All Clear - A Firefighter Health & Wellness Podcast
All Clear is a podcast that looks at the perils of modern firefighters, especially the physical and mental strains we face. Our goal is to help firefighters ignite The Fire Within and to build the best version of themselves as firefighters. Our conversations are real, sometimes raw but always honest. All Clear is presented by the NC Firefighter Cancer Alliance & First Responders Peer-Support Network.
All Clear - A Firefighter Health & Wellness Podcast
Hidden Insights - The Power of Ultrasounds with guest Truman Thompson
Join us for a compelling journey into the world of ultrasound technology with our expert guest, Truman Thompson. As an ultrasound specialist with over 30 years of experience, Truman takes us through his fascinating career from the early days of radiology to becoming a leader in non-invasive diagnostics. Discover how ultrasound has evolved from a fledgling technology to a cornerstone of modern healthcare, thanks to skilled sonographers and technological advancements. Truman's insights reveal the profound impact early screenings can have, especially in high-risk professions like firefighting, highlighting real-life stories of lives saved through timely interventions.
We also explore the crucial role of expert ultrasound technicians and top-notch equipment in ensuring accurate medical diagnostics. Much like choosing a skilled mechanic for your car, selecting a qualified ultrasound technician can make all the difference in medical evaluations. We delve into the qualifications and credentials that define a true professional in the field and discuss the importance of hospital-grade equipment and HIPAA-compliant systems. Truman's extensive experience offers a unique perspective on the investment and expertise required to deliver reliable and trustworthy ultrasound services.
Amidst these serious discussions, we find a moment of levity with a humorous anecdote about measuring a snake in inches, reminding us of the power of laughter even in the face of life's challenges. We express our heartfelt thanks to Truman for his invaluable contributions to the episode and encourage you to visit the North Carolina Firefighter Cancer Alliance's website for more resources and information. Don't miss this enlightening episode packed with expert insights, inspiring stories, and a touch of humor.
I appreciate you taking out time to listen. We can only do this with your support. Please subscribe, leave us a like and good review. Also if you are able a small donation will go a long way on keeping quality content and bad dad jokes coming to you. Visit allclearpodcast.com to learn more.
Your one stop shop for graphic design, screen printing, embroidery and more. Proud sponsor of the All Clear Podcast.
Use the code All Clear to get 10% off your first order.
studioprintshop.com
Thanks for listening to All Clear!
You can contact us with questions, suggestions or just to say hi at our website
allclearpodcast.com
Also pick up a bag of our signature All Clear Coffee. A unique cup that will quickly become your new morning hero in a cup!
Please like and subscribe on you platform of choice! It dosent cost you anything and it helps us more than you will ever know!
this is all clear firefighter wellness, where we help you light your fire I'm travis happy to be here with us.
Speaker 2:on all clear, we've got a great guest today, a personal friend of mine. I've been wanting him for quite a few years now. There's some work that we've been doing together in my own apartment. We've also been doing SelectWell and a few other folks who work with the Kids Reliance. We've got Truman Thompson with us.
Speaker 4:How are you doing, mr Truman? I'm great. I'm great, travis, appreciate you having me here today. It's an honor to come and talk to you.
Speaker 3:It's always fun to get to talk to you when we see each other at conferences and our mutual friend Vaughn McAfee. He's the one that really introduced me to you and explained a lot of what you've got going on. But you are an ultrasound specialist. I'm not going to use the term ultrasound tech. I think you're a lot more than just that. So I wanted to give you the chance to talk to our audience and maybe introduce yourself. Tell us what you're up to and what we can learn from an ultrasound specialist.
Speaker 4:Okay, great, being a specialist in ultrasound, that is my chosen profession. I started out in radiology about, oh, 32 years ago, post-education, so actually I started my educational process about 35, 36 years ago and then ultrasound was a really fairly new thing, man, to the public. We'd heard of ultrasound and ultrasound and the use, of course, looking at babies and how cute. But it was at the infancy of ultrasound and uh, you know, as I was already in the radiological field performing x-ray and cat scan and those type of ionizing radiation types of exams, one of the radiologists came and said hey, let's talk about this ultrasound thing. And that time there were no ultrasound schools. To be an ultrasound person you had to have a sponsor who was a doctor that would vouch for you and say you're worth that time investment to learn ultrasound from the ground up. And actually we had a few discussions and we dreamed about how ultrasound would progress in the future. And he's told me, hey, if you get in on ultrasound you're going to be like on the grandfather of ultrasound in 30, 40 years. And he was right, because the earlier you get into a profession, obviously you start out at the ground floor level and knowledge is accumulative. You build knowledge over time, much like your own profession. If you're starting out as a newbie your knowledge is more limited. But as you progress through the ranks and over time your knowledge accumulates and you learn more and more in how to handle different situations. I started in ultrasound basically in 1994, progressed on and started my first full-time ultrasound job in 1998 with Healthcare Corporation of America and from there ultrasound has simply grew and grew. With that we want to keep in mind. Computers were far different 32 years ago. It wasn't the kind of high-tech computers we have now. Ultrasound machines have progressed also. They're just very specialized computers. So during the course of the past 30 years the ultrasound machines have progressed, the knowledge has progressed. Until now we see ultrasound in every hospital in America.
