Major Student Screw-up (Kinda long)

[jedimaster91]

This one requires a little background. I am currently in school for Nuclear Medicine Technology. Basically this entails injecting people with tiny amounts of a radioactive tracer and taking pictures of where it goes. We use different tracers depending on what we're looking at (ie, bones, gallbladders, thyroids, ect). One of the more popular studies in recent years has been the Fusion PET/CT, where the PET (Positron Emission Tomography) scan tells the metabolic function of the cells (say, tumors), and the CT (Computed Tomography) tells where in the body the cells are located. This test is done for cancer screenings, stagings, and as a follow-up to therapy because the tracer is a radioactive sugar that gets sucked up by rapidly dividing cells more than normal cells.


Anywho, January was my first PET rotation. I was only scheduled for 2 days a week for 4 weeks, so I had to learn fast. The scanners used for PET/CT are more complicated than for general nuclear medicine, but I had that part down pretty well. I also had the spiel down to a science:

• Finger stick to make sure the blood sugar was below 200 mg/dl
• Start a small IV in order to inject the radioactive sugar water
• Kick back and relax for an hour to allow the tracer to circulate
• Go to the bathroom right before we get you on the camera both so you won't have to go during the scan, and to get as much radioactive urine out of our pictures as possible (tracer is excreted through the kidneys)
• Remove anything metal on your person, including keys, change, cellphones, necklaces, dogtags, glasses, ect (emphasized because this is important later)
• Scan takes about 25 minutes. You can breathe normally, but otherwise don't move. When we're done, you're free to go.

So, in comes a guy for lung cancer staging. The head tech injected him, and an hour later I set him up on the camera. Going back to the "Remove all metal" step, I noticed this guy had a gold chain around his neck and told him he'd need to remove it. He said he hadn't taken it off in years and that they usually just moved it out of the way when he went in for x-rays. This was a fairly short chain, and if we hadn't been looking at lung cancer, I would have let it go. However, I was concerned that the chain might cover up a spot further up in his chest if there was one there. In retrospect, this is where I should have gotten the head tech despite the fact the head tech hates students and was trying to schedule some kind of surgery for himself.

Long story short (too late, I know), I broke the guy's chain trying to get it off. It had one of those clasps that you insert one side into the other and snap a lever down over it. Since the clasp hadn't been messed with for years, it was unfortunately, stuck. I initially thought I had gotten it open, but when I looked at it, the clasp was still clasped and the chain had come off at the connection. I felt HORRIBLE. I offered to pay for repairs to the chain as the guy loved it, but he wasn't interested. And I did mention the incident to the head tech, but as usual, he ignored me.

[erasily_ani]

It sucks, but it does happen. Good for you for offering to pay for repairs.

However, if the metal needs to come off, the metal needs to come off. I wish someone had told him that before he came for his appointment (or, if they did, he'd listened) but you know, there's a reason for that rule.

Most people understand that sometimes in medical procedure's, things happen. My mother had surgery many years ago and couldn't have anything metal on -- they had to cut her wedding ring off because it had been so long since she'd moved it. There was never an offer to pay for it to be replaced, it was just accepted as something that had to be done.

So I say you did everything you could and, again, good for you for offering to help fix it.

[PepperElf]

hell... i'm not a doctor but i've watched enough House MD to know what metal can do in some of those fancy scanners.

[Hotfoot]

To be fair, usually when you see metal doing nasty things in a medical scanner, it's something with magnetic properties in a MRI machine, which involves very strong electromagnets.

Yeah, that's bad.

However, gold itself is not a magnetic metal. It won't react, unless it's mixed with something magnetic, usually iron.

However, a PET scan involves detecting radiation as I recall, and any dense material is going to distort the image and provide a less than accurate level of information to the people who need it. Gold is notorious for being just dense enough to mess with even gamma radiation.

Now, I'm no expert, but in a PET scan, do you actually use Beta Decay particles? If so, positrons? So dang cool. Think about it, antimatter jumping out of your body!

Sorry....I...uh...yeah. I'll go that way now.

[Chromatix]

Fun fact: gold and lead are roughly the same density. I think if you weigh them you can tell the difference, but not if you just pick them up. People would use gold paint on lead bars if they wanted to conceal the theft of gold bars.

And lead is the material of choice for stopping radiation. Probably because it's a heck of a lot cheaper than gold.

[jedimaster91]

Actually, we prefer Tungston for positron emitters. It's lighter, but still has the blocking capabilities of lead, so it doesn't need to be as thick. We can't actually image the positron particles (or any particulate radiation for that matter), but we do image the gamma rays that come off when the positron collides with an electron. A lot of fancy electronics then turn them into pictures.

[Hotfoot]

Actually, we prefer Tungston for positron emitters. It's lighter, but still has the blocking capabilities of lead, so it doesn't need to be as thick. We can't actually image the positron particles (or any particulate radiation for that matter), but we do image the gamma rays that come off when the positron collides with an electron. A lot of fancy electronics then turn them into pictures.

Haha, you have no idea how happy that makes me!

Antimatter, away! Ever had a warp core breach?

But seriously, that's some cool stuff, and yes, Gold will mess with the results. Stinks that his necklace got broken, but it had to come off if he wanted the procedure.