Sunday, July 18, 2010

CT Scan Risks: Radiation Danger and Overuse Threatens Patients

Many patients erroneously believe that x-rays and CAT scans have no risk. In their minds, they are non-invasive studies that can cause no harm. Since there are no incisions or anesthesia, they regard the experience as having the same risk as taking a family photograph. How wrong they are.  In my mind the danger from non-invasive radiology studies may surpass the risk of hard core medical treatment. True, radiology tests won’t puncture an organ or a blood vessel, as a surgeon or a gastroenterologist can. Imaging studies do not cause direct damage, but they may lead patients onto the medical battlefield. These diagnostic tests are an insidious force that draws patients into a spiral of direct risk and medical overutilization.

Is this post a shot at radiologists? No, it’s a shot at all of us. Remember, radiologists never order CAT scans; the rest of us physicians do. I certainly am distressed with the obsessive manner that my radiology colleagues interpret studies today, identifying innocent, tiny ‘abnormalities' that will then light a fuse for further studies. In many of these cases, the CAT scans were ordered for defensive purposes, and the radiologists' interpretations often keep the defensive medicine train lumbering forward.

On July 1, 2010, the New England Journal of Medicine, the most prestigious medical journal in the world, published 2 commentaries on CAT scans and medical imaging. While readers are free to review the first and second essays in the journal, I will summarize the major points here.

• Nearly 400 patients in the U.S. who underwent brain-perfusion scans are known to have received an overdose of radiation. How many folks have received a 'brain sizzle' that we do not know about?
• Radiation doses from CAT scans are hundreds of times higher than standard x-rays.
• There is persuasive medical evidence that radiation is carcinogenic.
• Physicians like me who order scans have limited knowledge of radiation doses and toxicity.
• Technology exists and can be further developed to reduce radiation exposure to patients.
• There are no evidence-based standards on the proper role for medical imaging tests. It's a free for all.
• CAT scans are overutilized. Amazingly, about 10% of the U.S. population undergoes a CAT scan each year.  So far, I've never undergone one.  How much longer can I hold out?
• Individual patients should have their radiation exposure history tracked.
• Physicians often order CAT scans and other imaging studies believing this will lower their risk of being sued for medical malpractice.  I can vouch for this in my own experience.
• Radiologists, also seeking to lower their legal risk, routinely identify insignificant abnormalities and advise that these ‘lesions’ be evaluated and scanned in the future to verify that they have not changed.
• Effective tort reform is one mechanism to reduce the number of unnecessary imaging tests.
• Scans are routinely ordered when the probability that the disease exists is low. I have addressed the consequences of this approach in a prior post.
• Radiologists serve as technicians, rather than serve as medical consultants to assist clinicians.
• Medical students are not trained to rely upon medical evidence with regard to imaging tests. Bad habits learned in medical school tend to be sustained throughout a career.

CT scanning, and related medical technologies, are towering milestones that have revolutionized the medical profession.  They have eliminated millions of exploratory surgeries and have allowed physicians to make and exclude various critical diagnoses.  We couldn't function without them.  Nevertheless, CT scan overuse is rampant, and there are no forces that are curtailing or guiding its use.  We are spending billions of dollars on scans that are not medically necessary.  I have ordered some of these scans personally, so I acknowledge that my own practice needs remediation.

We describe medical imaging tests as non-invasive, but this is deceptive.  First, there is direct risk of harm from accumulated radiation exposure.  Secondly, and more importantly, there are the indirect consequences.  For many patients, the radiology suite is a danger zone, a trap door that can drop patients into a medical cascade with no way out. 

40 comments:

Nicholas Fogelson, MD said...

Michael -

While I agree that lots of technology is overused, I think you are taking an idea of theoretical risk and unfairly extrapolating a real risk to patients. While limiting radiation dosing is important, CT scans do provide incredible benefits to medical care, and greatly advance our ability to diagnose and treat disease.

