Radiotheraphy Clinicals

Time flies, indeed when you love what you’re doing. My radiation theraphy (radiotheraphy) clinical has already come to an end and there are still lots of stuff to learn and master. Three weeks in the department is not enough. I’m sure going to miss the patients, the staffs and the linac (linear accelerator) machine. However, it would also be nice to go back to school again and prepare for the last exam this semester. The exam is going to be an oral exam via Zoom. Nerve recking but it saves a lot of time rather than a home exam for eight freaking hours!

Before the radiotheraphy clinical, I thought that this is the same as PET (Positron Emission Tomography) but no it is not. While PET is also used in the Oncology Department, its purpose is different from radiotheraphy. Radiotheraphy is used to treat sickness by killing cancer cells/tumors and relieve pain by ionizing radiation. PET on the other hand is used for visualizing the metabolic and physiological process of the cells in the body. In short, PET is used for imaging and examination only.

The first week in the department was both exciting and challenging for me and my classmate because we never had any lectures yet since this course about radiotheraphy and oncology is a third year course. However, the department’s adviser has given us some of her time and gave us an introduction and short lecture about the department and what radiotherapists do. We were also introduced to our respective supervisors and showed the treatment rooms that we were assigned to. My classmate was assigned at the treatment room for patients with prostate cancer and I was assigned at the treatment room with almost all kinds of cancer patients. Then my supervisor showed me around the department and of course showed me the linac machines. Linacs are used for external beam radiation treatments. External beam radiation treatment means that cancer cells are targeted and shot from the outside of the body. Then before the first week ended I got the chance to “drive” the linac and give my very first radiation treatment to a cancer patient. It was a great feeling and at the same time I was also tensed because it was my first time to operate a linac. 🙂

Varian True Beam at lab 3. A newer linac.

The treatment room I was assigned to has an old linac from 2007. I feel fortunate to be able to operate it because the department is going to replace it soon with a newer one. Unlike the newer models, this linac has two pedals (not in the pictures). Then, the newer ones are of course more automated and quicker. Thus, saving a lot of time and can treat more patients.

The control panel of Rapid Arc

The lab that I’m assigned to. The linac machine is a Varian Rapid Arc system from 2007.

During the second week of the clinical, I was again allowed to operate the linac and my supervisor gave me some “matching” tasks offline on the computer. When we say matching, it means that we match the CT images taken before the radiation dosage planning to the images that we’ve taken during the radiation treatment. Because radiation treatment is not just only done once but multiple times. To avoid unnecessary exposure and damage to other parts of the body or organs, the point of entry should exactly be the same every time.

Then my classmate and I was given short lectures about dosage planning, the software that they use, side effects of radiation theraphy, brachytherapy and hyperthermia treatment. Brachytherapy is an internal radiation treatment using a radioactive material enclosed in a capsule and hyperthermia treatment is a cancer treatment where the cancer cells are heated up at around 40 degrees Celsius to damage and kill the cancer cells. This old hyperthermia chamber (the picture below) is the only one in Norway. We were told that when this machine stops working, the patients who would need hyperthermia treatment should go to Germany because Norway has no plans of replacing it. Financial reasons, I guess?

A hyperthermia chamber.

Since the hyperthermia chamber doesn’t use/emit ionizing radiation, we were allowed to give it a try. Well, at least feel the pressure as the bag is being filled with water.

My classmate Magnus trying out the hyperthermia chamber.

Anyway, I can say that my clinical in the oncology department is a unique experience and very educational. I’ve learned a lot of new stuff and met wonderful people. The days varied as there were no days are the same even though most of the patients that I met are the same. There were the happy shifts and there were some sad as well because some of the patients displayed worsening symptoms and some had to stop the treatment because of the unresponsiveness of the cancer to the radiation.

School Progress (an update)

It’s finally spring break! I couldn’t be happier! This and Christmas break are the only breaks that we get at the school because you know, students taking up bachelor degrees are immortals! Nah, it’s just that we’re adults already and we should do adult stuff like worrying about our future through our assignment. :)) Kidding! Well, it’s the Lenten week (season) so it’s holiday here. I’m grateful for this school-free week because then my body can finally take the time to recuperate. All these roles (I’m a mom, student, gf, bff, friend, daughter, sister and a colleague) are making me insane sometimes because of lack of sleep and the stress I get from the deadlines and trying to have a social life in this time of pandemic.

