We try to set good examples for our kids. We rarely

drink, don't have alcohol in the house except for cooking wine/sherry, don't smoke, don't do drugs, are honest, hard working people.  My oldest son has "friends" who smoke, who put vodka in their Coke cans, cuss, steal, etc.  My son is a good kid and no I'm not naive and he isn't doing this stuff behind my back because we spend lots of time together.   My son is a health freak and won't allow anyone to smoke around him.  We've also tried to explain to him that even if he isn't drinking if someone he is with is caught drinking then he is guilty by association and he knows he needs to avoid these kids.  He has come home before upset that kids were using seriously foul language.  The "F" word at our house is spelled f-a-r-t. 

We live in a country club community.  The kids around here get new cars when they turn 16.  The parents don't keep up with their kids, just give them money.   My son has to earn his car with saving $$, keeping out of trouble, and good grades.  I don't keep tabs on him 24/7, but I know where he is at ALL times so that if I need to find him I can.  He even asks me if he can get on-line so I know he isn't using the computer for porn.  He is concerned that he doesn't have enough testosterone because he isn't wanting to sleep with anything that stays still long enough.  Don't know that his friends are, but they talk a good talk anyway.  

I think you are wise to be concerned and just need to keep open communication with your kids and hope that he makes good choices.  My son was a follower when he was younger and I had serious concerns about how he would be growing up, but now he has become a leader and I'm very proud of him because so far he is making good choices. 

• For parents, what do you think of your kids' friends? - deep thinking
  • Well, I have 3 rambuncious (sp), bull headed boys. sm - mlstoo
  • I learned along time ago: My house, my rules. sm - Mom of 4
  • We try to set good examples for our kids. We rarely - IKWYM
  • It's difficult but necessary to be in control - fg
    • I see your point. - deep thinking
      • ever heard of a happy medium? - fg
  • friends - ns
    • I totally empathize and sympathize, but you HAVE to be the one in control. - MTQ
      • friends. - typinfool
      • Thanks for that input. - deep thinking

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we lived in a 2-story house, ABOVE the landlord.  Try keeping 3 little kids quiet when your landlord is downstairs - so I guess my point is, that would be more stressful than what you are going through now.  Trust me.

matter where they go to school there are going to be kids that just struggle in a subject.   Not having family support could be a major issue too.  I never understood not having family support and why it mattered to a parent whether they had it or not because they are the parent.  It would be nice if the family was supportive though.  I have known people whose parents were so against it, but later saw that they were missing so much and bought into it and actually enjoyed helping them learn and explore.   It doesn't take an education to be able to educate your child, it just takes love, time, and patience.  Not all parents can provide that, but most can and do.  I have 1 year of college and my just turned 11-YO is so far ahead that we went to a local college bookstore today to get him books because he has pretty much mastered everything else.   I spend my free time reading his books trying to stay one step ahead of him and in the process getting a better education than I ever got when I was in school and I went to pubic and private schools and was also in advanced classes. 

Homeschooling is not for everyone, but it is an option and those who choose to do it should be allowed to do it without being degraded for it.  There are a tremendous amount of resources available to homeschoolers, the bigger the city the more options.  Lack of socialization is one of the first issues that a non-homeschooler brings up.  Our children still play with neighborhood children, participate in community sporting activities, scouts, 4-H, etc. so there are plenty of times for socialization.  My youngest son has never met a stranger and everyone wants to be around him from ages 1 to 100.  My oldest isn't as social and most of his friends are public school kids, but when he was in public school he didn't have but 1 friend, mainly because he was so advanced and the things he would talk about where things way over the other kid's heads and they thought he was lying.

Okay, I'll get off my soapbox now. 

Probably depends on the teachers and the corporate culture at your school.

They know to come in when the street lights flicker on.

Strength in numbers though. I'd never let one of my kids go to the playground on the next street over by themselves, but my parents never let any of us wander off too far by ourselves either. It was always with a bunch of other kids.

Could you give me any examples of questions asked?  I am just curious.

Thanks!

I am looking for examples of flyers to in the physican's boxes at the hospital for medical transcriptionist services.  Does anyone know where I could find some good examples....or does anyone have something they would like to share with me (from someone that is not very creative making flyers/resumes).  If you have something you wouldn't mind sharing you can email me at norma_OK@yahoo.com.  Thanks for the help.

