Say Nuclear X-ray

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Monday, 8 September 2014

I present myself at Sunninghill Hospital for my long anticipated admission, only this time I have no idea what’s in store for me.

The day goes by very slow, no action just sitting on a hospital bed tossing and turning. My mind is so preoccupied I cannot even focus on reading my book.

The language in this book I’m reading is heavy written by a Mexican author. It requires focus and you have to be in the zone to read and understand. So I put it away after a number of attempts. I decide to watch television…nothing exciting.

At about 7:34 my Specialist Urologist finally makes an appearance. A brief conversation occurs and from this, I have to do some extra texts the following day.

My doctor looks at me, and says “you look like you could use a good sleep tonight?” That was met with so much enthusiasm, I said “yes I would like some sleeping tablets”

I always find the 1st night of hospital I struggle to fall asleep. So after taking my meds with Stillnox, I had a glorious night.

Tuesday, 9 September

At 4am a representative from Lancet comes through for bloods. During morning I have a series of tests which I have done before…so I am almost rolling my eyes after every test.

The porter comes to fetch me at the ward at about 12:30 for some test, we get to that section and I realise that this will be the very first time I do this kind of test.

Nuclear X-ray, I have never even heard of it before, so I get there and a pleasant nuclear specialist or nuclear doctor makes me feel comfortable. So she explains the test and what it seeks to do. So I ask her a couple of questions and differences between the CT scan. So my lesson starts while the nice doctor prepares….

Nuclear Medicine
Nuclear medicine is a medical speciality that involves giving a patient a small amount of radioactive medication, called a radiopharmaceutical. This makes the body slightly radioactive for a short time. A special nuclear medicine camera detects the radiation, which is emitted (released) from the body, and takes images or pictures of how the inside of the body is working, in this case my kidney. She injected the radioactive medication into my blood stream through a vein.

Very interesting,

I made a pact to find out as much as I can about procedures performed on me, so I take care not to annoy the doctor. I ask her about the function of this machine that she is wheeling me into…she explains that it uses a gamma camera that is able to detect and make images from very small amounts of ionising radiation emitted from patients. So this machine she wheeled me into has a narrow table where I had to lie strapped on the sides. The camera has two heads, used to obtain the images. Each camera head has a flat surface that had to be very close to the me. Besides the fact that I could not feel any sensation, this exercise was very uncomfortable, for an hour I had to lie down with minimal movement.

I could feel my bladder was constrained. It was full and I needed to get off the table to empty it, but the nice doctor said “5 more minutes, and then you empty your bladder and come back for the last round”.

Five more minutes, the longest five minutes of my life, a full bladder is not the most comfortable feeling when you have a kidney that does not drain properly.

I remember that I have not asked doctor what is the difference between nuclear medicine from a normal X-ray and CT examinations?

During a normal X-ray or CT examination, an image is formed from the ‘shadow’ created by the body as it is positioned between the X-ray machine (source of the X-ray beam) and the X-ray detector. The body stops some, but not all, of the X-rays and the patient is not made radioactive by the X-rays.

In nuclear medicine studies, the radiopharmaceutical given to the patient makes them, and the organ system or body part being studied, radioactive for a short time. This ionising radiation (usually a gamma ray) is emitted or released from the body, and can be detected and measured using a nuclear medicine gamma camera. All living things contain some radioisotopes (such as carbon 14 and potassium 40); a nuclear medicine study will make them ‘more radioactive than normal’ for a short time – hours or days.

An X-ray or CT image is formed from ionising radiation (X-rays) that passes through the body, but does not arise from the body; whereas a nuclear medicine image is formed from the ionising radiation (usually gamma rays) emitted from within the body. A gamma ray has similar properties to an X-ray, but it arises from the nucleus of an atom, whereas an X-ray arises from the electron shell of an atom.

Another way that nuclear medicine is different from X-ray and CT examinations is that an X-ray study shows what something looks like. This gives indirect information about how it is working: normally, abnormally, diseased, injured and so on. In nuclear medicine studies, the radiopharmaceutical usually only goes to the part of the body or organ system if it has some function and so shows how it is working. The images can also give information about what the body part or organ system looks like.

Nuclear medicine and X-ray tests are often complementary, providing different information that together make a diagnosis more certain.

So that’s my lesson for the day, now I wait for my urologist to explain where to from here, whilst remaining hopeful that there will be a solution, at least a long term one.

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