#neuro radiology

[vitalrad01]

Vital Radiology excels in neuro radiology reporting, providing specialized diagnostic services exclusively for healthcare providers. Our team of expert radiologists delivers timely interpretations of complex neurological images, supporting reliable diagnoses and effective treatment planning. Utilizing cutting-edge imaging technology, we ensure reliable and comprehensive reporting, enhancing the quality of care for patients with neurological conditions. Trust us for expert neuro radiology reporting that advances clinical decision-making.

[kims-trivandrum]

Best Neuro Interventional Radiology in Trivandrum | Interventional Radiologist | KIMSHEALTH Hospital

KIMSHEALTH is recognized globally as one of the few hospitals that possess all the latest technological advancements when it comes to infrastructure. Our department of Imaging and interventional radiology uses state-of-the-art infrastructure at our facility to not only diagnose diseases but also offer treatment for a variety of conditions using minimally invasive techniques without any scar.

[fauvester]

more hospital au svsss

in interventional radiology (or anything involving procedural x-rays) you need to wear a lead apron and thyroid guard.. there’s usually lots of spares but usually the regulars invest in their own. they are very heavy lol. but it does help keep you cozy in a freezing procedure room

[floristieh]

october 7th, 2023

working on a radiology assignment :-) only two more weeks of med school lectures left. wooo!

[drchandrakant01]

Exploring the Advancements in Neuro-Interventional Radiology: Revolutionizing Neurological Care

In the dynamic landscape of modern medicine, the field of neuro-interventional radiology stands as a beacon of innovation, reshaping the way we approach and treat neurological conditions. With its amalgamation of radiology, neurology, and interventional techniques, neuro-interventional radiology (NIR) offers a spectrum of minimally invasive procedures that are proving to be game-changers in the realm of neurological care.

NIR encompasses a diverse array of procedures aimed at diagnosing and treating conditions affecting the brain, spinal cord, head, neck, and associated blood vessels. These procedures are conducted under image guidance, typically using fluoroscopy and angiography, enabling precise navigation through intricate neural pathways with minimal disruption to surrounding tissues.

One of the most ground-breaking applications of NIR lies in the treatment of ischemic stroke, a leading cause of disability and mortality worldwide. Through techniques such as mechanical thrombectomy, neuro-interventional radiologists can swiftly remove blood clots obstructing major cerebral arteries, restoring blood flow to the affected area and salvaging precious brain tissue. This timely intervention has significantly improved outcomes for stroke patients, reducing long-term disability and enhancing quality of life.

Beyond stroke management, NIR plays a pivotal role in the treatment of cerebral aneurysms, arteriovenous malformations (AVMs), and other vascular abnormalities of the brain. By deploying endovascular coils, stents, and embolic agents, neuro-interventionalists can effectively occlude abnormal blood vessels or reinforce weakened arterial walls, mitigating the risk of rupture and hemorrhage.

Furthermore, NIR offers innovative solutions for the management of brain tumors and intracranial hemorrhages. Through techniques like intra-arterial chemotherapy and embolization, clinicians can deliver therapeutic agents directly to tumor sites or staunch bleeding vessels, circumventing the need for open surgery and reducing associated risks and recovery times.

The evolution of imaging technologies has been instrumental in advancing the frontiers of NIR. High-resolution imaging modalities such as digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and computed tomography angiography (CTA) provide neuro-interventionalists with unparalleled insights into the intricate anatomy and pathology of the central nervous system, enabling precise procedural planning and execution.

Moreover, the integration of robotics and artificial intelligence (AI) into NIR workflows holds tremendous promise for enhancing procedural accuracy and efficiency. Robotic-assisted systems offer unparalleled precision in catheter navigation, while AI algorithms aid in image interpretation, lesion detection, and treatment planning, augmenting the capabilities of clinicians and improving patient outcomes.

Despite its transformative potential, neuro-interventional radiology is not without challenges. Access to specialized training and resources, as well as the high cost of equipment and procedures, remain barriers to widespread adoption. Additionally, concerns regarding radiation exposure and procedural complications underscore the importance of rigorous training, adherence to safety protocols, and ongoing research to refine techniques and mitigate risks.

