Ortho words

MT Diary, I come again,
Not much active in this lane,
Not that I m playing another game,
Can't cook up any excuse lame...




I do make a note of words that I come across during work, but most of these words do not find place in my blog...why?? ahh...the first and foremost excuse would be laziness....anyway..thought to break the pattern today....


While doing ortho files (podiatry)...came across these 3 words critical angle of Gissane and Bohler's angle, and Broden's view.  Critical angle of Gissane was recognized as "angle of same" by the speech recognition software.


From now on....will blog about the words as and when I get it instead of pooling the words.....;-)

English words

Last week I came across 2 words in English, which I was listening for the first time:  Off-kilter and touch base.


Dictator said that the anatomy was "off-kilter."  This word was not in American Heritage Dictionary.


The second word touch base was said in the context of patient getting in touch with the PCP.  Although this word was there in the American Heritage Dictionary, but still I never had the opportunity to hear/use it.


It has been after a long time that I am blogging about English words, hopefully more will follow......

Tourni-Cot

Recently, while doing a file, I heard what sounded like "Tournikot", I felt the dictator was dictating tourniquet in a slightly different way, but to my surprise, heard the dictator mentioning tourniquet clearly at the end of the procedure.  On carefully listening again, tourniquet was mentioned both at starting and ending, but in the middle portion of surgery (a hand surgery), it was "Tournikot", finally my friend google came to my rescue and threw up this.


The Tourni-Cot is an elastic ring that when rolled on a digit, squeezes the blood out and occludes the vessels.


So, dear fellow MTs, if you are doing a file and hear "Tourni-Cot," do not mistake it for tourniquet, although the technical function of both is same, i.e. constricting circulation...

Alternative career for an MT

At many MT forums and online communities, I have come across some people who rant about lack of alternative careers for a medical transcriptionist and how the skills developed in this profession do not serve as a stepping stone to some other avenues.  Here I would like to jot down my feelings on the same.


Most of the medical transcription companies are making available the work from home option and also providing flexible working hours (mine does that).  Working from home coupled with flexible working time can pave the way for adding some extra skill sets to one's resume (time scheduling is the key).


Indian hospitals are also taking in MTs, but the pay wont be anyway near the BPO sector, but on the positive side, there wont be any strenuous work pressure too.  However, many of these hospitals describe the job profile as data entry operator, which I strongly resent.  Working in such hospitals coupled with doing part time work for any MT company and also pursuing a distance education diploma in hospital administration would be a safe bet for the future.


The other opening is available in content writing, search engine optimization, , copy writing/editing, where good language skills and writing skills come handy.  Although above average English language skill is a must for an MT, flair for writing is not something part of the skill set of an MT, but still it may be lying dormant, who knows, only when one tries, does he realize what he can accomplish.


Medical writing is another venue for those medical transcriptionist with a flair for writing.




I will surely add to this post when I come across more options for an MT.

Hernia and coarctation

Today while searching for online reference for hernia, I came across this wonderful site, and found it to be a treasure trove of all available info on hernia.  Similarly, another term, "coarctation" led me to this site, which also was able to satisfy my query.  Really, we MTs have a special place in our heart for Sir Tim Bermers-Lee for his marvelous creation called world wide web.

Ehlers-Danlos Syndrome

There is a geneticist dictator in my account, whose dictation is clear, but still it is one of the last files to leave the pool, may be because of the load of information it contains.  From a line count productivity point of view, taking one such file would upset the rate of productivity, but still if one is on the lookout for new terms and diseases, this is the dictator to do.

Today while doing such a file, I came across the term Ehlers-Danlos Syndrome (EDS).  EDS is a group of inherited connective tissue disorder caused by defect in the production of collagen.  Simply put, the collagen helps to decrease elasticity in skin, muscle ligaments etc., but in this case, due to abnormal production of collagen, elasticity increases and causes a person with this condition to have hypermobility and hyperextension.  EDS most typically affects the joints, skins, and blood vessels.


Depending upon individual mutation, condition can be mild to life threatening.  There is no cure and treatment is supportive care.  


I guess Stan Lee keeps a tab on all the happenings in the genetics field....or how else could he create x-men, spider-man and the whole lot of other super heroes with genetic mutation, (although the life threatening/disease part is not highlighted there).


Info as usual was gleaned from my friend wiki and a couple of other sites which came up on top while googling.

CDE

CDE stands for Chronic disequilibrium of the elderly and I could not find this abbreviation in my Stedman's Abbreviation Dictionary.  The patient was an elderly who was on Antivert for this condition.

