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Requesting MRI instead of CT Scan - Radiation Concerns
Hi. I'm 26, female, BMI=26. I've been having dull pain and pressure in under my rib cage on the left side and in my lower back for a couple of years now. The first time this happened, I had abdominal and pelvic ultrasounds and they found some fairly large functional ovarian cysts. Those soon shrunk to almost nothing, while the pain has increased. I've had a number of blood tests and everything has come back fine.
My doctor has now ordered a CT scan. As I was researching the procedure, I learned about the amount of radiation it involves and began to question having it done. I have taken statistics and understand that the risk of developing cancer because of this test is incredibly small -- however I still don't feel great about having this done and wonder if it is really necessary. From what I've learned (on the Web, mind you!) MRIs now provide nearly comparable images of the abdomen with no radiation. However they cost more to insurers and take longer.
My questions basically come down to -- has anyone successfully lobbied their physician to get an MRI done instead of a CT scan (assuming insurance allows it) -- or lobbied to get another type of test done? How best to get the doctor to not brush this off? And of course, am I being paranoid or proactive?
Of course if you are familiar with reasons a CT scan is preferable to the MRI for back and abdominal pain, I would like to know this before I call the office on Monday. Right now I am also wondering if I shouldn't have a pelvic ultrasound first to rule out another ovarian cyst with pain referring higher.
Thanks!
My doctor has now ordered a CT scan. As I was researching the procedure, I learned about the amount of radiation it involves and began to question having it done. I have taken statistics and understand that the risk of developing cancer because of this test is incredibly small -- however I still don't feel great about having this done and wonder if it is really necessary. From what I've learned (on the Web, mind you!) MRIs now provide nearly comparable images of the abdomen with no radiation. However they cost more to insurers and take longer.
My questions basically come down to -- has anyone successfully lobbied their physician to get an MRI done instead of a CT scan (assuming insurance allows it) -- or lobbied to get another type of test done? How best to get the doctor to not brush this off? And of course, am I being paranoid or proactive?
Of course if you are familiar with reasons a CT scan is preferable to the MRI for back and abdominal pain, I would like to know this before I call the office on Monday. Right now I am also wondering if I shouldn't have a pelvic ultrasound first to rule out another ovarian cyst with pain referring higher.
Thanks!
You are correct. The risks from a CAT scan are extremely low. But they exist.
The basic issue here is a sober unbiased evaluation of the risks of radiation.
(a) There is the school of thought evidenced by every hospital in the world that "a silly x-ray is harmless".
(b) And the school of thought that every x-ray exposure has the potential to inducing a malignancy or a birth defect.
The answer is not "somewhere in between". The correct answer is (b).
X-rays damage by breaking molecular chains and bonds and producing free-radicals.
Females are particuliarly sensitive to such exposures because they have all their eggs on-board, and they are unprotected. That's why females should never serve on board nuclear submarines. The risk to females from radiation exposure is greater that the risk to men. And although the female sailor may insist she has the right to make decisions for herself, she has no right to make decisions endangering her eggs, and her future offspring.
Los Alamos Labs did a number of studies involving the hazards of radiation exposure for military purposes. I have copies of most of them. For a short period, decades ago, as a military officer I was involved in assisting with radiation risk analysis. I myself was involved in a radiation exposure causing loss of the sense of taste for a year.
The Los Alamos studies showed a number of other interesting things, such as your chance of radiation damage varies with the time of day, presumeably because of the bodies circadian rhythym.
When you get that dental x-ray, you should have a lead shield covering the rest of your body. Of any x-ray, for example. Try to convince the average x-ray tech taking your shot of that.
I did a study thirty years ago, placing strips of lead on dental films and placing them in a hundred areas of a room where x-rays were being taken at measured distances. After several days use of the machine, I developed the images, and every one of the films demonstrated exposure to some degree or another, even those on the far side of the room. So much for the theory that "only the area under the tube gets exposed".
The argument today is "the machines are better."
Maybe.
In terms of information obtained there is nothing the CT scan can detect that the MRI scan won't.
MRI's, incidentally, have their own hazards.
Outside the machine the north pole is far more dangerous to the nurses than the south, for example. One company that installs these devices always tries to point the north pole towards the parking lot.
Every diagnostic procedure involves a risk-benefit analysis.
Some hospitals only have a CAT scan available during certain hours. If you show up with a subdural hematoma, by all means get the CAT. The benefits outweigh the risks. And the window of opportunity for therapeutic intervention is limited.
If you want to be considered for a psychiatric evaluation, try to refuse the "routine" chest x-ray required before admission to every hospital in the United States. This is the infamous and generally worthless (to the patient) "insurance and malpractice prevention x-ray". The usual nonsense is to tell you "you are getting no more exposure than you would get on an airplane trip between two cities".
If you believe that I have a great bridge in Brooklyn I'll let you have for a song. And I'll get you a good deal on a hedge fund investment from a great guy named Berny.
Your finger is smashed?
Got to get a chest x-ray before admission, honey.
Ankle broken?
"Wait here for the portable x-ray of your chest before we can admit you, sir."
"What about that poster on the wall stating patients have the right to reject procedures?', you ask, innocently.
Listen to the nurses and the doctors giggle.
