Posted on July 27th, 2017 by wombwithaviewblog.com

Consulting Dr. Google About Your Abnormal Fetal Ultrasound

Don’t do it, Moms-to-be! As much as you may be tempted, I have to caution you to not web-surf regarding your abnormal fetal ultrasound. Here’s why…

Because you surf the net for these details, you end up finding an entire spectrum of possibilities ranging from normal to severely abnormal fetal findings. And most of them may not apply to your circumstances at all. The result is usually the same. Your imagination runs away with you, and you start to worry that everything you’re reading applies to you and your baby. I always know a mom has been consulting Dr. Google when I get questions like “Is my baby’s bladder inside its body??” My response is usually the same…I reassure her with an “It sure is!” Then with a little smile, I advise “Quit looking up stuff on the internet!” Moms’ responses are usually the same, too. “I know, I know…I just can’t help myself!”

In this day and age of anything we want to know at our fingertips, it is nearly impossible to NOT research something that piques our curiosity. So, naturally, when you get your ultrasound results from your doctor, and he mentions you have a lot of amniotic fluid (polyhydramnios) or your baby has cysts on its brain (choroid plexus cysts), you freak out a little (or a lot). It’s completely understandable! But these findings may VERY WELL not be a reason to panic!

If Your Doc Wants to Refer You

Sometimes, we sonographers (even the experienced ones) detect things we just can’t explain. This doesn’t mean something detrimental to your baby; it just means we can’t fully explain it. We know this is disconcerting to an expectant parent(s). Usually, if something requires the attention of a high-risk specialist (aka a perinatologist or MFM or Maternal Fetal Medicine), your doctor will tell you when he discusses your ultrasound results. In such a particular case, he/she will usually express that something noted on the examination stands out as abnormal (or possibly a normal variant – something that’s a little different but considered normal), and he would like a second opinion.

In my experience, if your provider feels it is not grossly worrisome, he/she will say so. Your doctor will then refer you to MFM so they can do a more extensive Level 2 ultrasound. The perinatologist should discuss this ultrasound with you, provide an opinion on the issue, and the severity of the problem. MFM will also let you know if they feel there really is no problem.

If Your Report is Normal

If you are not referred to a perinatologist, then it’s very likely that nothing worrisome enough was seen on your ultrasound. Your doctor will also let you know that your ultrasound was negative or unremarkable. At times, we can’t see something well because of Baby’s position or other factors. Usually, it’s something like Baby’s heart or spine. In these cases, your doc may want to look again to ensure a normal appearance. There are many minor findings that we may note on a regular sonogram which may not be alarming to your doctor. Mostly, they just require a follow-up later to see if the issue is resolved. They mostly turn out to be insignificant, especially if no other abnormalities are seen with your baby. In other words…they are likely not a big deal!!!

So don’t make yourself worry! Don’t ask Dr. Google, ask your doctor instead. Make a list of all your questions, and he/she will let you know if other tests are needed. I know it’s tempting, but this is only the beginning of all the things that drive us crazy as moms! Save your sanity for when your kid is a driving teenager!

 

As always, thanks for reading! Please feel free to email with any questions or comments at wombviewerblog@gmail.com.

 

Whether you are worried about an abnormal fetal ultrasound or not, subscribe to get reliable ultrasound information delivered straight to your inbox.

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Posted on April 29th, 2017 by wombwithaviewblog.com
Ultrasound results twins

8 Week Twins!

Ultrasound Results – What’s the Big Deal?

Your ultrasound results must always come from your physician! But why can’t your sonographer just tell you if everything looks okay? It’s so irritating when she won’t talk, right? The most frequent question a patient asks is if everything looks okay, healthy, or normal. Hmm, if I had a dollar for every time I’ve heard this… Usually, to the patient’s dismay, this is something we just can’t discuss with you. Read on for details about why we have to be so doggone tight-lipped.

Ultrasound Results Have to Come from the Docs

My usual response when a patient asked this question is “Your doctor has to look at all of these images and he/she will discuss your ultrasound when you see him/her next.” Only your physician has the legal right to give you this information. Yes, it is my job to know what I am seeing and to recognize it when something does not appear normal. However, sonographers are not physicians. We are trained to perform your ultrasound examination; not to manage the health of you and your baby. Your doctor studied for many years, learning how to do just that. And only your doc or other healthcare provider can answer the multitude of questions you will positively have in the case of a suspected problem. Our job is to share what we see with your doctor. Your doctor examines the information and concludes whether he or she agrees with our findings. The doc then shares his/her interpretation of the information with you along with what options he/she recommends next.

