Does anyone know about CT scan safety? How many of these can you have in a year, or over the course of years, without worry about radiation exposure/cancer risk?
@cattleya This question comes up frequently for people with chronic health conditions that require periodic monitoring via a CT scan or x-ray. So I looked for what the cancer experts had to say, and found this from Sloan Kettering Cancer Center: https://www.mskcc.org/news/scan-safety-radiation-reality-check
Essentially, the number crunchers say each scan, on average gives you a 1/2000 additional risk of developing cancer at some point. Compared to the risk of losing a lung, or worse, that is pretty low.
I talked to my new pulmonologist about how often my scans need to be done with stable bronchiectasis and no evidence of infection, and she prefers every 2 years because it can progress "silently" and we want to stay on top of things. (When I had an active infection, the scans were every 4 months.)
On the other hand, my cardiologist says we only need to repeat my heart CT if I get new symptoms or if the medication management stops working, as these would be clear signs of progression.
Both doctors stressed using the newest technology and techniques to minimize the amount of exposure, In fact my most recent lung CT only took 14 minutes from beginning to end, and the scanner didn't run the whole time. The tech explained how they keep updating her training with new software and positioning techniques, and that 10 years ago the same scan took over 30 minutes on a machine that used 4 times as much radiation.
So, how much is too much? Only you and the doctor can decide, but rest assured that no one orders these tests just out of curiousity.
@cattleya This question comes up frequently for people with chronic health conditions that require periodic monitoring via a CT scan or x-ray. So I looked for what the cancer experts had to say, and found this from Sloan Kettering Cancer Center: https://www.mskcc.org/news/scan-safety-radiation-reality-check
Essentially, the number crunchers say each scan, on average gives you a 1/2000 additional risk of developing cancer at some point. Compared to the risk of losing a lung, or worse, that is pretty low.
I talked to my new pulmonologist about how often my scans need to be done with stable bronchiectasis and no evidence of infection, and she prefers every 2 years because it can progress "silently" and we want to stay on top of things. (When I had an active infection, the scans were every 4 months.)
On the other hand, my cardiologist says we only need to repeat my heart CT if I get new symptoms or if the medication management stops working, as these would be clear signs of progression.
Both doctors stressed using the newest technology and techniques to minimize the amount of exposure, In fact my most recent lung CT only took 14 minutes from beginning to end, and the scanner didn't run the whole time. The tech explained how they keep updating her training with new software and positioning techniques, and that 10 years ago the same scan took over 30 minutes on a machine that used 4 times as much radiation.
So, how much is too much? Only you and the doctor can decide, but rest assured that no one orders these tests just out of curiousity.
Sue
If I remember correctly you had a CScan recently and were working on getting a good acceptable sputum for testing. Did you get an acceptable notification?
Was your CScan showing plugging?
I know you had to remove yourself from taking the antibiotics early on and yet cleared yourself of the infection???? had better CScan results eventually????
My new local pulmonologist, who I believe may turn out to be the right one after two other local "try outs"; so to speak; said that the CScan has greater determination of whether or not one is placed on the antibiotics vs the sputum results that show MAI. That was a surprise for me.
I wonder if different doctors differ on what to use as an indication for putting a person on antibiotics or is it the amount of plugging showing up on the CScan and knowing the person has an infection?????
Hope you are out of, or closer to, being out of the 'sling'. Such fun....dealing with muscles, organs, bones, systems and doctor visits for one health concern or another which gives us more things to work around and then be ingenious about in solving the problem of how to work around it. Need 10 laughing emoji's here and now.
Barbara
@cattleya This question comes up frequently for people with chronic health conditions that require periodic monitoring via a CT scan or x-ray. So I looked for what the cancer experts had to say, and found this from Sloan Kettering Cancer Center: https://www.mskcc.org/news/scan-safety-radiation-reality-check
Essentially, the number crunchers say each scan, on average gives you a 1/2000 additional risk of developing cancer at some point. Compared to the risk of losing a lung, or worse, that is pretty low.
I talked to my new pulmonologist about how often my scans need to be done with stable bronchiectasis and no evidence of infection, and she prefers every 2 years because it can progress "silently" and we want to stay on top of things. (When I had an active infection, the scans were every 4 months.)
On the other hand, my cardiologist says we only need to repeat my heart CT if I get new symptoms or if the medication management stops working, as these would be clear signs of progression.
