# Are CT Scans Safe



## The Jogger (19 Oct 2014)

I had one about three years ago to do with kidney stones and pain in the side and I guess it was fine, now urology want to do another one re side pain again. Its a scan of the whole area probably prostate kidneys bladder etc. I was thinking about not going for it as I'm due the camera again. Concerned over the radiation that turned out to be unnecessary last time and symptoms are the same. I think I'll do the camera firs, cancel ct and talk to the urologist about it first?


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## ColinJ (19 Oct 2014)

I have had 4 CT scans done in the past couple of years after my clotting problems. I don't really fancy volunteering for many more because each one is a pretty massive dose of x-rays. According to this article one CT scan might expose a patient to the equivalent radiation dose of between 150 and 1,100 conventional x-rays! 

I would discuss your concerns with the doctor.


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## ColinJ (19 Oct 2014)

Oh, and I asked the radiographer about allergic reactions to contrast dye. I was told not to worry about it. I found out later that my brother-in-law had nearly died from an adverse reaction when he was scanned!


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## Wobblers (19 Oct 2014)

Firstly, they won't ask you to have a CT scan if they don't think there's a clinical need. There are only so many CT machines, and they're always in use, with long waiting lists (I had to wait almost a month before getting one to determine just how badly I'd damaged my ankle) so this isn't a procedure that they're just going to casually ask for.

Secondly, the dangers of radiation are almost certainly exaggerated. As the Scientific American article says, most work on radiation risks are based on the A-bomb survivors. But most of them received large doses. A linear dose/effect relationship has been used to extrapolate cancer risk down to the small doses you'll receive in CT scans (and it is small). However, research in recent years has cast doubt on this assumption. In fact some research suggests that low radiation doses have a _beneficial _effect. Put simply, the risks have almost certainly been substantially over estimated - otherwise workers in the nuclear industry and users of the major scientific neutron and x-ray facilities would be dropping like flies. They're not. While there are many things to worry about, CT scans aren't amongst them.


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## slowmotion (19 Oct 2014)

I had one twenty years ago when I had a horrendously prolapsed disc in my back. In those days it was a real privilege to be invited to slide into the tube. I seem to have survived. Don't worry about it.


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## classic33 (20 Oct 2014)

I've had a few done over the years and I'm still here. If you are bothered about the radiation dosage you might receive, I'll point out that they have access to your records with regards any previous X-rays you may have had and the interval between each.
Never had a CT or MRI scan refused, but I was refused an X-ray years ago because the radiographer felt that I'd too many done over the previous year. Hazard of hitting the head on something solid, whilst in a fit.

See  CT Scan Radiation Risk 

The dye as pointed out by @ColinJ might be of more concern. This is covered in a standard set of questions asked beforehand.


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## Pumpkin the robot (20 Oct 2014)

I have one every 6 months to see if the tear in my aorta has not increased in size. I have not actually thought about the radiation dosage, I wouldnt have thought they would do it so often if there was a risk.


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## ufkacbln (20 Oct 2014)

Radiation "damage" is always possible!

IF a packet of radiation hits a DNA strand and breaks it and it repairs correctly - no damage occurs

However IF the DNA strand repairs incorrectly, and IF that cell survives and IF that cell then replicates and IF that replicating cell forms a grup of cells and IF that group of cells is malignant then you have a problem.

So really it is down t chance.

However these chances are all very small

Modern CT scanners are very efficient and teh dose used has dropped over the years.

To put this into perspective, depending upon the scanner, it is often no greater a risk than that of having an accident whilst driving to or from the appointment, taking a Holiday in a high natural radiation area like Cornwall for a fortnight or half a dozen transatlantic flights

I will get some more accurate figures and some references whilst at work

If you wish to continue the discussion on here then I am quite happy to do so, or if there is something you wish to discuss off the forum, please feel free to use the conversation option


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## MartinQ (20 Oct 2014)

A bit like Colin I've had a few (~5) a few x-rays and a nuclear v/q test, in the last couple of years. Must be addicted to the stuff. A good reply from a medic who got clots recently, from http://www.dailystrength.org/c/Pulmonary_Embolism/forum/18697455-willing-help-i/page-2