In conclusion, neuro-interventional radiology stands at the forefront of modern medicine, offering a paradigm shift in the management of neurological disorders. With its emphasis on minimally invasive techniques, precise imaging guidance, and multidisciplinary collaboration, NIR holds the promise of revolutionizing the landscape of neurological care, ushering in a new era of hope and healing for patients worldwide. As technology continues to evolve and expertise expands, the potential of NIR to transform lives and redefine the boundaries of possibility in neurology remains boundless.

[sureshgiragani]

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[alinladaru]

ESMINT: Agenda of the 2023 General Assembly

Monday, 4 September 2023, at 17.45 (CEST) The agenda of the next General Assembly of ESMINT will take place at the Palais du Pharo Congress Center in Marseille, France on Monday, 4 September 2023, at 17.45 (CEST) Apologies for absence 2022 General Assembly Minutes Treasurer’s report General Secretary’s report President’s report Change to the constitution Results of the election of the new…

[vitalradiologyservices]

Reliable Neuro Radiology Reporting Services

Renowned globally for its exceptional digital healthcare services, Vital Radiology Services stands out as a provider of top-notch quality. Within our comprehensive range of offerings, we specialize in Neuro radiology reporting services, handled by a team of dedicated radiology specialists. Leveraging our innovative technology, we ensure that scans requiring expert evaluation are seamlessly directed to the most suitable radiologist. For more information, contact us!

[rnmcenterrohtak]

PET CT Services in Rohtak, Haryana

PET CT is a procedure where small amount of dye (radiopharmaceutical) is injected into patient. For more information related to PET CT scan then do visit our website.

[doomspaniels]

Guinevere running normally, with full extension

Guinevere running injured, holding her shoulders tensed, short extension

In re: that Crufts agility dog that was so obviously pained--

I didn't get many photos of Guinevere when she was first injured. That whole open heart surgery thing. But that pained Crufts agility dog was moving *just* like Injured Guinevere: tight jerky motions of the forelegs, flatter motion overall, restricted foreleg extension, hesitating before any harder landing on her forelegs.

When Guinevere showed symptoms we got x-rays with our vet immediately; no clear answers. She got worse; we took her to the university vet hospital. First Emergency (6 weeks crate rest), then Neuro, we got her ALL the diagnostics. She had an MRI. They couldn't find anything in radiology. They really, really wanted to tell me that it was all behavioral. I insisted we keep trying.

So they reluctantly referred me to a weirdly titled department and said, "they do more with joints, maybe they can help". I was doubtful but I got there to discover IT'S FREAKING PT/REHAB. I didn't even know there WAS a veterinary rehab group, why did they disguise the name?? We would have taken Guinevere there immediately for PT back in Oct, while also pursuing a diagnosis.

But further, the PT/REHAB vet was able to diagnose Guinevere immediately with laxity of joints and palpable shoulder subluxation; the poor kid's got a connective tissue disorder, and it's just as difficult to get diagnosed in dogs as it is in people 🙃

And until then, every specialist we saw wanted to call it "behavioral." (Everybody remember the Internal Med specialist who did the CT in April? He didn't want to do diagnostics, he just wanted to send her to a behaviorist.) Even the Emergency department thought her shyness--freezing up in a strange place for strangers--meant it was all attention-getting behavior at home, not truly pain.

So yeah. I am not surprised that the dog at Crufts was labeled "behavioral" too. Whether the dog has been through diagnostics or not, this is apparently the new thing.

Rescue dog? Maybe a little shy? Mystery pain? Nah, it's just behavioral. It's the new "I don't immediately recognize your symptoms, so I diagnose 'anxiety' even though the psychs say there's no anxiety, enjoy your poisoned medical records."

[intubatedangel]

Pageant Fever : Chapter 3

Story Index    

Pageant Fever: Chapter 1 | Chapter 2

* * *

Lucy grabbed the foil packet from the rear pouch on the monitor, unravelling the cable before ripping the packet open to access the pads. She looked down at Zara's chest, noticing just how much sweat covered it, to the point it was forming small beads that rolled off down her side or into the valley between her breasts. Before attaching the pads, she grabbed another bag and pulled out a small towel, using to try and dry off Zara's flesh so the aed pads would get a good connection.

