CEP 818: Perception

    

Background Information

Therapeutic ultrasound is a modality commonly used in the rehabilitation of injuries. The ultrasound machine comes in various forms, but all deliver high frequency sound waves (via the reverse of the piezo effect) through the metal transducer sound head. These waves penetrate  the skin and stimulate soft tissue in the body to create a type of healing environment. There are several settings, each eliciting a different physiological response. Before entering the body the sound waves must travel through an aqueous medium which is essentially in the form of a water-based gel. The waves may also travel directly through water and when this is done the waves actually appear “visible” through the ripples in the water.

 

Observation

My observation is from the perspective of administering the treatment on a patient. 

Sight: I notice the machine itself, how the face has a backlight and how clearly the settings and “time left remaining in treatment” are displayed. I notice the light blue, transparent gel against the skin of the patient and the thick lines being traced in it over the area being treated by the sound head. I also notice the gel building up around the sound head as it is being glided through the gel. I also notice the colors of the machine which are light grey with navy blue trim and buttons with a light blue backlight on the display screen.

Touch: The buttons on the face of the machine are cool to the touch. They are slightly softer than the rest of the plastic on the machine almost as if they are made of silicone. The gel and sound head are both warm upon picking them up to negotiate set-up of the treatment.  The handle is shaped to ergonomically fit a hand and brings a comfortable weight with it. It’s constructed from plastic, which feels cold but soon warms from the heat of my hand. I also notice the front of my shoulder becoming fatigued from the continued circular motion that needs to take place for proper application of the treatment. I can also feel the sound head gliding through the ultrasound gel with very little resistance. I can feel the patient’s tissue rebounding from pressure being applied through the sound head.

Hearing: I hear the beeping of the buttons as I push them to set up the treatment. The “last ounce of ketchup left in the squeeze-bottle” squirting sound the gel makes as it exits the cap. The machine itself makes a soft hum from all the processes being run within it. The sound waves at a frequency that is inaudible to the human ear so I cannot actually hear them. I hear the chatter within the clinic of various conversations taking place in addition to the beeping of machines that have turned off after finishing treatment.

Smell: The gel has no smell. The only smells entering my olfactory bulbs are the perfume of my patient (which is sweet but has warm vanilla undertones) and the clean and sterilized smell of the clinic.

Taste: Not applicable : ) 

 Re-Imagine and Re-Present of Therapeutic Ultrasound 

Since I am not able to fully appreciate the use of my smell and tasting senses with this particular modality (or visual of what the sound waves are actually accomplishing in the body!) I imagine using it in a slightly different way. Imagine a thick ribeye steak, so fresh it’s still purple. If set on the correct settings, ultrasound can have a thermal effect on soft tissue.  Set the machine up, squirt the gel on the steak then apply the sound head and start treatment. I imagine the smell would smell would be a less intense version of the steak on a grill, without the actual smell of the grill. The tissue should start to turn a greyish-brown color as it heats up. You then can cut the steak down the middle of the treated area and see how deep the waves have penetrated the muscle tissue. You could even use your fingers to feel the difference between the treated and untreated areas. Now this exact reaction of “cooking flesh” isn’t what is done during a treatment on an injured patient, but it offers proof that the sound waves actually exist and a visual of power of the thermal effects of the sound waves. Bon apatite!

 

Discussion 

Perception means to take in all types of sensory information and use known information and prior experiences to make sense of everything.  The person’s own personality and thought processes mold these to make them fit into what makes sense to them at the time. 

My original observation of administering an ultrasound treatment enlightened me to many things I did not actually acknowledge before. I had noticed many of the things I wrote about, but never actually took the time to pay attention to them. I can see the handle for the ultrasound is shaped specifically for a hand based on the location of certain curves and indents, but had never concentrated on how it fit my hand so well and was perfectly balanced in weight. Had it been unevenly balanced I surely would have noticed that!

 I had reimagined this procedure in several ways but thought best to create things that could not be obtained in the original observation such as seeing the meat literally being cooked using something (sound waves) that is neither directly felt by the human body nor can be seen by the human eye. I acknowledge that this demonstration is not all too different from the usage of the original application and many of the same senses are being used in the same way, but I feel that it presents the actual effects of the high-frequency sound waves create within soft tissue. This cannot actually be seen when performed on a human body, though other effects may be evident. This thermal effect essentially primes the tissue for elongation and one effect may be a larger range of motion within a joint. A non-thermal effect of ultrasound is to decrease inflammation. As this cannot be seen, a decrease in pain or edema represents a positive effect. 

I feel this “re-imagined” representation of ultrasound is actually quite useful. It would help students trying to understand certain parameters of ultrasound treatments and have a better grasp on something that is hardly felt and cannot actually be seen. It’s a way to bring all the science they have learned regarding therapeutic ultrasound “to life”.