CT scans. A chest CT angiography (used for diagnosing PE) is more radiation than just a regular chest CT. It's equal to about 2 years of "average" background radiation exposure in the U.S. (approximately nine months if you live in Denver, where the elevation means more cosmic radiation exposure and there are uranium deposits in the soil). What does this mean in terms of risk? 
Well, one in five people in the U.S. will develop cancer in their lifetime. One chest CT means that as many as 1 in 1000 people who are part of the 4/5 that wouldn't have gotten cancer will get it from the CT. And that's the risk of developing a cancer spread throughout the patient's lifetime. So if you're young, there's more time after the exposure for a cancer to develop than if you're older. The time frame used to calculate the increased risk is 30-40 years. So if you're 70 you don't have as much to worry about as if you're 20, because the chance that you are going to live to be 110 is about the same if you have a CT or if you don't. 
That being said, younger people have stronger immune systems and better cellular repair systems than older people do. So they have a lower chance of "mis-repair" of radiation-damaged cells than older people do, which is what causes these cancers down the road. 
Also, one must take a lot of the information out there about radiation exposure with a grain of salt. Most of the studies conducted on it were done on survivors of Hiroshima and Nagasaki or on patients who had neck irradiation in the mid-1900's as children to treat enlarged thymus glands. These patients were exposed to very high doses in a very short time period, whereas our modern radiology testing exposes patients to smaller doses over a longer time period. Dose rate does matter, to a certain extent. Of course, someone already diagnosed with cancer who has had 30-40 CTs over a 5 year period and who is also having radiation therapy (which is many, many CT's per treatment) has reached a point where exposure is exposure. 
All in all, one or two CT scans performed on a patient who could very well die without the information the CT provides poses a pretty minimal risk to the patient. It's all about benefit vs. risk. I see my physicians wrestle with this on a daily basis. Your doctor, you see, can't just order a CT or Nuclear Medicine study without it being approved by the specialist physician. Our physicians routinely reject requests for exams if they feel that there is a more appropriate exam to diagnose the patient, especially if all options for not using radiation or using less radiation have not been exhausted (MRI, ultrasound, plain X-ray, etc.) 
Many patients who have large amounts of medical radiation exposure (PET/CT every 3 months, for example--which is 7 years of background each) already have a malignancy. The benefit for them is targeted treatment. Being able to tell whether the chemo and radiation treatments are bringing about a reduction in tumor size or number is a very good way of judging the effectiveness of treatment or a need to change course. For these patients, the risk of developing an additional cancer is negligible compared to their risk of succumbing to their present cancer. 
I would say that if you go into the ED with all the symptoms of a recurrence that CTA is the fastest, most accurate way to diagnose a PE and get you the immediate treatment you require to save your life. I wouldn't necessarily be worried about the radiation exposure at that moment, because you might not have 30-40 years of life left without that treatment. Recheck with CT on a non-symptomatic patient who wants to know if the clots are gone? Not so fast. What is the risk to the patient from not doing the test? Minimal. So don't do the test. If your symptoms come back, by all means get into that machine so you can get diagnosed and treated. 
It's like driving your car on the freeway at rush hour. Do you take the surface streets because it's safer or the freeway because it's faster? You do benefit vs risk analysis in your everyday life all the time, you just don't realize it. 
Just one more note. That CT scan is 7mSv. I know that number doesn't mean much to you, but realizing that every single radiation worker in this country is allowed 50mSv per year of employment as occupational exposure over top of the incidental background everyone else gets should put it in some perspective. I've been doing this 22 years. That means I've been allotted 1100mSv of extra exposure for that time just to do my job. That's 150 CT scans. Just for some idea of scale. That doesn't mean you still shouldn't do your own benefit/risk analysis on any non-emergency scanning. Bring your doctor into the conversation. Ask what other tests can be done. Ask what happens if you don't do the test, if the diagnosis can't be confirmed any other way, if you put it off and don't get the proper treatment. Be your own advocate, but out of a due amount of caution, not sheer terror.


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## SatNavSaysStraightOn (20 Oct 2014)

To the OP, talk with your urologist and GP and go with their advice. It may be possible for some other non-radiation using test to be used (both ultrasound and MRI's are radiation free - I used to work with nmr technology in a chemistry lab).



McWobble said:


> otherwise workers in the nuclear industry and users of the major scientific neutron and x-ray facilities would be dropping like flies. They're not. While there are many things to worry about, CT scans aren't amongst them.


