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I complained of arm and chest pain and a doctor scheduled me for a nuclear stress test. I had no clue the amount of radiation I would be exposed to and was never warned about it. 6 months later I still had the pain and a cardiologist scheduled a CTA.
The cardio xray I had at the emergency room was a few days ago. By then I was aware of the dangers and asked for a TEE or MRA instead, but they said the CT was the only option. This time I asked for a number for total radiation exposure and he wrote down 1290 mGy cm. I found a formula online and converted it to msv and got 22 which is 2.2 rem.
You weren't at a V.A. hospital by ny chance were you?
A TEE will not give you the same information and are not equivalent exams. A TEE cannot diagnose any blockage of the coronary arteries or downstream vessels.
CT angio is a much more common study and more accurate in diagnosing coronary heart disease which is what they were looking for. Some facilities don't even perform cardiac MRA despite having an MRI machine. The best gold standard test is the cardiac angio performed by an interventionalist. It has its own set of problems including possibility of kidney failure, MI, arrhythmia, etc and is an invasive procedure. So basically you are looking at risks anyway you go or an inferior exam which may miss a life threatening defect/occlusion.
My guess is you signed a waver of some sort to receive the exam. Depending on the facility it may have warned of radiation exposure. The one at my facility does include that information.
I should have been more clear about the emergency room visit. They were checking the aorta, not the heart because I had upper back pain as well. A TEE or mra would have been fine for that. I was never handed a waiver to sign. Was never once notified of radiation risks with any scan.
I was exposed to 22 msv from the Aorta scan. Appropriately 40 to 50 msv from the nuclear stress, 20 to 35 from the cta and 12 to 20 msv from the abdominal and pelvic scan. I will check hospital records to see if I can get access to accurate numbers.
Its really insane how much radiation they use.
A TEE would not have been equivalent. They were then looking for a dissection which cta is superior and an MRA would have taken hours vs minutes for cta. You likely would have waited an hour at least for a TEE in any case depending on the time bc an ER physician is not trained in tee and neither is a radiologist. TEE is hardly ever if ever used to diagnose a dissection except in the setting of the operating room when patients are having open heart surgery and ct is not even possible. The delay in care if you had a dissection and were waiting on a MRA would have amounted to malpractice and would likely have killed you if you had one.
It's hard to believe you never signed a medical waiver before treatment at anytime. Nearly all hospitals have you sign a medical waiver prior to any treatment prior to receiving care. The exceptions are trauma patients/ unconscious patients where consent is implied. Otherwise when people sign into ER the next thing they give you is a medical waiver. If they didn't that was an obvious mistake and oversight on their part. It's standard of practice.
CTs and imaging in general are grossly overused today. It is sadly part of the defensive medicine practiced today. Obviously was not there when you had symptoms but if you had a true dissection the quickest most accurate study to get would be CTA and it isn't even close. You can sometimes pick them up on cxr but in all reality few if any physicians will institute the aggressive treatments needed for a dissection without ct evidence. In case of dissection time to treatment is essential to survival.
Dont believe me no problem take a peak at the american college of radiology guidelines for diagnosing aortic dissection. Here is link since it wont let me attach it.
This post has been edited 2 times, most recently by buckiwild42 13 months ago
You doubled the limit of a radiation worker in one day. I will also add that a radiation worker is typically never exposed to that much in a short period of tim.
That is certainly a lot of dose and the worse kind (acute). I am surprised they don't explain the risks more and track your exposure better . They could easily make you wear a TLD or ED and track your exposure(the person who scanned you probably wore both of those )
Steve Spurrier is a God, and Mark Richt worships him
Yes, I was shocked how much patients are exposed too. Many of these tests are unnecessary. I had no family history of heart disease yet an urgent care doctor schedules me for a nuclear stress test which emits twice the radiation of the more thorough CTA scan. Nuclear stress test will only detect a blockage if it's at least 65% while a CTA can detect much smaller build up and also give a calcium score. The doctor was simply ignorant. I went to radiology today and ask for information about how much radiation I was actually exposed to from the scans. They acted as though no one ever asked them that before. They had to get their supervisor. She took down my name and number and said she would have their physicist compute the numbers. She acted defensive asking me why I wanted to know and what do I intend to do with the information. Perhaps she thought a lawyer was involved for a potential lawsuit..lol. I simply wanted to know, that is all.
god forbid we question these damn doctors. my daughter had 2 CT scans recently.
we wanted to make sure the nuerosurgeon is the one doing the surgery and not some resident. he got so offended and said we were overly concerned about our daughter.
the surgeon mentality
What is happiness? The feeling that power is growing, that resistance is overcome.--Friedrich Wilhelm Nietzsche
They are just going to estimate it,they don't know real numbers cause you didn't were doseimetry
They just called me back and wanted to know if a doctor was requesting the information. I told them it was just me. She said it would take some time because it's very time consuming. Each image records the amount of radiation and there are several hundred images in a CT scan. She said that they don't have to do it because it isn't required by any regulatory agency, but they would do it anyway.