As she did that, Janice had rotated around to Zara's head. She did a quick visual exam to look for a head injury but found nothing noteworthy. Janice tilted the young woman’s head back and thrust her jaw forward to open her airway. Lucy saw Janice frown out the corner of her eye, then the retired medic reached for the airway bag and pulled out a manual suction device. She worked the tube on the end of it into Zara's mouth, pushing it in deep, then pulled on the handle in the centre, expanding the bellows style bulb in the centre, sucking out the foamed spittle that had collected in Zara's airway during the seizure.

Lucy peeled the plastic backing off each of the large square Quick-Combo pads, placing one just above Zara's bra, towards her right shoulder, while the other went on her left flank, between the bottom of her rib cage and her left breast. Lucy pressed them both hard, smoothing out the pads and ensuring the adhesive had a good grip. She then turned to the monitor, twisting the dial around to point at the 100J mark and pressing the button to begin the charging sequence.

Meanwhile, Janice put the suction device to the side and selected a geudel airway, inserting it backwards then rotating it into position so that the green ringed tip rested against Zara's lips. "She's barely making any respiratory effort. I'm going to start bagging her." Janice told Lucy as she ripped the sterile packaging of a purple ambu bag open and readied it, attaching the mask and plugging a line from the small oxygen canister into the back of the bulb..

Lucy watched as Janice sealed the mask over Zara's mouth and nose, squeezing the bag and pumping oxygen into Zara's lungs, inflating her sweat slick chest. Beside her the monitor let out a double beep. "Ready for synchronised shock at 100 joules, bag away." Lucy said, noticing there was still a lot of people around them. "Everyone stay clear!" She said assertively, quickly checking she had her finger on the shock button before making sure nobody was too close to the limp form on the floor. "Shocking!"

* * *

Anna stood quietly next to Tilly as Carl spoke briefly on the phone. He finished, hanging the phone back on the wall and was halfway turned when Tilly spoke up.

"What have we got?" She asked, excited and clearly jumping at the chance for something juicy.

Carl took a moment to share a knowing smirk with Anna. It was almost exactly how she used to react to the red phone when she had started here. Hell, she had felt the question bubbling up to her own lips, even though she wasn't working. Tilly looked between them for a second, slightly confused by the interplay between them, but snapped her attention back to Carl when he started to speak.

"Just an early heads up. Young woman having a seizure at the convention centre. It's only a mile down river so they'll bring her in shortly. Ambulance isn't there yet, but the centre has volunteer paramedics, so they don't expect much of a delay. ETA is anywhere from 15-20 minutes."

"Oh, cool. Is there anything I can do?" Tilly asked, practically vibrating as if ready to take off at a moment’s notice.

Carl glanced at Anna and chuckled. "I need to give Neuro a heads up, and radiology too in case an MRI is needed. Details are pretty thin though, so we'd better play it safe. Go and get Resus 3 setup and ready just in case." He looked around the nurses station, but evidently couldn't see what he was looking for. "Apparently Trish is busy, do you want to go and observe her?" He asked Anna.

Tilly turned to her expectantly, looking hopeful and somehow even more excited. "If it won't cause any problems. I'm not sure where things would stand legally."

"So long as you aren't treating patients I don't think there'll be an issue, and I'll send Trish along when I see her for the official sign off." Carl replied.

"In that case, I'd love too." Anna said with a smile towards Tilly. She reached out to give Carl's hand a quick squeeze then followed the bubbly young nurse through the black marked doors to the Resus Suite.

It was amazing to see just how much Tilly had grown in the last two years. Not physically. She was about 5 foot high, with an almost quintessential cheerleader build and such a youthful face that if you only looked at that you'd place her closer to 17 than her actual 21. It was the confidence that had been the biggest change. Back during Anna's ICU stay, Tilly had been meek, quiet and nervous to the point of being positively twitchy. As they'd talked over a couple of weeks, the younger nurse had started to open up and more importantly begun to believe in herself.

Now, like Carl had said, the young nurse gave of a sense of having been born for the role. And her personality, her energy, shone through, even in the way she moved. To boot, it was infectious. Just following Tilly, Anna felt a little more pep in her own step and every single person Tilly passed seemed to get just a little brighter simply by her very presence.

Anna had wanted to come back to work. Simply being around Tilly made her excited for it.

* * *

Zara's whole body gave a single sharp twitch as the burst of electrical charge zapped across her chest in an instant. One of her thin strapped shoes was kicked off by the motion and her head limply rolled to one side. Lucy frowned as she watched the monitor that continued its urgent alarming.