From personal observation, I only wish that was true for my mother's friends. - sadly I think it only applies to the current generation and the current equipment in use which for the OP is good news, but not so for my family or my mother's friends. Her friends (the other nurses she trained with and worked with) have been dropping dead like flies for the last 20 odd years and no-one who knows their background has failed to notice that they are all dying of the same thing - cancer or leukaemia. the only difference has been 'of what'... There could be other factors involved, such as the era they were in, not exactly known for its lack of smoking and the likes, but also the fact that even with standard x-rays nurses were not shielded from the radiation and the radiation dose was much higher then as well... None of them have died from anything else, unlike their partners/husbands.

To the OP... there are risks, but from current experience (my sister collapsed with a bleed on the brain after knocking herself out) they won't do another CT scan on her unless she collapses again (which is about every 6 months at the moment, with no reason known). She had 3 done inside 6 months before they called it as too many and now have her on this 'restriction'.



Martin Archer said:


> I have one every 6 months to see if the tear in my aorta has not increased in size. I have not actually thought about the radiation dosage, I wouldnt have thought they would do it so often if there was a risk.


I would imagine the risk of it increasing in size and the life threatening consequences are far higher that the risks regarding radiation dosage with modern equipment.


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## classic33 (20 Oct 2014)

The time they refused to X-ray me, I was issued with a lead blanket, whilst they X-rayed the ankle I'd snapped.


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## machew (20 Oct 2014)




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## swansonj (20 Oct 2014)

McWobble said:


> Firstly, they won't ask you to have a CT scan if they don't think there's a clinical need. There are only so many CT machines, and they're always in use, with long waiting lists (I had to wait almost a month before getting one to determine just how badly I'd damaged my ankle) so this isn't a procedure that they're just going to casually ask for.
> 
> Secondly, the dangers of radiation are almost certainly exaggerated. As the Scientific American article says, most work on radiation risks are based on the A-bomb survivors. But most of them received large doses. A linear dose/effect relationship has been used to extrapolate cancer risk down to the small doses you'll receive in CT scans (and it is small). However, research in recent years has cast doubt on this assumption. In fact some research suggests that low radiation doses have a _beneficial _effect. Put simply, the risks have almost certainly been substantially over estimated - otherwise workers in the nuclear industry and users of the major scientific neutron and x-ray facilities would be dropping like flies. They're not. While there are many things to worry about, CT scans aren't amongst them.


ooo errr, @McWobble, controversial stuff! Are you really aligning yourself with the hormesis lobby? [inset suitable smiley to indicate I'm being friendly not critical]

As you are clearly aware (but others may not be so familiar), most radiation protection (below the doses that produce acute, deterministic effects) is indeed based on LNT - linear no threshold. But as @Cunobelin suggests, that's not as silly as it can sometimes sound - it's based on the premise that each alpha particle (or beta or gamma or neutron) has a certain probability of causing a DNA strand break, and each strand break has a certain probability of resulting in a cancer. So the chance of getting cancer depends on how many strand breaks you get which depends simply on how many bits of radiation your body has stopped in total, not on how rapidly they were accumulated. Or that at least is the argument for LNT.

Of course there are alternatives suggested. Trouble is, this is a political as well as a scientific area, and when we look at the alternatives that are suggested, we need to be aware of the interests of those promoting them. Basically, the green movement (or those bits of the green movement who oppose nuclear power) have an interest in low doses and low dose rates having GREATER effect than LNT suggests, because those are the doses associated with nuclear plants, and if the risks were higher than the LNT orthodoxy, the health argument against nuclear power would be strengthened. Conversely, the nuclear industry has an interest in low doses and low dose rates being LESS harmful than LNT suggests, because then nuclear power looks safer, and they don't have to bother expensively remediating sites any more.

What everyone (except the lunatic fringe) agrees on is that, as you say, risks from the doses received from xrays, occupational exposures, etc, are low whether assessed under LNT or an alternative. Which is why I'm not fully persuaded of your comment about not seeing occupationally exposed workers dropping like flies. There have been a lot of epidemiological studies of occupational groups - a new one looking at the BNFL workforce came out earlier this year - and while they all generally find excess risks, they all struggle to say anything truly definitive about whether those excess risks are LNT-compatable or not because the risks are just too damn small to start with.


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## PK99 (20 Oct 2014)

Chapter and verse with dose comparisons

http://www.radiologyinfo.org/en/safety/?pg=sfty_xray


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## The Jogger (20 Oct 2014)

Thank you all very much for taking the time to reply to my query/worry. It has been really informative and reassuring. Lets hope the head can rationalise all this and calm down. Just received a copy of the letter from my consultant to my GP saying reason for CT is because of my history of kidney stones, the pain in the side and neither x ray or ultrasound could detect a stone.