Speaker 4:Ultrasound is a leading-edge technology for early detection in many disease processes and that's because it does not use ionizing radiation. It uses a little cold gel and you lay on a table, but it's relatively harmless. Overall it has no harm factor and you can use it with any 115 volt electrical outlet. So you don't need a special electrical requirement like what MRI and CAT scan. You got to have some really specialized power sources for that. So ultrasound is quite portable. It's quite easy to use, but it is 100% dependent on the technologist that's operating it.
Speaker 4:Ultrasound is not one of those types of technologies where a machine does all the work. All the work is actually done by the sonographer. His knowledge base or her knowledge base is how you get a good result or a good study. If they don't have that knowledge base of what to look at, how to look at it, this looks funny. Let me interrogate that more. Let me change my angle, change my power, optimize my image.
Speaker 4:If they don't have that base knowledge and that acute knowledge of what to do talking to a person, gain some insight into their personal history in a very quick manner, in a matter of minutes, and understand what you should be seeing versus what you are seeing. Does that match up logically? And the ultrasound person is 100% in control of the ultrasound. The radiologist gets the pictures we give them. They're dependent on us to find that information. Do those pictures correctly, alter our machine in ways that will make the picture optimized and then present that to the radiologist in a way where the report is written and structured so that the radiologist can understand not only what I saw, how I saw it, what is it pertaining to so they can make that medical judgment that I need to tell the patient this.
Speaker 3:So I guess to encapsulate all that, you've got a huge amount of knowledge on this. You've learned a lot and you just taught me ultrasounds are not just for babies anymore.
Speaker 4:Basically, they are not.
Speaker 3:My first experience with an ultrasound is when my son was before he came along and my wife was getting the ultrasounds to check on his health and all that. And then I got introduced to this idea about, hey, as an adult, there's things that we can use an ultrasound on to determine as well. And I had my first ultrasound as an adult about three years ago when we were doing our department physicals and they found, when they imaged my heart that's all they were doing at the time they found a valve that was mildly leaky. I was told that, eh, you know what? That's pretty common, most people have it. You may never notice it and then move forward.
Speaker 3:And the following year that's when I met you, when SelectWell was helping set up our physicals, and boy, you did a thorough ultrasound, top to bottom, and I will share my story because I think it bears some importance.
Speaker 3:You found, when you imaged my heart again, you found yet a second valve that showed some, some deficiencies nothing life-threatening, but it was enough of something that you're like, hey, this is something you might need to look at. And then you gave me the information that I was able to take to my doctor that I've been going to for 25 plus years and Dr Roy Croft looked at it and said okay, it's a thing. You're not showing symptoms, it shouldn't impact your work, but we'll watch it. So through my meeting with you, truman, I was able to find out something about myself. I didn't know, and one of the things that our department, where I work professionally here in Concord, north Carolina, is the fact that we've incorporated that as a regular thing for specific firefighters as they get to a certain point, as they get old. I'll just leave it at that like I am Older.
Speaker 3:So when we talk about the value of the ultrasound I've made some notes here what are some of the areas of ultrasound that can be beneficial? What are some of the things you're looking for? I know you mentioned it's not just for babies anymore, but I know in my case you looked at our heart, but what other things are you looking for other than, just, say, a heart valve or something like that? What are some of the things you look for when you do an ultrasound, maybe specifically on firefighters?
Speaker 4:Specifically when we're doing firefighters and the 1582 type of ultrasound program, we're doing as you say, I do a top to bottom scan. We look at your thyroid and we're looking for thyroid nodules there, that evidence that you may have hypothyroidism or hyperthyroidism and large thyroid or hyperthyroidism, enlarged thyroid, and we check all that soft tissue there, including the surrounding structures, because there are some firefighters that are like, oh wow, look at that lymph node over there, it doesn't look exactly right. And our neck? There's also hundreds of lymph nodes and I have found some lymph nodes in your area of North Carolina with some of your firefighters that have had to have them surgically removed because it was being by their medical professional. That lymph node may have some issues. We need to get that out of there and address that issue.
Speaker 4:So we start there in the neck. We also look at your carotid arteries and what we're looking for there is the carotid arteries. We're looking for plaque, atheromas, any kind of blockage or stenosis that could slow down or impede the flow of blood from the heart to the brain. Everything goes through the neck to get to the brain. If the blood can't get through, it doesn't go through and that would be the equivalent of having a plug in your fire hose. You got to get water out that other end. If there's something in there blocking it up, you're going to have a deficient strength flow. So we check that and then I move down to your heart. And with the heart it's also tied into the carotid. So your vascular system, your heart, is the pump. It's pumping blood to all parts of your body. However, even if the pump is working 100%, if your heart's 100% clean, 100% efficient, it needs those conduits to your body to also be efficient. And with that there are certain things in the vascular world, such as what we call Winn-Kessel effect. I'm checking the effect of blood passing through your arteries to see if it's moving in the normal fashion.