Both doctors stressed using the newest technology and techniques to minimize the amount of exposure, In fact my most recent lung CT only took 14 minutes from beginning to end, and the scanner didn't run the whole time. The tech explained how they keep updating her training with new software and positioning techniques, and that 10 years ago the same scan took over 30 minutes on a machine that used 4 times as much radiation.
So, how much is too much? Only you and the doctor can decide, but rest assured that no one orders these tests just out of curiousity.
Sue
If I remember correctly you had a CScan recently and were working on getting a good acceptable sputum for testing. Did you get an acceptable notification?
Was your CScan showing plugging?
I know you had to remove yourself from taking the antibiotics early on and yet cleared yourself of the infection???? had better CScan results eventually????
My new local pulmonologist, who I believe may turn out to be the right one after two other local "try outs"; so to speak; said that the CScan has greater determination of whether or not one is placed on the antibiotics vs the sputum results that show MAI. That was a surprise for me.
I wonder if different doctors differ on what to use as an indication for putting a person on antibiotics or is it the amount of plugging showing up on the CScan and knowing the person has an infection?????
Hope you are out of, or closer to, being out of the 'sling'. Such fun....dealing with muscles, organs, bones, systems and doctor visits for one health concern or another which gives us more things to work around and then be ingenious about in solving the problem of how to work around it. Need 10 laughing emoji's here and now.
Barbara
Barbara, sorry for the late reply, my typing time is very limited and will be so for another 4+ weeks while I am in a sling full-time. Only then can I start PT - let me say that I am not a patient person and this enforced inactivity is driving me bonkers.
Back to your question - The answer is BOTH are important - watch the YouTube video below, one of the latest from NJH. In addition, symptoms and progression are taken into account. That's the purpose of "watchful waiting."
My own CT is stable, with some scarring from long-term infection. My radiology reports don't include descriptions of "mucus plugs" - I know I had them in early days - I haven't seen one in my sputum in years. Right now, we have decided not to do a sputum culture unless I have an exacerbation, so I have a standing order.
Barbara, sorry for the late reply, my typing time is very limited and will be so for another 4+ weeks while I am in a sling full-time. Only then can I start PT - let me say that I am not a patient person and this enforced inactivity is driving me bonkers.
Back to your question - The answer is BOTH are important - watch the YouTube video below, one of the latest from NJH. In addition, symptoms and progression are taken into account. That's the purpose of "watchful waiting."
My own CT is stable, with some scarring from long-term infection. My radiology reports don't include descriptions of "mucus plugs" - I know I had them in early days - I haven't seen one in my sputum in years. Right now, we have decided not to do a sputum culture unless I have an exacerbation, so I have a standing order.
Sue-
I think I lost my first response.
You do good with one arm still in a sling. So kind of you to reply. Thanks.
I have a better understanding now after the video.
I thought one had to be having a full blown exacerbation....fever, night sweats, chills, etc. etc. along with the BE/Infection for the start of the antibiotics.
I have not had fever, night sweats, chills, etc. and I am gaining weight and sleeping well. It's the constant need to clear the throat of what automatically comes up all day long...'mucus' etc.
Hopefully I will see an improvement in that also, besides the infection, once I start the antibiotics.
Barbara
Sue-
I think I lost my first response.
You do good with one arm still in a sling. So kind of you to reply. Thanks.
I have a better understanding now after the video.
I thought one had to be having a full blown exacerbation....fever, night sweats, chills, etc. etc. along with the BE/Infection for the start of the antibiotics.
I have not had fever, night sweats, chills, etc. and I am gaining weight and sleeping well. It's the constant need to clear the throat of what automatically comes up all day long...'mucus' etc.
Hopefully I will see an improvement in that also, besides the infection, once I start the antibiotics.
Barbara
Does your Dr really think the antibiotics are advisable in your case? No usual symptoms of exacerbation and good PF testing? The throat clearing must be very annoying but if it is clear mucus then again are the antibiotics really advisable at your age? Just my thoughts for what it is worth.
Your thoughts are worth a great deal to me and so are Sue's or others of those having been on this road a long time. We newbies need all the help we can get. Having to think it all out on my own is not the best thing and having other's thoughts to consider and come to my own decision is best.
Believe me I am thinking, still, long and hard.
