A few days ago, a 42-year-old man was stopped by a state
policeman because radiation coming from his vehicle was detected by a device in
the patrol car. Earlier that day, he had undergone a cardiac stress test which
involved the injection of a small amount of radioactive isotope into his body.
He was released when he produced a doctor’s note stating he had undergone the
test. [Full story here.]
Two things make this story interesting.
One, the report reveals the fact that many police cars have
radiation detectors that are so sensitive that a man emitting a small amount of
radiation while driving could be fingered as a possible terrorist. Despite my being
a news junkie, I did not know that such detectors were deployed. Did you?
Now the terrorists know too. What is to stop them from
bringing a nuclear weapon into a city now that they are aware of the existence
of these detectors and that a note from a doctor can get one off the hook?
The second interesting point involves the stress test. The
story says the man had what seems to have been a transient hypertension. There
was no mention of any cardiac symptoms or a family history of heart disease.
The man is employed as a fireman, a strenuous occupation.
Why was a nuclear stress test ordered?
I am a mere, “non-cognitive” surgeon, but I believe that an
asymptomatic 42-year-old fireman with hypertension, episodic or not, does not
need a cardiac stress test.
Do you wonder why we spend so much on health care in the
United States?
11 comments:
Is there a radiation risk with a nuclear stress test? I asked a tech I worked with once about it and he said it is so minimal and he is in there everyday with patients.
And I've had mag III lasix renal scans and my joke is I give the fire flies competition and light up the back yard in the summer. :)
Anyway, I am curious too because then what about all the people patients come in contact with after the test that we stand next to, ride with or do whatever. As for myself ..I drink so much water before and especially just before the test and after, I always figured it is flushed out when the lasix hits.
I agree about alerting terrorists about this. maybe they want to? or ...just stupid reporting.
Everyone says there is no risk from radiation for these scans. Some cardiologists tell me that it is well-known that patients will set off airport radiation detectors for as many as 4 weeks after one of these scans. That's why they give the patients notes.
Interesting ...I didn't know that either ..about the airport scanners. I wonder ..do they glow on them too? :)
Thank you for your answer.
My answer is coming in the form of a blog post. I'll post in the morning.
Here is my answer..
http://www.drjohnm.org/2012/05/did-the-radioactive-firefighter-need-that-stress-test/
I think this is a great story, but only in so much that it get's a chuckle out of the unintended consequences of walking around after a nuclear stress test.
It calls to mind a story from my fellowship that comes up from time to time at social gatherings. I was on my rotation in the Heart Station doing stress tests. We had a leaky IV and some Thallium splashed on me. They made me put my shoes into a lead box and change my scrubs.
When I got home to my (then pregnant) wife, I called up the stairs, "Honey, I'm radioactive!" Needless to say I then spent the night on the couch.
Beyond that laugh, we really are treading into unknown territory. Based on second or third hand information, we really don't know why or whether the fireman should have had his stress test. I do agree he looks pretty healthy in the picture, but what do we really know? Speculating on the indications for his stress test is Monday morning quarterbacking at its worst. It makes us doctors guilty of the same type of half assed quality review that we complain about daily.
Pretty funny anyway. Just try not to draw too many lessons.
Jay
P.S. comments also posted on Skeptical Scalpel.
Dr. John M, Great blog. You defend your brethren well. And thanks for the kind comments.
Jay, Great story. Part of the fun of blogging is to elicit responses. Yours was a good one too.
I remember being somewhat concerned a few years ago after my Iodine 131 dose to kill my thyroid when the discharge paperwork included a card to carry with me for several weeks in case I tripped any radiation detectors including the airport. I had a 9 month old at the time.....
whawww... i wonder what will happen in Indonesia if indonesian police have radioactive detectors
I had an isotope injection before a lumpectomy 9 MONTHS AGO and I still set alarms off.
I appreciate these comments. Saps, I really cannot explain the fact that you are still setting off alarms. The isotope should be long gone by now. You should mention this to your doctor and possibly have some tests.
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