Speaker 4:As we age and all of us do age, unfortunately we start to lose some of that Winn-Kessel effect, and Winn-Kessel is the scientific name that's used for how blood passes through a certain point in an artery, and it has a certain way that it does that. That's why blood can go from here to your head and not destroy the brain tissue, because there's only this much room, but it's got to pump from here to your toes at a higher pressure, so the pressure is not the same throughout your entire body and we need to understand that on a vascular level, is the blood making the proper movements through your abdomen, through your legs, down to your toes to get that blood down to your pinky toe or your little toe? And also, is it moving appropriately to go a short distance to the brain without destroying the tissue in the brain? Because that's only eight or 10 inches above the heart, but high pressure would just give you a big stroke. So there are certain things in your body that determine how that blood flows. We look at the heart, I'm looking at the vessels there. I move down into your abdomen, I check the aorta, which is the main vessel coming down to your navel and then it splits to each leg and we're checking those.
Speaker 4:And this coming year because I want to be more into the vascular tune of a person we're also going to start to do some evaluations through the legs and not just stop at the lower waist. We're going to go ahead and continue that evaluation into your legs, checking the flow, checking for peripheral artery disease and, because that's tied in all of your arteries, tie into how well does your overall circulation work. It's okay to get the blood down to the toes, but it's also got to come back up to the heart. If the heart cannot receive blood back, it cannot pump it out again. So this is the circulatory system and for simple math we'll just say you got 100 drops of blood in your body. Obviously you have more than that, but we want to stick with a simple terminology If my heart pumps out 100 drops, it needs 100 drops back in order to pump it out again. So we want to make sure that circulatory system is working, not only going out but coming back to the heart and in the abdomen I also check the inferior vena cava, which is the conduit back into the right side of the heart. We want to make sure that flow coming back into the heart is appropriate and there's easy things I can do to check that inward flow into the heart to make sure that it matches the outflow from the heart. So when I go through this 1582 physical, as it relates to our vascular system, I check your heart, I check your aorta, I check your carotid artery.
Speaker 4:I'm going to now be checking the blood flow in the legs, checking that arteries down into the toe, and we're going to make sure the reverse circulation is pumping back into the heart in a normal fashion or if it's abnormal, we'll bring that up to first patients' attention. They'll discuss that with their doctor. Then we're going to stay in that abdominal space and look at the soft tissues in there, starting with the liver. We're going to check your liver for any signs of hepatic steatosis, which is a common factor in that today, because of our dietary habits here in America, hepatic steatosis is when we start to accumulate a fatty liver which can cause pain. The liver, if it gets more than 5% enlarged, causes pain and stretching in the liver capsule. So we check that to make sure. Is that liver becoming fat what we call fatty common term or is it normal? We look at the texture of the liver. Are there any masses, lesions, anything abnormal inside the liver? Check the blood flow into the liver, such as the portal vein. If you have an impedance of flow from the body through the liver, the blood is routed through the liver because that's part of your metabolistic system and we check that flow of blood in there to make sure it's flowing properly. We'll check your both kidneys. Check to see if there's any lesions. There are lesions.
Speaker 4:I have found here in Arizona a fireman we won't mention his name, although we have permission to do so. We found that on his kidney, which is a little tumor. We found it at two millimeters, which is very small. Two millimeters is a very small tumor. And this was a person who was basically a triathlete. He runs, he jogs, he runs marathons. This is a very, extremely healthy young man who was in his I believe 38 when I met him.
Speaker 4:But we found that Uncle Sartoma. We found it in October. We got him sent out to a specialist, a cancer specialist. They worked him up immediately. By December they had excised that Uncle Sartoma and sent it off to be biopsied by the professionals and therefore he now I saw him this year, actually at a conference, and we met and we discussed how was he doing. He was very thankful because he had young kids and family, much like all of us, and now that thing's gone, he has peace of mind. He's going to see that is not going to be an issue in his life and, like I told him, you got rid of it, it's gone. Have a good laugh about it with your family and all that. Give it a name and laugh about it. But it was a small, two millimeter tumor. Early detection was the key thing there, because many times the oncologists tell them they're silent, they don't cause any problems.
Speaker 4:Until you have an issue they can become cancerous and then from there your outcome can be far different than just having a funny story to tell on the porch when you're older. So we want that early detection in all cases to be the rule. It's not always the rule. Sometimes I meet people that's beyond early detection. But the key here is early detection. That's what gives you choices. You get to make choices with your doctor for your family and decide what's best for your lifestyle. So after I check those kidneys and we check your left spleen, we check your spleen to make sure it's not enlarged. The spleen and liver are closely matched together. Typically, if you have a liver disease problem, you will have a spleen disease problem, and that's because they're closely linked.
Speaker 4:Your spleen provides blood immediately into your liver.
Speaker 4:Your spleen is part of your immune immune system. So it's very important. And then we check that spleen also for soft tissue damage, lesions, anything we can find. And then we're also going to move south of that. Going up the bottom, we're going to check if you're male. We're going to check your urinary bladder for any lesions.