"No response. Bag her, I'll charge again at 150." She ordered, setting the defibrillator to charge up. As it did so, she returned to the drug bag, taking out an IV kit. With the practiced efficiency of years of experience she cracked it open, swabbed the back of Zara's wrist with a sterilising wipe and was lining up the needle with the vein by the time the monitor let out it's notifying bleeps. She ignored it, pushing the needle into the vein with a smooth motion, then deftly peeled off the backing of the adhesive wings. "Going with a round of adenosine." She said, hurrying to draw the drug.

Deep in focus, she didn't notice the approaching commotion until it broke through the ring of onlookers. "...tell me what is going on? Why isn't anyone on the st..." The voice cut off with a strangled shriek. Lucy glanced up to see a woman with a shocked expression on her face. Although her frame was substantially different to Zara's, squat and heavy set compared to Zara's lithe, graceful appearance, judging by the features she could see, and the reaction, it was clearly Zara's mother. She still didn't expect the next words out of the dumpy woman's mouth. "Do you have any idea how much that dress cost!" She shouted.

A wave of revulsion swept across the onlookers like a physical force as they realised what she had just said. Lucy felt it too, though she'd been in the job long enough to know that sometimes, though rare, the shock of seeing a loved one in a medical emergency can make people blurt out things without even thinking. She hoped this was one of those instances. Luckily Janice intercepted Zara's mother's attention.

"Ma'am, your daughter is very ill right now, please stay back." She said, shuffling back on her knees as Lucy finished inserting the drug and returned to the monitor.

"Adenosine in, ready to shock at 150, everyone stay back." She repeated, doing another check down the length of Zara's body. "Shocking!" She announced as her finger pushed the button. Zara gave another jerk as her heart was struck by the jolt, her arms and legs flicking out slightly before falling still. The monitor continued its alarming for a few more seconds, then settled into a rapid bleeping. "Back in sinus tach. How's her breathing?"

"Still diminished, but she's making a bit more effort." Janice reported.

"Keep bagging her for now." Lucy said, blowing out a breath and taking a moment to reset herself.

Now that the current emergency was resolved, there was still the underlying issues to take care of. Lucy pulled over a bag and took out a unit of saline, spiking it with the line that she then plugged into the IV catheter. After that she rooted through a different piece of kit for an ear thermometer, passing it to Janice as she stood up.

"Katie." Lucy said to the girl who was still hovering around. "Just hold this up about here for me ok." She told her, waiting for Katie to take the bag and nod in understanding. Now to deal with the mother. Her comment about the dress had cleared some space around the woman, which was probably for the best when discussing potential medical information. "Ma'am? What's your name?"

"Jaya." The woman said, staring down at her daughter.

"Right Jaya. Has Zara ever had a seizure before?" Lucy asked her gently.

The woman finally pulled her gaze away from the limp young woman. She shook her head slowly. "No...No never."

"Okay." Lucy nodded, making the motion big to keep Jaya's attention on her. "Has she been ill recently? Headache? Nausea? Fever?"

"She hasn't mentioned anything. She was fine when I left her in the dressing room."

"Is she on any medication at all?"

A slight hesitation then another shake of the head. "Nothing."

"Right." Lucy braced herself before the next question, knowing it could lead to some sort of explosive reaction. "Has she ever used any drugs? Cocaine? Ecstasy?"

A frown cut across Jaya's face, and she seemed to tense up, gripping her handbag tightly, but her voice at least remained at an indoor level. "No she would never even dare!"

Lucy held up a placating hand. She waited a moment until Jaya subsided. "Has she been out in the last couple days? She might not have taken anything intentionally."

"No. She doesn't go out. Not to bars and not to parties! Why are you asking all these questions?"

"I'm sorry, I'm just trying to rule things out." Lucy told her, using her best sympathetic voice, despite Jaya's increasingly combative attitude.

Janice took that moment to interject. "She's at 39.5 C."

Lucy glanced around in shock. If Zara truly hadn't shown any signs of being ill just an hour ago, then whatever caused this fever was incredibly aggressive. A temperature that high is on the cusp of being a life threatening emergency in itself.

Which is why Lucy was very relieved when she heard a booming voice commanding the ring of onlookers to move back. She didn't need to even look around to know that it was her regular partner on the ambulance, Dave. More help was here.

