As I mentioned in my last post, I had a CT scan today. It was actually kind of fun, and a lot faster than I expected.
My scan was of my upper spine, from my skull down to just below the shoulder blades. I didn’t have to undress or put on one of those funky hospital gowns or anything- just take off my glasses and watch, lay down on a bench, and let the technician do her thing. This is a picture of a scanner similar to the one that I saw today (same brand and I think the same model- this is just a miscellaneous picture I found on the web):
The process itself was painless. Since the scan was focused on my spine, I didn’t need any kind of contrast solution injection or anything like that. I was a bit clumsy laying down on the bench itself: there was a sort of head rest thing that holds your head somewhat snugly, and I missed it on my first try. Once I was lying down, the tech put a little strip of some kind over my forehead: I’m not sure what that was for, certainly it didn’t hold my head in place, so I’m guessing it was some sort of reference strip for positioning or aligning the machine. The bench rose up to align with the donut-shaped scanner itself, then slid a bit back and forth (I guess so that the technician could check my position).
The technician then went to the operations booth, letting me know that she’d run a few tests before starting the actual scan. The bench I was on slid slowly back and forth through the scanner, and I was able to get a look at the inside of the “donut”. I was initially a bit surprised to see that there was a glass “window” on the inside of the ring. I assume the glass passes xrays more completely than say translucent plastic, but the glass gave me the benefit of being able to see the innards of the machine a bit. Unfortunately, there wasn’t much to see: several things that sort of looked like lenses flashed by on some sort of spinning armature. A moment later the technician asked me to refrain from swallowing and to hold my breath, and at that point I could hear the spinning mechanism inside the ring speed up a bit. It didn’t sound super fast…more like washing machine speed rather than jet turbine, so I’d guess something less than 100 RPM (but I could be completely wrong). A few seconds later the technician said I could breathe again, which was handy since I was not doing too well holding my breath with this cold. She came out and checked the scan (or I assume that was what she was doing) for a moment, then told me I was all done.
Netting it all, the process took less than 15 minutes. It was actually easier and faster than the traditional X-Rays I’ve had in the past. The staff in the Diagnostic Imaging area at Langley Memorial were cheerful and efficient. They also appear to have a sense of humour: hanging on the big door into the CT scanner room was a cartoon showing a nervous patient lying on a bed with a couple of technicians standing by: one tech is reassuring the patient, saying it was normal to be a bit nervous during a first cat scan. The other technician in the cartoon was holding a cat starting down at the patient through a pair of binoculars 🙂
The machines are faster, and have a higher resolution than they did 20 years ago when I went through my “intensive diagnostic investigation.” But as you noted having a cold, they are still set up for healthy people. The narrow bench, lying completely flat and holding one’s breath are still very difficult for the sick and very old people they are often scanning.
You seem to have had a unit with a decent sized bench… last scan I had ( a PET scan ) had me lie on a tray that was no more than 12 inches wide. ( For those that don’t kow me, I’m a LOT wider than 12″! ) Even though I was feeling fine at the time, trying to keep all my bulk perched on this little balance beam and immobile was not exactly a cake walk.
On another note, most of the delays in getting scans is not from lack of equipment, or even really technicians to run them. THe scans are quick, as you noted, and it really isnt that complicated to operate the machines these days. What the real hold up seems to be is a lack of radioligists to interpret the scans. Back in the days of fuzzy x-rays that made sense… nowadays I just don’t know if we really need someone with 6+ years of university education to interpret most of the scans that are crystal clear images that look like they came out of “Grey’s Anatomy.” Maybe we would be better off to train ALL doctors to interpret basic scans anand only call in specialists when there is something funky that the regular guys can’t figure out. I mean we train all our doctors to do minor surgery, which most of them will never do, and that they will be horrible at anyway without continous practice. Yet we don’t train them to interpret diagnostic tests which are almost de-riguer fro anything more complex than a sore throat.
Yeah, I was reading about the changes in CAT scan machines as part of my “research” (I know, I know…I’m weird). Its interesting to me that in the the early ones, in the 80s I guess, the scanner armature or gantry couldn’t spin more than one full revolution because of the wiring. So they’d spin one revolution, step the the bed back and reverse the spin to untangle the wires, spin another revolution…. Then someone came up with a way to mount the wiring on a contact plate so that the gantry could spin continuously- that’s where “helical” scans came in, but I guess that wasn’t until the late 80’s or early 90s. For some reason, the idea that the wiring was more of a challenge than the scanning itself strikes me as somewhat funny.
And you are right- the bed I was on wasn’t too bad to lie on. The only challenge for me was holding my breath- my lungs are just a bit too congested I guess. I “sipped” a tiny bit of breath during the scan, and since she only had to do it once I assume it didn’t cause any problems.
One thing that bugs me is that I don’t get to see the images. I was reading the GE Healthcare product site (http://www.gehealthcare.com/usen/ct/products/hiproducts.html) and some of the images it can output…I think it would be cool to be able to look at pictures of my own spine. And look at the blurb in the middle of this page: DVD interchange, JPG files and AVI movie output, USB FLASH drive support…heck, it supports all of that stuff. And yet doctors hide any diagnostic images from patients like its some sort of great secret. I don’t understand why…
It’s the “god” cult that doctors fall into… which in a way was understandable because in the 18 and 19 hundreds they pretty much developed the power of life and death. But they forget it’s “our” body, not theirs. ( Some of that is an attempt at objectivity, which is why they will believe a test result over what a patient tells them. Of course, the whole point of medicine I thought was to make us patients feel better. )
Nowadays though most of the problems that patients face are either strange things the doctors haven’t seen, or “lifestyle” issues. In both cases the doctors can’t do anything unless the patient is on board. Now some patients like to be told what to do … but folks like you and me, well we look at doctors as expert advisors. They interpret the data and the jargon, keep abreast of the latest developments and give us their expert opinion… but the decision is ours. Lots of doctors don’t like taking orders from people with no medical education…even if that person is the patient.
