Wednesday, 1 February 2012

Radiology education

Today I had my CT scan - the one that the team (oncologist, chest physician - and presumably surgeon) felt I should have just to be sure that the small shadow remaining on my lung is, as suspected, scar tissue. It's a bother having to visit the hospital again and paying to park for the privilege. However I get over my aversion to parking charges by considering what I'm getting for my money. In municipal car park that's car parking surfacing, oil interceptors in the drainage, white lining and parking charge stations. At the hospital I look at it slightly differently. I work out that £2.20 is a very small price to pay for such an expensive procedure as a CT scan. It's not really logical but it stops me building up the resentment which so damages the human body.

Not wanting the visit to be wasted I interrogated the staff in the CT unit. First I asked about the dye that they inject into me and what it shows up. I had a scan first without the dye and then one with it. It's iodine. I got a very warm feeling in my thyroid - well half my thyroid - which seems logical. But I also get the same warm feeling (being a woman) in my labia. I wonder whether men experience a warm flushing feeling in the same area. They warn you about this. It passes after just a few seconds.

Anyway, I digress; the iodine I was told enables emphasis in the imaging of vascular structures, so that they show up to be more dense than the surrounding tissue. So in my case, if the shadow contains active blood vessels it would give cause for concern I guess. If not, then it's as originally indicated, scar tissue from the mess that my right lung originally was.

The second thing I asked about was that big question: who is responsible for my personal radiation exposure? Who is counting the sieverts? The answer is, legally, the referring doctor. So in my case Xrays requested by my GP, Xrays requested by my chest physician and Xrays requested by the surgeon. All should take account of my previous Xray exposure.

The big problem with this, it seems to me, is that the Xray records in my local hospital do not take account of my Xrays at the hospital at which I had my surgery. They apparently aren't able to see those, whereas they can see the Xray records acquired at other hospitals in the same region. And on top of that you've got dental Xrays; whether those are recorded by my local hospital, I don't know. So, each time I am sent for an Xray, the specific person sending me has the personal legal responsibility to have weighed up that the benefits to me outweigh the risks. If they can't see my previous Xray history of course, that's a nonsense. I think this is one of those issues that I might discuss the next time I'm at the cancer patient partnership's meeting.

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