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## classic33 (20 Oct 2014)

PK99 said:


> Chapter and verse with dose comparisons
> 
> http://www.radiologyinfo.org/en/safety/?pg=sfty_xray


As given above under CT Scan Radiation Risk!


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## vickster (20 Oct 2014)

slowmotion said:


> I had one twenty years ago when I had a horrendously prolapsed disc in my back. In those days it was a real privilege to be invited to slide into the tube. I seem to have survived. Don't worry about it.


Ditto here...I was off my face on morphine at the time, so don't remember anything much of the experience!

I have had many dental and other X Rays this year (most recently on Saturday), and am having an MRI on Thursday. I also fly a fair amount for work/holidays and figure any radiation from imaging is less than that from being in an airplane (in 2012, I probably made 15-20 return flights various)

Personally, I'd rather have the imaging so the tooth butcher / doctors know what's going on, rather than poking around blind or having to do something more invasive / surgical


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## swansonj (20 Oct 2014)

vickster said:


> Ditto here...I was off my face on morphine at the time, so don't remember anything much of the experience!
> 
> I have had many dental and other X Rays this year (most recently on Saturday), and am having an MRI on Thursday. I also fly a fair amount for work/holidays and figure any radiation from imaging is less than that from being in an airplane (in 2012, I probably made 15-20 return flights various)
> 
> Personally, I'd rather have the imaging so the tooth butcher / doctors know what's going on, rather than poking around blind or having to do something more invasive / surgical


Minor point of information: dose of IONISING radiation from an MRI = zero.

Indeed, when the EU brought in occupational exposure limits to NON-IONISING radiation a few years ago, which could have jeopardised some MRI because the nurses and technicians would have been exposed when they approached the bore to help a patient, one of the arguments the MRI community used to lobby against them was that if they couldn't do MRI they'd have to do CT scans instead, which would have increased the risk to patients (albeit not by much - see multiple posts above). They won - the revised Directive has a derogation for MRI.


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## The Jogger (20 Oct 2014)

Based on what I've read on here and a quick chat with Mrs J I will go ahead with the scan, you have all been very helpful.
Thanks
J


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## e-rider (20 Oct 2014)

vickster said:


> Ditto here...I was off my face on morphine at the time, so don't remember anything much of the experience!
> 
> I have had many dental and other X Rays this year (most recently on Saturday), and am having an MRI on Thursday. I also fly a fair amount for work/holidays and figure any radiation from imaging is less than that from being in an airplane (in 2012, I probably made 15-20 return flights various)
> 
> Personally, I'd rather have the imaging so the tooth butcher / doctors know what's going on, rather than poking around blind or having to do something more invasive / surgical


dental x-rays using modern equipment are very low dose - I was getting concerned after having about 30 images over a 10 year period due to continuing problems but actually the radiation turned out to be the least of my worries.


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## slowmotion (20 Oct 2014)

Random useless fact alert!
In the mid to late 1950s, shoe shops had X ray machines so that prospective buyers could see their feet and bones inside their new shoes. I remember them as a small child. They were entirely unregulated, as far as I know. Shoe shop sales people had a high incidence of cancer due to excessive levels of radiation exposure. My parents were both medics with an understanding of the risk and banned me from ever using one. I really wouldn't worry about a CT scan. A fortnight in a Cornish holiday cottage is probably far more risky.
[media]
View: http://www.youtube.com/watch?v=QVlEXd9w7vk
[/media]


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## MartinQ (21 Oct 2014)

The Jogger said:


> I will go ahead with the scan



Also has the advantage that your natural glow after the scan means you won't need any high-viz clothing for a while


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## swansonj (21 Oct 2014)

slowmotion said:


> Random useless fact alert!
> In the mid to late 1950s, shoe shops had X ray machines so that prospective buyers could see their feet and bones inside their new shoes. I remember them as a small child. They were entirely unregulated, as far as I know. *Shoe shop sales people had a high incidence of cancer due to excessive levels of radiation exposure.* My parents were both medics with an understanding of the risk and banned me from ever using one. I really wouldn't worry about a CT scan. A fortnight in a Cornish holiday cottage is probably far more risky.


That's a new one to me - evidence? Even with high dose occauptional groups, the excess risk of cancer is still quite small, so you need large studies to detect it, and I'd be surprised if there were enough shoe shop sales people, or that anyone had found a way to track them.


