Nuclear Cardiology

Some processed images of a MIBI scan… Shows a heart with a fixed perfusion defect. Image from http://journals.tums.ac.ir.

Today, we were rounding, we decided to do a particular nuclear medicine test on a patient.  I internally got a bit excited.  And then the med student asked what it was and I gleefully explained.

It brought me back to my real Nuc Med days when I had a delightful teacher named Debbie who was extremely smart, but not always quite so aware of how ridiculous some of what she was saying is.  She is up there in my favourite teachers count.

You see, the patient was female and I pointed out the high false positive rate (especially when we were using this as a test to rule out a problem).  The reason for false positives… Breasts.

Hmmm… Ya know, my breasts could attenuate 80keV.  You just have to flop those dog ears of the way. –Nuc Med wisdom said while holding one’s chest.

Breast tissue attenuates (decreases) the radiation from the tracer that is deposited in the heart.  The center I worked at used a different tracer than the one here.  Where I trained, it was only 80keV as opposed to the 140 keV.  Still there could be some decreased detection and a possible false appearance of cardiac ischemia.

Of course we are still doing the test.  But I apparently even taught the cardiologist that new fun fact.

In those days of Nuc Med we had a secret quote board.  There, we kept track of all kinds of ridiculousness that came out of our faces those three years together.  And there was a lot of it.

We are such a nerd full of vans. –A

The trip in which we were a nerd full of vans... A Molecular Imaging conference in San Diego.  This is my class with the class from the year ahead of us and my favourite physicist ever.

The trip in which we were a nerd full of vans… A Molecular Imaging conference in San Diego. This is my class with the class from the year ahead of us and my favourite physicist ever.

Truth be told, I wish I had kept a copy.  I only remember a few gems.  Like the fact our patient care instructor couldn’t pronounce technetium, that Debbie asked us one day if she had an S on her head and that the condition cardiac tamponade will always make me chuckle more than the average person because one of the guys thought it was a tampon to the heart (and we all got assigned an extra reading assignment).

Our styling "star trek" lead vests.

Our styling “star trek” lead vests.

But, despite not remembering all of the ridiculousness, I still conveniently have a strange knowledge of bone metabolism, cardiac perfusion imaging, thyroid function and conditions and a variety of small niche type imaging techniques.  The stuff comes in handy from time to time, strangely enough.  Plus, the whole radiation safety and physics training is pretty handy now that the whole rad onc thing has started.

Our full lot at our hospital graduation celebration.

Our full lot at our hospital graduation celebration.

It made med school seem easier.  It helped me appreciate the health care team more.  It increased my laughter to schooling ratio.

If I ever catch you wearing scrubs outside the hospital, I will cut your fingers off… Using appropriate sterile technique. –Patient care instructor.

And the friends that I have are pretty awesome too.  Even if we only get to have approximately semi-annual outings together due to our spread across the country.  Very few people share fond memories of hanging an inflatable santa out a window with a noose, blowing bubbles out the same window, just to see people’s reactions and the joy of playing catch in any season, in any location.

All dressed up for our last day of clinical... With a stand-in.

All dressed up for our last day of clinical… With a stand-in.

It hit me… Right in the thyroid cartilage! -Me during a rowdy frisbee match… Indoors…  During the lunch break between the two halves of our licensing exam.

Hooray for Cardiology.  It brought me back to my good old days in my bizarre little radioactive niche.

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