The only thing I am worried about it how long will I live and do I want to take a chance of not taking them and developing nodules etc. etc. due to not taking them. Although I just read nodules can be caused by a multiple of things not just an infection. However with BE we are more susceptible to the other possible reasons for developing nodules. I often think of what I learned as a kid having to take care of all things myself and especially related to a car 'one problem can lead to another if not fixed' and then there is the school teacher in me "nip it in the bud."
Yes, it is Dr. McShane who I see. I am a bit concerned for various reasons and the perceptions I have developed. She had first suggested that I go on the trial study and come in every two months to see her. She may not have remembered or looked to see I live in OKC or thought that driving 6 hours every two months shouldn't be a concern for an 82 year old in view of all one has to do to leave your home (I'm single, no family) get there, stay overnight etc. etc. or she wanted to give me the opportunity to consider the trial and for me to weigh the pros and cons. Yet her very professional and good RT was concerned for me with the thought of that requirement alone and politely suggested not to do it. Go figure. Turned it down because I didn't want the drive etc. etc. I was then told to start the Azithromycin and Ethambutol.
My PFT is off the scale in the right direction.
Scan two areas of improvement.
One area new plugging in lower lobe. I am working harder on that area since being told that. I have been doing airway clearance with a better understanding for six months.
I can clearly feel and see I am clearing mucus. Most of the time it is clear and other times I can even tell from the feeling I have in my throat that I am bringing up colored mucus or a plug. Colored mucus is light in color.
Like so many of us other things happen also....I am dealing with a sore swollen foot after hitting it on something hard (can't remember what I hit it on but remember saying to myself, "that hurt.") Can hardly walk for a couple of days and especially not fun in the middle of the night in having to make my way to the bathroom. Don't we have fun and challenges! Thanks Irene.
Barbara
Does your Dr really think the antibiotics are advisable in your case? No usual symptoms of exacerbation and good PF testing? The throat clearing must be very annoying but if it is clear mucus then again are the antibiotics really advisable at your age? Just my thoughts for what it is worth.
Your thoughts are worth a great deal to me and so are Sue's or others of those having been on this road a long time. We newbies need all the help we can get. Having to think it all out on my own is not the best thing and having other's thoughts to consider and come to my own decision is best.
Believe me I am thinking, still, long and hard.
The only thing I am worried about it how long will I live and do I want to take a chance of not taking them and developing nodules etc. etc. due to not taking them. Although I just read nodules can be caused by a multiple of things not just an infection. However with BE we are more susceptible to the other possible reasons for developing nodules. I often think of what I learned as a kid having to take care of all things myself and especially related to a car 'one problem can lead to another if not fixed' and then there is the school teacher in me "nip it in the bud."
Yes, it is Dr. McShane who I see. I am a bit concerned for various reasons and the perceptions I have developed. She had first suggested that I go on the trial study and come in every two months to see her. She may not have remembered or looked to see I live in OKC or thought that driving 6 hours every two months shouldn't be a concern for an 82 year old in view of all one has to do to leave your home (I'm single, no family) get there, stay overnight etc. etc. or she wanted to give me the opportunity to consider the trial and for me to weigh the pros and cons. Yet her very professional and good RT was concerned for me with the thought of that requirement alone and politely suggested not to do it. Go figure. Turned it down because I didn't want the drive etc. etc. I was then told to start the Azithromycin and Ethambutol.
My PFT is off the scale in the right direction.
Scan two areas of improvement.
One area new plugging in lower lobe. I am working harder on that area since being told that. I have been doing airway clearance with a better understanding for six months.
I can clearly feel and see I am clearing mucus. Most of the time it is clear and other times I can even tell from the feeling I have in my throat that I am bringing up colored mucus or a plug. Colored mucus is light in color.
Like so many of us other things happen also....I am dealing with a sore swollen foot after hitting it on something hard (can't remember what I hit it on but remember saying to myself, "that hurt.") Can hardly walk for a couple of days and especially not fun in the middle of the night in having to make my way to the bathroom. Don't we have fun and challenges! Thanks Irene.
Barbara
She has such a good reputation. I guess I would just make sure she understands you are so symptom free other than the very annoying throat clearing thing. And that your PF tests are so good. I know she has told people with Pseudo not to treat unless sick but with MAC it is probably different. I do not have MAC as far as I know. But my Pseudo is awful and I live with exacerbation daily (very bad symptoms compared to most). Have tried some of the nebulized antibiotic option for it, afraid to try the oral choices due to other co morbidities. IV in hospital on something like Meropenem is my only choice it seems. Still high risk of colitis and C Diff with it. In my case treatment is obviously needed but side effects and co morbidities scare me off.