If you are aware of any hard evidence that links real disease to CT scan exposure, I'd like to see it. I've know of the theoretical issues, but have never seen any real data. Radiation is carcinogenic, but clearly there is a dose-response curve to this, but there's no evidence I'm aware of that we're far enough into it. That being said, its certainly worth research. It is a pretty hard thing to study, though, as people who are diagnosed with cancer are certainly more likely to be exposed to CT radiation, as part of their diagnosis.

This whole issue a huge problem in obstetrics, where radiologists freak out if we want to do a CT on a pregnant mother, even though an abd/pelvic CT has less than 3 rads of radiation, with 5 rads being the minimum exposure ever shown to have any effect on the fetus. They don't consider the alternative, which is _not_ diagnosing the condition we are looking for. They are worried about a theoretical 1/5000 increased attributable risk of childhood leukemia. I am worried about the 50% fetal loss rate associated with a ruptured appendix in pregnancy.

CTs are overused in some situations, but to say that they are clearly dangerous is going to far in my opinion.

Anonymous said...

Yes, Doctor.. another excuse to be pro-tort deform and take away patient's rights.

Anonymous said...

btw regarding the link posted on tort reform, readers should read the comments... only illogical self serving doctors would gloss those over.

Anonymous said...

"Effective tort reform is one mechanism to reduce the number of unnecessary imaging tests."

Well, we've passed what physicians claim is "effective tort reform" and had it for decades and in those states physicians still order the same amount of tests.

So we can throw that "solution" out.

Got another?

Anonymous said...

Last anon.. I love how some of these illogical doctors keep crying tort deform every chance they get, even though their idea of tort reform (tribunals that take away the 7th amendment right to a civil jury, caps, et al) never even address the problem..

Further, I am trying to acquire statistics on how many times LAWYERS get sued for legal malpractice vs. how many times the holier than baby Jesus doctors get sued for malpractice.

I'd bet lawyers get sued more often than MDs/DOs in my state, I just cant find stats to prove it. The physicians are the ones that make all the noise so they can buy that 4th BMW while taking away their patients right to a jury trial.

In Texas, if you are a child, older person, or housewife, you are SoL (because of the caps) if you get paralyzed by a doctor who is more worried about his restaurant that is going under because of his lack of business skills than on concentrating on his patient. If you are rich and have lots of economic damages, you can still sue them. How is that fair?

Anonymous said...

To all you doctors reading this.. if you are so interested in "helping" the system become more efficient, why not become expert witnesses? You get paid by the side you feel is representing the "truth" and instruct the jury of your opinions. You would all gain an understanding of how the Rules of Evidence keep out "junk science" that you keep mentioning because some DeVry educated newpaper columnist says John Edwards somehow got them in..

In reality, the only way an expert witness would be useful is if you are 1) currently practicing 2) went to a good medical school 3) NEVER have had ANY blemishes on your record by your state licensing board 4) (preferable, not required) you publish in peer reviewed journals.

Michael Kirsch, M.D. said...

Thanks, Nick. You might find the first NEJM link in the post useful. The link takes you to a sign-in page; I could only link to the abstract. The brief article gives some of the available hard data on your inquiry.

By the way Nick, how many BMWs do you have?

Nicholas Fogelson, MD said...

I have one volkswagen, bought used.

Anonymous said...

In Texas, the mean annual salary for a general practicioner in 2009 was $181K a year. That is one of the top paying jobs PERIOD.

What makes things interesting is that doctors are always claiming lawyers are anti-tort deform for the money, when you guys are raking the cash in left and right. We can make the same comments about your motives.

Lawyer salaries have gone up in Texas since tort deform hit in 2004, so your argument is moot for most of the profession anyway.

Lawyers would be willing to work with doctors to make the system more efficient (the one major inefficiency in the system deals with DISCOVERY), but when all doctors seem to want are 1) caps or 2) special tribunals that infringe on the already dying 7th amendment lawyers should be ethically forbidden from being involed in these 'measures'.