* * *

Anna leaned against a counter just inside the doors of Resus 3, watching Tilly as she pulled open the drawers of the crash cart, checking everything on the list fixed inside the drawer was there. As she did, her head bobbed, as if she was listening to some music. She worked up from bottom to top, and after finishing that drawer, she closed with a bump of her hip.

"Everything's there." She said to Anna with a smile.

"You're sure, you've got everything?" Anna asked her.

Tilly cocked her head, looking around the room, her gaze falling on each cupboard, cabinet and piece of equipment. She turned back to Anna. "I'm pretty sure..." She said.

Anna nodded. "You did. But it's always best to double check yourself. Mistakes in here can literally be life or death."

"I know." Tilly said, stepping over to the counter and leaning against it next to Anna, looking towards the trauma bed with a thoughtful expression.

"Carl say's you're doing well." Anna told her. "And you seem to be enjoying yourself. I mean, I've never seen anyone practically dancing as they checked supplies."

Tilly glanced at her, a slight blush warming her cheeks. "It helps me focus. Like you said, there's a lot riding on us doing things right."

"That's one way to do it. Can you still focus when things get intense?" Anna asked, curious. Dancing around the resus room would be basically the opposite of professionalism.

"I have no problem there. When things are going crazy, I'm in the zone. It's why I love working down here. When it's quiet though..." Tilly shrugged. Anna got the sense that she'd explained things this way many times, and after a moment it finally twigged.

"You have ADHD." Anna made it a statement, rather than a question. Tilly nodded, while seeming to shrink in on herself slightly. "Do your supervisors know?" Anna asked.

"It's in my file. I don't know if they read it, I don't exactly broadcast it though. People sometimes get the wrong idea and don't trust me with anything important, which just makes things worse."

"Hmm." Anna, murmured as she thought for a moment. Tilly was looking at the floor, clenching her arms tighter. Anna turned and laid a hand on her shoulder. "Well. If you come back here after you graduate, I promise to always throw you at the biggest fire."

Tilly snapped her head up. "Really?" Anna smiled and nodded, prompting Tilly to grin, that bubbling energy returning in an instant.

Carl took that moment to come into Resus 3. He looked grave. "Paramedics are on site, but they're rushing the patient in. She's got a fever of 40.2 and climbing, and has already had a run of SVT." He looked to Tilly. "We're going to need as many cold packs as you can carry. Then get into high grade PPE, we may be dealing with an aggressive infection" He told her.

Tilly glanced at Anna, the corner of her mouth curling in a quick smile before she darted around Carl, heading for the store room.

* * *

The gurney rattled gently, it's wheels squeaking on the polished floor of the central corridor of the convention centre as the paramedics rushed it towards the entrance where the ambulance was parked. Lucy pushed with her elbows, her hands occupied with holding the ambubag to Zara's face, pumping the bulb every few seconds.

As soon as Dave and Steve had arrived to find their patient no longer simply seizing, but apparently gripped by a rapidly escalating fever of unknown source, they made the call to scoop and run. She needed cooling as soon as possible, and the few cool packs the ambulance carried had been left inside it. With Zara in such a precarious state but as stable as she was likely to get without intense intervention, the decision had been simple. They'd hurried to swap monitors, then load her onto a board then the gurney, throwing a thin sheet over her bared chest to preserve some modesty, and had placed the ambulances monitor between her legs.

Lucy kept an eye of the display, watching Zara's rapid heart rate flicker across the screen. Dave and Steve drove the gurney, guiding it through the gap being formed ahead of them by the centre's security. Janice trailed behind them, shepherding Jaya while carrying a bag in her hand in addition to the one strapped to her back.

The team of paramedics finally broke out into the sunshine outside, rolling the gurney down the access ramp and up to the ambulance, spinning it around so that Zara's head would go in first. Once the doors were open Lucy dropped the ambu bag onto the bed, climbing into the ambulance and helping to get the gurney inside. She resumed bagging as the others got themselves sorted, Dave joining her in the back while Steve went up front to drive. Janice showed Jaya to the front passenger seat, then popped her head in through the side door.

"Here's your drug kit Luce, I'll take the rest of our gear back." She said to Lucy, who nodded in thanks. Janice looked at Zara, still limp and sweating on the gurney, a grim expression on her face. "Let me know how it goes." She said, before pushing the door closed.