But, But…

Occasionally, I will have a persistent patient or spouse who will say, “Yeah, but you KNOW whether you see something wrong or not.” I’ll admit that I do, but I always defer to the physician’s interpretation. Sometimes, the patient presses a third or even fourth time, and I just have to stick to my guns. I know it simply comes from a place of parental anxiety. We do understand. For the nervous patient, waiting for ultrasound results can feel like a lifetime. I do empathize because most patients have a valid reason for being nervous. A previous pregnancy loss or abnormal ultrasound is enough to scare serious fear into the hearts of anyone. I want expectant moms to understand that if your sonographer says something inappropriate, she could lose her job. Only your doctor can calm your fears and reassure you about your pregnancy issues in a way that no one else can. Your results are part of the sacred and private relationship between you and your doctor!

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Your questions and comments are welcome at wombviewerblog@gmail.com!

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Posted on November 10th, 2014 by wombwithaviewblog.com

Even though most patients know results need to come from their physicians, they still try to get answers. I guess one cannot blame them for the interrogation. I’ve got to give them credit! Sometimes the persistence is relentless.

When I routinely get the question, I give my usual spiel. “Your doctor will receive my report and images and she’ll have to review them, then give you call with results.” Despite this statement, the inquiries sometimes continue. For those most persistent, the line of questioning goes like this:

  • Does everything look okay?
  • So what are you seeing?
  • What is that black thing?
  • Can you just tell me what you think?
  • So, you’re not going to tell me anything?
  • I know you’re not supposed to say anything, but what do you see?
  • I know you can’t say anything, but – off the record – what is your opinion?

 

A patient’s concern is certainly understandable. It’s hard not to chuckle a bit, especially when a patient will ask two or three of the above questions back to back.

In the history of ultrasound and probably forever more, this will remain the protocol. It would be unusual that the physician disagrees with our assessment, but results will always have to be delivered to you by your doctor. As experienced sonographers, there are a whole slew of questions we can address about ultrasound itself. However, until we obtain a medical degree and become the ones managing your care, your doctor is the only person who can really answer all your concerns entirely and completely.

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Posted on July 12th, 2014 by wombwithaviewblog.com

Technology has its pros and cons. We THINK we want to know the second we conceive…but do we really? When all we can see is early first trimester sacs, your doc cannot confirm the pregnancy is off to a good start. At least not until we can see an embryo and strong heartbeat at 6 Weeks. Some patients find out that (often times) ignorance is bliss. The wait is long and miserable! This is why your doc will elect to scan you around Week 7 or 8.

Early First Trimester Sacs – Week 4

Very early in the pregnancy, less than 4 Weeks gestational age, we can’t see a thing. To clarify, we start to see a gestational sac at around 4 Weeks. This sac will measure only about 2mm and will literally appear as a tiny black blip within the uterus. All we can report at this time is that we think it’s an early sac.

Week 5

Monumental changes are happening every week!  At 5 Weeks pregnant, we see a much bigger sac. However, it’s only enough information to say, yes, the sac has grown, it measures around 5 Weeks, and that is good. Around 5 1/2 Weeks, we should see the presence of a yolk sac. It looks like a little circle inside of the sac and provides nutrients for Baby who is still too tiny to see by ultrasound. Below is about a 5 1/2 Week pregnancy of twins (obviously! Dichorionic/Diamniotic or fraternal).

Yolk Sacs, 5 Weeks pregnant, twin pregnancy, early first trimester sacs

 

Week 6

6 Weeks pregnant, 6 Week ultrasound, 6 Week embryo

By the next week at 6 Weeks gestation, an embryo measuring about 3.5mm with cardiac activity should be seen! A nice, round yolk sac and a bigger gestational sac factor into what we expect for this exam. Baby is still very tiny, and it can be difficult to visualize well if the embryo is lying against the wall of the gestational sac.

At 7 Weeks we can see a little better, and Baby is a few mm larger. But 8 Weeks usually gives us a great image of what we want to see!

Week 8

Baby, on your 8 Week ultrasound, is much easier to measure at this point.

8 Weeks pregnant, 8 Week ultrasound, early first trimester

Isn’t the growth in two weeks incredible?!!!

It’s all a process of Mother Nature. It can’t be rushed, and only time will tell if your pregnancy is growing appropriately! If you think you are farther along by your LMP (last menstrual period) dates, we perform an ultrasound, and we don’t see what we expect, it can feel like such a long wait! There’s no way to know whether the pregnancy may not be progressing normally or whether you may just be too early!