If someone was exposed to that amount of radiation from a nuclear plant accident they would be immediately hospitalized.
The FDA has investigated reports of radiation overdose at several hospitals and clinics. One big problem is lack of safety standards. There can be extreme differences in how much a patient is exposed to depending on the professionalism and competence of the technician.
The U.S. Food and Drug Administration has been investigating reports that patients undergoing computed tomography (CT) brain perfusion scans were accidently exposed to excess radiation. The FDA found that when properly used, the CT scanners did not malfunction. Instead, it is likely that the improper use of the scanners resulted in these overdoses. However, the FDA has identified a series or promising steps to enhance the safety of these procedures. These steps could reduce the likelihood of radiation overexposure in the event of improper use of the CT scanners.
Immediately hospitalized? Did you have nausea vomiting? Skin changes to the area? Thats a bit of an overstatement. Perhaps someone would get sent in to get "checked out" but they would be immediately discharged home. The reason they would be sent in is bc they were working at a nuclear power plant that had an accident.
Yes, you should be concerned. Yes there are alternatives to almost every exam, but the facts are this. A CTA can tell you if you have stenosis, but cannot tell you clinical significance. So if that exam had come back "positive" you would have likely needed to undergo the nuclear stress which would have an all reality exposed you to even more radiation. If you do not have a reversible defect the risk of doing intervention is not worth it and would potentially expose you to a life threatening procedure/intervention that would also require you to also be placed on blood thinners for a period of time which obviously has it own sets of risks. Nothing in medicine is ever black and white. I can appreciate the concern you have about radiation exposure, but in reality what are you going to do with the information?
I 100% agree one should be aware all of the risks of all exams/interventions.
Do with the information? Because I want to know how much radiation I was exposed to. Every patient should be monitored for radiation during a CT scan. It's shocking that they are not. There are no standards, and one could get twice the exposure than what is typical, but would be clueless about it. Radiation exposure is dangerous and symptoms may not appear for years. Workers at nuclear plants are constantly checked, yet in most cases are not exposed to the amount of radiation of some CT scans can give one in just a couple of minutes. There is actually more concern about radiation that airline crews absorb because of high altitude travel, yet are in far less danger that a patient undergoing a CT test. Many scans are being ordered for patients who really shouldn't be getting them, and there are things that can be done to reduce radiation exposure without sacrificing image quality, yet hospitals are dragging their feet because no one is forcing them to set safety standards.
Most people in the medical community don't care because it's not happening to them, just the person who is undergoing the test, that's why we need government oversight, to force the medical community to take it serious.
The important thing is that the patient should be informed about radiation exposure and how much they are receiving.
I find your entire presentation to be very misleading and disingenuous. If you wanted to make a point/troll that is one thing.
Pretending like you're ignorant and need someone's advice on radiation, then you spit out studies and all these 'facts' you've found about it- it's all obviously a setup.
Would you like to rephrase the OP to say "I THINK CT SCANS GIVE YOU CANCER- YOU SHOULD BE SCARED TOO" so you can stop this charade?
My guess is no. His entire post screams hypochondriac.
It's rather obvious.
It's like asking: "How many NC's does Alabama have" and when someone says fifteen, he comes back with three pages explaining how each individual year is crap and never should have been awarded.
He asked a question then berates you with the answer he already had = troll.
They are monitored which is the reason you will be able to get the numbers you seek.
Define "really shouldnt be getting them". Are you a physician? Do you work in the medical field? You want to blame the doctors, but the symptoms you were complaining of were severe enough to present to an emergency medical facility for. Sounds like they tried to rule out the life threatening causes which in all reality is the job of the physician on staff there. They did this using the most accurate and least invasive test. No offense, but what would you want them to do? If they say you know what probably not a aortic dissection and you die= lawsuit.
"there are things that can be done to reduce radiation exposure without sacrificing image quality, yet hospitals are dragging their feet because no one is forcing them to set safety standards"
Really? Now you really are sounding like a troll. you do know why many facilities do not get the certifications right? It costs money to be certified and many of the smaller hospitals simply cannot afford it despite meeting the standards. The piece of paper on the wall is just that a nice wall hanger.
There are better machines that use reduced radiation but have you checked on the cost of a new CT scanner? Many of the advertised low radiation CT scans do have reduced quality in comparison but are adequate for most purposes. I left a link of cost below. Keep in mind its not only cost but maintenance and etc involved.