After reading some of your posts about 'junk science' I started to realize that most doctors are grossly misinformed how civil justice inside a courtroom works. Any law school student knows the Rules of Evidence are designed to weed unreliable information out..

Perhaps you should go to an unbiased source (such as the Rules of Evidence and the civil statutes in your state) and quit getting all your information from college dropout, pill pushing Rush Limbaugh.

Anonymous said...

Wow, with all the Anons getting down and dirty on you Doc, I may have to get a name lest you confuse us.

Anon 4:47

Michael Kirsch, M.D. said...

Good point. Perhaps, those who rant anonymously might refer to themselves as Anon #1, anon #2, etc. This post is about 800 words long. One sentence was devoted to tort reform. This sentence was not even mine, but was one of several summary points taken from a New England Journal of Medicine article. Yet, this small sentence captured the attention of some tort reform antagonists. No comment on the remaining 98% of the post. Amazing selectivity.

Somehow, the inflated salaries of physicians relates to the dangers of CT scanning and radiation exposure.

Sorry about the Volkswagon, Nick. You'll just have to work harder.

The Medical Contrarian said...

I think you will find this article interesting.
http://radiology.rsna.org/content/224/3/927.full

Michael Kirsch, M.D. said...

MC, thanks for the link. Scary stuff.

Paul Dorio said...

Where to begin.

First, I never post anonymously. If you can't stand behind the power of your convictions, why post?

Second, I was reading your post at kevinmd.com and wanted to see what you blog about. Lo and behold the very first blog I read is a pretty amazing, if inaccurate, depiction of radiology and radiologists.

Perhaps I'll ponder your blog for a bit, while I politely suggest you read my comments, compiled from various sources, about the same subject. I think that there is a significant amount of misunderstanding about radiologists and our cornerstone role in health care delivery. But I'll leave that for a different time:

http://drpauldorio.squarespace.com/blog/2010/7/18/radiation-exposure-from-ct-scanning-balanced-perspective.html

and

http://drpauldorio.squarespace.com/blog/2010/7/18/radiation-is-your-radiologists-focus.html

Paul Dorio said...

These diagnostic tests are an insidious force” – seriously? A bit dramatic, perhaps. Good for readers. Don’t you think that most tests, even those performed under the argument of “defensive medicine,” are useful in some manner? There’s no hint of “insidious” in any component of my work day.

“I certainly am distressed with the obsessive manner that my radiology colleagues interpret studies today, identifying innocent, tiny ‘abnormalities' that will then light a fuse for further studies.” – Radiologists call what they see. I agree, however, that conclusions are not always helpful, in that the identification of indeterminate abnormalities may lead some radiologists to suggest additional follow-up or another test. But lawsuits against radiologists are won because of failure to diagnose and also failure to communicate findings adequately, in addition to other reasons. So we have little choice, sometimes, no matter how dogmatic I personally like to be, but to recommend “follow-up if felt to be clinically appropriate.” The actuality though, is that follow-up is the purview of the ordering physician, is it not? Really, if defensive medicine accusations are to be carried through, the physician reading the radiologist’s report now has to make the decision whether to take his “technical consultation” and ignore the recommendations, or act on them. Why it is always the radiologist’s fault is a bit tough for me to swallow.

“Radiation doses from CAT scans are hundreds of times higher than standard x-rays.” – Irresponsibly inaccurate, forgive my abruptness. As stated in the NEJM, (http://content.nejm.org/cgi/content/full/357/22/2277) “a conventional anterior–posterior abdominal x-ray examination results in a dose to the stomach of approximately 0.25 mGy, which is at least 50 times smaller than the corresponding stomach dose from an abdominal CT scan.”

“Physicians like me who order scans have limited knowledge of radiation doses and toxicity.” And “Radiologists serve as technicians, rather than serve as medical consultants to assist clinicians.” – While I think the second sentence grossly underestimates your radiology colleagues, I refrain from taking too much insult as I’ll assume it is stated out of ignorance of my entire chosen field. But, constructively, I would also suggest a solution to both issues: Make/allow radiologists to once again be “gatekeepers” (http://drpauldorio.squarespace.com/blog/2010/7/17/gatekeepers-could-radiologists-fill-this-role-again.html).

