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Thread: gonad shielding during x-rays

  1. #1
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,163

    gonad shielding during x-rays

    Hi everyone,

    My daughter had a routine scoliosis x-ray today and I think they may have shielded her incorrectly. It was a PA x-ray (shot back to front, with her facing the x-ray plate and the x-ray beam coming from behind). They taped the shield to her tummy, and were very quick about everything, but later I thought they shielded her from the wrong side! I think they should have placed the shield at her back.

    I called the Dr's office where the x-ray was done and spoke to the rad tech. What she told me sounds strange: she said "the main x-ray beam is not harmful at all, it is the scatter that bounces back that is harmful." I know about scatter, but I think the statement "the main x-ray beam is not harmful at all" can not possibly be correct. I asked if this was something new and she said no. So does this sound strange to anyone else?? We have never had x-rays done here before.

    I know what's done is done, but any thoughts?
    Last edited by leahdragonfly; 09-12-2008 at 08:34 AM.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

  2. #2
    Join Date
    Nov 2003
    Location
    PA
    Posts
    360
    The shield should have been placed on the other side of her. It's good they usually use shield though since I never have one! Regarding the x-ray beam, I'm surprised by the answer for the main beam not being an issue. I've used x-rays in labs for some of my chemistry classes and we were always told the incident beam is the most harmful. The scatter isn't as harmful because energy is lost. X-rays now are so much safer than they used to be. The amount of radiation from one x-ray is equivalent to about 10 days of normal living radiation. I've also heard that a 10 hour flight gives the same amount of radiation as an x-ray.

    Hopefully this won't happen next time!

    Shell
    Chemist, 30

    1998- 18 degrees
    2003- 33 degrees
    2005- 37 degrees
    2006- 44 degrees
    May 2007- 47 degrees
    December 2007 - 50 degrees X-ray

    Surgery May 27, 2008
    Fused T1 to L2
    Curve corrected to 15 degrees X-ray

  3. #3
    Join Date
    Aug 2004
    Location
    ny
    Posts
    1,809
    Hi Gayle,

    I agree the shield should have been place on the other side of her.

    I also was told by Dr. D'Andrea that she always ordered PA x-rays because they were safest.

    I hope you get to the bottom of this and find out why you were told differently.
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

    http://pediatricspinefoundation.org/

  4. #4
    Join Date
    Nov 2008
    Location
    SW Ontario
    Posts
    8

    Smile

    This is a cause of arguement amongst health professionals. Different hospitals/clinics have different protocols regarding the 'proper' placement of the gonadal shielding. Our hospital's policy is that if the pt is PA, then the lead faces the tube (source of ray). But I also know of hospitals that place it facing the bucky (away from the tube).

    The primary beam (that exiting the tube) is for the most part, high energy and as such will penetrate the pt and exit towards the plate. Those that are lower in energy are absorbed by body tissues.

    If a high energy photon exits the pt and is scattered (detoured by something else), energy is lost upon collison. Since it is now low energy, the body will absorb it (therefore increase dose). The idea with the shield facing the board is that it will prevent these lower energy ones from re-entering the pt.

    Both arguements sound valid in my opinion, but what I don't get is why don't they just provide one that wraps ALL the way around Lol
    Oh well, hopefully they'll figure it out!

    ~**~ Congenital Scoliosis w associated radial clubhand/thumb aplasia ~**~
    *~2 Harrington rods + fusion in 1985 (age 10) by Dr.W Bobechko, Toronto~*
    23 yrs post op...have 3 kids, training to be MRT, next to nil pain!
    http://s152.photobucket.com/albums/s...view=slideshow
    Last edited by MRTmum; 11-12-2008 at 09:48 PM.

  5. #5
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,163
    Hi MRTmum,

    Thanks so much for your reply! I saw your other post yesterday and hoped you would reply to this thread. I have actually called around to several pediatric radiology departments (including Shriners) and asked this question, and I was told that no one seems to agree about the placement of the shield. Most told me they would shield from the primary beam (shield on the back for PA), but some said it was reasonable to shield from the scatter. I asked if it would be unreasonable to insist on shielding on both front and back, and was told this is a reasonable request (I would have insisted anyway, just wanted to be ready if the techs tried to refuse). So from now on, I will insist on front and back shielding for my daughter.

    Good luck with your studies. Thanks again for the helpful input. I know I am not alone in worrying about the radiation exposure our scoliosis kiddos are exposed to.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

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