Speaker 4:Prostate cancer. Last year I found a young lady who had no symptoms I'm sorry she's not a young lady, she's a middle-aged lady had no symptoms whatsoever. We found a very large bladder cancer on her and fortunately we were able to get that excised right away. We got her to see a specialist. She got that bladder cancer out at an early stage where they could take it out and still save her bladder. So that made it a lot better for her. Instead of losing her bladder and having a urostomy bag, she had a surgery. It was gotten taken care of. And then of course, she goes through the monitoring process to make sure she's okay after that, because with all cancers, your doctors, they're going to put you in a little bit of a monitoring program to check you afterwards. They're not just going to take care of and throw you away. They're going to monitor you and make sure everything stays good.
Speaker 4:So we check your bladder as a male and female. We check your prostate. Obviously, for males, we're looking for any nodules or enlargements. It's common for males, as we age our prostate gets a little larger. The typical prostate is about 25 cubic centimeters. But as we age it gets larger and that's just part of life for us as a male. But, however, we want to make sure that enlargement hasn't gotten too far. If it has. There again, early detection with that can lead to a lot of inhibiting problems such as urinary retention, other issues that can affect your urine and your bladder and your kidneys, because that's all one system and you go to your doctor. They have many wonderful treatments for that nowadays. And then for males, we're going to move a little further south and check your testicles. We're going to check for common things like hydro I'm sorry I can't speak today hydro to make sure there's no fluid in the testicles, which is a common male problem and that happens and it's a pretty benign finding. But we're looking to see if there's any testicular cancer, any tumors on the testicles, any tumors in the epididymis and anything abnormal in the testicles.
Speaker 4:For females. We're checking their bladder, we're checking their uterus and ovaries and we're doing a basic GYN study on females transabdominally to check the endometrial lining. That is one of the key things for ladies is to make sure the endometrial lining is homogenous, which means it's all one even layer and that it's of the normal thickness for your age and menstrual cycle. Having an endometrium that's too thick for your age and menstrual cycle line can be an indication of endometriosis or any kind of endometrial disease process. We check the cervix, make sure there's no lesions in the cervix and we check the ovaries as we can see them.
Speaker 4:Sometimes we can't see the ovaries trans-abdominal, but 90% of the time we can if a person's fasted properly. Most of these exams are very dependent on the patient fasting properly so that we can get rid of any overlying gas and fecal matter. We can see in there quite well with the ultrasound if the person's fasted really well and hydrated properly, and that's pretty much the focus of our 15-day tube physical. With that being said, if a person has something personal, they tell me about that. Hey, I have a history of this or that. I'll investigate that also.
Speaker 3:You just said a ton there.
Speaker 4:Yeah, it's quite a bit.
Speaker 3:And I can't explain enough to our listeners how important every bit of what you said was. One of the big focuses that has been a drive of the North Carolina Firefighter Cancer Alliance for a long time is cancer and we've always known the things the respiratory. We know about, skin absorption, we know about all these things. But when you really start breaking down and looking at what the outcomes are, when you start talking about okay, yeah, we know how we're being exposed to it, but what's it actually doing to us? And when you start talking about the liver, you start talking about prostate, you start talking about all these things. You really start to understand how big the cancer problem is in firefighters in our industry.
Speaker 3:But when you're doing all of these exams and different things like that, I know you find a ton of things that, like you mentioned, some are way out man, you need to be looked at sooner than later. And then some I'm like, hey, let's just watch it. How important is it from information that you gain that you understand from your imaging? How important is it that be transmitted to the healthcare provider that firefighter may have, whether it be their family doctor or the doctor that the department uses? How important is it that information be transmitted?
Speaker 4:I think all of it is important and the reason I say that is what is the value of a human life? We tend to place a lot of value on that. What is the value of the quality of that human having a life? And as I say so when I do, yes, I am focused on cancer because of their implication of cancer in firefighters having a higher percentage of cancer incident versus the normal population, and some of the data. Of course, we all can talk about data. 12 percent of cancer in america is about 150 um. So we know these statistical data, um. We also know that every now and then you're going to have that one like way out there person that I do babies, I do a neonatal, all sounds all the time.
Speaker 4:Yes, children do get cancer and they're not even adults. We know that. We see the commercials from St Joseph's. We know that children can get cancer, babies can get cancer, anyone can get cancer. But, however, when we look at the general population male to male, just the average guy, average female we know they're firefighters because of some of the things you guys come in contact with hazardous materials, such as the firefighting foam you use. That's a very known. It's a known cancer agent. It can help lead to cancer.
Speaker 4:So you guys and ladies are taking risk for us, the society, and you deserve to have the best possible outcome from your physicals. So knowing that high probability, higher probability of the average person versus Joe Blow on the street, is very important. We get that data, give it to you and your medical professional so that early detection becomes the norm, not late detection. So I consider, even though I'm focused on cancer, I consider the entire health of a person because, let's be honest, no one gets out of life alive. We all, as we get older, develop something, but most of us. That's why we have insurance, that's why we go to medical exams, because we want that early detection. We don't want to find out, travis, had you come a year earlier, we maybe could have helped you. That's the one thing you don't want to hear. You want to hear wow, we found this early, we're going to take care of it and you're going to be fine. That's the statement that you want to hear. So, with that being said, all of your health is important. Giving that information to our medical providers the fire department uses is just the first step, because that information is then going to be passed on to your personal provider or the specialist that you're going to go see afterwards, if that's necessary. Having that channel of communication also means that one from the ultrasound perspective. We did a thorough exam and the exam we do is going to be the same as what I do at the hospitals and at the specialist.