"Don't be a baby," says the admitting physician.
You shrink in embarrasment.
After all, these are DOCTORS who are giving you advice.
In fairness, many physician truly believe these machines are harmless.
There were also, at one time, a large number of physicians who believed the earth was flat.
I call this mind-set a "structured delusional system".
You should not be frightened of having an x-ray if YOU REALLY NEED ONE.
Nor should you be afraid of a CAT scan is it's the only game in town and you have a problem that can't wait.
The basic issue here is a sober unbiased evaluation of the risks of radiation.
(a) There is the school of thought evidenced by every hospital in the world that "a silly x-ray is harmless".
(b) And the school of thought that every x-ray exposure has the potential to inducing a malignancy or a birth defect.
The answer is not "somewhere in between". The correct answer is (b).
X-rays damage by breaking molecular chains and bonds and producing free-radicals.
Females are particuliarly sensitive to such exposures because they have all their eggs on-board, and they are unprotected. That's why females should never serve on board nuclear submarines. The risk to females from radiation exposure is greater that the risk to men. And although the female sailor may insist she has the right to make decisions for herself, she has no right to make decisions endangering her eggs, and her future offspring.
Los Alamos Labs did a number of studies involving the hazards of radiation exposure for military purposes. I have copies of most of them. For a short period, decades ago, as a military officer I was involved in assisting with radiation risk analysis. I myself was involved in a radiation exposure causing loss of the sense of taste for a year.
The Los Alamos studies showed a number of other interesting things, such as your chance of radiation damage varies with the time of day, presumeably because of the bodies circadian rhythym.
When you get that dental x-ray, you should have a lead shield covering the rest of your body. Of any x-ray, for example. Try to convince the average x-ray tech taking your shot of that.
I did a study thirty years ago, placing strips of lead on dental films and placing them in a hundred areas of a room where x-rays were being taken at measured distances. After several days use of the machine, I developed the images, and every one of the films demonstrated exposure to some degree or another, even those on the far side of the room. So much for the theory that "only the area under the tube gets exposed".
The argument today is "the machines are better."
Maybe.
In terms of information obtained there is nothing the CT scan can detect that the MRI scan won't.
MRI's, incidentally, have their own hazards.
Outside the machine the north pole is far more dangerous to the nurses than the south, for example. One company that installs these devices always tries to point the north pole towards the parking lot.
Every diagnostic procedure involves a risk-benefit analysis.
Some hospitals only have a CAT scan available during certain hours. If you show up with a subdural hematoma, by all means get the CAT. The benefits outweigh the risks. And the window of opportunity for therapeutic intervention is limited.
If you want to be considered for a psychiatric evaluation, try to refuse the "routine" chest x-ray required before admission to every hospital in the United States. This is the infamous and generally worthless (to the patient) "insurance and malpractice prevention x-ray". The usual nonsense is to tell you "you are getting no more exposure than you would get on an airplane trip between two cities".
If you believe that I have a great bridge in Brooklyn I'll let you have for a song. And I'll get you a good deal on a hedge fund investment from a great guy named Berny.
Your finger is smashed?
Got to get a chest x-ray before admission, honey.
Ankle broken?
"Wait here for the portable x-ray of your chest before we can admit you, sir."
"What about that poster on the wall stating patients have the right to reject procedures?', you ask, innocently.
Listen to the nurses and the doctors giggle.
"Don't be a baby," says the admitting physician.
You shrink in embarrasment.
After all, these are DOCTORS who are giving you advice.
In fairness, many physician truly believe these machines are harmless.
There were also, at one time, a large number of physicians who believed the earth was flat.
I call this mind-set a "structured delusional system".
You should not be frightened of having an x-ray if YOU REALLY NEED ONE.
Nor should you be afraid of a CAT scan is it's the only game in town and you have a problem that can't wait.
Thanks. My physician hasn't exactly pressured me to get the CT (I've had to push to get any imaging after the first ultrasound) and it would take place at an outside facility. I suspect she just regards the risks as low. If an MRI can provide similar diagnostic capabilities it seems the motivation is mainly financial/ insurance-related.
Honestly, from the research I've read, the risks seem very small--but not small enough or well enough documented to ignore if there is another option, particularly at my age. I'm hoping she'll understand.
Honestly, from the research I've read, the risks seem very small--but not small enough or well enough documented to ignore if there is another option, particularly at my age. I'm hoping she'll understand.
Once again, my position regarding an MRI vs. a CAT does not reflect the opinion of the majority of physicians in the medical community, nor the hospitals who sponsor this website.
Do your own research and come to your own conclusions.
Do your own research and come to your own conclusions.
Get the MRI. Your concerns are justified.
There is no reason to get a CAT except to amortize obsolete equipment purchased by the hospital/doctor. You are being served a baloney sandwich on toast.
If your physician insists on a CAT, get another physician.
Incidentally, the secret to not getting claustrophobia in an MRI is to close your eyes before going into the tube and not opening them until you are out.
There is no reason to get a CAT except to amortize obsolete equipment purchased by the hospital/doctor. You are being served a baloney sandwich on toast.
If your physician insists on a CAT, get another physician.
Incidentally, the secret to not getting claustrophobia in an MRI is to close your eyes before going into the tube and not opening them until you are out.
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