The Husband is a pediatric radiologist. He works at Children’s. He’s passionate about reducing the amount of radiation a child receives when they have any imaging. In the medical world, “imaging” includes x-rays, CT scans (“cat” scans), bone scans, MRI studies, ultrasound, and procedures like “swallow studies” and VCUGs. He’s real smart and has taught me why to reduce the number of x-rays and CT scans I obtain in my own clinic.
Our tale began when we met the first day of medical school. I went up to the physician lecturer and made a comment after a lecture on gun violence. Jonathan stood right behind me. He said, “Ditto to everything she said.” I don’t think he’s ever said ditto again. Darn.
Read his guest post. You’ll learn ways to reduce radiation exposure for your children. I say, “Ditto to everything he said.”
Let me begin by saying that I live in awe of Mama Doc’s efficiency. In the time that I put this short post together, Mama Doc has posted 3 blogs including the Disaster preparedness video. Mind blowing. To those of you who are thinking about taking up this blogging thing and who do not have Mama Doc’s alien-like efficiency, let me say this very slowly…keep your day jobs.
Potential topics I considered for my guest blog entry.
- How the success of this blog somehow explains or redeems the fact that my family members bypass me for medical advice and go straight to Mama Doc. Example conversation, “Hey bro…” Me, “Yeah Wendy’s here…yeah…no, I understand.” “WENDY, my brother is on the phone…he wants to ask you something about medicine.”
- The eerie parallel between this blog and the plant from Little Shop of Horrors. Think “Feed me!”
- The risk of medical radiation, especially in children. How parents can reduce the risks for their children.
Alas, I chose option #3. No wonder my family members ask for Mama Doc when they call.
When my mom was a child, she would go to the shoe store, try on shoes and then go to the handy-dandy in-store x-ray machine to see if the shoes fit. Foot in, foot out. X-ray on, x-ray off. Every time she checked, she received radiation. No one told her that the radiation might be bad for her.
Fast forward sixty years. Sorry to date you, Mom. A study in 2007 suggested that only 13% of parents of children in medical settings understood that there is a theoretical risk that the radiation associated with CT scan might increase the risk of cancer.
We can do better than that. Since 100% of people should know this:
- To be safe, assume low doses of radiation may cause harm. Any radiation for a baby, child or adolescent carries risk as their bodies are still developing. However, a typical chest x-ray provides no more radiation than you get while flying in an airplane from New York to Seattle.
- A head CT scan provides the equivalent amount of radiation to between 100 and 250 chest x-rays.
- The amount of radiation a CT scanner emits is adjustable. For example, an adult head requires more radiation than that of a child to get quality images. Therefore, when a child gets a head CT scan, the radiation can, and should be, dialed down.
So here is the deal – There is no conclusive evidence in scientific literature that radiation from one simple X-rays causes cancer. However, some studies of large populations exposed to radiation have demonstrated slight increases in cancer risk even at low levels of radiation exposure, particularly in children.
Do everything in your power to minimize risks from radiation for your children going forward, especially if they have underlying medical problems and get repeated CT scans. However, if your child has had numerous CT scans, don’t freak out. CT scans provide a tremendous amount of information and often the benefits truly outweigh the associated risks.
Much, if not all, of this information is available at www.imagegently.org , a web site set up by the Society of Pediatric Radiology.
- Go to the Image Gently and look for the “Parents” tab under What Can I do? Here you will find excellent resources about the medical risk of radiation, CT scans, and interventional radiology.
- Print out the Medical Radiation Record (found on the Image Gently parent page). It is like a Vaccine record. But different. The idea is that by tracking each and every study that your child has had, it is less likely that a study will be repeated unnecessarily. Also, your child’s doc will have a better idea of how much radiation your child may have received already.
- Be proactive. Tell your pediatrician about the Image Gently website. It’s ok to tell your pediatrician what you know. They work to protect your child, too. Direct them to the section for pediatricians. Some doctors image more than others. If you think your child is going to get an x-ray or CT scan it’s always okay to ask them about alternatives (like an MRI or ultrasound that don’t provide radiation). If your child’s doctor or an ER doctor orders a CT scan for your child, ask if another study without radiation would answer the question they are looking to solve.
- If your child is about to have a CT scan in any hospital, ER or clinic, mention the Image Gently program. If the CT technologist is not aware of it, have them google it and look at resources on reducing radiation to your child before they scan your child. If nothing else, it may remind a technologist who is used to scanning adults to use a lower dose with your child.
- Get a digital copy (on a CD) of your child’s studies (CT scans, x-rays, MRIs) and bring them with you if your child gets referred to another doctor or hospital. This too will decrease the likelihood of a repeat study. It is often easier and faster for a doctor to repeat a CT scan than it is to track down the images from a CT scan from an outside hospital. Don’t give them the choice! Bring them the study yourself.
Medical imaging is amazing. Often, the benefits of imaging and CT scans far outweigh the risks of radiation because of what we learn and how we can treat and cure disease. But, like most amazing scientific advances, there are associated risks. Use these resources to inform yourself, your pediatrician, and the imaging center where your child is cared for so that your child gets the best care, the right answers, and the least amount of radiation.
And, if your child never needs an x-ray or CT scan, may good fortune continue to shine on them for the rest of their lives.
–The Husband, aka Dr Jonathan Swanson