Speaker 4:I'm not going to take shortcuts. I don't believe in shortcuts. I'll never take a shortcut and sometimes that means I'm going to run over schedule. But it's important to your life. It's important to your wife, your children, your family, your fire department unit. You are an effective person when you are healthy for everyone involved and we're going to make sure that happens the people I part with SelectWell and other people I part with. That's their key focus. It is cancer detection, but overall health. That's why we check for more than just cancer. We're going to focus on cancer while, but overall health. That's why we check for more than just cancer. We're going to focus on cancer while checking your entire health altogether, and the fire department, of course, understands that, and they add in other things also that are semi-related to health as well as cancer. So how important is it that we get accurate detection? Give that information to you, let you pass it on to your provider, to your doctor, to your specialist. It's 100% important.
Speaker 3:All of that is very true. But I think you'll probably agree with me when I say this, and I'm speaking from my own experience on this one that kind of intangible factor that you can get is when you know that, okay, my heart's been checked, my liver's been checked, my prostate, whatever the case is. And when you go to your doctor in fact I know when I went to my doctor and presented the packet that I got that had all my blood work, the ultrasound he's my goodness. He said if everybody got this done, there would be a whole lot less problem and a whole lot less disease that we would see. And I do think in a lot of ways, when you work for certain departments, you are blessed that you have additional screening and that's one of the things that we reach out and try to do is encourage departments to look at more advanced and more comprehensive physical steps, such as chest x-rays and the ultrasound and things like that.
Speaker 3:But that intangible knowing, okay, there's an issue, I found it, let me go talk to my guy. And when the doctor looks at it he's like you're okay, let's watch it. Or if it's okay, you have an issue with your thyroid, let's go get it. Let's go get it looked at, let's get it fixed. When you have that in your back pocket, knowing that you have done everything within your power, it's easier to rest assured when you do your job and things like that. But so I know that you, like I said, I met you through SelectWell and I know you work with a lot of different folks across the country. But let's say there is a department, there's a training chief, there's a chief officer that's listening right now that's maybe responsible for doing the physicals for their department start including the ultrasound as part of their arsenal of tests and things that they're providing. What is a good source that people can find quality ultrasound technicians, ultrasound services, what's a good way that and what should they look for when they're asking questions to folks that maybe present those services?
Speaker 4:The first thing I should look for is someone who has the type of experience that can be well-rounded, but what is the focus of? We'll just say that person's focus on cancer or it's focused on cancer and well-being. So the first thing I should figure out is what do we want to focus on? Do we want to focus on all the body parts? Do we only want to focus on cancer and make sure the sonographer has experience in that level of ultrasound? There are a million ultrasound people in America. There are a million firefighters in America, but every person is not the same.
Speaker 4:It's much like going down to your local mechanic shop to get your car fixed. There's some that can. They can take a wrench and a lube job and make your car run like a F1. And there's some that maybe can't do that so well. It's important to understand the experience level of the person that you're going to have through the old salesman. So I want to start with some basic things. Are they registered? Okay, we have several different registry programs here in America. The Register of Diagnostic Medical Sonographers has been one of the most prevalent and widespread, and so, in other words, it's like a license to drive.
Speaker 4:Do you want unlicensed drivers driving around with your family on the road. You really don't. You want them to at least have a license, so that way you say someone's vetted them and said they have the basic skills. So you want that as well. This is your life, this is your family's future, betting on you being healthy to take care of your family. So you don't want an unlicensed person just doing your ultrasound. You don't want a person who at some point and I've had people say to me well, isn't there someone local here that can do this? There may be, you'll have to find them. Is there someone local that has my experience level? There may be, you'll have to find them. Is there someone local that has my experience level? There may be, you'll have to find them. Is there someone local that has my experience level that's at a comparable value as myself? There may be, you'll have to find them. So with all of this, you can't just say I'm going to pick a person out of the pod, have them do these ultrasounds and I'm going to feel good about it. That ultrasound person, are they registered? Registered would be step one. If that person's registered, then you want to say what are they registering in? Just like I have a seat driver's license. I can't jump an 18 wheel and drive it, but I can drive right. So you want to make sure that I'm registered to drive the thing that I'm driving. You don't want me in an 18th wheeler. It might turn out to be really bad for everybody else on the road. So you want to make sure that I have a license to drive the type of ultrasounds you want.