You did not specify how many examples you wanted, so I included quite a few, hope it helps.  All of these are from one group of radiologists, all american.  In answer to your question, unfortunately most of these I believe to be the result of laziness.

THREE-VIEW RIGHT HAND

There is decreased relative small of the distal aspect of the 4th metacarpal. (There is diminished size of the distal aspect of the 4th metacarpal.) Otherwise, the hand is unremarkable in appearance for a patient of this young age. 

MRI LUMBAR SPINE

This is best visualized from L3-4 through L5-S1 where there are actual images in addition to the sagittal imaging through the entire lumbar spine.( This is best visualized from L3-4 through L5-S1 where there are axial images in addition to the sagittal imaging through the entire lumbar spine.)

ABDOMEN, THREE VIEWS

The colon has lost his Hounsfield markings in the transverse portion and splenic flexure. (The colon has lost its haustral markings in the transverse portion and splenic flexure. )

CT ABDOMEN W/WO CONTRAST

There is a small left inguinal hernia with fat within the hernia sac but no bile (no bowel).  No inguinal lymphadenopathy.

NAME OF EXAMINATION:  Sinuses.

FINDINGS:  Paranasal sinuses demonstrate generally some metric pneumatization.( Paranasal sinuses demonstrate generally symmetric pneumatization)  No bony abnormality is seen.

MRI OF THE LUMBAR SPINE

Compared to December 23, 2003, there has been no objective change in the L5-S1 left posterolateral disk herniation. It causes narrowing at the left lateral recess. It doe snot produce central stenosis. ( It does not produce central stenosis.)

OB ULTRASOUND COMPLETE

There is no polyhydramnios. However, the fetal kidneys are abnormally hyperechoic. This has been associated with polycystic kidney disease and so I recommend a postnasal follow-up study.( This has been associated with polycystic kidney disease and so I recommend a postnatal follow-up study.)

MRI OF THE HIPS WITHOUT IV CONTRAST

The muscles about the shoulder show normal signal on all sequences.( The muscles about the hips show normal signal on all sequences. ) There are no soft tissue masses.

RIGHT HIP TWO VIEWS

DISCUSSION: There has been destruction of the right femoral headache and femoral neck.( There has been destruction of the right femoral head and femoral neck. )

AP PORTABLE CHEST

EXAM DATE: January 22, 2005 at January 12, 2005 hours(January 22, 2005 )

MRI ANGIO ABDOMEN BEFORE AND AFTER IV CONTRAST

TECHNIQUE: 3-D time of flight MRA of the abdominal aorta and renal arteries was obtained following contrast administration. In addition, evidence of the kidneys was also obtained before and after IV contrast.( In addition, imaging of the kidneys was also obtained before and after IV contrast.)

TWO-VIEW CHEST

FINDINGS: Left apical pneumothorax measuring 1-2% is stable. Left lower lobe maxillary sinus is again demonstrated.( Left lower lobe mass is again demonstrated. )There are no other findings.

GALLBLADDER ULTRASOUND

 In the porta hepatis, there is a consistent with echogenic lesion measuring 1.1 cm.( In the porta hepatis, there is an echogenic lesion measuring 1.1 cm) This could represent a lymph node in the porta but also could represent an exophytic hepatic meningioma. (This could represent a lymph node in the porta but also could represent an exophytic hepatic hemangioma. )

OB ULTRASOUND COMPLETE

DISCUSSION: There is moderate dilatation of the left renal pelvis. There is mild dilatation on the right. However, neither uterus is abnormally dilated. (However, neither ureter is abnormally dilated. )

 ULTRASOUND OF RIGHT BREAST

There is heterogeneous echo texture in that region compatible with typical combination of breast parenchyma and fatty/femoral tissue, but a discrete mass lesion is not identified. (There is heterogeneous echo texture in that region compatible with typical combination of breast parenchyma and fatty/normal tissue, but a discrete mass lesion is not identified.)

AP PORTABLE CHEST

Underlying fusion is suggested, again worse on the left than the right.  (Underlying effusion is suggested, again worse on the left than the right.)