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## classic33 (21 Oct 2014)

swansonj said:


> That's a new one to me - evidence? Even with high dose occauptional groups, the excess risk of cancer is still quite small, so you need large studies to detect it, and I'd be surprised if there were enough shoe shop sales people, or that anyone had found a way to track them.


 See  Shoe Fitting Fluoroscope 
@slowmotion must be older than he's letting on!


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## Pumpkin the robot (21 Oct 2014)

I think in the last year I have had 4 CT scans and 5 xrays. Have to stop having these accidents!


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## w00hoo_kent (21 Oct 2014)

ColinJ said:


> Oh, and I asked the radiographer about allergic reactions to contrast dye. I was told not to worry about it. I found out later that my brother-in-law had nearly died from an adverse reaction when he was scanned!


When I had mine recently I was curious as to why they left the cannula in for so long and so asked. Was told that it was so they had a quick point of entry if you had an allergic reaction to the contrast, and they sit you around for 20 minutes to make sure you aren't going to (although most reactions happen a lot quicker.) Allegedly my CT scan was to prove they hadn't missed anything obvious in what they were looking for (rather than to find anything specific out).


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## swansonj (21 Oct 2014)

classic33 said:


> See  Shoe Fitting Fluoroscope
> @slowmotion must be older than he's letting on!


Well, at risk of turning into one of those pedants who spin threads out ad nauseam by harping on about the same point, that link doesn't say anything about cancer risk in shoe shop staff.....


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## The Jogger (25 Oct 2014)

Had this today, no injections just had to drink half a jug of water and less than five minutes on the table, quite glad I went ahead with it. Thanks all.


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## gbb (25 Oct 2014)

The Jogger said:


> Thank you all veris much for taking the time to reply to my query/worry. It has been really informative and reassuring. Lets hope the head can rationalise all this and calm down. Just received a copy of the letter from my consultant to my GP saying reason for CT is because of my history of kidney stones, the pain in the side and neither x ray or ultrasound could detect a stone.


The only trouble with most peoples experiences of scans and Xrays, logically, you will not know what effect it may or may not have for decades in all probability.
2 CTscans in the last 18 months, one with dye and possibly 6 xrays, mostly for TB, pneumonia and pleural thickening.. I accept they have definately aided my diagnosis and treatment, but I hope there are no longer term implications. 
Im sure my exposure is piffling compared to some, I dont lose any sleep over it, but every time I have another one...I wished I didnt have to.


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## ufkacbln (25 Oct 2014)

ColinJ said:


> Oh, and I asked the radiographer about allergic reactions to contrast dye. I was told not to worry about it. I found out later that my brother-in-law had nearly died from an adverse reaction when he was scanned!






w00hoo_kent said:


> When I had mine recently I was curious as to why they left the cannula in for so long and so asked. Was told that it was so they had a quick point of entry if you had an allergic reaction to the contrast, and they sit you around for 20 minutes to make sure you aren't going to (although most reactions happen a lot quicker.) Allegedly my CT scan was to prove they hadn't missed anything obvious in what they were looking for (rather than to find anything specific out).




The problem is how much you tell the patient 

If you tell the patient "I am about to give you an injection that may kill you" then there is obviously going to be a lot of concern, anxiety and probably a cancellation

However if you have checked the patient's risks (iodine allergy, use of metformin, asthma) and associated indicators, and reduced these, then the chances of a reaction are very low.

In this case the benefit of telling the patient is far outweighed by the worry and concern you will cause



The other point is that diagnostic imaging has two possible outcomes, to confirm or disprove a diagnosis. Quite often the clinical presentation of an illness has several possible diagnoses. 

Although a CT scan not finding anything seems to be an unnecessary radiation dose, the fact that you have excluded a particular illness enables the proper diagnosis and hence still justifies the dose to the patient


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## The Jogger (25 Oct 2014)

PS: I have to say they were ultra efficient............


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## ufkacbln (25 Oct 2014)

classic33 said:


> See  Shoe Fitting Fluoroscope
> @slowmotion must be older than he's letting on!



Howzabout radioactive underpants?







Or.....


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## ColinJ (25 Oct 2014)

Cunobelin said:


> The problem is how much you tell the patient
> 
> If you tell the patient "I am about to give you an injection that may kill you" then there is obviously going to be a lot of concern, anxiety and probably a cancellation
> 
> However if you have checked the patient's risks (iodine allergy, use of metformin, asthma) and associated indicators, and reduced these, then the chances of a reaction are very low.