It’s so hard to wait. And it may feel like the longest week or two of your life before your doctor orders another scan!

What most women do (and I caution you to not!) is to talk to friends and family and search Dr. Google furiously for what to expect. Only no article or blog post can predict the outcome, and only that next scan will (hopefully!) give you answers.

Here’s sending you best wishes and much-needed patience to all you expectant moms out there!

Email me at wombviewerblog@gmail.com with your questions or comments:)

 

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Posted on July 1st, 2014 by wombwithaviewblog.com

I’d like to share an email sent by a very worried mom-to-be and my response. I’m hoping my advice will help other moms who are concerned about results.

anxious mama:  I’m writing to you because I find your blog really interesting especially now when I’m pregnant. This whole world of pregnancy-connected things is quite overwhelming to me. I am now 25 weeks pregnant. And although I’m quite a rational person, sometimes I freak out.

Actually, I have some doubts as to my ultrasound scanning. During my 22nd Week, I had a prenatal ultrasound scan. The doctor checked everything, and everything seemed perfect except my son’s feet. He described them to be “strange” and suggested that those are sandal gaps. I was even more scared when he advised me to do an amniocentesis which I didn’t do. Now, I know that such feet can suggest DS, but my husband says that probably our son has such strange little toes because my toes are not “normal,” either.
Anyway, do you think you could take a look at some pictures of my child’s feet? I keep thinking that maybe the moment for the scan wasn’t right, or he was moving his toes, or anything…
If you agree to look at these photos, I will send them immediately 🙂

wwavb:  Thank you for reading my blog, and I hope it’s answered some questions for you. And, yes, while pregnancy is very much an exciting time in a family’s life, it can also come with a variety of worries and concerns.

Firstly, I have to tell you that I am not a physician, and I cannot in any way confirm whether your baby has sandal gap toes. Even if I saw your images, I did not scan you live or real-time and did not observe your scan, so I could never diagnose something by a single frozen image.
My best advice is this. If this is a concern you now have and it is one that causes you to lose sleep and if it is also an answer you feel you must now have, talk to your doctor. He is truly the only person who can provide you with an answer. Sometimes, if there are no other abnormal findings, this can just be a normal variant meaning your baby is otherwise normal. However, your doctor offered you an amnio because only an amnio can tell you for sure. This is your doctor’s purpose…to manage your pregnancy and to help you navigate through such concerns.
I’ve assisted on hundreds of amnios in the past, and it is usually a pretty quick test with a little stick of a needle and a mild cramp. Talk to your doc about all the pros and cons, and let him know if you are reconsidering.
I hope I’ve helped to some degree, and I hope you’ll subscribe to receive future posts! I wish you all the best for a beautiful and healthy baby:)
wwavblogger
***
My reader never sent me her images, but as I stated in the email, it’s something only her doctor can confirm for her. I do know pregnancy can be a scary time. It’s always fun when everything is normal, and everyone wants a healthy baby. But in those times when health is questioned, and especially when it is a reality, rely on your doctor to help you through it.
Our babies come to us for all sorts of reasons that we can’t know about now or understand. Sometimes it’s all in the big plan of life that we are chosen to care for those very special children who need very special parents. It’s not the end of your world, it’s the beginning of theirs and your life together!
Many blessings to all mamas and babies out there!

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Posted on June 29th, 2014 by wombwithaviewblog.com

Not so much. Not when it comes to pregnancy and we see it every week. A patient is given ultrasound results by her doctor, she goes home to Google the information and then calls back to the office in a complete panic over what she’s read. This is a big mistake! The internet is filled with more information than we need and than what applies to you in your pregnancy. You are likely causing yourself more heartache and worry than is necessary.

What you find when consulting Dr. Google is the whole spectrum of findings and worse-case scenarios. This is also the case on most every blog and site, no matter credible. You also get forums of patients with no medical background discussing their results with quasi-knowledge and missing links.  At the end of the day, your doctor is your advocate for managing your pregnancy. Only she/he has your chart full of pertinent medical information. Only your doctor can advise you on what the next step can be or order further testing. Whatever the decision, discuss it with your obstetrician or other healthcare professional taking care of you and Baby.

Remember this. Dr. Google cannot advise you, console you, or discuss test results. This is why you have an obstetrician.

