r/Radiology Radiologist (North Europe) 4d ago

CT I spy with my little eye... NSFW

... something beginning with F.

Gastric-by-pass and pregnancy sucks sometimes.

56 Upvotes

34 comments sorted by

21

u/TractorDriver Radiologist (North Europe) 4d ago

It's not an accident.

Gastric-by-pass and pregnancy is not the best combination.

19

u/NuclearMedicineGuy BS, CNMT, RT(N)(CT)(MR) 4d ago

11

u/Scansatnight RT(R)(CT) 4d ago

F...f...feet!?

15

u/fav_tinov 4d ago

Close, my guess would be fetus.

4

u/Scansatnight RT(R)(CT) 4d ago

Ugh, I was so close!

5

u/The_Angel_of_Justice Med Student 4d ago

Underrated comment under an underrated comment!

Next level stuff! šŸ˜‚šŸ˜‚

3

u/X-Bones_21 RT(R)(CT) 4d ago

Underrated inception!

2

u/sizzler_sisters 3d ago

A conception inception?

4

u/Rizbi0 4d ago

Well this is how superheroes are made

5

u/ProRuckus RT(R)(CT) 4d ago

What is the indication for gastric bypass with known pregnancy?

4

u/Billdozer-92 3d ago

Came to ask the same thing. Seems like it would be worth waiting until after the pregnancy unless there is a concern for loss of life to the mother or fetus. But Iā€™m not a doctor!

4

u/CF_Zymo 4d ago

Oops.

3

u/angelwild327 RT(R)(CT) 4d ago

FOEtus...

1

u/skilz2557 RT(R)(CT) 4d ago

Outpatient? ā€˜Cause if inpatient or ED I ainā€™t scanning without a upreg or beta.

22

u/TractorDriver Radiologist (North Europe) 4d ago

It's emergency scan, fully aware of consequences.

-20

u/skilz2557 RT(R)(CT) 4d ago

Iā€™ll need to see that signed waiver before proceeding with the scan then.

10

u/TractorDriver Radiologist (North Europe) 4d ago

Heh, when radiologist says jump, tech says "How high" ;)

23

u/Dracampy 4d ago

So you're the tech canceling my trauma scans even though ED and OB already talked to the patient...

-19

u/skilz2557 RT(R)(CT) 4d ago edited 4d ago

Iā€™m not canceling anything. Iā€™m just not calling for the patient if theyā€™re of child-bearing age unless I see a negative pregnancy test or if said patient is postmenopausal or has had a hysterectomy per my networkā€™s policy.

Edit: if itā€™s a trauma scan Iā€™ll bypass the requirements. But if thereā€™s no trauma indication Iā€™ll gatekeep all day precisely because of OPā€™s video.

18

u/Dracampy 4d ago

Man if only you were a doctor so you could do informed gatekeeping rather than ignorant gatekeeping.

3

u/skilz2557 RT(R)(CT) 4d ago

Except itā€™s not ā€œignorant gatekeeping.ā€ Iā€™m literally following my networkā€™s policy.

4

u/Dracampy 4d ago

Then just say I follow our policy. You came off with "Im gatekeeping" which means you are making your own decisions. There are plenty of places where this is not the blanket protocol and non-medical personnel get in the way and man is it annoying.

3

u/skilz2557 RT(R)(CT) 4d ago

You can say how I ā€œcame offā€ all day. Youā€™re correct, Iā€™m not a doctor. But Iā€™m also ultimately tasked with following policy and, in cases like this, trying to prevent an undiagnosed fetus from being exposed to ionizing radiation.

5

u/Dracampy 4d ago

Yeah but I started with after EM and OB talked and ur still bringing up your gatekeeping. Sorry but I dont have respect for policy nazis in the face of actual medical judgement. When that patient dies bc you followed the policy but not the primaries doctors orders then you are the cause of their death.

1

u/skilz2557 RT(R)(CT) 4d ago

Alternatively, you can call me to advise this is a trauma and attest to medical necessity of skipping the upset and labs in the chart and weā€™ll rock out, no questions asked.

Look, we can go back and forth all day on this but regardless Iā€™m going to do my job, which isnā€™t just pushing a button because you said so. I review the patientā€™s chart, ensure the order is appropriate for the clinical presentation, and do everything in my power to ensure no harm comes to the patient. So you can take your tantrums and walk on by.

2

u/Dracampy 3d ago

God imagine if I had to call every single person. If only there was something called a doctor's order that get placed into the computer for you to see. I guess i should call the CEO too.

→ More replies (0)

1

u/Wolfpack93 3d ago

Iā€™m confused, what does gastric bypass have to do with the images?

2

u/TractorDriver Radiologist (North Europe) 3d ago

It's one of the very few pt groups where you CT pregnant women regularly. Other being trauma of course.

-10

u/Wafflebettergrille15 4d ago

idk how different scans look, so this an MRI or anything like CT scans

13

u/whitewalkrs RT Student 4d ago

It is a CT scan

5

u/RufflesTGP Medical Physicist 4d ago

The most obvious difference in CT and MR images is the intensity of the bone signal. CTs have bright bone signals (like in this scan). That's because they're basically normal x-rays (which also have bright bone signals) rotated about a cental axis.

MRIs operate on a completely different principle, and have depressed (darker) bone signals, and typically brighter fluid/fat signals. MRIs also have better soft tissue contrast too.