Given that I had not seen a doctor for over 25 years when I got ill, that nobody asked me about allergies or other illnesses, and the amazing lack of a working nationwide NHS computer system, I feel pretty sure that my CT scan was done without checking whether the dye might cause problems.

When I asked the radiographer about it, she said that it would be obvious very quickly if the dye did not agree with me ...!


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## ufkacbln (25 Oct 2014)

Something else (off topic but relevant to the present WW1 anniversary)

A little known fact is that Madame Marie Curie was unable to work during WW1, but was not idle

She recognised that a lack of X-Ray facilities were compromising the health of soldiers at the Front

She actually badgered wealth French individuals to give uo their cars, converted them to vans and into mobile x-ray units, known as "Petit Curies"

She then learned to drive, taught herself anatomy and physiology, and how to operate the machines.

She then drove these vehicles to the Front Line and operated the equipment personally

Second from right in this image






Driving to the Front:


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## classic33 (25 Oct 2014)

ColinJ said:


> Given that I had not seen a doctor for over 25 years when I got ill, that nobody asked me about allergies or other illnesses, and the amazing lack of a working nationwide NHS computer system, I feel pretty sure that my CT scan was done without checking whether the dye might cause problems.
> 
> When I asked the radiographer about it, she said that it would be obvious very quickly if the dye did not agree with me ...!


If the same one is still used, you'll end up on the floor if standing.
No reaction to newer ones.

One lasting memory was having X-rays done that required a barium meal/drink beforehand. I was left the two litre jug & a cup with the instruction to drink as much as possible. 
Knew that if I drank the one cup, I'd drink no more. Previous experience. Took hold of the two litre jug and drank the contents. Joined a few minutes later by a few more an a radiographer, with some more cups and a puzzled look on her face when she saw the empty jug.
Two or three cups would have sufficed!


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## ufkacbln (25 Oct 2014)

classic33 said:


> If the same one is still used, you'll end up on the floor if standing.
> No reaction to newer ones.
> 
> One lasting memory was having X-rays done that required a barium meal/drink beforehand. I was left the two litre jug & a cup with the instruction to drink as much as possible.
> ...



The new ones do have reactions as the basic problem is the iodine content

They have a different form and a lower concentration, which has reduced, but not removed the chance of a reaction

Edited:
Found what I was after... Typically the reaction rate was 6-8% in the old days, but the low osmolarity, non-ionic compounds used now this is 0.2 % of patients

Of those who do react the majority are minor with only 0.06% being moderate and severe


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## classic33 (25 Oct 2014)

Cunobelin said:


> The new ones do have reactions as the basic problem is the iodine content
> 
> They have a different form and a lower concentration, which has reduced, but not removed the chance of a reaction


I'm told I went white, before just dropping to the floor.
Next time I mark that form yes.


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## classic33 (25 Oct 2014)

Cunobelin said:


> The new ones do have reactions as the basic problem is the iodine content
> 
> They have a different form and a lower concentration, which has reduced, but not removed the chance of a reaction


I'm told I went white, before just dropping to the floor.
Next time I mark that form yes.


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## ufkacbln (26 Oct 2014)

classic33 said:


> I'm told I went white, before just dropping to the floor.
> Next time I mark that form yes.




Should not need to as it will now be marked on the imaging department's computer (and in many cases the main computer) as an alert if you have had a reaction.

However it is always advisable to tell the Radiographer that you have had a reaction to contrast media, we would rather be told and not need to know than deal with a reaction

There is just so much paperwork to fill in!


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## ColinJ (26 Oct 2014)

Has there been any progress with that national NHS computer system? 

When I had my second PE last year the hospital that I ended up at in Northampton could not access my records in Halifax. It shocked me that I had to tell the consultant my history because he could not just look it up!


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## fossyant (26 Oct 2014)

No, Manchester can't access Stockport, so despite me seeing a specialist in Manchester, he can't see my records and treatment I have at Stockport.


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## ufkacbln (26 Oct 2014)

ColinJ said:


> Has there been any progress with that national NHS computer system?
> 
> When I had my second PE last year the hospital that I ended up at in Northampton could not access my records in Halifax. It shocked me that I had to tell the consultant my history because he could not just look it up!



There is the new national patient record scheme, - The Summary Care Record is in progress

However many (including me ) have opted out over concerns on privacy and the sharing of data outside the NHS in research, insurance and use of demographic data


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## MartinQ (26 Oct 2014)

ColinJ said:


> Has there been any progress with that national NHS computer system?!


