Melanie (Host): Welcome to Healing Heroes PDX, the podcast series from the specialists at Shriners Hospitals for Children in Portland. I'm Melanie Cole and I invite you to listen in as we learn more about the Radiology Department at Shriners Hospitals for Children in Portland, advancements in the field and how their processes are unique compared to other children's hospitals. Joining me is Richard Bennewate, He's the manager of radiology at Shriners Hospital for Children in Portland. Richard, it's a pleasure to have you with us today. Thank you for joining us. Tell us a little bit about yourself and how long you've been with Portland Shriners Hospital.

Richard Bennewate (Guest): I started with Portland Shriners back in 2016. I'll be here four years at the end of this month,

Melanie: Well, thank you for that. So tell us a little bit about the Radiology Department and tell us about the location, about your team, the volume of patients that you serve.

Bennewate: We're a smaller radiology department. We specialize in pediatric radiology. So that's pretty much all we do. We have a team of x-ray techs. Most of my x-ray techs here have been around for quite a while. They're very experienced and they all love working with children. So along with our x-ray units in the different radiology rooms, we also have a unit that's called EOS and that's a biplane scanner that we use for spines and for lower legs primarily, but we can use it for any part of the body.

The thing about EOS that's so awesome is that it is low dose. So I can do a two-view spine, complete spine on a child 10 times in EOS for the amount of radiation it would take to do at one time in a regular x-ray machine.

Melanie: Isn't that amazing? I'd like you to expand a little bit and thank you for telling us about EOS, but how has radiology changed, Richard, in the time that you've been there? How has it advanced during your career? Share some besides EOS some of the cool technology for capturing x-ray images and things that have changed in your field?

Bennewate: I'm an older x-ray tech. I've been around since we used to use film. We used to shoot x-rays on film, in cardboard cassettes. And then we went to using cassettes that had light sensors in them, so we were able to decrease the amount of radiation that we used at that point.

We went from using the cassettes with film to using what's known as computed radiography, which is CR that has a detector inside of a cassette. That works basically the way that the detector works on your phone when it takes an image on your phone. So you take the image, it reads it line by line down the cassette and then produces an image.

And then beyond that we've gone to what's called digital radiography or direct radiography. We're using a sensor that is used much like a cassette, only we don't have to change it out and run it through a processor. You shoot the x-rays through the part into the detector, and it produces an image in about four seconds. So our x-ray speeds are a lot faster than that. So then we talked about EOS a little bit. That's been a new thing in the last five years or so where we have the biplane straight imaging.

And then recently, we introduced an O-arm into our surgical arsenal and the O-arm basically will give us a three-dimensional volume of data that we can then feed into a computed stealth scanner or a stealth navigator, I'm sorry. And then the surgeons can use that navigation information when we're doing like spine surgeries to place screws in exactly the right place where they want to place them. When they put screws into the spine, they put them into a place where sometimes they only have a millimeter's worth of tolerance on either side of that screw. So it has to be in exactly the right place. And this navigation system provides that information for them so they can do that.

Melanie: What an exciting time to be in your field. Now let's talk about the patients that you see in radiology. Do most kids receive just a single x-ray? Are there some who need x-rays again and again? Speak about the volume of patients that you see in radiology.

Bennewate: Sure. Some of our patients we see from the time they're just starting to toddle to the time they age out at age 18, We get to see them all as they grow up, which is really kind of fun. We also have, you know, our fracture clinic. So we see patients with fractures that we might see them two or three times as we're following up the fractures and the fractures are healing, but then that's all we would see them for. But on the cases where we're doing long-term care like spines and cerebral palsy, that type of thing, we'll see those patients throughout their adolescent years and into their young adult years.

Melanie: What are some ways that you make the kids comfortable having an x-ray? You mentioned that you see some that are just mere toddlers. How do you get kids to sit still? How do you make them comfortable and feel, you know, not really afraid?

Bennewate: We involved the parents in all of the imaging procedures. We let the parents hold the children, stand there with their children. So the child doesn't feel like they've been abandoned and left alone. All of my staff are really good with kids and we all have just worked with enough children, and had children of our own to know how to keep children at ease.

There are times when you have some children that are just so scared that it's difficult to, you know, get the images right away and so sometimes we have to, you know, sit and just talk with them and comfort them and soothe them and give them a better comfort level with us. But typically we never send a patient back and say we just couldn't do it.

Melanie: Well, I'm sure you're just absolutely wonderful with the kids. I can hear that in your voice. What would you like parents listening to know about the Radiology Department at the Portland Shriners Hospital if their children have to have an x-ray, if they're feeling nervous? Tell us what makes you so unique.

Bennewate: I think what makes us so unique is that we're never in a hurry and we care about those kids. So, we will take the best care of them that we possibly can. We don't try and push them through and try and get them out so we can get the next patient in. We give every patient the best care that we can give them. We set them at ease. We help them to understand that we're not going to hurt them. We're just going to take pictures and, you know, at the end of this, we're going to be friends.

Melanie: Thank you, Richard, so much for coming on and telling us about the Radiology Department at Shriners Hospitals for Children in Portland. If your child could benefit from specialized pediatric orthopedic care, please call us at (503) 221-3422. Or you can visit us online at portlandshrinershospital.org. And that concludes this episode of Healing Heroes PDX with Shriners Hospitals for Children in Portland.

Please remember to subscribe, rate and review this podcast and all of our other podcasts. I'm Melanie Cole. Thanks so much for listening.