Moreover, Dr. Google will certainly not be the one to catch your precious bundle of joy on the day of delivery. Direct all your concerns to one who will be – that’s why she is in the baby business:)

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Posted on March 1st, 2014 by wombwithaviewblog.com

What exactly do I do? Let’s break it down. This information will definitely be helpful to anyone interested in training for a career as a sonographer. Many are fascinated by ultrasound! So, this may also be an interesting read for those who are merely curious about what we do. This may also be a little long, so hunker down with a good cup o’ joe.

Ultrasound is very technical, so attention to detail is of great importance. We work in the millimeters, so spacial concepts and 3-dimensional thinking are necessary. We can visualize mentally what we are only partially seeing on the monitor. For new sonographers, this gets easier with improved scanning ability over time. None of us were great sonographers right out the gate!

So, what am I? I have many names…sonographer, ultrasound technologist, ultrasound tech or technician. A certified sonographer is someone with a couple of years of experience who has passed a Physics exam and one specialty examination (like OB/GYN). You then earn the credentials of RDMS, Registered Diagnostic Medical Sonographer. There are many other examinations for which one can earn more credentials.

We start off with some book knowledge. We learn medical terminology, A&P, pathology (disease) and how it presents, ultrasound physics, biology, and examination protocol, for example. In my particular training, we started clinical rotations where we visited different clinical settings for a period of time. We would follow other more experienced sonographers to observe examinations. I learned a little about the technologist/patient relationship like what to say and (most importantly!) what not to say.

We also learned how to present our examinations to the Radiologist, the reading physician. You better have all your ducks in a row here, people! They are tough. They can and will ask you a hundred questions, and you better have the right answer waiting. Like any other profession, some are easier to work with and offer more guidance. Some, well..don’t. After you are more experienced and have proven yourself time after time, the tough ones let up a little:) They know when a sonographer knows her stuff, and they know when they can trust your skill and ability. It just takes time.

We learned how to handle patients in hospital beds, how to transport them, and how to handle their catheters. Learning to keep urine, vomit, or blood off your person was a good time, too! We also learned what to do if it happened anyway and how to not get sick yourself. It doesn’t help your patient! If you have a good teacher, you also learn how to handle patients with dignity and respect. It’s hard for someone to feel that when they lie in a hospital bed. In an outpatient setting, you learn that patients are the lifeblood of a practice. When dealing with the general public, you can’t always say what you want, and you have to learn to filter.  This is sometimes VERY HARD to do!

A sonographer learns scanning ability with hands-on training with a machine and an experienced sonographer at the helm. Ultrasound machines are very much like most computers. They all have the same basic functions, but some have a few more bells and whistles than others. We learn what something looks like by watching someone else.  S…l…o…w…l…y over time we begin to be able to recognize parts ourselves. Then we take over the probe. We have to learn how to hold it and find the parts ourselves. We learn how to properly measure organs and how to adjust 40 knobs so that the image looks the way it should. Additionally, we have to learn image protocol which includes what images to take and how many.

Eventually, after a few months of scanning, these technical details become second nature. As soon as the probe touches the skin, we set about making our image look as needed without much thought. It is only then that we start to recognize pathology. Sometimes, disease processes present exactly as one learned from the book, sometimes not. Oftentimes, we see something we know is NOT normal, but we can’t exactly put a name to the process. What students need to know is that one of the most important things they’ll learn about ultrasound is to first learn what “normal” is.  Once one scans many normal exams, it is much easier to recognize when something is wrong.

We learn all the above for many different parts of the body! Some aspects of ultrasound include Intracranial and Peripheral Vascular (vessels of the arms and legs), Echo (the heart), Small Parts (breast, testicle and thyroid), Abdominal (all abdominal organs and vessels), OB or Obstetric (maternal and fetal), GYN or Gynecology (pelvic organs in a non-pregnant female), and many others. Ultrasound is also performed on the eyes and in more recent years, muscles and nerves. We also spent a bit of time learning about biohazard waste management and HIPAA regulations that keep patient information private.

Over time and with more experience, we learn how to better manage our patients and case loads. I say it’s a process with a long learning curve, especially for anyone starting out with no medical background. At times, I cursed my choice of career, place of employment, and certain unpleasant physicians. I sometimes cried before and after a particularly hellish workday or weekend of call. It was the hardest thing I’ve ever done. BUT I did it. And slowly but surely, the puzzle pieces came together. They began to fit in a way that brought light and clarity to every exam I performed. Suddenly, it just started to make sense.

