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I got the idea for this post from Midwife with a Knife.

This is what I did on Wednesday July 25, 2007.

Note: I apologize for not providing meanings and links to the medical terms in this post. It looked like too much work on a long post.

7:05am - Woken up by a call from the Hospital. The Dermatologist is online. He tells me that he has got his sister to the Casualty with severe loin pain and increased frequency of urination. Sounds like a ureteric colic. He asks if it is possible to do an ultrasound scan. I tell him I’ll be there in 15 minutes and do a bedside scan.

7:05 to 7:20am - Wash (face). Brush (teeth & hair). Dress. Wake my daughter and tell her to start getting ready for school. Tell my wife & mother (who is here on a short visit) that I’ll be back before 8am and leave.

7:25 to 7:40am - Reach the Casualty. Do the scan. Find nothing wrong. But her urinary bladder is empty. I tell the patient and her brother that I would like to repeat the scan with a full bladder at about 10am in the Ultrasound clinic. She feels a lot better after the analgesic shot they gave her in the Casualty. So they decide to go home and come back at 10am.

7:45 to 9:15am - Get back home. Find out that the cook hasn’t come today. P (my wife) and my mother are in a flurry of activity that ensues to get my daughter ready for school. One gets breakfast and lunch ready, while the other chases the kid around getting her to shower, dress up in her school uniform, get her books and bag in order all in time to catch the school bus at 8:45. She just makes it on time. I keep out of the way, read the newspaper & have my coffee. Get ready. Eat four idlis with sambhar for breakfast.

9:15am - Drop my mother at the bus station to catch a bus to return to Coimbatore. Call my brother and tell him which bus she’s on and the expected time of arrival, so he can go pick her up.

9:20 - 9:45am - Reach the hospital. Report two CT scans of the Brain that were done in the morning.

9:45 - 10:15am - Two bedside ultrasound scans in the NICU. One routine Neurosonogram for a term baby admitted with respiratory distress following a vaginal delivery with meconium-stained liquor. The other was an abdominal scan for a very sick preterm infant with abdominal distension. The scan seems normal. The bedside x-ray taken on admission showed a hugely distended stomach and a suspicious pneumoperitoneum. I asked for the x-ray to be repeated, it confirmed the pneumoperitoneum. I called and spoke to the Neonatologist and the Pediatric Surgeon. The baby will be operated later in the day after the doctors talk to the parents.

10:15 - 10:45am - Back in Radiology, saw a middle-aged woman’s plain CT scan of the abdomen. Looks like the “Case of the Month.” I asked for oral and intravenous contrast. (More about this case a little later).

10:45am - Get a call from the Ultrasound clinic that the Dermatologist’s sister has arrived for her repeat scan. There are three other patients waiting there. The Ultrasound room is in our outpatient clinic which is about 5 minutes away.

10:55am to 1:45pm - Work at the Ultrasound clinic. Fourteen patients scanned: 8 abdomens, 3 pregnancy scans, 2 scrotal scans and 1 swelling in the leg. Most notable was an abdominal scan in a 50-year-old man which showed a long segment of bowel wall thickening - involving the caecum, ileocaecal junction and ascending colon. Looks inflammatory on ultrasound. But you never know. A strong recommendation for CT scan or colonoscopy. Both scrotal scans are easy surgical cases for our urologist. One was bad - Torsion testis. Not viable. Will have to be taken out. The other one was a hydrocele. I also had to report 5 CT scans of the brain - one head injury, two strokes and two ‘normal’ headaches.

1:45 - 2:15pm - Quick lunch with P (she has her OP clinic in the same block) in a spare consultation room. Steamed Rice with sambhar & rasam with some greens and a small coconut burfi (my mother made them during her visit) for dessert.

2:15 - 5pm - The slow afternoon session. Two abdominal ultrasound scans. 3 Brain CT scans. The contrast CT of the abdomen proved my initial impression on the plain scan. A retroperitoneal Liposarcoma. Well-encapsulated. Mostly fat containing. Few solid elements and septations. No necrosis. No calcification. Most likely a well-differentiated (meaning low-grade) tumor. Eminently operable. But huge (22 x 17 x 12cm) displacing every other structure on the left side of the abdomen. Hope the patient gets operated soon. I’ve only seen one other such tumor in my nine years in radiology. A rare case. Blogsurfing between patients.

5 - 6pm - Time spent at home. Couldn’t see much of my daughter as her twice-a-week Bharatanatyam dance class between 4:30 to 6pm was rescheduled to Wednesday & Thursday this week instead of Friday & Saturday. Snacked on some banana chips. Coffee. A little rest.

6 - 8pm - Back to the hospital to report a Neck CT. It ideally should have been an MRI. But since we don’t have one and it is easier to get a CT done than schedule an MRI somewhere else. A post-radiation tonsillar malignancy with recurrence and lymph nodes. Four more Brain CT scans. Nothing important. One ultrasound scan of the abdomen.

8:30 - 9:30pm - Went out to Dinner at a nearby shopping ‘mall’ - the quotes are for the Americans. What we call a ‘mall’ wouldn’t even come close to what you people are used to. Between the three of us we had one pav bhaji, one vegetable spring roll, one bhelpuri, three pudina rotis with a stuffed capsicum gravy a soda and an ice cream. Lots of food.

9:30 - 10:30pm - Put my daughter to sleep. Checked a few emails and blogs.

10:30 - 11:45pm - P decides to rearrange clothes and stuff in our 3 cupboards / wardrobes. The rooms look a mess. I try to keep out the way as much as I can while pretending to work

12midnight - Lights out. Sleep.

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