In this episode we’re finding out what you can expect at your scan appointment. 

Charlotte chats with sonographer Humera Faisal who takes you through what happens during a typical ultrasound scan. 

We cover some of the ways you as a patient are made to feel comfortable during the appointment as well as how you can best prepare yourself for the scan.

If you have any extra questions about your appointment or referral to PML you can get in touch with the team via the Physiological Measurements website physiologicalmeasurements.com

Welcome to the Physiological Measurements podcast for patients who have been referred for an appointment for a scam. I'm Charlotte Foster, and I've been taking a look behind the scenes at the head office in Shropshire, as well as speaking to members of the team, including one of the sonographers who works in one of the clinics. Now, throughout this series, I'll be finding out about who PML are you, the work that they do, and what you can expect as a patient. In this episode, I'm chatting to Humera Faisal, who is one of the sonographers at PML. I began by asking her what her role involves.

We are conducting a clinic. It's directly related to the patients. We scan them, try to make them as comfortable as possible, try to make them feel that they are being seen in an appropriate way. But for me, the thing that matters actually is the patient's satisfaction, how comfortable they feel while they come into the clinics, speaking to them and bringing their minds to ease, just making them feel more relaxed and making them feel that obviously, if they have any problems, any health problems, that that's been addressed.

So it's one of those things. Nobody likes having to go to have a scan. Patients can be a bit nervous, can't they? But what can patients do to prepare themselves for an appointment with yourself?

We do variety of ultrasounds that might need slight preparations, like in cases where people need the abdominal scans, obviously, to look at the internal viscera, including the liver and the gallbladder. We need the patients to come in fasting. There's not more than six to 8 hours of fasting that we need, and we try to make it quite clear to them that they are still allowed to have some water or maybe drink some clear coffee or tea without milk. So it's basically the dairy and the carbs that have to be avoided. If a patient is a diabetic, we often advise them to bring a small snack with them so they can have it immediately after. If they come well prepared, we'll be able to see, look at all the structures in detail and provide confident diagnosis to their GPs. Sometimes we do ask patients to come with full bladders because we want to look at the urinary bladder, or maybe for the pelvic scans in females. When we have to look at the womb and the ovaries, we need to have a full bladder in order to get good quality images and to formulate a confident diagnosis.

So Humera patients will be given a time to arrive at the clinic. How important is it that patients get there on time?

Well, that's a very important question, Charlotte. The reason for coming in 15 minutes earlier is, as we know, going to GP surgeries many times, we ourselves, we do struggle finding a parking space or finding the correct location. So it is always advisable to reach there, find a nice place for yourself, have peace of mind. So it's always advisable for them to reach slightly before their time. And we try to be dot on time.

Everyone being on the same page is really useful, isn't it? Making sure that everyone is. Both you and the patient are happy. And I also know that you, if people need some accessibility, use things such as Sign Live and Translate Now, that obviously puts you at ease and it puts the patient at ease as well. When everyone's at ease, everything's better, isn't it?

It is. Exactly. We do cater people with special needs. If they need any assistance on sign language or if anybody needs an interpreter, we always have a chaperone accompanying us. We do have them all the time, but especially for the intimate scans, we make sure that we've got the chaperone and we make the patients aware of the procedure of the instrument that we're using, as well as about the sanitization of the instrument. They are not being exposed to any germs or any infections.

So patients are going to come in for their appointment, they're going to have that letter and quite often I'm a terror for this. I'll go on Google first and I will try and figure out what will happen and find stuff out. And the Internet is not necessarily the best place to understand what's going to happen to you. So I can imagine that some people will come in with some misconceptions about things that will happen during the appointment. What are some of those misconceptions that patients have? And let's do some myth busting on this.

Right, you've raised a very valid point. Obviously we have. Many times people are concerned if they are exposing themselves to unnecessary radiation. So one thing that could be made clear is ultrasound has no radiation. It's not like an x-ray or a CT scan. It is ultrasonic rays which do not have ionising radiation. It would not cause any harm. We do take care when we are exposing the patient to any Doppler ultrasound, we don't do majority, we don't do Dopplers, but that's also the minimal risk.

And as well as people, many times patients do worry about the gel as well. So just to let them know that the gel is hypoallergenic. And there are no irritants in it. So that could be used very easily.

Another thing that's really important as well is the, is consent as well, you tell me a little bit about how you make sure that patients are consenting every step of the way.

Before starting any procedure I would say, are you happy for me to proceed? Are you okay for me to proceed with this procedure? Especially for the intimate scans, we always ask if the patient is happy or maybe confident having an internal scan. Sometimes we have elderly ladies or young girls booked in for the pelvic exam examinations, and in that scenario, we have to be extra careful asking their consent. There are many instances where we have people with special needs going for intimate scans as well. So in that aspect as well, we have to be extra careful to make them understand all the carers who are accompanying them, let them know or explain in detail what would happen and how would they react to any situation. So that is very, very important.

It sounds like this is a really patient centred experience, from what I'm understanding, from what you're saying to me, that the patient is at the core of what it is that you're doing. Is that accurate to say?

In health industry, in health service, we have to put patient at ease. And throughout my career, I have learned patient first. So they are our priority. We want them to be happy. We want them to be satisfied. And more than everything, we want correct diagnosis to get the correct treatment.

So we talked a bit about, you said about diagnosis and about results. I know that when I've gone for scans or things like that, you want to know what's wrong, basically, you want to know what's going on, and you want to understand that as a patient, what are you able to tell patients on the day of the scan?

Well, we do encounter that many times. We do try to reassure the patients to an extent, but I would always tell a patient that we just know one piece of that jigsaw puzzle, whereas the GP would know the whole picture, what's going on with them. They would know their past medical history, the medications that they are taking, their family history. We would just know just a piece. And that might not actually help the patient to an extent that rather than speaking to their own GPs, who would know the whole scenario, would be able to speak in a broad term with them. We do send the results immediately to our results team, who then deliver the results to the GP practice. And this whole process doesn't take more than five working days, so it's not a long time for the patients to wait and, you know, worry about the results.

I love what you say about how it's only one piece of the jigsaw puzzle on the day that you're having your scan and actually your GP is the person who's got the box, the cover, the whole picture as such. And you can put that piece of that jigsaw into that, into that place. And I think that's a really, really useful way of thinking about it because we do get impatient for wanting to know if everything's okay. And if it's not okay, what do we need to do next? So we've gone through the appointment, the scan. What happens next? Obviously, the results go to the GP and they hear from the GP. That's the end of it, is it?

If everything is normal, then definitely we have R A G criteria, which is red amber green criteria. The red is the high alert criteria, where we send all the results immediately and as urgent within a few hours in case the result was not of utmost urgency. I would say then we mark it as Amber. Amber result means that the result would be communicated to this GP the very same day, or at the most, the next day, in that the results are marked as amber, where patient might need further imaging or maybe a specialist review. So we do mention that in our reports as well.

What would you say the one message then to patients is that you would like them to hear from you today.

It's all about them. It's their health. PML is working to deliver the best practice in the best interest of the patients.

Thank you to my guests today for spending some time with me and sharing such brilliant knowledge. And thank you for listening to this episode of the Physiological Measurements podcast. I hope you enjoyed it and I hope you found it useful. You can find out more and get in touch with the team by visiting the website physiologicalmeasurements.com.