Overall, I found your blog interesting, if a bit dramatic. If I might suggest that you refrain from inaccuracies and perhaps consult your radiology colleagues, dissemination of accurate facts about my chosen field might help people and not continue to inflame the radiation discussion.

Michael Kirsch, M.D. said...

Paul, thank you for your thoughtful comments under your own name. First, I intended no offense toward radiologists. I admire their skill and artistry and rely upon them regularly. My point is that we clinicians do not avail ourselves of their cognitive knowledge and judgment sufficiently. Regarding your inquiry, "Don’t you think that most tests, even those performed under the argument of “defensive medicine,” are useful in some manner?", I don't think so. I believe that all of the incidental and vague finding cause more harm than good. How many pulmonary nodules have you identified in the past months. The vast majority of these are innocent and cost a fortune to follow and generate great anxiety for patients and their families. For those few malignant nodules you and your colleagues find, it is arguable whether this discovery alters the natural history or the lesion. (lead time bias)

From the NEJM piece: "Radiation doses from CT scans are 100 to 500 times those from conventional radiography, depending on what part of the body is imaged".

I enjoyed your blog post and your larger-than-life photo. I devote many posts to radiology subjects and welcome your perspective.

Nicholas Fogelson, MD said...

I love my GLI. Its a great car, and has a wonderful double clutch transmission. Sure I could buy a BMW but I'd rather come home and sit on a throne made up of glued together $100 bills.

Paul Dorio said...

Ha! I'm working on that darn photo - trying to get it smaller and fit it on the front page. Can't seem to figure it out!

Also, I suppose you're right about incidental findings, and I'd even say 99.9% of all nodules we see under 5mm are nothing. But here we must reconcile what to do about the large and frequent number of other incidental findings that definitely change the course of a person's life: aneurysms, kidney cancers are two great examples that we find with frequency. We do a disservice by calling kidney cancers "incidentalomas." They are much more than incidental to the patient's life, despite the serendipity of the find.

Thanks also for the kudos. The site is a work in process but I appreciate you're acknowledgment very much.

Former Anon said...

" Yet, this small sentence captured the attention of some tort reform antagonists. No comment on the remaining 98% of the post. Amazing selectivity. "

Well, on the medical aspects, if you're not a physician that should probably be left to the physicians to debate. However, when you get into the legal realm, well, that's where you typically head off course for obvious reasons.

Kathleen Clark said...

Dr. Kirsch: How does tort reform help the patient?

You mentioned in a previous post that physicians overtest for reasons other than fear of liability. What, in your experience, are the reasons for that?

Thanks very much. PS: I'm a lawyer, not a physician, interested in non-adversarial practices after adverse medical events.

Michael Kirsch, M.D. said...

Tort reform would reduce the need for physician´s to practice defensively. Medical overutilization has many other causes. Patients and families demand testing. Physicians often pull the trigger on diagnostic testing prematurely. There are financial conflicts of interests that favor testing. And, the medical culture today is one of diagnostic and therapeutic excess. Thanks, Kathleen, for your comment.

Anonymous said...

Tort reform (tribunals/ caps) is the solution to everything, guys and gals. Haven't you heard? Let the right to a jury trial be taken away from the patient, the doctor is the only one that matters.

The doctors never mess up or get worried simply because they don't have time to examine the statutes and rules of evidence.

Michael Kirsch, M.D. said...

No, doctors do mess up. The current medical liability system rarely finds them. Instead, you target the rest of us.

Former Anon said...

"Tort reform would reduce the need for physician´s to practice defensively. "

If this is true, how come in nearly 40 years of tort reform there's no evidence of it? At what point does the data drive the conclusion for you, Dr. Kirsch?

