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Ultrasounds of War

Dublin radiologist aids children and wounded veterans

For a victim of post-traumatic stress disorder, physical pain – caused by, for example, shrapnel pressing against nerves in the body – can trigger memories of traumatic events.

Fragments from explosives can lodge themselves inside a soldier’s body during combat. The agony of these events can surface years later when the victim moves the wrong way.

Victims of everyday accidents may endure the same experiences when foreign objects are unceremoniously injected into their bodies.

Dr. William Shiels, a Dublin resident and interventional radiologist at Nationwide Children’s Hospital, uses ultrasound to guide removal of these undesirable bits and pieces.


“We can find everything from wood to shrapnel in adults and children,” Shiels says. “We can find it and remove it without major surgery. Wounded veterans have this stuff in their bodies and it drives them crazy. It’s hard to get over PTSD when you feel the injury every day. ”

The entire country, Dublin included, has been impacted by the wars of the past 10 years.

“Dublin soldiers have seen a lot of casualties in the Iraq war,” Shiels says. “The impact is real. More than 15,000 Ohio veterans suffer from PTSD. There’s a really close connection between Dublin residents and their troops.”

In the past, doctors have had difficulty finding shrapnel in patients’ bodies. The use of ultrasound, instead of X-rays, has proven helpful in finding these fragments and, now, wounded veterans come to Nationwide Children’s Hospital to see Shiels, who removes the embedded fragments.

“You can X-ray all day long and never find anything,” Shiels says. “Ultrasound shows anything that is solid: glass, metal, plastic and babies. It’s the same technology the Doppler weather radar uses. After we detect the debris, we use millimeter guidance to move an instrument into the body, remove scar tissue and then remove the foreign bodies.”

Injuries sustained from foreign bodies don’t just happen to soldiers; a splinter from an unfinished deck or an errant sewing needle can embed itself in skin just like shrapnel can.

Some patients live with the pain and try to forget the foreign body is there.

“A microbiology professor at Ohio University approached me after one of my lectures, and he had a sewing needle in his foot for 20 years,” Shiels says. “Other surgeons wouldn’t remove it because it was too deep and too small. He couldn’t walk barefoot on a hardwood floor. He came to Children’s and we took it out in 15 minutes.”

Shiels has also assisted patients who suffered serious eye injuries while outdoors.

“We had one child who fell off an ATV and a branch went into his eye socket, and another man who was a hunter who walked right into a thorn tree,” he says. “We did minimally invasive ultrasound-guided removal, and they were both able to see perfectly after.”

Different types of debris cause different types of problems. If metal is trapped in the body, it may press against nerves, or it may go completely unnoticed. But wood fragmentation is a situation that needs to be handled immediately.

“Wood will always cause an inflammation, whether an infection or continuous irritation,” Shiels says. “It will never stop causing pain until you get that thing out.”

Shiels bridged the gap between war wounds and childhood injuries when he was asked to help Nationwide Children’s undergo a complete remodel of its radiology department almost two decades ago. At the time, he was working as the radiology consultant to the Surgeon General of the U.S. Army. Before the move, he was in charge of the entire army radiology department, including 2,000 technicians, 200 doctors and 49 hospitals.

“This offer came just at a time when I was deciding to become a general in the army or to leave the army and do something else,” he says. “They had this need for strategic change and asked if I would come there. I’ve been in Dublin since 1995.”

Before moving to central Ohio, Shiels, a Cincinnati native, worked at the Pentagon. Prior to that, he was a high school teacher in Pennsylvania, where he taught ninth-grade physical science and 10th-grade biology. He found that teaching did not use his entire skill set. Radiology has been the best career path for him, he says, allowing him to become a detective of the human body.

“Radiology is such a broad field that needs such a breadth of knowledge and skill sets,” Shiels says. “I get to be the ultimate Sherlock Holmes of medicine every day of my life. My job is to help the other doctors figure out exactly what the disease is, where it is, what it looks like and the best way to treat it.”

Shiels cites the City’s sense of togetherness and push for social action as part of his inspiration to continue to help others.

“Dublin is a dynamite community,” he says. “It is committed to a high quality of life that starts with nurturing family development and community support.”

When he isn’t expanding the world of radiology, Shiels in-line skates, snow skis, cooks and spends time with his two daughters, Courtney and Moira.

Stephan Reed is an editorial associate. Feedback welcome at laurand@cityscenemediagroup.com.

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Old to new | New to old
Apr 7, 2014 07:16 pm
 Posted by  melissa

Hi,
I know this is a weird question but do you think that any metal fragments left in the body weather it to be free floating or lodged could cause pain in just everyday people. I am one of 7,000+ women who have had a procedure done called Essure. It is a permanent form of birth control. I have had pain since it was put in but like all the other dr.s they say it is too small to cause such pain. We all have the same pains and problems... Some women who have had theirs removed, small piece broke off inside and attached to other organs and their dr.s are saying again too small to cause pain. Your article was very interesting.. We live in constant pain and even though we are not war vets or victims of bombings this is exactly how we feel as they do.. Just curious on your thoughts.
Essure consists of
Titanium, Nickel, platinum w 10% iridium, stainless steel alloys, silver solder, gold, those are the metals in it..
There are also several polymers in it also like PET fibers...
thanks,
Melissa

Apr 8, 2014 08:59 am
 Posted by  StephanReed

Melissa,
Dr. Shiels made a good point during the interview in saying that any irregularity in the body or fragmentation is going to cause some sort of inflammation and maybe more. It is possible that your body is reacting poorly to Essure. Some experience worse pain than others.

If you contact the hospital directly, they should be able to put you in contact with Dr. Shiels in Radiology. (614) 722-2363

Apr 8, 2014 07:16 pm
 Posted by  melissa

Thank you so much!
Melissa

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