Neutraceutical

Ever heard a word like that? Just now I heard it and this is what my dear friend wiki tells me...


"Nutraceutical, a term combining the words “nutrition” and “pharmaceutical”, is a food or food product that provides health and medical benefits, including the prevention and treatment of disease"


They keep on churning out new words all the time.....;-)

Equine-assisted Therapy

I have always associated horse riding with machismo until today, when I got a file in which the patient who suffered from autism and also Asperger's syndrome was referred for equine therapy.


In an Equine Assisted Activities program, a certified or specially trained riding instructor teaches a person with a disability how to ride a horse. However, the environment of the horse can provide more than just riding skills. The programs which offer the equine environment to people with disabilities can teach companionship, responsibility, leadership, vocational, educational skills as well as offer competition venues in the different horse disciplines. Riding a horse provides a unique and often profound recreational or leisure activity for many people. There are many sports which people who have disabilities can participate in for enhancing their lives which offer social and physical fitness as addressed in the Special Olympic programs for people with a cognitive disability. There are hundreds of programs around the world as well as many organizations dedicated to the various forms of horse riding or horse care which address many other disabilities and may not have a cognitive disability.

The student who interacts with their horse may extend this to others and to form meaningful relationships with people. Building a relationship with an animal is very rewarding in many aspects; for a person with an emotional, social or psychological disability, the trust and loyalty of an animal demonstrates to the student how important they are and then they may extend these attributes to personal relationships. Horses also help people feel in control of their situation because there is a direct correlation between action and reaction. To learn how to care for and ride a horse, a student must also be able to communicate efficiently with the horse and the instructor. In this way, riding is a very social activity, but is less daunting to people who are uncomfortable in social situations. However, the experience of riding a horse is very different. Riding helps to empower people and enables them to connect on a personal level. The sometimes unpredictable nature of animals and situations also creates a real-life environment in which students will be able to confront fears and make adjustments to situations beyond their control.

Types of Anesthesia

Usually in operative report and procedure notes, we come across terms like local anesthesia, regional anesthesia, and general anesthesia.  What is the difference between all of these?


Here's a basic look at each kind:


Local anesthesia. An anesthetic drug (which can be given as a shot, spray, or ointment) numbs only a small, specific area of the body (for example, a foot, hand, or patch of skin). With local anesthesia, a person is awake or sedated, depending on what is needed. Local anesthesia lasts for a short period of time and is often used for minor outpatient procedures (when patients come in for surgery and can go home that same day). For someone having outpatient surgery in a clinic or doctor's office (such as the dentist or dermatologist), this is probably the type of anesthetic used. The medicine used can numb the area during the procedure and for a short time afterwards to help control post-surgery discomfort.


Regional anesthesia. An anesthetic drug is injected near a cluster of nerves, numbing a larger area of the body (such as below the waist, like epidurals given to women in labor). Regional anesthesia is generally used to make a person more comfortable during and after the surgical procedure. Regional and general anesthesia are often combined.


General anesthesia. The goal is to make and keep a person completely unconscious (or "asleep") during the operation, with no awareness or memory of the surgery. General anesthesia can be given through an IV (which requires sticking a needle into a vein, usually in the arm) or by inhaling gases or vapors by breathing into a mask or tube.


source:  http://kidshealth.org/teen/your_body/medical_care/anesthesia_types.html

Parathyroid and thyroid gland

Hypothyroidism and hyperparathyroidism are one of the most common diagnoses in dictated notes.  The former is related to thyroid gland and the latter to parathyroid gland.  Now, although thyroid and parathyroid gland are similar sounding, and are endocrine glands, there functions are entirely different...

The sole purpose of the parathyroid glands is to control calcium within the blood in a very tight range between 8.5 and 10.5. In doing so, parathyroid glands also control how much calcium is in the bones, and therefore, how strong and dense the bones are. Although the parathyroid glands are intimately related to the thyroid gland anatomically, they have no related function. The thyroid gland regulates the body’s metabolism and has no effect on calcium levels while parathyroid glands regulate calcium levels and have no effect on metabolism.  More information can be had from here.

HHectic

Phew....last few months have been a little hectic.  Apart from my work, I am also doing DIFA which stands for Diploma in Indian and Foreign Accounting, at the end of which I will be eligible to also appear for IAB level 3 examination.  Also I have to appear for 4 papers in my Masters examination scheduled for next month.  All this have resulted in a mad scramble which has left me with very little time for MT diary, but I will be back next month with my MT findings...:)

Pink, blue, and white sheet

In psychiatry files, one usually comes across scenarios where it is dictated that patient was pink sheeted or blue sheeted! What exactly is the principle behind this pink sheet or blue sheet or white sheet?  I searched the web and came across Eric Tadehara's blog where he had described this in his own jocular way. The gist of which is, in case of a pink sheeted patient, the admission is involuntary and the form is filled out by doctor or any other medical professional and they are placed in residential setting for a specified number of hours.  The only difference between pink and blue is that blue sheet is filled by a law enforcement officer and white sheet is for commitment hearing and filed so that patient may be held until seen in court.