"The current medical liability system rarely finds them. Instead, you target the rest of us."

Not really. There are an astonishing lack of claims considering how much malpractice occurs. Although, I think we've shown this complaint of yours is pretty hollow.

Anonymous said...

I met a man who had a CT scan.... who is now dyeing of linked fibromyalgae caused by the dye infused into his body prior to the scan.
The dye stayed in his blood system longer than it should have and now his body / muscles have hardened like a rock. He asked me to touch his leg...... knock on it. So I did, and he felt like I was knocking on a leg of a mannequin it was hard as a rock.
I am looking for more information about this risk related to CT scans.
-TIm

Lizzy said...

What if you have a doctor, like I do, who orders the scan, fights with insurance who says I don't need it- and then takes the money and runs? I had a scan 2 months ago that he deemed necessary- never heard from him again.No you're ok- don't even know or believe that he even read it.

Michael Kirsch, M.D. said...

More on risks of CAT scans in a very brief article. http://bit.ly/ay3WSz

Anonymous said...

Dr Kirsch,

I am in total agreement with your description of the dangers inherent in these scans - if only I was aware of this prior to subjecting myself to a few - I would most definately not have had them at all. Your warning are legitimate and should be heeded.
My experience unfortunately concurs with your description and warnings in your note above - and my advice to all my family & friends and anyone who reads this - is NOT to agree to have one - perhaps an MRI is the safer way to go. I understand it does not use Xrays.

I am quite sure no MD or scan Technician would subject themselves to these extremely concentrated and intensive Xrays

Anonymous said...

Radiation does cause cancer. My Mother was radiation overdosed when she had ductal breast cancer and developed angiosarcoma of the breast from it It was not 10 years later either. It was four. If she had not had radiation she would still be alive. Oncologist know or should know that radiation can cause angiosarcoma.

Medical CT said...

CT scans are far more detailed than ordinary X-rays. The information from the two-dimensional computer images can be reconstructed to produce three-dimensional images by some modern CT scanners. They can be used to produce virtual images that show what a surgeon would see during an operation.

Mike King said...

As an X-ray tech I know that Michael is right. The companies can reduce the radiation dose to each patient but if millions of them receive a CT, the risk increases rather than decreases. As with Hiroshima etc, it is the total population dose that counts. Most people would not send their family member in a car if the danger of death was 1 in 1000 but chest and abdo CTs are OK???

Sue said...

The ionizing radiation techniques used to help doctors and dentists "see" beneath the surface take very heavy toll. Here is a link to an article on the risks of dental x-rays. http://www.medicalnewstoday.com/articles/191025.php

The published study showed that having as few as four dental x-rays in a lifetime doubled subjects’ risk of thyroid cancer compared to controls who had had no dental x-rays. The study found that those who had received ten dental x-rays had a 5.6 times higher rate of thyroid cancer than those undergoing no x-rays. Most Americans, and I count myself among them, have had many dozens of dental x-rays over the years. The cancer and immune-system risks of x-rays are not discussed by dentists nor even acknowledged by most. Most dentists deny any risk, and assert that a dental x-ray is like "being in the sun for ten minutes." If they actually believe this, they are woefully ignorant of a technology they use every day. If they know the analogy is wrong, then they are being intentionally deceptive. Where is the ethical obligation to fully inform the patient of risks?

I would be willing to patronize a dentist who relies on non-ionizing diagnostic techniques, and sign a form that I release the dentist from liability due to non-x-ray use. Too many health care professionals think that a small cancer risk is acceptable to achieve their own professional ends. I envy my friend Martha, an American college professor originally from Ghana – she’s never been to the dentist in all her 50 years! And her teeth are like beautiful piano keys, no problems. But given the choice, I would rather live to be 90 and have a few missing teeth than to experience breast cancer at 48, as my friend is dealing with now. She dutifully got the full mouth series of x-rays every two years. (Other research shows that dental x-rays are associated with higher risks for brain cancer and breast cancer.) It is sad to me that those who are charged with patients’ well-being are so cavalier with that well-being. Professionals are deciding for others that a certain risk is ok, when it is in reality playing Russian roulette. Cancer is a horrible lot.