No offense but if you are going to keep a lifelong tally of radiation you probably should put on a detector for life. You are talking about accumulative lifelong risk. Nuclear facilties also monitor all their employees not just for the employees sake persay, but also to help detect a nuclear leak quickly in order to protect the public.
As for radiation exposure I will be exposed to far more radiation in my lifetime than any patient. This in order to provide care to those patients. So if anyone should be concerned it would and should be me. It is a concern, but does not dominate my daily activities. I wear protection, but nothing is remotely close to 100%. I get exposed every single day. So for you to say "Most people in the medical community don't care because it's not happening to them" is absolutely wrong and an irresponsible statement. Physicians and the like do care but they are often focused on making sure someone doesnt die in the short term. The medical community does care as evidence by the studies being funded on the subject.
A basic overview of CT scanner prices, costs and expenses. Find out how much you can expect to pay for your next CT scanner.
The first point I think is what drives the CT scanner the most- defensive medicine. If you send a patient out and they die from something that MIGHT have been found on CT then you/insurance owes the family (and their attorney of course) a fortune. The way our legal system works is that we will accept a thousand people being irradiated in order to save one person. Physicians cannot take these risks in order to lower costs or reduce radiation exposure.
And can you imagine how ridiculous it would be to have ANOTHER layer of the federal government interceding between you and patient care in order to 'reduce radiation exposure'? My god, it's like they think that you can press a button to cut the radiation in half without any problem. I also love how he says he could have just received an MRI, like the doctor was too dumb to think of that. Don't you enjoy patients folding their arms and demanding an MRI with no regard to cost, effectiveness, or availability? A little knowledge is a dangerous thing...
Are you in radiology? I'm a 4th year wrapping up a rotation with IR and I never realized how often they work around an actual operating CT scanner. Yea they're wearing lead apron and skirts along with thyroid shields, but they get that exposure every day for DECADES. The troll story above involved the guy getting a few scans over a year or so- not even in the same stratosphere.
Pretty scary stuff. Many CT technicians are either retarded or insane.
Reports of overdoses, which began to emerge late last summer, set off an investigation by the Food and Drug Administration. But an examination by the New York Times has found that radiation overdoses were larger and more widespread than previously known, that patients have reported symptoms considerably more serious than losing their hair, and that experts say they may face long-term risks of cancer and brain damage.
This poor kid was almost killed in a CT scan. Will probably get cancer and other health problems. Some of these technicians are trained apes who cannot think or have a conscience. It's unreal how incompetent they are.
At a time when Americans receive far more diagnostic radiation than ever before, the cases underscore the risks posed by a diagnostic tool when used incorrectly.
I'm had several in the last year and never worried about this. Just relax.
Like a troll you don't address the legitimate points people are making, you just continue to make the same point you've made again and again with minor variations.
Basically you read this article and each point you have made is pretty much directly from it.
This article is crap- it's a collection of *scary stories* involving people in a very specific study involving brain perfusion studies. It's terrifying for gullible people who now will think they need an MRI for every belly pain they have. Please link an article demonstrating a significant increase in cancer for people who are very infrequently irradiated by CT scanners.
I get your mind is made up- I'm just trying to help other people you will mislead here.
don't take this guy seriously
You will never be exposed to such a large amount of radiation in one minute as someone who had a nuclear stress test or CTA. And there are no restrictions on how much radiation they can be exposed to.
No it isn't crap. The patients imagined their hair fell out? Perhaps they pulled it out themselves? I read all the responses and many just don't care what happens. Doctors make stupid and irresponsible decisions all the time. They're human beings, not gods and some of these medical technicians have no interest in patient safety.
So because these people in a small study received higher doses of radiation that normal you think that people should be afraid of being scanned by CT or getting myocardial perfusion imaging? You cite two articles that are both about the same few people in the same exact study. You also post another *scary story* about a kid who got a butcher job of a CT and got tons of radiation more than normal. Both of these are extremely rare incidents and give no useful information to a person who may or may not receive a routine CT scan or perfusion study.
Do you know how many people died on hijacked aircraft in the last 15 years? Do you fly airplanes?
Do you know how many people die from bee stings? Do you go outside?
Do you know how many people die from evisceration by sitting on hot tub suction filters? Do you go to the pool still?
Yes, doctors are not infallible but they are NOT going to give you a CT unnecessarily. Stop trolling on stuff that matters.
Edit: i missed the "these medical technicians have no interest in patient safety" line, wtf? Are they not human beings? Do you think they get off on irradiating people unnecessarily? Were you rejected in any form by a female CT tech- serious question.
This post was edited by faceman237 13 months ago
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