"Get them cool packs out." Lucy told Dave. Now that the ambulance doors were closed, she cast the sheet off of Zara, baring her chest once more.

Dave quickly pulled out all three chemical cool packs, cracking them to activate the reaction. They were bigger than those you could buy at a pharmacy, large enough that they covered the span between Zara's arm pits, fully covering her breasts. The second went over the beauty queens abdomen, while Dave did his best to shape the third around Zara's head and neck. With that done, Dave looked around to the front of the ambulance. "Get us going Steve, we don't have time to waste!"

The ambulance rumbled and started to move. Even though the journey would be short, there was still plenty for the two medics in the back to do. Dave was taking a pair of shear to the rest of Zara's dress, cutting from the side of the waist down to the top of the side slit. Without that small bit of fabric he could fully spread the dress to be clear of Zara's body. He also removed the slim set of underwear, leaving Zara totally naked on the gurney. Her whole body was slick with a layer of clammy sweat.

At her head Lucy was doing her best to keep breathing for Zara, while also trying to get a temperature sensor attached. It was tough, the sweat repelling the adhesive, but with a clean and quick movements she was eventually able to get the sensor to stick. It probably wouldn't hold for long, but it wouldn't need to. Once they got Zara into the emergency department they'd probably insert a probe into a central port. As it stood, the monitor began to show a reading, the number joining that of her heart rate and flashing an angry red.

"Surface temp is already 40.7C. She's burning up." Lucy said with a shake of her head, looking down at Zara. Her eyes had cracked open slightly, but there was no alertness behind them.

"Going with another bag of saline and some antipyretics." Dave said, shuffling about and manipulating the iv line.

They were halfway to the hospital when Zara twitched slightly, her arms and legs contracting for a brief moment. Lucy looked between the monitor and the body on the gurney. The monitor was still alarming at the extremely rapid heart rate, and Zara gave another small twitch.

"Muscle tremors." Dave said in a low voice. "This isn't looking good."

[vitalrad01]

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[kims-trivandrum]

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[fauvester]

svsss hospital au (aka take your blorbo to work day). SQQ would’ve been an ID doc if the money for neurology wasn’t sooo good. and he does love all the accessories and fancy little accoutrements. LBH was his intern at a very toxic program when he was a neurology fellow and fell ass over teakettle in love with him for doing such things as Telling him he did a good neuro exam and Letting him go early that one time. LQG is the new star ortho attending who SQQ rags on for not knowing “body medicine” (LQG: I was in AOA with you, shidi!) SQH is either the palliative/pain attending or the long suffering charge nurse who couldn’t afford med school. the demons are surgeons (trying to think of a class of physicians who prompt such a strict and violent hierarchy). MBJ is the IR chair (both a proceduralist/workhorse of the hospital AND a lover of cold dark solitary radiology rooms) and SHL is the worlds first plastics doc who enjoys ED trauma surg consults because she loves seeing fucked up hands and faces

[nadyagifary]

Tersuspek Ensefalitis

"Aneh, kalau tipes atau demam tifoid harusnya dengan titer widal serendah ini, tidak akan menyebabkan nyeri kepala terus menerus dengan tipe menekan (tension) disertai demam seperti ini, mbak DM. Tidak ada keluhan pencernaan juga." ujar dokter penyakit dalam kedua di rumah sakit ketiga yang pernah merawatku. Kali ini bukan rumah sakit pendidikan, karena punya waktu dan tenaga yang sedikit lebih baik untuk lari ke IGD RS lain daripada saat itu; pingsan.

"Saya konsulkan saraf ya" tambah beliau

Dalam hati, "Allah, jangan tentang saraf yaAllah, sungguh sangat menakutkan kalau sakit ini dikaitkan dengan masalah saraf tepi ataupun pusat (otak)" Selain itu, dokter saraf di rumah sakit aku dirawat juga merupakan guruku sendiri sejak preklinik. "Ah, malu sekali kalau ndak bisa menjawab misal nanti ditandem soalnya sudah lewat stase neuro" batinku

Sebelum dokter saraf visite, aku sudah memikirkan alur pemeriksaan dan arah diagnosisnya. Pemeriksaannya, pastilah cek tanda tanda meningeal sign dan refleks patologis, karena jelas gejala nya yaitu demam dan nyeri kepala. Kalau ada tanda meningeal sign satu saja di antara kaku kuduk, brundzunkii I - IV, Lasegue dan Kernig, pasti akan mengarah ke meningitis. Tambah, tidak ada penurunan kesadaran, maka meningoensefalitis dapat dieleminasi. Syukurnya tidak ada satu pun dari tanda radang selaput otak itu, tapi masih ada satu jenis radang yang belum bisa dieleminasi tanpa pemeriksaan penunjang, yaitu ensefalitis atau radang otaknya itu sendiri; bukan selaputnya lagi.