Michael Kirsch, M.D. said...

From today's New York Times. Wonder what risk these kids will face in the future? No need to read the whole article, but quick skim of opening paragraphs is worthwhile. http://nyti.ms/gNsvWd

Anonymous said...

I am NOT a medical professional. That being said, I research a lot of health issues. The one thing that astounds me about the medical profession is how they are TAUGHT to do their medicine with "blinders". They are actually taught, not consciously, to purposefully blind themselves to reality so they can continue down the wealth path they have chosen. After all, if one were to truly delve deep inside their own psyche, they would see how they decided upon their respective medical professional for the pure profitability of that profession rather then a 100% desire to SERVE the sick. More and more, the internet is revealing this truth and the medical profession is finding out that they can no longer control the internet. Truth is getting out and putting this current WAY of doing medicine in it's real and proper place. More and more, medical professionals are coming forward and admitting that their practices are dangerous, useless, way over priced, deadly, or continue to keep people rolling through the doors to keep well paid medical professional's wallets fat. Let's be truthful, medicine used to be humane and run by CHURCHES!!! Now, it's just GOOD business! Until this problem is solved, than all these other serious problems never will. The heart of humans must change first!

Anonymous said...

My husband died of kidney cancer. While we watched the cancer move in his body via numerous CT scans, I also watched my husbands symptoms violently become inflamed post his CT scans or MRIs. I suspect they upset the atoms and molecules in our bodies. His body always had a bad reaction to them. I use to call him the litmus test because he would become ill after eating certain things that we found out were not healthy for one to consume.
They also told us radiation therapy had no side effects when we asked about them. They told us he might just fell tired. Well we soon learned there is more to it. Radiation therapy kills tissue and your body has to process it to be rid of it via your kidney. To much can give you kidney failure, in which he suffered in his healthy kidney, and passed on after a horrible experience. Gratefully the Good Lord relieved him and took him home before he was tortured anymore and ended up with a merciful death.
Eileen Light

Anonymous said...

Thank you for your outstanding honesty Dr.Kirsh. Please continue to stand up and speak the truth, for you are keeping your vows to help people and it is hope inspiring to see doctors putting people before their practice. It really is dishonest when doctors practice just because the whole medical institution is doing a particular practice, even when it is harmful to some people or they are about to change protocol but continue treat their patients with questionable practices to cover themselves mean while putting people at risk, and talk out of the sides of their mouths. People appreciate honesty and to be treated the way you yourself would treat your self and your loved ones. $$$$ had ruined the medical profession and our health care system. Doctors are afraid to treat with total honesty and some are greedy and few are brave.
Eileen Light

Anonymous said...

Hello. I am Karen. I am fifty six years old.
I was diagnosed w/ NHL Lymphoma Sept.2009. It is believed I had had it awhile. My younger sister died at 44 in 2002 from the exact same cancer. No once seems interested in our family history.
I had six ct scans. The surgeon said each ct scan was valued at 400 x-rays. I got a little
concerned today when I overheard some nurses discussing the fallout due to over exposure.
Seriously; I want to tell you that my sister refused treatment. I told my oncologist to throw everything at me that he had. I said experimental stuff, a locamotive, everything.
I informed him I have the cutest grandkids on the planet and I was in the middle of three quilts. He put me on R-CHOP (Rituxin) I did not tell him this because I was afraid. I was not. I told the doctors if I expire I'm packed and ready to go. But I'd prefer to stay. I never got sick. I watched cooking shows and cooked and ate like a pig. I never ocurred sp to me that I wasn't going to live. I look at the CT Scans the same way. Throw everything at me. I'm alive! I'm a little rubbery when I walk but I am alive. The jury is not in on Scans. But I remember Dr. Lister and how bad he was treated regarding anteseptics. How bad were Dr's treated over many different kinds of
research. If we're going to complain; how about the Bernillion dollars RX companies are making on antidepressants instead of properly diagnosing hypothyroidism. The research is there! The jury is in. The immune system could be strengthened but no. Keep up the good work
I look forward to more discretion on the CT scans but did I mention....I'm alive!