She has such a good reputation. I guess I would just make sure she understands you are so symptom free other than the very annoying throat clearing thing. And that your PF tests are so good. I know she has told people with Pseudo not to treat unless sick but with MAC it is probably different. I do not have MAC as far as I know. But my Pseudo is awful and I live with exacerbation daily (very bad symptoms compared to most). Have tried some of the nebulized antibiotic option for it, afraid to try the oral choices due to other co morbidities. IV in hospital on something like Meropenem is my only choice it seems. Still high risk of colitis and C Diff with it. In my case treatment is obviously needed but side effects and co morbidities scare me off.
Yes she does...good reputation. Going to message a couple of questions to 'them', meaning I get messages directly, only, from the nurse(s). Not sure if my message/questions ever get past the nurses. They are a help however..... and her main nurse has been in pulmonary for years.
I understand your thoughts with side affects. That is one reason I am hesitating just yet.
PCP and then eye doctor tomorrow for baseline. No matter my decision to take or not take, glad I did get the hearing baseline, moderate hearing loss both ears. That was a surprise.
Hope your daily exacerbation is mild tomorrow, if that is even possible.
Barbara
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@cattleya This question comes up frequently for people with chronic health conditions that require periodic monitoring via a CT scan or x-ray. So I looked for what the cancer experts had to say, and found this from Sloan Kettering Cancer Center:
https://www.mskcc.org/news/scan-safety-radiation-reality-check
Essentially, the number crunchers say each scan, on average gives you a 1/2000 additional risk of developing cancer at some point. Compared to the risk of losing a lung, or worse, that is pretty low.
I talked to my new pulmonologist about how often my scans need to be done with stable bronchiectasis and no evidence of infection, and she prefers every 2 years because it can progress "silently" and we want to stay on top of things. (When I had an active infection, the scans were every 4 months.)
On the other hand, my cardiologist says we only need to repeat my heart CT if I get new symptoms or if the medication management stops working, as these would be clear signs of progression.
Both doctors stressed using the newest technology and techniques to minimize the amount of exposure, In fact my most recent lung CT only took 14 minutes from beginning to end, and the scanner didn't run the whole time. The tech explained how they keep updating her training with new software and positioning techniques, and that 10 years ago the same scan took over 30 minutes on a machine that used 4 times as much radiation.
So, how much is too much? Only you and the doctor can decide, but rest assured that no one orders these tests just out of curiousity.
-
Like -
Helpful -
Hug
3 ReactionsSue
If I remember correctly you had a CScan recently and were working on getting a good acceptable sputum for testing. Did you get an acceptable notification?
Was your CScan showing plugging?
I know you had to remove yourself from taking the antibiotics early on and yet cleared yourself of the infection???? had better CScan results eventually????
My new local pulmonologist, who I believe may turn out to be the right one after two other local "try outs"; so to speak; said that the CScan has greater determination of whether or not one is placed on the antibiotics vs the sputum results that show MAI. That was a surprise for me.
I wonder if different doctors differ on what to use as an indication for putting a person on antibiotics or is it the amount of plugging showing up on the CScan and knowing the person has an infection?????
Hope you are out of, or closer to, being out of the 'sling'. Such fun....dealing with muscles, organs, bones, systems and doctor visits for one health concern or another which gives us more things to work around and then be ingenious about in solving the problem of how to work around it. Need 10 laughing emoji's here and now.
Barbara
Thanks for your reply! Good article too!
Barbara, sorry for the late reply, my typing time is very limited and will be so for another 4+ weeks while I am in a sling full-time. Only then can I start PT - let me say that I am not a patient person and this enforced inactivity is driving me bonkers.
Back to your question - The answer is BOTH are important - watch the YouTube video below, one of the latest from NJH. In addition, symptoms and progression are taken into account. That's the purpose of "watchful waiting."
There are guidelines for deciding, like these:
https://ntminfo.org/wp-content/uploads/2020/07/NTMguidelines2020.pdf
This is the treatment guideline for physicians.
Or in an easier to follow format:
My own CT is stable, with some scarring from long-term infection. My radiology reports don't include descriptions of "mucus plugs" - I know I had them in early days - I haven't seen one in my sputum in years. Right now, we have decided not to do a sputum culture unless I have an exacerbation, so I have a standing order.