Speaker 4:So I have several. I have four. I'm registered in diagnostic medical sonography, for abdominal, for echo cardiographers, I have one for abdomens, I have one for heart, I have one for vascular technology. So I have three or four registries. And then I'm a registered technologist in radiology. With that being said, I have four registries over several different subspecialties and I've worked in every setting. There is hospital, outpatient surgical, neonatal, obgyn. I do vascular specialty for several large companies where I conduct their surgeries. I conduct their surgeries on arteries and veins. So I have a lot of experience and I even have some background in neuro. I used to work at a mental facility. It was fun. I was like, hey, you want to learn neuro? Of course I do. I'll learn anything, just give me a chance. So I have a very eclectic background in these things.
Speaker 4:So you want to make sure that ultrasound person A is registered. There's the basic registry, which is registry diagnostic medical sonography At least they need to have that at a minimum. And then from there, if you're concerned with vascular health, they need a RVT registering vascular technology because then they have a license to say I have been vetted, I know vascular medicine, I know vascular ultrasound and I should have the basic background to check those things out for you. So you want to make sure this person's registered and some registries. You want to make sure. Do they have some experience in what you're wanting to know? Do they have experience in finding cancer? Do they have experience in health backgrounds? How to talk to the person, find out their health background quickly and then apply that through the ultrasound. How are they going to record these images? Because taking a picture on my iPhone is not the same as if I had a nice Hollywood setup and I'm taking a picture there. There's different qualities to taking pictures. Now, with that being said, there are different ultrasound machines as well. So you want them to have a reasonably modern ultrasound machine that's connected to a PACS, which is a patient archival communication system.
Speaker 4:So when I come out to your place and I do these ultrasounds. I feed those images into a PAX. It is a hospital-based grade PAX system. Those images are not just something I've put on a thumb drive and stuck on my computer. They feed into a hospital-grade PAX system where it's HIPAA compliant, secure, and then from there I can construct a report. This report is the same as you would get at any hospital.
Speaker 4:All of this requires, of course, investing in these technologies so they can work for you, the patient, not doing something on a cheap basic level, where I come out and I shoot a bunch of pictures and they're on my thumb drive. I lose the thumb drive. How is that thumb drive secure? Do I drop it and some guy picks it up and says, oh, what's on this, and stick it in his computer and he's got all of you's images? No, you want to know.
Speaker 4:This is a HIPAA-compliant system, it is secure and I store that data for a minimum of seven years. So if I come out and do a physical this year for seven years, I can reference that longer if I need to and I can reference the images. I can reference the report and then the providers have the ability to log in and look at those images your provider, if I so desire, you so desire. More specifically, I can give them a password. They can log in, look at those images. If you happen to go to a specialty clinic or whatever, I can give them a password based on your permission set and I can let them look at them. So this is a completely shareable type of imaging system where anyone in the world can be given access. Log in just like you would log into your email anywhere in the world.
Speaker 4:Look at those images, say, oh, I see what we're talking about. Or oh, I see the report and I agree. I disagree. Whatever the provider needs to do, so it's important that A they're qualified to do what they're saying they're going to do. Two, are they licensed to do it? Three, how are they storing your images? What are they doing with the images now that they've made those images, and how can they share them with the next person? You need to see Because, god forbid, if we find something serious, you're going to need some follow-up.
Speaker 3:How are we going to scale that image? And I think you hit on a lot of stuff that is so important right now Data sensitivity, HIPAA, compliance, that stuff that I had never even thought about. I was just thinking about all right, here's a guy that knows how to do abdominal imaging. No, you need a lot more than that.
Speaker 3:You need to understand where it's going. How it's going, what's going to happen? So now, if we do locate folks that are qualified for firefighters in our industry in particular, like yourself, what if? I know budgets and money drive a lot of things in all industries, but if they do find a service that they're comfortable with, that's competent and able to do the imaging? If a department can only afford to maybe do a partial panel of imaging, what would you say are probably the top three things that a department should think about? If they can't afford or they can't work out being able to do a head-to-toe scan, what would be the top three things that you would recommend that a department talk to a ultrasound tech?
Speaker 4:about. I'll start with the first thing, which is not one of the three things you mentioned. Affordability many times hinges on the number of people we're going to look at. Clearly, if I'm coming to look at five people, there's not a lot of fat that can be cut because there's time involved. The more people that are scanned at one time, the cheaper the service can be. And the reason why is now you can fractionalize that cost to come there. If I have to come there and I'm doing 10 people, how much can I cut off the cost of it? But if I'm doing 100 people, I can start cutting some costs. Now, because it's fractionalized from 10 people to 100 people, the cost is spread out. With that being said, the more people this is just like Walmart the more people I do, the cheaper I can make per person.
Speaker 4:When you look at cost per person, it's easy to say okay, we need to make this worthwhile for all parties involved. We need to have some minimum involved so this can be economical for the department to pay for. Also, there are people who have HSAs. They have money in their health spending account where, if the department says, you know what, we can't pay for it all, but maybe we can pay for half and get you a discount. Are you willing to pay that other half with your HSA, which is money you've already of course we know how that works paid into the government? Blah, blah blah. It's there for healthcare reasons, so part of that cost can be absorbed by an individual's HSA or insurance in some cases also. So sometimes you can say okay, the department can pay for this segment If you'll pay this part as HSA, and then your insurance, your private insurance, can cover X. So there's ways to fractionalize that cost. It doesn't always have to be where the department's paying the whole 100%. There are ways to make that economical. Depending on how many people are being done, it can be done on an economical basis. So, with that being said, if you say to me how are the top three things you should do?