When I began to ask more questions about something I didn’t understand, I received better response from docs I admired for their extensive education, intelligence, and knowledge. You can’t be afraid to ask questions! It’s important to your docs, their practice, and patients. It’s also important to you, the sonographer, for your own developing skill and ability. This confidence grows over time! It’s a great feeling when you finally get to this point.

To this day, I still get a rush when I recognize pathology and all the puzzle pieces come together. It makes me happy when I can explain something to a patient that gives clarity to her understanding. There’s nothing like a “thank you” (or even a hug!) by a patient. And who doesn’t love positive feedback by a physician who says you did a great job? As difficult as my career was in the beginning, I’m still at it after 23 years. And year after year, post all the blood, sweat, tears and pain, I feel I’ve come a long way:)

 

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Posted on February 27th, 2014 by wombwithaviewblog.com

So, I wrote this post about two years ago as one of my firsts.  It’s worth addressing again.  Now that I have a few regular readers and since most of you are pregnant, it’s definitely worth repeating!

Basically, you have questions..some we (sonographers) can answer and some we just can’t!

***

Probably, the most frequent question I get asked is if everything looks okay, healthy, normal, etc.  Wow, if I had a dollar for every time I’ve heard this I could retire by now!!  Usually to the patient’s dismay, this is something NO SONOGRAPHER can ever tell you.  Firstly, not everything that is abnormal can be seen by ultrasound (some chromosomal abnormalities, for example).  No sonographer can ever say that a fetus has Down Syndrome simply by an ultrasound examination alone.  Yes, we look for red flags; occasionally, we see them; sometimes we don’t.  However, other tests have to be done to confirm such.  If you’ve ever been pregnant, you know there are a multitude of tests that your doctor will request at certain times in your pregnancy depending on what the two of you have discussed.

Secondly, only your physician, his/her nurse or doc on call in his/her absence has the legal right to give you these results.  Yes, it is my job to know what I am seeing and to know if something does not appear structurally normal.  That is the scope of my job..to find abnormalities and report them to your doctor.  I have to be able to answer his/her questions about what I am seeing, questioning or diagnosing and how other parts of your baby are functioning in light of the finding.  It’s a big piece of your pregnancy puzzle that helps your doctor determine how your pregnancy needs to be managed.

Regardless of whether it is something relatively insignificant that we see or seriously abnormal, it is NEVER our place to inform you of these findings.  Our job is to share this information or any suspicions with your doctor, your doctor examines the information and concludes whether he or she agrees with our findings and your doctor then shares his/her interpretation of the information with you along with what options he/she recommends next.

The reason it is done this way is because

a) sonographers are not physicians; your doctor went to school for many years to learn how to manage your pregnancy and care and

b) your doctor is the only person who is truly qualified to answer the plethora of ensuing questions when a problem IS suspected.

Finally, you have to remember that it is your physician with whom you have the personal relationship.  Your doctor cares for you and your unborn child and your doctor wants to be the person to break any news to you, console you and inform you.  Occasionally, I will have a persistent patient or spouse who will say, “Yeah, but you KNOW whether you see something really wrong or not.”  I’ll admit that I do but I always defer to the physician’s interpretation.  I know it is simply parent anxiety and a lack of understanding of proper medical protocol that drives the questions.  For the nervous patient, it does sometimes feel like an eternity waiting for results.  My usual response when a patient has asked this question is “Your doctor has to look at all of these images and he/she will discuss your ultrasound when you see him/her next.”

Only your doctor can advise you, calm your fears and reassure you about your pregnancy in a way that no one else can!

***

As always, feel free to ask me your questions!  If it pertains to the scope of my job, I’ll be happy to answer.  If it’s a question your doc needs to answer, you can be sure I’ll defer to your physician!

Happy pregnancies to you all 🙂

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Posted on February 20th, 2014 by wombwithaviewblog.com

This is a first trimester screening test for chromosomal abnormalities which I have performed for a couple of years now.  We have to have special certification in order to perform this examination.  I will not get into any serious depth regarding the subject because I am not a doctor, I am not YOUR doctor, this testing is quite complicated, and only your doctor can give you the most pertinent, accurate, and up-to-date information, as well as, answer all your questions on the subject! I literally am only scratching the surface here from an ultrasound standpoint.

Read on for this question from a reader regarding NT scans:

reader:  I just read about NT scans and how they can be a way to detect Down syndrome. My doctor never mentioned anything about this to me. Do you think it was done during my 12 week dating ultrasound? Or is this something that you need to specifically request? I’m 29 and have no family history so I’m not sure if that’s why it wasn’t offered. After my 12 week ultrasound she did offer other tests but she said I wasn’t high risk and we opted not to do them.  Thank you for your time!

wwavb:  I can chime in on this because I do the NT scan so I know a bit about them.  You answered your own question.  The tests that your doctor talked to you about may have included the NT scan, but you opted not to do them, so that’s why you didn’t have it.

