Monday, April 16, 2012
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A few months ago, I got an ‘office bug.’ I had the usual symptoms: a stuffy nose, sore throat and a slight fever. I typed my symptoms into Google and ‘sinus infection’ came up in the search results (among a long list of other ailments). As I read the ‘Remedies’ section of WebMD, I saw that antibiotics were necessary to treat my cold. I made an appointment to see the doctor, convinced that all I needed to feel better was the correct prescription.
As soon as the doctor entered the room, I explained my symptoms and requested antibiotics. However, it turns out that I had a virus. Antibiotics would not only be ineffective, but would potentially boost my chances of acquiring antibiotic resistant bacteria. Disappointed – and a little angry that I couldn’t get medication to make me feel better – I called my mother to complain. She asked if I would’ve felt the same way had I not diagnosed myself in the first place. I sighed, knowing she was right – once again.
With the growing popularity of the internet, many patients (and caregivers) are requesting specific treatments or tests before their physician even examines them. At Maimonides, this has lead to parents specifically requesting CT scans or other forms of testing for their children when they are brought into the Pediatric Emergency Room.
A CT scan is similar to taking a series of X-rays from different viewpoints that are then combined to create images of the bones and soft tissue inside the body. To help you visualize this concept, looking at these images is like looking down at one slice of bread from a whole loaf. Doctors can look at each ‘slice’ individually, or they can perform additional manipulations of the image to view the body from different angles. This technology is extremely useful when quickly examining a patient who experienced a physical trauma and may be suffering from internal injuries.
When a child is rushed to the Emergency Room, parents are worried and frantic. Understandably, they want their child to be okay, so they request tests like a CT scan to ensure that their absolutely nothing is wrong with their son or daughter. Unfortunately, getting unnecessary CT scans may ultimately be detrimental to your child’s health. Over the last 10 years, limiting radiation exposure (much of which occurs in the ER due to specific diagnostic tests) in pediatric patients has been a major focus of the medical community.
Pediatric diagnostic tests that emit radiation, such as CT scans, are becoming more prevalent. Studies have shown that the number of pediatric emergency department visits using CT scans increased almost 500% between 1995 and 2008. I spoke to Dr. Estevan Garcia, Vice Chair of Pediatric Emergency Medicine, about why CT scans are increasing in use and if parents should be concerned.
“Our goal is to inform parents, as well as pediatricians, which children are appropriate candidates for CT scans and which are not,” explains Dr. Garcia. Unfortunately, there’s a mounting body of scientific evidence that supports a relationship between exposure to radiation and development of cancer. “We believe it’s important to follow evidence-based practice guidelines to make the best decision for the health and safety of children,” emphasizes Dr. Garcia.
At Maimonides, our physicians follow the Image Gently Campaign’s recommendations for decreasing radiation exposure. The primary recommendation is to scan only when necessary. So, before ordering a CT, our physicians weigh the risks and benefits of the scan for each individual patient. “To protect against the unnecessary scanning of organs,” explains Dr. Garcia, “we limit scanning to select organs if possible.” This ensures that the radiation exposure to vital organs is minimized, thus reducing unnecessary potential harm.
As an alternative to CT scans, we also utilize ultrasonography to reduce unnecessary exposure to radiation. Ultrasounds don’t use radiation and are thus safer alternatives to CT scans for children in the assessment of conditions such as pelvic pain, abdominal pain, and blunt abdominal trauma.
Although I thought I needed antibiotics, my doctor was much more knowledgeable about the potential risks. Could he have prescribed me antibiotics in response to my request? Sure, but the antibiotics wouldn’t have helped me. Instead, they would have potentially increased my risk for a more serious condition. In the age of the internet – where information and resources are readily accessible – it’s difficult to separate out the vital information. It’s important to research treatment and tests so you know what options are available, but it’s also important to listen to your doctor.