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  • x-rays and covering breasts/ovaries

    Can anyone please offer what they believe to be the proper protocol in covering a girl's breasts and ovaries during both in-brace and out of brace scoliosis x-rays?

    Yesterday, before getting an in-brace x-ray, I was thoroughly assured by the radiation department manager that my daughter's ovaries would be covered by a radiation shield (he said her breasts would not be able to be fully covered because of her curvature). This morning I looked at her x-rays, and noticed that the ovary shields are below her pelvis on her upper thigh area! I contacted the higher-ups at the hospital, and am waiting to hear back. I am beyond livid.

    If anyone knows what can and cannot be covered, please let me know. Also, for anyone who knows, would it be so difficult for radiation departments to create some sort of small lead circles that could be stuck on the appropriate areas? Especially for these kids who have to get repeated x-rays?

    Thank you so much,

    Brooke

  • #2
    Hi Brooke...

    I moved this thread from the kids forum to the parents forum.

    Most scoliosis centers have lead shields that are placed either on the patient or on the equipment. Here are some xrays showing that shields were placed on the equipment:

    http://www.srs.org/patients/adolesce...ic/imaging.php

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

    Comment


    • #3
      Hi Brooke,

      I sent you a PM.
      mamandcrm

      G diagnosed 6/08 at almost 7 with 25*
      Providence night brace, increased to 35*
      Rigo-Cheneau brace full-time 12/08-4/10
      14* at 10/09 OOB x-ray
      11* at 4/10 OOB x-ray
      Wearing R-C part-time since 4/10
      latest OOB xray 5/14 13*
      currently going on 13 yrs old

      I no longer participate in this forum though I will update signature from time to time with status

      Comment


      • #4
        Hi Brooke,

        My daughter has had x-rays at four different places. Two hospitals and two orthopedic surgeons offices. Not one of them has shielded her for any reason on any of the x-rays. At the x-rays at the first orthopedist's office I asked the doctor why they didn't shield, and he said that on the lower radiation x-ray machines it's hard enough to get a good image on the x-ray and if they put shields on it would lead to more x-rays having to be taken to get a good image, if I remember the answer correctly. So I just don't worry about it anymore. If my daughter were a juvenile case, I'd probably worry about it more. In fact, at that appointment, my daughter had to have an x-ray retaken because her cervical spine was too dark to see the image, which upset me because she had already had an extra x-ray taken just a month prior due to an unusual situation.

        Comment


        • #5
          You are your daughter's advocate

          Hi Brooke,

          I am so sorry to hear about your experience with improper shielding--we have had a lot of trouble with this too, and I know how worrisome it is. There have been two recent discussions here about this very topic, you might want to check them out:

          http://www.scoliosis.org/forum/newre...uote=1&p=67268
          If these links don't work, go to the top bar, select the search function, and enter "gonadal shielding". The two threads will come up.

          Good for you for advocating for your daughter! It is so important, and you will never regret it.

          Good luck,
          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

          Comment


          • #6
            Here is the second link:


            http://www.scoliosis.org/forum/showt...adal+shielding

            Good luck,
            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

            Comment


            • #7
              Thank you everyone for your input. I really appreciate it.

              Brooke

              Comment


              • #8
                Unacceptable error from top children's hospital

                I just got off of the phone with the Chief of Pediatric Radiology at a world renowned children's hospital where my daughter had x-rays on Monday.

                She first tried to convince me that ovaries "COULD possibly lay at the bottom of the pelvis" where the gonadal shield was placed, which then means all of my daughter's previous x-rays had a gonadal shield that was too high. She could only explain this by telling me that "no one really knows where the ovaries are."

                After discussing my daughter's breast exposure, she told me that since her back was facing the radiation machine, her breasts would not be absorbing much radiation. I told her that my daughter was facing toward the x-ray machine, not away, which is why I was demanding breast shields to begin with. She said her x-rays had indeed been done INcorrectly-and that yes, her breasts were fully exposed during the x-ray.

                She told me that my daughter should have either been facing away from the machine, or had her breasts covered. Which means, since this same situation happened during her last x-rays, they made the same error twice. I would never have allowed this to happen if they did not repeatedly tell me, "due to the magnitude of her curve, if we shield her breasts, it might result in the need to re-take the image" (my error for believing them).

                In other words, a top children's hospital makes errors in something so simple as taking an x-ray.

                When my daughter was first x-rayed years ago, half of the time I had to remind the technicians to give her shields.

                I am relaying this information not merely to vent, but to let all parents know they have to demand the best protection for their children during x-rays, and all other issues for that matter.

                These kind of errors are UNACCEPTABLE, even more so for children who will go through their growing years receiving multiple series of x-rays.

                Brooke

                Comment


                • #9
                  We have had similar experiences. Our doctor also says it is difficult to know where the ovaries are (I believe her on this as she is trying to cooperate with us on limiting x-ray exposure). And at our last x-ray, the tech faced her toward the machine and told me it didn't matter which way she stood. I insisted she be faced away. He still resisted and I had to remind him that he had just told me it didn't matter so please do it my way (and according to the doctor's order).

