any of that lub they use. I was quite curious at the time, and since, about the viewing method, so I was paying attention to that.

Hmmm - all a bit of a mystery,then. I'm very much out of touch, but radiation certainly hasn't got any safer (so I doubt that the aprons can have got thinner and lighter), but I'm not aware of any real options other than X-rays or US - and if the stent was being put in your renal artery (was it?) I would really have expected the former.. as I recently wrote (albeit I was then writing to the wrong person ), maybe @darreng1983 may have some thoughts, in relation to modern kit and practices ?

 

[Harry Bloomfield]

Yes, a renal stent.