Anyway, this semester started with the second part of clinicals or OJT (on-the-job training) in the hospital last January. This time I was back at Haukeland University Hospital (HUS) for the CT (Computer Tomography) clinicals for four weeks. I was excited and a bit tensed during the first meeting because I’ve never been on a CT clinical before and the last time I touched a CT scan machine was back in 2018 before I took a maternity leave. My clinicals last year was at the ER in Bergen and at Stavanger University Hospital (SUS) in 2018 and they’re both conventional X-ray clinicals.

One of the CT scan machines at HUS. Siemens Somatom Definition AS

I’m happy that I got another image modality the last time and in the right order too. Because this course always starts with the conventional x-ray then CT, MRI and so forth.

Unlike the conventional x-ray, a CT examination requires more time for the preparation. Depends on what type of CT scan examination, if it is with contrast or without contrast. If it is with contrast, the patient is required to have a PVC (peripheral venous catheter) in one of the arms. In Norway, the radiographer does this preparation. Then, it is also important to pay attention to the allergic reactions and contradictions to the examination.

After the CT clinical, I had to review for the exam that I failed last year. Because of the pandemic, exams are digitalized. Thus, turning the exams into home exams. While this type of exam sounds easy, no it’s not. At least not for me because I have a small kid in the house and radiation physics is not easy. I find it harder and brain draining because the exam load is more than doubled. So don’t tell me that I’m just pushing the button or else I’ll bite you! haha!

The control panel for the Siemens CT scan machine

Moving on, my efforts paid off after the stressful days and nights of reviewing for the exam and now I am qualified for the next clinical and it is after the spring break. This time I would be at the Oncology Department to work with radiation therapy. I’m ecstatic about this clinical since this would be the first time to work with a linear accelerator. At the same time, I’m sure that this is more challenging than my previous clinicals because this time I’m going to work with lots of cancer patients.

Till next update! 🙂

No Room for Error

Last Friday, I had an exam in drug dosage calculation and I can say that it’s the most demanding and stressfull exam this semester because we can’t have any mistakes. I understand why the program requires us to master and to feel secure in our math because lives are at stake when we start working in the hospital. Just a single wrong unit or any wrong calculations can cost a patient’s life. In real life, this is just one of the tasks at work. Thus, we should be confident in what we do.

 

 

 

Radiography

Whenever I’m not at work, home and travelling, I’m definitely busy with my studies. Yes, I’m studying again. This time, it is relevant to my job experience (in health sector) and I can say that I’m thriving in this program. Thriving because when people ask me why I chose to take this course, I cannot help but talk about it with enthusiasm. Also, as I’ve mentioned above, this is relevant to my work as an assistant at the home nursing job that I have.

I’m studying Bachelor of Science Major in Radiography at the University College of Bergen (Høgskolen pÃ¥ Vestlandet). I just started this fall and I’m so glad that I’ve chosen this program.

Before I continue, let me tell you what a radiographer is, because most of the people I know thought that I’m going to be a spesialist in X ray imaging or AKA radiologist.

A radiographer is someone who takes X ray images of patients. In addition to that, they also perform CT scan examination and MRI examinations to diagnose for example, an injury. Depending on what country the radiographer is working at, the scope of work task is different. Like for example, here in Norway, the radiographers are very hands on to their patients and they administer medicines and etc. Unlike in the other countries, the radiographer’s only task is to take X rays and report to the radiologist.

A radiologist on the other hand is a medical doctor (a physician) and is a specialist in using medical images to diagnose and treat a disease. 

 

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In order to be a good radiographer, it is important that you know your anatomy, radiological physics and radiographic positioning. The photo above, is a photo of Bontrager’s handbook.

 

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Røntgen lab

 

This is the school’s X ray lab. I love how we can come here anytime to practice what we’ve learned in the classroom and to master the art of conventional X ray. Don’t worry, we only practice on phantoms and not on each other!

 

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Wearing my oversized scrubs

And because we are training to be a professional radiographer and health worker, discipline in the field is a must. Hence, the uniform.

 

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The human skeletton

 

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The school’s X-ray machine from Siemens

 

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Medio lateral X ray of right knee. Took by me.

Some of the reasons why I chose to study radiography is that the idea that I’ll get to work with high-tech equipments, work with patients and work with research. A radiographer is not limited by x ray/CT/MRI machine alone, but he/she also do research. Because the health sector is constantly changing.

The Bachelor program at the University College of Vestlandet is 3 years to complete and has 180 units. On the job training is included. All of the lectures and exams are in Norwegian, except for one of the subjects in the last semester (I think).

For more information about the program, kindly check this HVL’s website: https://www.hvl.no/studier/studieprogram/2017h/grr/ .