A month ago I had a wasted 8 hour round trip to Addenbrooks. I realised this when he started the meeting with "have you got a copy of your records"


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## swansonj (26 Oct 2014)

Cunobelin said:


> The problem is how much you tell the patient
> 
> If you tell the patient "I am about to give you an injection that may kill you" then there is obviously going to be a lot of concern, anxiety and probably a cancellation
> 
> ...


I do not dispute that a patient's concern at possibility of side effects may outweigh the benefit the procedure will bring to them.

But please be very wary of going down the line of assuming that patients will treat information irrationally so you will withhold the information; that you can make better judgements on their behalf than the patient can for themselves, so it's better to make the decision for them. Not only is that ethically dubious ("informed consent"?), it is counterproductive, as the sagas of nuclear power and BSE among others have shown.


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## midlife (26 Oct 2014)

You don't have to tell patients all risks, I stick anaesthetic in or onto people most days but never recall telling them a side effect might be methaemoglobinaemia...............

Shaun


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## classic33 (26 Oct 2014)

midlife said:


> You don't have to tell patients all risks, I stick anaesthetic in or onto people most days but never recall telling them a side effect might be methaemoglobinaemia...............
> 
> Shaun


Lignocane stopped my heart twice, on seperate occassions. So now its no longer given/used.


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## classic33 (26 Oct 2014)

ColinJ said:


> Has there been any progress with that national NHS computer system?
> 
> When I had my second PE last year the hospital that I ended up at in Northampton could not access my records in Halifax. It shocked me that I had to tell the consultant my history because he could not just look it up!


Any idea why they didn't just phone the General Hospital?


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## ColinJ (26 Oct 2014)

classic33 said:


> Any idea why they didn't just phone the General Hospital?


I imagine that doctors do have to do that all the time in the UK. I wear a tag with my NHS number and various other bits of information on. If I were found unconscious somewhere then they would have to start making phonecalls if they can't look up my records using that number.

It isn't quite the same thing is it, to have to phone people up and get them to read documents out to you rather than just bringing the records up on a computer screen and reading them yourself?


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## Tin Pot (26 Oct 2014)

I always take the gamblers approach to these things, and I can see some thought has already gone into defining the tiny chance if something going wrong from the scan.

However, what are the chances of benefiting from the CT scan, let's say in a Dr Banner style Hulking?


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## ufkacbln (26 Oct 2014)

Tin Pot said:


> I always take the gamblers approach to these things, and I can see some thought has already gone into defining the tiny chance if something going wrong from the scan.
> 
> However, what are the chances of benefiting from the CT scan, let's say in a Dr Banner style Hulking?




Totally OT... And probably something I shouldn't share, but for the greater good

I have two new staff and sent them for ID Badges and due to a printer fault, their faces are bright green

Forget the Hulk or Shrek, these badges woukd work as HiViz

I have refused to accept as it is unprofessional,and you cannot say there is no risk of your staff ARE BRIGHT GREEN


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## The Jogger (31 Oct 2014)

Just an update, had the cystoscopy today (legs crossed) all good, he also had a look at the scan as well and said he has yet to hear from the radiologist but it looks good to him, (the urologist that is) and no kidney stone that he could see or anything else. Phew


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## ufkacbln (31 Oct 2014)

Good news, and As I said earlier, although counter-intuitive, a negative result excluding a problem is still a valid reason for the scan


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## The Jogger (31 Oct 2014)

Cunobelin said:


> Good news, and As I said earlier, although counter-intuitive, a negative result excluding a problem is still a valid reason for the scan



I totally agree and thanks.


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## Smurfy (4 Nov 2014)

machew said:


>


I eat bananas most days


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## Lisa21 (6 Nov 2014)

I have had a couple, the last one about 5 years ago, on my head. I suffer intermittently with extremely bad Trigeminal Neuralgia and the specialist wanted to see if there was a specific cause which surgery may help. There isn't. But some may say im still absolutely fine ..


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## The Jogger (9 Dec 2014)

Got a letter about the UT CT scan, showing essentially healthy bladder and kidneys, however showing a tiny 1mm stone in the lower pole of the left kidney, no treatment needed........hopefully I will pee it out, yet the twinges are on the right side. I don't care, quite pleased actually.............


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## ColinJ (9 Dec 2014)

The Jogger said:


> Got a letter about the UT CT scan, showing essentially healthy bladder and kidneys, however showing a tiny 1mm stone in the lower pole of the left kidney, no treatment needed........hopefully I will pee it out, yet the twinges are on the right side. I don't care, quite pleased actually.............