LEFT SECOND TOE

There is an old, healed fracture of the proximal phalanx of th cleft third toe.( There is an old, healed fracture of the proximal phalanx of the left third toe.)

TWO-VIEW CHEST

There are remote compression fractures involving the right 5th and 6th ribs.( There are remote fractures involving the right 5th and 6th ribs. ) The lungs are otherwise clear.

THYROID ULTRASOUND

DISCUSSION: In the left lobe of the thyroid, there is a moderately large maxillary sinus that measures 2.2 cm in greatest diameter and is mostly sold and have a cystic center. (In the left lobe of the thyroid, there is a moderately large complex mass that measures 2.2 cm in greatest diameter and is mostly solid and has a cystic center.) The remainder of the left lobe is normal.

There is a small 6 mm nodule in the inferior aspect of the right lobe. The gland itself is not overall enlargement. (The gland itself is not overall enlarged.) The gland is heterogeneous overall in echogenicity.

TWO-VIEW ABDOMEN

No convincing evidence of small bowel obstruction, although developing shortness of breath could theoretically give this appearance and follow-up is recommended. (No convincing evidence of small bowel obstruction, although developing small bowel obstruction could theoretically give this appearance and follow-up is recommended.)

OB ULTRASOUND

DISCUSSION: There is an intrauterine gestation with a large yolk sac. However, the crown-rump length measures 7 mm and this corresponds to an estimated gestational age of about 6 weeks 4 days. However, there is no detectable cardiac activity. The amniotic fluid volume is probably normal of ra fetus of this age.( The amniotic fluid volume is probably normal for a fetus of this age. )    The placenta is closed. (The cervix is closed.)

EXAM OF LEFT FOREARM

FINDINGS: No fracture. There is prominence of the anterior fat patient which suggests effusion. (There is prominence of the anterior fat pad which suggests effusion) No other findings.

MRI LUMBAR SPINE WITHOUT CONTRAST

Tip desiccation of L4-5. (Disk desiccation of L4-5.)

TWO-VIEW ABDOMEN

FINDINGS: Findings of right chest, cardiac size is normal, no infiltrates or effusion. (FINDINGS: Upright chest, cardiac size is normal, no infiltrates or effusion.

TWO-VIEW CHEST

Stable right breast opacity, likely represents

fibrosis.( Stable right basilar opacity, likely represents

fibrosis.)

AP CHEST

Picture of congestive heart failure/volume

overload not significantly changed from

exam 4-hours earlier.( Features of congestive heart failure/volume

overload not significantly changed from

exam 4-hours earlier.)

RIGHT SHOULDER

FINDINGS: The patient has history of a right humeral fracture, plus surgical fixation noted.( The patient has history of a right humeral fracture, postsurgical fixation noted. ) Alignment is intact.

IMPRESSION

1. Postsurgical change involving the right

proximal femur.( Postsurgical change involving the right

proximal humeral.)  Alignment is anatomic.

OB SONOGRAM

FINDINGS: Transabdominal and transvaginal evaluation of the pelvis was performed. An intrauterine collection and yoke sac is identified. (An intrauterine collection and yolk sac is identified. )

 LEFT HIP

FINDINGS/IMPRESSION: Two-view left hip demonstrate a fracture of the neck of the left humerus in varus angulation.(  Two-view left hip demonstrate a fracture of the neck of the left femur with varus angulation.) No additional fractures identified.

THREE-VIEW ABDOMEN

In this since, bowel gas pattern slightly improved since the 14th, but otherwise there has been no significant change. (In this sense, bowel gas pattern slightly improved since the 14th, but otherwise there has been no significant change. )

NUCLEAR MEDICINE CHOLESCINTIGRAM WITH GALLBLADDER EJECTION FRACTION

.After initial accumulation of tracer within the gallbladder, the patient was given solid bolus intravenous injection of CCK and additional anterior sequential imaging was obtained.( After initial accumulation of tracer within the gallbladder, the patient was given slow bolus intravenous injection of CCK and additional anterior sequential imaging was obtained. )

MRI BRAIN BEFORE AND AFTER IV CONTRAST -

There is confluent periventricular signal abnormality in the lungs bilaterally consistent with chronic small-vessel ischemic change.( There is confluent periventricular signal abnormality in the pons bilaterally consistent with chronic small-vessel ischemic change.) Probable remote lacunar infarcts noted in the left posterior frontal subcortical white matter.