Setelah visite, beliau ternyata sangat mengingatku, ntah mengingatnya karena aku adalah dokter muda yang rajin atau sebaliknya, wallahu'alam. Mungkin karena beliau adalah pembimbing lapsus ku, dan kala itu aku mengambil penyakit yang beliau dalami, Acute symptomatic seizure on 1-5 years old toddlers and it's implication with their brain development : a case report, "judul yang agak menantang" ;kala itu beliau berpendapat. Lanjut, aku langsung tertidur setelah diberikan obat racikan analgesik + amitriptilin + diazepam. Awalnya juga, aku sedikit kaget, "kenapa diazepam?". Mengapa obat anti kejang "dewa" ini diresepkan? Apa yang terjadi?. Ya walaupun bioavaiblitas nya tidak sebaik apabila dimasukan lewat IV, tapi dosis per oral ini cukup tinggi; 10 mg. Aku agak was was dengan itu.

"Mbak Nadya, sudah bangun? Siap siap, sebentar lagi CT Scan dengan kontras ya" ujar perawat lewat speaker microphone di ruang rawat inap ku.

"Astaghfirullahaladzim" sontak aku terbangun dan menangis. Tidak usah dijelaskan mengarah suspek apa, dan kenapa harus menggunakan kontras, pastilah ini mengarah ke infeksi / radang ; jelasnya ensefalitis. Aku berdoa dan terus berdzikir saat berjalan menuju radiologi. Sambil sesekali menitikan air mata. Menangis.

Kau tau? Pemeriksaan CT Scan adalah momen paling menakutkan yang pernah aku rasakan dalam hidup. Rasanya sangat sangat sangat menakutkan. Suara gemuruh saat kepala dimasukan ke dalam "donat" besar itu, seperti sebuah truk besar yang datang menghampiri dengan kecepatan tinggi. Seperti akan menabrakku. Rasa nyeri pada saat cairan kontras masuk ke saluran IV-ku saja tidak ada apa apanya dengan rasa takut itu. Padahal rasanya sangat nyeri, karena cairannya kental juga vena tangan ku yang sangat kecil dan halus; sangat mudah plebitis. Aku memilih memejamkan mata disertai aliran air keluar dari celah kedua mata juga bibir yang tidak bisa berhenti mengucap asma Allah.

Pesan untuk teman sejawat dokter muda, sekarang aku paham, bagaimana ketakutan para pasien yang biasa kita antar untuk Ct Scan atau MRI kepala, sekarang aku bisa merasakan ketakutakan mereka juga sekarang aku bisa menghayati bagaimana kekhawatiran juga rasa sedih mereka ketika kita antar ke radiologi. Mungkin kita sudah cukup berempati, tapi ternyata, lebih dari itu. Mereka ketakutkan, mereka khawatir, mereka juga bertanya tanya ; "apa yang ada atau apa yang terjadi pada otak/kepalaku ini?"

Persis dengan apa yang aku rasakan, setelah sampai ke ruang rawat inap, aku terus menangis, ketakutan. Rasanya amalku masih sedikit juga dosa ku masih menggunung, aku masih butuh waktu untuk beribadah pada Rabb ku.

Beberapa kali aku menemui pasien ensefalitis dan meningoensefalitis di IGD, tapi keadaanya sangat buruk. Demam. Nyeri kepala. Penurunan kesadaran. Delirium bahkan koma. Pasien juga low intake.

"Tapi keadaanmu sangat bagus nad, kamu bisa jalan, lari juga bisa kan, menelan dengan sempurna, ndak ada defisit neurologis. Tapi aku juga ngga paham apa trias ensefalitis itu harus ditemukan pada klinisnya. Sudah. Ikuti saja dokter sp N kita" kata teman stase (aku menyebutnya profesor) yang sangat cerdas di bidang neuro dulu.