Anonymous said...

Have you ever noticed in all the reports and studies that have been done on the risk of radiation that they use the general population as the "control" group? What this does is downplay the risk. If they were being truthful they would use people who have never undergone an x-ray as the control.

Also, ever notice that that in layman articles they say things like "one CT scan carries a risk of 1/8000 of getting cancer, which compared to the lifetime risk of 26% chance of getting cancer, only changes your risk from 26% to 26.24%"

They make it seem like it's not a big deal at all, almost as if you're going to get cancer anyways, so don't worry.

My first objection to that is, yes there is a 26% chance of getting cancer in each person's lifetime, but most of that occurs starting at age 60. So how does that justify giving a 20 or 30 year old a scan that can cause them to get cancer in the next 20 years?

And secondly, have any of these researchers or doctors even considered that perhaps the reason a large number of people drop dead of cancer in their 70s is the fact they had so many x-rays and CT scans in their 50s and 60s to diagnose other ailments?

Third, there is a lot of fudging of cancer data. Just recently SEER reportedly mis-coded radiation treatments in a large population of their cancer data.

Fourth is how the ICRP converts GRAY to SIEVERT to downplay the risks of CT scans. The LSS study on Hiroshima survivors and other radiation studies use air-kerma values, usually in Gray, and measure the risk per Gray per PY. But what the ICRP did around 1991 was they made up, based on what I could only call a SWAG-guess, what they call "tissue weighting factors" that convert the radiation dose to Sieverts and make it much less than what it really is.

Last, why is it every article always use studies that downplayed the risk, and never mention other studies, like by John Gofman, which emphasize the more insidious aspect of radiation?

scared said...

I had several CT scans because I complained of arm and chest discomfort. After a nuclear stress test, my symptoms got worse. I had no idea why. They then ordered a CTA of my heart. A few weeks later, I started having constipation and faster heartbeat. An odd symptom was much lower blood pressure. My digestive system got a little better, but a few months later I went to the emergency room with back pain radiating to my chest. The doctor wanted to do a scan of my aorta. I asked for an MRI or MRA instead. Told her I was concerned about radiation and I had 3 scans in the past year. She said MRI wasn't an option and pushed for the CT. I finally agreed to it. I asked the radiologist how much radiation would I be exposed to. He looked puzzled as if no one ever asked him that before. He finally agreed to give me a figure after the test was completed. He wrote down 1290 mGy cm. I was able to convert that to msv with a formula I found online. It comes out to 23 msv. Much higher than the 7 to 15msv that is officially claimed for cardiac scans. I'm having great difficulty getting info about radiation exposure from the hospital that did the previous 3 scans. They keep giving me excuses and delaying it for weeks. Why is this such a secret? How come there is no regulation? If I received this about of radiation as a nuclear plant worker, it would be taken very seriously, but as a patient, it is kept from me. Anyway, I was healthy before all of this, now since this last scan, I am short of breath and have diarrhea. I told a doctor about it and he had this confused look. He knows nothing about radiation risks. There is a lot of ignorance out there in the medical community about radiation.

Wendy said...

I doctor ordered series sinus X-ray suspecting sinus cancer when I mentioned to her that I felt a bump on the roof of my mouth.

After supposedly seeing something suspicious from the X-Ray, the doctor followed up with CT-Scan.

I also had a few root canals during this time exposed to many X-rays. Each time the doctors told me that the amount of X-Ray is very minimum and safe...

Anyhow, I was recently diagnosed with hypothyroidism and I can't help it but to think all these radiation must have something to do with it...

I wish the doctors will be more careful when they order radiation on patients...

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