Speaker 4:Thyroid, and the reason I say that is because they're cancer-causing agents that firefighters come into contact with the heat. All the factors, thyroid is one. After that I'm going to say heart, one of the cardiologists I work with. He says the problem with first responders is they're addicted to adrenaline. And the reason I say that you're sitting out there at your station everything's calm, you're just having a great time. The buzzer goes off. Now it's all hands on deck. You're getting hit with adrenaline, adrenaline, adrenaline. You're running, you're going, your heart rate's elevated, you're hyped up, you get into that tunnel focus mode. Adrenaline is now controlling your body for a short period of time that's going to make your heart rate elevate, your blood pressure elevate. We all get what adrenaline does to you, but that's a killer on the body. Your body is not really designed to be under adrenaline stress for long periods of time like you guys and ladies are. They can affect your heart, they can affect your heart valves. With that, dietary things that we have in America affect your heart, affect your valves, affect your circulatory system. So thyroid heart. Next after that is, I'm going to say, your abdominal organs.
Speaker 4:As much as we like to focus on prostate cancer, if I have to pick between your abdominal organs and your prostate, I'm going to pick your abdominal organs. There's a higher, much, much higher rate of disease process in your liver and kidneys than there are prostate. Prostate is very important because people do. Obviously, my father died from prostate cancer. My father, grandfather died from prostate cancer. Prostate health is very important to me. I have all the markers for that. I get mine checked regularly because I have such a heavy family history of death and prostate cancer. So it's very important to me. But if I had to pick on myself between getting my prostate done or my liver, I'm going to get my liver. You know why your liver digests everything you eat for your entire life.
Speaker 4:It's your filter it's your filter and it's filtering every single thing you eat or drink. It is designed to be regenerative. The liver can take a lot of damage. It's designed to. It's one of the regenerative not telling your skin. Obviously, our skin regenerates. It sloughs off skin all the time, but your liver can regenerate as long as you don't damage it more than 70%. It's super, super important that liver is healthy, because when you have an unhealthy liver, your whole body is going to be unhealthy. If it's not working properly, you're going to develop a problem with your lifestyle. That's going to affect your lifestyle. I would say thyroid, heart, abdominal organs, which is your liver kidneys, gallbladder. I checked the biliary system. We make sure there's no biliary lesions or biliary problems.
Speaker 3:So those three things are the most important, in my opinion, from a sonographer's position that that is something that's huge to look at is what works for one department might not work for all, and it is important that you have a plan going into it and you don't just throw the dice and say we're gonna do these three organs and we're going to call it. Sometimes you have to look beyond that and sometimes, sadly, money does drive the decisions that have to be made when it comes to things like that. But it's good to know that even a few small exams can pay off in huge dividends and huge benefits can pay off in huge dividends and huge benefits. But in your time I know you've been working with firefighters for quite a few years here recently what would you say that you can talk about? I know HIPAA and things like that what would you say is probably the biggest save or the biggest thing that you found that has had a massive positive impact on a firefighter's life?
Speaker 4:As I mentioned earlier, we did find an onco-sartoma on a young man in Arizona. That was pivotal for him having a better outcome. So that was one Recently, this year, we found a young man, a very young man, actually had a stage for hydronephrosis in his left kidney, which the process of hydronephrosis in a kidney and what should be a 20-something-year-old man is. How did he get there? You have to always say how did he get there? Okay, things don't just happen. Yeah, age happens, we get older, we can't stop that. We get that part.
Speaker 4:But when you look at the disease process, why does a 28-year-old man have a stage 4 hydronephrosis in his left kidney? So man have a stage four hydronephrosis in his left kidney. So of course this person was immediately sent to hospital, followed up immediately with specialists and so forth and so on. Because the risk of that is this young man could lose his kidney conceivably. If it's something going on there, disease processes generally just don't appear out of thin air. Something is a causative agent. With that being said, I've had men in their 20s who have severe heart disease. That was why would a 28-year-old man and this is speaking of someone in Arizona, young man, very fit, very physically fit to look at him like. This guy is like a Grigodonus. Why would he have any heart issues and he's got this terrible heart situation going on? Of course we got him sent out to a cardiologist specialist, blah, blah, blah. But here we should not be seeing that in a 28-year-old man who is so physically fit.
Speaker 4:A lot of the firefighters, especially young ones, are very physically fit. They work out. You guys. Most firefighter departments have a workout program. They keep the guys fit because it's a very physical job. You're not just walking around, you guys are putting on a lot of equipment and running into fires and saving property and lives. So it's a very physically requiring job.
Speaker 4:So those are some that stick out to me. Like right now In the North Carolina area, like I said earlier, we've had some people that had some nodules in their neck. That was very concerning and over the course of the past year they had to have a surgical assay because it was their family history and it was very concerning to their provider enough that it needed to be surgically removed. So we do find things like that. I'm always. I don't ever want to find anything like that, but I'm glad I find it because that gives you the chance the patient that gives you the chance to decide what's best for your life and to make decisions earlier rather than later, and to make decisions in your health care, while you're able to have the time, the luxury of more time, to decide what's best for you.
