During a trip to the United States in 1993, a fall down a stairwell landed me in St Joseph’s hospital in Atlanta, where I was wheeled in to have an ankle X-ray. As part of the process I was covered with an incredibly heavy, 5 mm thick, lead “drape”. The “drape” was more a tent, because it extended down to the floor covering my head, and going down to the floor on three sides. During the five minutes or so it took the lead smocked staff to do the X-rays, I had to breath carefully, and be aware of heat rising. The staff knew what I was going through, because the minute the X-rays were finished, the trolley was pushed out the doors into the cool corridor, and the lead covering whipped off double quick. "Would a child cope with this?" I asked the staff. According to the radiologist...."Yes".
Fast forward to 1997, when Ian messed his ankle, and we landed up in Pukekohe X-ray. Was he covered with a lead sheet? No. What to do?. I looked around, and there hanging in the corner, covered in masses of dust (which escaped the cleaner's notice....) was a pathetic 2 mm thick, lead apron.
I understand.... that I have been a trial to my children over the years, but when it comes to their safety, I make no apologies for fighting in their corner – even if they hated it. “Mum, you’re an embarrassment!”
”Are you going to put that lead apron on Ian?” I asked the radiographer.
”What for?” the technician sneered. “The only radiation in this room” said she gesticulating through the air in a line, “is this tiny bit, that goes down the beam onto the ankle and into the plate.”
I stood and waited. The technician placed his ankle on the plate, and then went out the room to take the x-rays. I remained, next to Ian.
The door swung open again. “Mrs Butler, you need to come out here please!!” said Ms Grumpy Bum.
”Why is that?” I asked innocent faced.
”Because it’s dangerous, and everyone not having an X-ray must be out here, not in there!” Intoned Grumpy Bum.
”But you just said this was quite safe for Ian because the rays only go down this wee area here” (putting my hands under the beam) “and if it’s quite safe for Ian, ... which is why he doesn’t need an apron, ....then it’s even safer for me, surely!” She knew I was going for her…..
Grumpy Bum flung the apron on Ian, and near hauled me out by my ear. Suddenly she swung around and said, “Oh, I know who you are. You’re that nut who doesn’t vaccinate. Now it figures!” as if only a non-vaccinator could think of something as lunatic as radiation protection….
I replied, ”No, you’re the one that doesn’t figure. It doesn’t seem to occur to you just how inconsistent your arguments are. You said Ian didn’t need an apron, yet had kittens when I wanted to stay in there. You can’t have it both way. In 1993, when I had a similar X-ray to Ian in USA, they damned near squashed and asphyxiated me under a 5 mm very heavy lead drape. They even wanted to know what part of my menstrual cycle I was in. Yet you treat X-rays like some glass of water, ….. until someone puts you on the spot!”
By this time, Grumpy Bum was really angry....”Well, you’re the first person who has EVER asked for a lead apron for their child.” That explained the layer of dust just about like concrete....
“Why is it, the regulations say you have to stay out here, in a safety room during x-rays?” I asked. Grumpy Bum snapped, “Because we do it all the time, that’s why!” I looked at her and said, “Do you honestly think that a dust laden lead apron, is just a decoration for show? It’s not even thick enough, for a start. Every single person who is x-rayed in this room should have a 5 mm lead apron at least… put on, as a matter of course. Not one parent should EVER have to ask you to protect their child with a lead apron.....”
Just last year, a parent approached me, very upset that this “discussion” was still considered “lunatic fringe neuroticism” in our local X-ray facility.
New Zealand appears to be continuing this utterly irresponsible blasé attitude to X-rays, which perhaps is why most parents don’t even think about it, and consider CT scans akin to a blood test.
Seems that not much has changed in three regards. Most parents are still either ignorant of the dangers of X-rays – or would prefer to expose their children, rather than ask for protection for their children. And most x-ray technicians still live in la-la land. Part of this blasé attitude might stem from the fact that during my childhood, when we went to shoe shops, this cool looking machine
was where we were sent to entertain ourselves, while Mum tried on shoes. We’d stick our feet in the slot around the back, and look down at our wiggly toes in our shoes, and swap places, looking at everyone else’s toes as well. It was great fun and a great giggle. It was “scientific” shoe fitting, and medically sanctioned as “quite safe”. Hahaha. Not.
And this was what our feet were being zapped with.
You will find a good history of the shoe fitting flouroscope here: At least they moderated the amount of radiation for children, though no doubt, it was far too high even so…
But I wonder, if a past generation, desensitised to radiation issues by such things as these, is part of the problem today?
Just recently the FDA issued a cat scat radiation alert The Chicago Sun Times is only one of the newspapers reporting this. I note so far, that there is "silence" in the NZ media. The risks of a cat-scan depends on who you listen to. In 2011 ABC ran this article which is airy-fairy and not particularly precise. Yet, in 2003, ABC ran a much more definitive programme, which has disappeared from their archives, pointing out that if you have a cat-scan you might as well have sat on the outskirts of Hiroshima (PDF embedded). It's understandable that such "emotive" language would be frowned on today, even though it's a very realistic portrayal of the risks of Catscans.
The FDA Catscan recommendations for parents are....that parents:
Keep track of their child's medical-imaging histories as part of a discussion with the referring physician when a new exam is recommended (see the "My Child's Imaging Record"23 24 card, available from the Alliance for Radiation Safety in Pediatric Imaging).
Ask the referring physician about the benefits and risks of imaging procedures, such as:
How will the exam improve my child's health care?
Are there alternative exams that do not use ionizing radiation and are equally as useful?
Ask the imaging facility:
What safeguards are in place to mitigate the risks to my child? For example, does the facility use reduced radiation techniques for children?
Are there any additional steps that may be necessary to perform the imaging study (e.g., administration of a contrast agent, sedation, or advanced preparation)?
Can you imagine what the reaction could be…. to asking these questions in a New Zealand hospital today???? Would some Grumpy Bum jump down your throat? After all, if it happens in normal Xray facilities, would these FDA suggested questions about catscans be considered... questioning their competence? And perhaps exposing their ignorance?
The FDA says that Ionizing radiation exposure to pediatric patients from medical imaging procedures is of particular concern because pediatric patients:
are more radiosensitive than adults (i.e., the cancer risk per unit dose of ionizing radiation is higher);
have a longer expected lifetime for any effects of radiation exposure to manifest as cancer; and
use of equipment and exposure settings designed for adults may result in excessive radiation exposure if used on smaller patients.
The medical community has emphasized dose reduction in CT because of the relatively high doses of CT exams and their increased use, as reported in the National Council on Radiation Protection and Measurements (NCRP) Report No. 1604 5. the increased radiosensitivity of pediatric patients compared to adults makes it important to adjust equipment settings to optimize radiation exposure to pediatric patients for all types of X-ray imaging exams.
This is the website the FDA refers parents to.
But, get this.... .....
Note that CONTRARY to my experience in 1993, NOW the patient isn’t required to have an apron at all!!! HOWEVER, ..... anyone else moving around in the room at the time has to have “wraparound protection”. Wouldn't that seem to make the FDA's questions which parents should ask...sort of... redundant?
More bizarre “eminence based” medicine.
There may come a time in future history – if there is anyone around to write it…., when this type of “risk-neglect” - not providing lead shielding for patients being x-rayed.... is considered as “barbaric” as bloodletting once was.