I think I passed a stone when I was about 20 years old. I had agonising pain for a couple of hours and peed some blood, but then it all eased. I never had the problem again.


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## ufkacbln (10 Dec 2014)

ColinJ said:


> I think I passed a stone when I was about 20 years old. I had agonising pain for a couple of hours and peed some blood, but then it all eased. I never had the problem again.



Allegedly the closest that us men will ever come to child birth!

Now if only getting a renal stone was as much fun!


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## ColinJ (10 Dec 2014)

Cunobelin said:


> Allegedly the closest that us men will ever come to child birth!
> 
> Now if only getting a renal stone was as much fun!


And, as usual, I did not see a doctor! (It all happened in the middle of the night and I decided to wait until the surgery opened in the morning, by which time I was ok.)


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## The Jogger (10 Dec 2014)

I've had a few big kidney stones and after having spoken to a colleague who has not only had stones herself but also given birth, she can testify that in her experience the KS pain is worse than that she experienced in CB.


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## confusedcyclist (10 Dec 2014)

Benefit of having the scans always outweigh the risks of not and missing something serious, otherwise your clinician wouldn't recommend it.


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## ColinJ (10 Dec 2014)

confusedcyclist said:


> Benefit of having the scans always outweigh the risks of not and missing something serious, otherwise your clinician wouldn't recommend it.


Thalidomide?


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## vickster (10 Dec 2014)

Still used in cancer treatment...just with rather more caution now and not in pregnant women / women who may become pregnant


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## ColinJ (10 Dec 2014)

vickster said:


> Still used in cancer treatment...just with rather more caution now and not in pregnant women / women who may become pregnant


I was just making the point that clinicians are human and do make mistakes, so it pays to at least question what they are doing.

My late mum's GP decided to double the dose of some of her medication. She collapsed within hours and ended up spending 3 months in hospital. When told about that he said, "_Oh, perhaps I should have *halved* the dose_"!


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## vickster (10 Dec 2014)

I think it was more the Pharma companies who were less than open about potential side effects (or they may not have known)

Why most drugs are used with extreme caution in pregnant women, pharma companies now won't risk trials in pregnant cohorts. And testing drugs in children is another dangerous area and mostly done only in pure paediatric indications


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## confusedcyclist (10 Dec 2014)

I work in clinical research and there are whole swathes of people employed to ensure exposure to radiation is minimised as there are risks associated with excessive exposure. That's because ionising radiation doesn't play nice with your DNA. The problem occurs when it knocks out the sections of your DNA which help prevent cancers, i.e. destroy or impair genes responsible for cell repair, validation genetic sequences, controls on cell division, cell growth, voluntary cell death and so on. As you slowly stack these up you have the workings of an unstable and immortal cell which may lead to invasive cancers. This is why continuous exposure to toxic air pollution, alcohol, smoking, processed foods and all things yucky eventually lead to cancers. Yet this needs to happen to dozens of genes, all within the same cell before any cancers can emerge, even then there's a chance the immune system will fight it off before it becomes a problem.

But as I said, the act of doing nothing is often worse in the long run. Lets say I wouldn't want to have a CT scan daily, but 3-5 a year would still be a negligible dose. The chart on page 1 does a good guide of summing it up.

CT scans have been used for two decades so the risks and rewards are well understood. Thalidomide at the time was not, ask Vickster rightly pointed out, lessons we learnt in the 50s and we now have tighter controls on medications, particularly for those in use prior to licensing. Exposure to radiation sounds like a scary concept, but we are being barraged by the stuff on a daily basis and baring standing in a nuclear reactor, our evolutionary past enables us to cope remarkably well with the exposures we face on a typical day.

Unless you spend your life standing inside the Fukushima reactor, this one time you have a CT scan might be the fabled straw that breaks the camels back, but most likely it is not. So, given that information I hope you can make a slightly more informed decision on whether the risk is worth it.


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## confusedcyclist (10 Dec 2014)

ColinJ said:


> I was just making the point that clinicians are human and do make mistakes, so it pays to at least question what they are doing.
> 
> My late mum's GP decided to double the dose of some of her medication. She collapsed within hours and ended up spending 3 months in hospital. When told about that he said, "_Oh, perhaps I should have *halved* the dose_"!


This sounds like a case of clinical negligence, but obviously I don't have the specific details. Sadly people react to drugs differently and you will never be able to eliminate all the risks, but the cost of inaction? Probably worse.


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