The NT scan is an attempt at a measurement of the nuchal area along with a finger stick.  The measurement cannot always be obtained.  It is probably one of the most tedious examinations I do and this measurement can only be taken one way. There are a number of variables which depend mostly on fetal position that dictate this. If we can’t get the measurement, the test cannot be performed. The lab takes the measurement from the scan and some numerical values from your blood and personal history and puts that all into a formula.  The result determines your RISK or CHANCES for having a baby with four different chromosomal abnormalities – Down Syndrome is one.  This result does NOT tell you whether your baby has these abnormalities or not, only your risk for having a baby with this problem.  If it comes back elevated, you have to decide whether you want to proceed with other tests like amniocentesis which WILL determine if your baby has a particular one of these abnormalities.
For your greatest clarity, you should ask your doctor at your next visit if the NT is something she would have offered.  If you have a concern and would like to look into genetic testing, certainly discuss with your doctor what options she would recommend for you.  She is your best educator!!  
Hope that helped!
Here’s to your happy and healthy pregnancies!

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Posted on November 23rd, 2013 by wombwithaviewblog.com

This one is for sonographers.  I thought initially the patient could read it, also, to understand what it is she should expect from her sonographer.  However, I quickly realized this isn’t something the patient needs to read to understand..it’s something she already expects.  Every patient that walks into your room, regardless of how she reacts to you, EXPECTS to be greeted kindly and with a smile; EXPECTS to be explained in a fully understandable way what kind of examination she can expect to have performed and how it will be performed and whether it will be painful.  She expects conversation..and she deserves it.

Sonographers, you have GOT to get out of the mindset that your only job is to look at that monitor and say nothing else to your patient.  She is human, she has feelings.  Sometimes, she is even scared and anxious about the examination she is going to undergo.  Sometimes, she’s not afraid of the examination but fearful of results.  Sometimes, she’ll even tell you so.  YOU are a provider.  YOU are the master and conductor of the environment in your room at that moment.  You have to remember that the exam you are performing requires “invading” the personal space of another individual and actual contact with that person.  It IS a very personal experience for that patient and, often, a very uncomfortable one.  Your patients are trusting that you will do a good job for them because you are there representing, an extension of, her physician.

You can ask her how she’s feeling today.  If she says ‘Terrible’, you can lend apologies and say you hope her day will be better as soon as this test is over!  Patients often laugh as I’m gelling up the middle finger of a vinyl glove as I slide it down over the vaginal probe.  I always say ‘Gotta have a little comedy in medicine somewhere, right??!’  They’ll ask about your family, pictures, your kids, your experience in your career.  Talking to them during the exam helps most people to just get through it a little more easily.

Don’t be afraid to open a conversation for fear of being asked the question we all cannot answer regarding results.  The best way to respond to this is to simply state ‘Well, my job is to take these measurements and images.  Your doctor will want to examine them along with your other clinical information and then decide how your ultrasound fits into that picture.  Only your doctor has all the pieces of that puzzle!”

For OBs, you just about can’t get through an exam without mom or dad asking ‘Does everything look ok?’  I’ll usually say ‘So far, so good but, you know, your doctor will go over this entire exam with you and you can ask her any questions you have.’  Point out their baby’s parts as you take your images.  Thank the heavens for postprocessing!  You can always go back and focus on things that need special attention after your patient leaves.

On occasion, they’ll say ‘Yeah, but you know what you’re looking at.’  I’ll say ‘Yes, I have to know what I’m seeing to know which measurements to take but it’s your doctor who has to decide what it all means for you.’  Or otherwise explain that her doctor will get a report from the radiologist.  And be knowledgeable regarding how long they’ll have to wait to receive results.  You can bet the farm you’ll get THIS question.

One thing I’ve realized over the years, and anyone who works with the general public would agree, that you can’t make everyone happy all the time.  It’s just impossible.  Some people can’t be made happy.  But when you go out of your way to make conversation with your patient, make her feel comfortable, answer her questions and show her how cute and fat her baby’s cheeks are, it (most of the time) makes for a happier patient.

It feels good to get a warm ‘Thank you’ as you walk your patient out.  If you can send her out with a good chuckle, even better:)

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