BTW: Technically you own your medical records so they can’t keep them from you. They put up one hell of a fight about it, but if you really want them, they have to turn over the files.
( And I’m sick as a dog with a chest cold / flu… something going around. )
Yeah, I suspect you are right about that “god” cult thing, Chris. Like I might look at the images and challenge their diagnosis, or ask them a knowledgeable question. If I had my preference, I would be able to log in to some goverenment health website like my bank account, and access/download the diagnostic data if I wanted to. I guess I didn’t really ask the question: Maybe if I said “Hey, can you write that out on a DVD?” they would have said “sure, here you go”…but I doubt it 🙂
I’m sorry to hear you are feeling sick. The flu (I’m calling it a flu) Irene and I had was nasty. I spent four days with a fever, and got up to 102 degrees (which is high for me). Two days ago, though, was the worst. Its hard to describe why it was “bad”, but part of it was the fact that my extremities (arms/legs/hands/feet) were all tingling…combined with fever/chills..for over 12 hours. I seem to be past the worst of it now.
Next year, I think I’m going to see about getting the flu vaccine. I doubt it will help, but you never know.
Sounds like what I’ve got. Aches, shakes, tingle, hot and chills combined with a nasty sore throat that makes swallowing feel like chewing on glass. Started with a cough. And I had the flu shot so don’t expect relief there 😉
I could rant about flu shots and how they cannot work they way they try and use them… but I can barely stay upright with my fingers on the keyboard. Ugh
Amusing reads, thanks for putting up pateint thoughts on CT scanning!
I am a young neuroradiologist who loves radiology – but hates the doctor culture !
Maybe it’s because my dad still works in a pizza shop at the age of 74 that i can feel like a
normal human being, and not like a robot surgeon (like my wife ;-))
Anyhoo, the culture of manufacturing CT and MRI machines and reading the scans is a freaky world to be sure. We can, and i do a lot of, 3D reconstruction of data for our non-radiology doctors to put it all together in a Gray’s anatomy/ Frank Netter anatomy way. In fact, the future should hold portable bedside scanners that the average doc will/should use, and heck, why not a holographic projection of 3d data, ala star trek.
you engineers out there, start working on it, cause the money is in gadgets, not the art of medicine. don’t get me started on how corporate culture has nearly effaced the human side of taking care of patients.
i do head and neck radiology as a speciality [taking a break from rewriting a chapter by typing this now] and my best days are when i talk to patients a little [biopsies, myelograms, etc] because they need a smiling face put “on the machine….”
enough ranting – just know that radiologists in general DO hide scan images from patients – it is pretty rare for us to show the patient their scan or invite them behind the scan console for one simple reason.
WE HAVE TOO MANY SCANS TO READ!!! i crank 35 scans/day, and in private practice i cranked out 50. you can’t talk to more than 1-2 patients/day and get throught the pile and see your family otherwise. and, you’re right, it is a powerplay to keep patients out of the loop…but you can always ask the nice tech for a cd of your scan! they should give it to you; lie tell them your doc wants it!
BTW – for the flu, lots of vitamin C and chicken soup. Linus pauling took 18grams/day, and for any virus, fringe (read orthomolecular) docs advise 1-2 grams every 2 hours…really. Haven’t tried it yet myself though.
Cheers!
Greetings, Dr Phil 🙂
I sort of understand a lot of what keeps doctors and medical techs from “sharing” with patients. What the medical profession needs to do often has to be done on a tight time budget. And I also expect that the “average” patient is more likely to misunderstand or start thinking the one minute helpful briefing they get qualifies them to second guess every little thing the professional is trying to do. I deal with that every day as a senior computer geek, and my work is far from life and death!
That said, as a somewhat non-average patient, I’d love to have better access to my own information. If it could be done in a way that minimized extra effort on the part of the medical staff, that would be ideal. For example, if there was a secure way for me to log in somewhere and download/request my own medical data, including scan results, I’d be right there checking out the pictures of my innards. Not because I really have any desire to second guess someone who has specialized education and years of experience: but because instead of my doctor picking up one of those plastic vertabrae things and saying “here’s where your owie is”, I could look at the real thing. The ability to see inside in three dimensions, to show slices and to distinguish/highlight/hide different densities is, to me, very cool. I’d probably spend far too much time playing with the data if I had a chance 🙂
By the way: nothing new really showed up on my CT scan. Arthritic/bony growths at (if I recall correctly) C4/C5 aggravating/inflaming the nerve that runs down my right arm. No disk involvement, so no real option for surgery according to my doc- just physio and painkillers when it flares up.
Re: the flu- thanks for your advice! I am pretty good at looking after myself that way, having suffered through more than my fair share of sick times. I have allergies (I had mild asthma as a kid), and have funky sinuses. When I get a tough virus, it usually follows that I end up with a bacterial sinus infection, and quite often end up with a sort of allergic reaction in my lungs, and then sometimes something like bronchitis. Netting it out, it took me from December 27th until January 30th to get back to “normal”. Stupid messed up immune system doesn’t know when its done….