THREE-VIEW ABDOMEN -

There is gas within the large and small-bowel. No distension. There is a round calcification in the pelvis which probably represents calcification in the wall of a cyst. There are no suspicious calcifications. No pathologic skin or nipple alterations(this sentence does not belong in this report). Mild hypertrophic change in the lumbar spine.

TWO-VIEW CHEST

REPORT: Bones free of consolidative infiltrate.( Lungs free of consolidative infiltrate.) No pneumothorax or pleural effusion identified.

LUMBAR SPINE SERIES

REPORT: There is very mild levocurvature of the cervicalium spine. (There is very mild levocurvature of the thoracolumbar spine.)

THREE-VIEW ABDOMEN

No evidence of bowel destruction. (No evidence of bowel obstruction.)

CERVICAL SPINE SERIES

FINDINGS: There is a fracture of the CT vertebral body inferior to the junction of the dens with the body.( There is a fracture of the C2 vertebral body inferior to the junction of the dens with the body.)There is retrolisthesis of the dens in relation to the CT vertebral body. (There is retrolisthesis of the dens in relation to the C2 vertebral body. )

I would put 32-year-old male, but no hyphen if it's something like *Patient is 32 years old.*  (Same with 11-pound weight loss vs pt has lost 11 pounds.)  I can't quote the rule on this offhand, but whatever the rule is, I personally I think the hyphens make it easier to read/understand. 

AAMT. They started the whole problem, and then they bailed out after everybody decided it was the most honest method to determine what a "real line" was.

But there's still a way to break even. Go to this web site:  http://www.medicalese.org/line_count.html

Figure out what you want to bill for gross lines. That would be under the 45 cpl column (trust me on this ... I did stats for years when I was billing for gross lines). Compare it to what you would get paid if you billed for a 65-char line and that's what you want to be paid.

IOW, if you want to make 9 cpl for gross lines, under the 45 line length column it would be $200. Go over to the 65-char line and see how close you can match things up. It's 13 cpl = $200.00. That's what you want to make the same amount.

However, I would get Vera Pyle's Med. Term book, Ellen Drake Sloane's Medical Word Book, and Claudia Tessier's Surgical Word Book.  Also Quik-Look Drug Book.  This is only if you are still using books 24/7/365.  The web has faster access in my opinion.   

I wonder what the change is?  Do we parents have egos because now most of us have as much education as teachers do?  Are we unwilling to sit back and never question "authority figures"?  Do we remember being wronged in our own childhoods, so we're quick to defend?

I try not to be a buttinsky at my kids' schools, but sometimes I just don't agree with how they're doing things there.  One day, three bigger boys with bad home lives and a history of fighting jumped my son, who is the most peaceful kid you've ever met.  Two of them held him down while the third one was on top of him punching and kicking him.  My son had to bite the kids to get them off of him.  He was cut, bruised, and had a bloody nose.  Guess who got punished?  My son did, for biting.  I called the cops and intervened at the school because my son has my full permission to defend himself against bullies, especially on a 3-on-1 situation.

I also remember being punished for things at school when I did nothing wrong, then my parents punished me a second time because of what the teacher said.  I got detention for sneezing in class once.  One of my teachers publicly humiliated me and threatened to pull me out of all the advanced classes if I didn't publicly apologize to another teacher when I wasn't even the one who said whatever it was she was upset about.  One of my male teachers actually picked up a student and slammed him into the chalkboard, ripping the kid's shirt off in the process.  So yes, I'm going to stay on the schools and make sure my kids aren't hassled by any burnt out teachers who are just biding their time until retirement.  My kids aren't angels, but they're not demon spawn either.

I have one client for 11 years, another one for 15 years. They wait...they don't want anyone else doing their work. Are they spoiling me or am I spoiling them? My vacations consist of a 2 day fishing trip. One day to the site, 1/2 day fishing, and back home again.

If I'm sick, they understand. I still do the work, but at a pace that won't make me sicker. I sually catch up in a couple days.