                  It's very frustrating and is always the most stressful part of her appointments for me.
                  Last edited by mamandcrm; 06-08-2009, 03:22 PM.
                  mamandcrm

                  G diagnosed 6/08 at almost 7 with 25*
                  Providence night brace, increased to 35*
                  Rigo-Cheneau brace full-time 12/08-4/10
                  14* at 10/09 OOB x-ray
                  11* at 4/10 OOB x-ray
                  Wearing R-C part-time since 4/10
                  latest OOB xray 5/14 13*
                  currently going on 13 yrs old

                  I no longer participate in this forum though I will update signature from time to time with status

                  Comment


                  • #10
                    Journal article

                    I found this journal article abstract (recent it looks like). It's a bit greek to me (I am going to ask a doctor friend to translate it for me) but it might be of interest to some.

                    http://www.springerlink.com/content/6272g35p26w8540k/
                    mamandcrm

                    G diagnosed 6/08 at almost 7 with 25*
                    Providence night brace, increased to 35*
                    Rigo-Cheneau brace full-time 12/08-4/10
                    14* at 10/09 OOB x-ray
                    11* at 4/10 OOB x-ray
                    Wearing R-C part-time since 4/10
                    latest OOB xray 5/14 13*
                    currently going on 13 yrs old

                    I no longer participate in this forum though I will update signature from time to time with status

                    Comment


                    • #11
                      Brooke,

                      Thanks for letting us know about your conversation with the head of pediatric radiology for us. That is very interesting to know all that info! The people working in the radiology departments are the most significant source of stress to me at these appointments as well. In fact, the poor impression I got from the treatment during x-rays figured prominently into my decision to move from two of the doctors my daughter had been seen by. These docs should be aware of the poor impression their x-ray staffs are making on us.

                      One of the worst experiences my daughter had in x-ray was also at a top children's hospital. When I was concerned with the x-rays at her prior appointments, the physician's assistant of the surgeon at this children's hospital assured me that their x-ray staff was expert and the surgeon had the kids from his private offices at another location come to the hospital to have the x-rays done because they were so familiar with the issues.

                      The first thing I had to make a big stink about was the fact that this young man doing the x-rays insisted she take her shirt and bra off and face towards the x-ray machine. He has been the only one who required that, all the others have let her keep her bra on. I immediately insisted that if she had to take her bra off that she needed a covering of some sort...you would have thought I had asked for an elephant! What an ordeal. Then the x-ray tech had her face towards the machine with no shields whatsoever. Unbelievable. At least at her first hospital visit at another hospital, they had her face away from the machine. I'm glad I know now that I should insist, at the bare minimum, they face her away from the machine.

                      I asked my daughter about her x-rays last night because at the orthopedist's offices, the x-ray staff never lets me into the room...I certainly know why! Thankfully, she told me that her new orthopedist's staff did use a blanket shield that she held (for the first time ever) at her last out-of-brace x-ray, however, it doesn't show on the x-ray so it was probably at her thigh level also. And at the last in-brace x-ray (supine) they didn't use any shielding at all.

                      Thank goodness I have my sister to get advice from because she doesn't seem very worried about the x-ray exposure. Her remark is always that a CT scan has hundreds of times the x-ray exposure as a regular x-ray and they don't hesitate to use it when medically indicated. However, out of an abundance of caution I guess I will go back to shaking up the system when my daughter has x-rays. I guess it will help all of us dealing with these issues.

                      Comment


                      • #12
                        Originally posted by Ballet Mom View Post

                        The first thing I had to make a big stink about was the fact that this young man doing the x-rays insisted she take her shirt and bra off and face towards the x-ray machine. He has been the only one who required that, all the others have let her keep her bra on. I immediately insisted that if she had to take her bra off that she needed a covering of some sort...you would have thought I had asked for an elephant! What an ordeal. Then the x-ray tech had her face towards the machine with no shields whatsoever. Unbelievable. At least at her first hospital visit at another hospital, they had her face away from the machine. I'm glad I know now that I should insist, at the bare minimum, they face her away from the machine.
                        That's absolutely ridiculous. I've had plenty of scoliosis films taken in my life, and I was never required to be bare from the waist up. I can understand why they don't want the patient wearing a bra, but a shirt or gown has absolutely no effect.
                        Originally posted by Ballet Mom View Post
                        And at the last in-brace x-ray (supine) they didn't use any shielding at all.
                        Are in brace xrays usually taken supine? If so, any idea of why? It seems to me that one would not get an accurate measurement of Cobb angle, as our curves flatten somewhat when we lay down.

                        Regards,
                        Linda
                        Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                        ---------------------------------------------------------------------------------------------------------------------------------------------------
                        Surgery 2/10/93 A/P fusion T4-L3
                        Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                        Comment


                        • #13
                          Linda,

                          My daughter gets supine in-brace x-rays because she is prescribed the night-time bending braces which is apparently the way that these bending braces are x-rayed...i.e. the way it will be when they are sleeping.

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                          • #14
                            Oh, and yes, in all her x-rays except this one, her underwires are clearly visible and it has never been a problem.

                            Comment


                            • #15
                              And hooks and eyes!

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