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From: Johnny1000 on 2 Apr 2008 11:09
Hello... I am plagued with they type of stones (probably uric acid) that
don't show up on a normal x-ray. As a result, when it comes to getting
the lithotripsy done, I'm faced with a medical system (in British
Columbia here), where the Drs. won't do anything now without a catscan.

I've expressed my concerns, given the massive dosage of x-rays that one
receives during this procedure, but it seems to fall on deaf ears.
...I'm expected to have a diagnostic catscan first, then another just
prior to the lithotripsy, then an IVP during the treatment, then 6 weeks
later another catscan.

For my last lithotripsy, I had the diagnostic catscan which showed 2
small stones in my lower left kidney, and a 5mm one, in the middle part.
...My right kidney is clear.

When it came time for the lithotripsy, I told the technician that my
stones don't show up on a conventional x-ray. She wanted to do another
Catscan, but I convinced her and the Urologist to go with the IVP.
...It turns out, they blasted only one of the smaller stones, and now 4
months later, my Urologist wants me to go back through the same catscan
procedure.

OK... So I'm aware that an abdomen catscan can inflict one with an
x-ray dosage equivalent to having 500 chest x-rays, and an IVP can
inflict a dosage equal to having about 150 chest x-rays, but what is the
normal procedure for a person like myself, who's afflicted with such
stones? ...My stones do show up well with an ultra sound, but it seems
like the lithotripsy operators and urologists won't have anything to do
with them.

Is anyone in the same boat? ..And if so, how do you get around, or
rather avoid being subjected to such massive doses of x-rays, when it
comes to getting your stones blasted? Thanks.. Jon




From: Peter on 2 Apr 2008 17:16
Johnny1000(a)webtv.net wrote:
> Hello... I am plagued with they type of stones (probably uric acid)
> that don't show up on a normal x-ray. As a result, when it comes to
> getting the lithotripsy done, I'm faced with a medical system (in
> British Columbia here), where the Drs. won't do anything now without
> a catscan.
>
> I've expressed my concerns, given the massive dosage of x-rays that
> one receives during this procedure, but it seems to fall on deaf ears.
> ..I'm expected to have a diagnostic catscan first, then another just
> prior to the lithotripsy, then an IVP during the treatment, then 6
> weeks later another catscan.
>
> For my last lithotripsy, I had the diagnostic catscan which showed 2
> small stones in my lower left kidney, and a 5mm one, in the middle
> part. ..My right kidney is clear.
>
> When it came time for the lithotripsy, I told the technician that my
> stones don't show up on a conventional x-ray. She wanted to do
> another Catscan, but I convinced her and the Urologist to go with the
> IVP. ..It turns out, they blasted only one of the smaller stones, and
> now 4 months later, my Urologist wants me to go back through the same
> catscan procedure.
>
> OK... So I'm aware that an abdomen catscan can inflict one with an
> x-ray dosage equivalent to having 500 chest x-rays, and an IVP can
> inflict a dosage equal to having about 150 chest x-rays, but what is
> the normal procedure for a person like myself, who's afflicted with
> such stones? ...My stones do show up well with an ultra sound, but
> it seems like the lithotripsy operators and urologists won't have
> anything to do with them.
>
> Is anyone in the same boat? ..And if so, how do you get around, or
> rather avoid being subjected to such massive doses of x-rays, when it
> comes to getting your stones blasted? Thanks.. Jon

Jon...I have never had a lithotripsy, but I believe the radiation from
fluoroscopy during the procedure is much greater than the radiation
associated with a catscan. The fluoroscope will stay lit for the amount of
time deemed necessary to identify the stones to blast, and will depend on
how long the procedure takes. My last upper GI with cine esophagram was two
minutes total lamp time, and about 4 rads because I am medium build (a heavy
person could have been 10 rads). You ought to ask you uro about how long
the fluoroscope is lit during the procedure (I believe it could be
significant) and approximately how many rads.

He won't know and will probably tell you he's not a radiologist, but tell
him you would like an answer (ie approx how many rads and how long is the
fluoroscope lit up - ie, total lamp time). If he won't get you an answer,
try calling the radiology dept. where you have the procedure done and see if
you can speak to a radiologist and ask how many rads per minute of lamp time
is associated with a typical lithotripsy for an average size person, etc.
He wont know how many minutes the uro will keep the lamp lit but he ought to
have a rough idea for a typical procedure. And your uro should certainly be
able to tell you approx how many minutes the lamp is lit during his last
procedure on you. The medical physicists are the ones who really know all
about radiation and radiation poisoning, etc.

Hope this helps...Pete





From: mainframetech on 4 Apr 2008 01:22
On Apr 2, 5:16 pm, "Peter" <pe...(a)nospam.net> wrote:

Just a thought, but if you suggested that you can't do the
procedure without knowing, they may want to get you an answer so they
can make the money from doing you. :)

Chris
From: Peter on 4 Apr 2008 14:05
mainframetech wrote:
> On Apr 2, 5:16 pm, "Peter" <pe...(a)nospam.net> wrote:
>
> Just a thought, but if you suggested that you can't do the
> procedure without knowing, they may want to get you an answer so they
> can make the money from doing you. :)
>
> Chris

Chris...who did you intend this for (me or Jon). I don't need a lithotripsy
and don't have kidney stones. I was just trying to offer my assistance
about some of the features and dangers of radiation (eg conventional
fluoroscopes are much worse than catscans, because they stay it when they
are on). And CT fluoroscopes are even worse (used for guiding needles for
biopsies, etc). A CT fluoroscope may be from 20-60 rads/minute.


From: Peter on 4 Apr 2008 14:23
Peter wrote:
> mainframetech wrote:
>> On Apr 2, 5:16 pm, "Peter" <pe...(a)nospam.net> wrote:
>>
>> Just a thought, but if you suggested that you can't do the
>> procedure without knowing, they may want to get you an answer so they
>> can make the money from doing you. :)
>>
>> Chris
>
> Chris...who did you intend this for (me or Jon). I don't need a
> lithotripsy and don't have kidney stones. I was just trying to offer
> my assistance about some of the features and dangers of radiation (eg
> conventional fluoroscopes are much worse than catscans, because they
> stay it when they are on). And CT fluoroscopes are even worse (used
> for guiding needles for biopsies, etc). A CT fluoroscope may be from
> 20-60 rads/minute.

Oooops! That was supposed to be "stay lit when they are on" :-)


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