Speaker 3:So those are some of the things that just jumped to mind right away, truman you truly do see the unseen when it comes to what's going on in our bodies with our processes and things like that, and I know today's been a pretty deep dive with some really technical stuff, but it's very important that firefighters hear this. I know some people might've snapped off the radio or not a radio turned off listening 15 minutes ago because God the radio or not a radio turned off listening 15 minutes ago.
Speaker 3:Because God this doesn't affect me, but genuinely, as we get older, even as humans, as we get older, the more knowledge we have about what processes are going on in our body, the more beneficial it can be for us and, like you say, it buys us time to be able to make decisions that will affect us long-term, because none of us are doing this just for ourselves, because I myself I've got a wife and a son at home and I do this for them. Likewise, I know you've got family that you do your job for, and if I can't do my job, I'm letting them down. Likewise, if I get sick and something happened to me, I'm not able to care for them and they'll be the ones that suffer. And it's very important the work you're doing and folks like yourself around the country that are making this effort to try to help us understand what our conditions are. And again, personally, I want to say thank you for helping me figure out what all is going on with me and that's helped me make changes and smarter decisions in how I live.
Speaker 3:I am by no means the Adonis that you were talking about. What I do. I think I'm good for what I do, but I always want to be better and diagnostics like y'all's are what do that. But if folks want to find out more about you, truman, and the things that you do and maybe some other resources, how can folks learn about you or get in contact with you?
Speaker 4:They can always contact me directly and my cell phone number is 702-789-8096. They can also contact me by email. I'm always willing to work with any group of people at any time. I'm passionate about what I do, I love what I do and I've been doing it a very long time. And they can contact me by email at truman7atoutlookcom. That's truman7atoutlookcom, the number seven, not the word, and they're welcome. Want to make sure, cause there's two kinds of seven truman7atoutlookcom. I'm also always willing to work with.
Speaker 4:There's a lot of volunteers in your area, smaller departments, and many times I can piggyback those smaller departments onto bigger, what we call runs, bigger runs when I come through the area and I'm in that North Carolina area four or five times a year, and these are things we set up in advance. It's all done in advance, scheduled in advance. We know exactly how many people we're going to do, what days we're going to do them, who's coming at what time on what day, and those smaller departments that may be out there that say we don't have a big budget. I'll work with you, we'll get it done. I want everyone to receive the benefit of a healthy life. I want to be healthy, I want everyone to be healthy, and if I need a little thing I can do to make that happen, I'm always willing to do it, not only myself, but those I partner with. We are into helping other people. That's why we do this. So if there's a small department or a volunteer department that can reach out and contact me and say, hey, we don't have that big budget, that's fine, you don't have to have a big budget. Are you willing to just work with me and let me work with you? We can make these things happen.
Speaker 4:We can get you a strong physical program set up that involves ultrasound and I'm speaking strictly for ultrasound right now at this point. I can come in there, do your ultrasound, make it thorough, make it complete, have my provider or your provider overlook that information, give you best scenario indications for what's best for your health, and all of this I can do as long as you give me a room that's somewhat private, an electrical outlet to plug into and a table. Many times we'll just use a massage table that we have in the area. We'll bring that massage table, set it up with a little string, get you in, get your people behind there, scan them all. Typically, I tell people I can do a full body scan in 45 minutes an hour at the most.
Speaker 4:If we start running into some issues that we need to investigate further, and that's because I've set up a patented type of system where I can do this quickly and efficiently. It's normally not something that most sonar grids can do that much scanning in that short period of time but after doing it for years and years, refining the process much like anything, get it down to an efficient way to do the scan where, as long as everyone has done everything they need in advance, we can zoom those people through there and get them done quickly, easily and efficiently and get that information over to the appropriate provider to give them what is hopefully going to be a good bill of health. It's very comforting to know that you had things looked at and everything would be fine.
Speaker 3:Truman, thank you for that, and we will have your contact information available on our website so folks can reach out to you, learn more about you and what you're doing. And thank you for taking time to be with us today. But before you go, I don't know if you've listened to our podcast much, but I do have a question I wanted to ask you real quick before you go Do you know how to measure a snake?
Speaker 4:Well, let's see how to measure a snake. Well, let's see how to measure a snake.
Speaker 3:Yeah, how far he is yeah, that's true, but I learned today that you have to measure a snake in inches because they don't have feet. Oh my God, that is my terrible dad joke. I had a friend of mine, maddie Pless, and her sister, elizabeth, tell that to me today and I just wanted to share that and I thought it was funny. And everything is so serious these days. A little laughter goes a long way Again.
Speaker 1:Truman, thank you for taking time to be with user wellness. All clear is presented by the north carolina firefighter cancer alliance. You can find out more about us at all clear podcastcom. Leave us a message. We'd love to hear from you. If you like what you hear, tell someone. All opinions expressed on the podcast do not always reflect the opinions of the podcast. As always, light your fire within.