Sound alike list

I have been thinking of making a sound-alike list of late.  It will serve as a guide to newbies in this profession and also a database to those active...I have started recording them now seriously...yesterday I got one....heard "strict 9 overdose", was actually strychnine overdose.


Thank you

HELLP??

February being a 28-day month had left me with no other option, but to work both mornings and evenings.  As like always, I found a lot of words, terms, procedures, but could not blog about it immediately, anyway managed to keep a log of all of them and will try blogging about at least some of them as and when time permits.....


I got this term "HELLP syndrome" in an OB-GYN file....The acronym HELLP disguises a very serious complication, which if not diagnosed early, can prove to be quite serious.


HELLP syndrome is a group of symptoms which occur in pregnant women and stands for


H:  Hemolysis (breakage of red blood cells)
EL: Elevated liver enzymes.
LP:  Low platelet count.


HELLP syndrome is the complication arising out of preeclampsia and eclampsia.


More info about this serious condition can be had from here and here.


HELLP symptoms can also lead to misdiagnosis such as hepatitis, gallbladder disease, ITP or TTP.


Although there is no way to prevent HELLP syndrome, early prenatal care can help the care provider to find and treat the symptoms before they get out of hand...

Gravida and Para

In Ob-Gyn files, we usually come across this term Gx Py-a-b-c.  Here it has been explained in simple yet clear manner.


Suppose I say patient is G10 P 7-2-1-9, it means that patient has had 10 pregnancies out of which 7 were full term (y), 2 were premature (a), 1 was abortion/miscarriage/ectopic pregnancy (b), and 9 is the number of living children that patient has (c).


thnx

The "f" sound

A TAT to beat, a no blank status file with 3 blanks, all 3 same word....sounds familiar?? Yeah this is what happened to me yesterday.  The only problem was that I was clearly hearing the blank/word which was a drug name, but what I heard was naphazoline, which is a Adrenergic Agonist Agent, where as dictator was clearly stating that he is adding another antibiotic to clindamycin which the patient was already taking, so this drug was an antibiotic, which naphazoline was clearly not.  Then I remembered that apart from "ph", the letter "f" also produces "f" sound...:)...and there there....I found it....nafcillin..so simple...yeah..some times simple things are hard to decipher....


An MT transcribes what he/she hears, but relying only on hearing can be a dangerous path to follow as it can lead to very dangerous pits, it is always best to search for references from reliable sources, of whatever words one comes across.  If there is any confusion regarding drugs, it is always prudent to check the medication usage,category, and dosage.


One more thing I will like to add regarding cracking blanks is never guess....you may be forced by people higher up to reduce the blanks or produce blankless documents, but what you must remember is "if in spite of your best efforts you are unable to crack a blank, then leave it as it as, but go through the QA version and make sure the next time, this word never escapes you."  This has been the golden rule that I have followed from the first day that I started transcribing, it has held me in good stead over all these years, and I am sure so will be you...

Cheerful and upset

Yesterday while doing a psychiatry file, I kept hearing this, "The patient is cheerful and upset."  The patient had psychosis and it was also said that she was very cooperative, so I guessed may be what the dictator meant was that patient was acting cheerful although she was really upset,..but I could not find even a single reference for such a case with my under trial ammo and my time tested ammo.  Then it suddenly came like a flash...I felt like kicking myself....it was the word tearful, which was also logical, and actually this is a quite common usage in psychiatry files....


Speaking about psychiatry....in psychiatry files, in the Impression/Assessment part, dictator sometime says DSM IV which is an acronym for Diagnostic and Statistical Manual Disorders, 4th edition.  More info can be had from here.


For the past 2 days, I am getting psychiatry files, and I do not know if that is a general rule, but I find that most psychiatry dictators are good...(at least in my account) may their tribe increase......:)

Borrelia burgdorferi

Borrelia burgdorferi wow.......really what a name....one has to admit, although they are invisible to naked eye, but all these bacterial species have got regal names, much better than the scientific names of those visible without a microscope.

Borrelia burgdorferi is an agent of Lyme disease, which is an emerging infectious disease.