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October is Ultrasound Awareness Month. Because 60-70% of HLHS cases are diagnosed in utero by ultrasound, the ultrasound sonographer often plays a crucial role in a family’s HLHS journey. Earlier this month, we shared Part 1 of our interview with Kate Praska, RDMS, an obstetrics (OB) sonographer at Mayo Clinic. Below, she tells us about the training, challenges, and what keeps her interested in this exciting field.
What got you interested in this job and what keeps you interested?
My first job was mainly in OB and then I worked in a high-risk clinic, which is where I became passionate about the heart. And the job is still really challenging, but yet it’s rewarding and fun! The majority of babies are perfect and it’s a blast. Even when there’s something minor that means they need to come back for another scan, it’s like, who doesn’t want to come back and see their baby again? I have an ultrasound picture of my 28-yr old son, and he still looks like he did in the image!
What’s also changed is that people used to come in and not say very much. But now the job has really changed into more entertainment. People want 3Ds, 3Ds of the face, 3Ds of the legs, they want to know why their friend got a better picture. And I do want to make that exam fabulous for them! When I have a fun patient come in, we have a blast! But if I have someone making a lot of demands, or if I need mom to be on her side so I can look at the baby and she’s complaining about not being able to see the screen, my first and foremost goal is that I want to make sure that anatomy is ok. That’s what I’m there for. But I wouldn’t be in this field if I didn’t love it!
What kind of training does a sonographer need?
I graduated in 1989 and have been scanning ever since. Back at that time, one would have gone through x-ray training for 2 years and become registered. Then if you wanted to specialize in ultrasound, you would go back through a one year program that was strictly ultrasound and then become registered. At that time, it was a nationally certified program, so you took your national boards. We didn’t have computers much then, and I had to drive to Chicago to take mine! And now it has progressed to a bachelor’s program.
What’s the most challenging part of your job?
The hardest part is the position of the baby. Ultrasound works using sound waves, and it’s helpful if you can go through fluid or get close to what you’re taking a picture of. But if the spine is facing up and the heart is down, then it can be very difficult to look at the heart. So we’ll flip patients around to try to get the chest of the baby up so we can get a better look at it. It seems silly when we ask people to come with something in their bladder, but it acts like a window for us and takes the bend out of the uterus to help us see better.
If a patient weighs 300 pounds and I’m trying to look at something that’s as big as my thumbnail, that can be hard. We can sometimes push into the abdomen to get closer and see better, but that’s understandably uncomfortable. But if there’s six inches between the baby and my transducer it can be hard to see the baby’s heart. Sometimes we can scan through the belly button or on the side of the abdomen instead. Also, some people’s skin just scans differently. For example, diabetic patients’ skin seems a little tougher, and some ethnicities have skin that scans differently. Sometimes we bring patients back to reevaluate, not because we’re concerned, but because we may need more time for the baby to grow so we can see better.
What’s the most important thing that you tell the students you work with?
Even as I get older, I don’t just want to do easy cases. I still like to be involved in challenging and complex work because it keeps me on my toes and forever learning. I tell students all the time, if I see them going fast, I say, “Ok, you’re fast now. But your pictures are sloppy. What are you going to do if you miss something?”
I know we sound difficult sometimes when we want people have to have a full bladder, lay in an uncomfortable position, or are annoyed if they want to be entertained the whole time. But in the end, I’m there to make sure the baby is healthy. Once we can check all the little boxes in our head, then we can entertain away!
How many people want to know the sex?
It’s totally changed again. It went from not wanting to know, to wanting to know, then we had the gender reveal trend. I had one patient ask me to call the local bakery and I got put on hold for five minutes. It was such a busy day and I got so far behind, so now we just put it in an envelope. But I’d say today it’s about 50% want to wait for it to be a surprise. They say over in labor and delivery now, it’s so much fun!
Thanks for your time, Kate!
Meet other people talking about HLHS or CHD on Mayo Clinic Connect – an online community designed to help patients and families connect with each other. Our community is a safe space to share experiences, ask questions, find answers, and exchange support. The discussion groups and topic pages are moderated to ensure that all posts are respectful, and Mayo Clinic Connect never sells or shares posted information to third parties. Here are some you might like to follow:
- Congenital Heart Disease (topic page)
- Heart & Blood Health (discussion group)
The Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome (HLHS) is a collaborative network of specialists bonded by the vision of finding solutions for individuals affected by congenital heart defects including HLHS. Our specialized team is addressing the various aspects of these defects by using research and clinical strategies ranging from basic science to diagnostic imaging to regenerative therapies. Email us at HLHS@mayo.edu to learn more.
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