-
Like -
Helpful -
Hug
1 ReactionSue-
I think I lost my first response.
You do good with one arm still in a sling. So kind of you to reply. Thanks.
I have a better understanding now after the video.
I thought one had to be having a full blown exacerbation....fever, night sweats, chills, etc. etc. along with the BE/Infection for the start of the antibiotics.
I have not had fever, night sweats, chills, etc. and I am gaining weight and sleeping well. It's the constant need to clear the throat of what automatically comes up all day long...'mucus' etc.
Hopefully I will see an improvement in that also, besides the infection, once I start the antibiotics.
Barbara
-
Like -
Helpful -
Hug
2 ReactionsDoes your Dr really think the antibiotics are advisable in your case? No usual symptoms of exacerbation and good PF testing? The throat clearing must be very annoying but if it is clear mucus then again are the antibiotics really advisable at your age? Just my thoughts for what it is worth.
-
Like -
Helpful -
Hug
1 ReactionYour thoughts are worth a great deal to me and so are Sue's or others of those having been on this road a long time. We newbies need all the help we can get. Having to think it all out on my own is not the best thing and having other's thoughts to consider and come to my own decision is best.
Believe me I am thinking, still, long and hard.
The only thing I am worried about it how long will I live and do I want to take a chance of not taking them and developing nodules etc. etc. due to not taking them. Although I just read nodules can be caused by a multiple of things not just an infection. However with BE we are more susceptible to the other possible reasons for developing nodules. I often think of what I learned as a kid having to take care of all things myself and especially related to a car 'one problem can lead to another if not fixed' and then there is the school teacher in me "nip it in the bud."
Yes, it is Dr. McShane who I see. I am a bit concerned for various reasons and the perceptions I have developed. She had first suggested that I go on the trial study and come in every two months to see her. She may not have remembered or looked to see I live in OKC or thought that driving 6 hours every two months shouldn't be a concern for an 82 year old in view of all one has to do to leave your home (I'm single, no family) get there, stay overnight etc. etc. or she wanted to give me the opportunity to consider the trial and for me to weigh the pros and cons. Yet her very professional and good RT was concerned for me with the thought of that requirement alone and politely suggested not to do it. Go figure. Turned it down because I didn't want the drive etc. etc. I was then told to start the Azithromycin and Ethambutol.
My PFT is off the scale in the right direction.
Scan two areas of improvement.
One area new plugging in lower lobe. I am working harder on that area since being told that. I have been doing airway clearance with a better understanding for six months.
I can clearly feel and see I am clearing mucus. Most of the time it is clear and other times I can even tell from the feeling I have in my throat that I am bringing up colored mucus or a plug. Colored mucus is light in color.
Like so many of us other things happen also....I am dealing with a sore swollen foot after hitting it on something hard (can't remember what I hit it on but remember saying to myself, "that hurt.") Can hardly walk for a couple of days and especially not fun in the middle of the night in having to make my way to the bathroom. Don't we have fun and challenges! Thanks Irene.
Barbara
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Like -
Helpful -
Hug
1 ReactionMessed up.....meant to send you the reply directly. Hope you find my reply.
She has such a good reputation. I guess I would just make sure she understands you are so symptom free other than the very annoying throat clearing thing. And that your PF tests are so good. I know she has told people with Pseudo not to treat unless sick but with MAC it is probably different. I do not have MAC as far as I know. But my Pseudo is awful and I live with exacerbation daily (very bad symptoms compared to most). Have tried some of the nebulized antibiotic option for it, afraid to try the oral choices due to other co morbidities. IV in hospital on something like Meropenem is my only choice it seems. Still high risk of colitis and C Diff with it. In my case treatment is obviously needed but side effects and co morbidities scare me off.
Yes she does...good reputation. Going to message a couple of questions to 'them', meaning I get messages directly, only, from the nurse(s). Not sure if my message/questions ever get past the nurses. They are a help however..... and her main nurse has been in pulmonary for years.
I understand your thoughts with side affects. That is one reason I am hesitating just yet.
PCP and then eye doctor tomorrow for baseline. No matter my decision to take or not take, glad I did get the hearing baseline, moderate hearing loss both ears. That was a surprise.
Hope your daily exacerbation is mild tomorrow, if that is even possible.
Barbara