Prognosisnya sebenarnya baik, tapi bergantung juga dengan deteksi dini juga penanganannya.

Bagaimana dengan orangtua ku? Hati mereka hancur ketika aku izin pamit akan Ct-Scan, ayah mama bukan dokter, mereka perawat dan bidan, tapi pastilah mereka tau suspek apa yang membuat anaknya harus di Ct Scan kepala. Tanpa pertimbangan apapu, mereka langsung melesat ke Jember, dengan transportasi dadakan; bus Rosalia. Esoknya mereka hadir dan langsung memelukku. Aku melihat tatapan mereka (terutama mama) yang begitu sedih dan sembab melihatku meminta maaf atas segala kesalahan yang aku lakukan kepada mereka berdua.

"Hasilnya bersih, tidak ada tanda radang ( tidak ada tampakan seperti bintang berkelap kelip di hasil Ct Scan kontras ; kalau dari gampangannya aku belajar baca Ct Scan dulu )" ujar dokter Sp.N saat visite.

Syukur alhamdulillah, kedua orangtua ku langsung bersujud. "Tapi Nadya ngga boleh kebanyakan pikiran ya, sementara saya serahkan ke dokter penyakit dalam, tapi tetap saya resepkan amitriptilin dan diazepam ya, profilaksis TTH nya, sudah saya izinkan dokter forensik agar Nadya fokus dulu" tambah beliau.

Alhamdulillah, rasanya seperti mendapatkan kesempatan kedua untuk hidup kembali. Walaupun, setelah itu, hasil cek laborat menyatakan LED (Laju Endap Darah) yang tinggi dan tersuspek autoimmun jadi langsung di ANA tes. Ntah mengapa, rasanya aku sudah ikhlas apapun yang terjadi, melihat orangtua ku terseyum senang maka apa yang aku harapkan lagi.

Dan, besoknya aku langsung dibawa pulang untuk rawat jalan di rumah (ayah mama perawat ya, insyaAllah aman), dan mama langsung ngendika,

"Berhenti sejenak, nak. Ambil cuti, istirahat di rumah. Pindah Solo ya, nak, Mama Ayah urus ke Om Tonang, sampeyan istirahat" Kata Mama.

Ternyata, kejadian kemarin itu membuat mama syok sampai dengan sekarang, mama takut apabila aku masuk RS atau opname sendirian lagi di jember, mama tidak bisa membayangkan lagi putri ragilnya di Ct Scan sendirian tanpa orangtua di sana. Jadilah, kepindahan akan segera diurus

walaupun, rasanya sedikit berat.

pastilah akan menambah masa studi, menambah dana, menambah tantangan juga masalah yang ntah apa pun itu pasti akan aku dapatkan di tempat baru nanti. kuatkan hamba dalam memperoleh keridhoan orangtua hamba yaAllah.

Karena ridho orangtua adalah ridho Mu yaAllah

[izvmimi]

hey mimi, how many overnight shifts do docs usually do per month? if you do them/did them, how did you juggle them with day shifts and trying to keep your sleep schedule on track? trying to see if i’m mentally strong enough for it. ty in advance if you’re okay sharing!!

it depends a TON on what year you are training wise and specialty

as a body imaging fellow i only do one week (next week) this year but as a year 2 radiology resident i did six weeks plus random single nights

my friend who was a surgical resident did rainbow 28s (call-postcall-call) for months for multiple years (she’s currently on a couple research years cuz she was Tired)

when i was an internal medicine intern we just had 28h calls while on icu months but some programs had them every 4 days even on the wards (regular medicine floor rotations)

but like derm for example doesn’t really do overnights so it really heavily depends

for my radiology nights in residency i mainly slept super late for the days leading up to them and i was never a full day time sleeper so i’d do two four hour naps with like regular tasks in between. Week long blocks tend to be easier than single days and tbh switching to night isn’t the hard part it’s mostly switching back. usually you’ll stay up due to adrenaline if your night is busy. In radiology depending on the institution you’ll be up all night but like internal medicine or like neuro sometimes will give you time to sleep, especially if you are on nights with a senior or coresident

this will be completely different once you’re an attending, my godmom was a night only hospitalist for 20 years

we can talk more in dms if you have more questions!