what are your rad readings?

Is anyone else wearing your lead?

I've never exceeded what they recommend, and I haven't seen my numbers in several years.

The funny thing is I do procedures at two places, but no one adds them.

Try experimenting with even shorter bursts of fluoro - slight tap on the petal, extension tubing, collimation, etc.

An interesting anecdote. One of our surgeons decided to experiment and fluoro'd his badge for 30 consecutive seconds. He still did not exceed the limit and he does a lot of fluoro for surgeries.

daphilster78 said:

Just got briefed on my radiation dosimetry report for last 6 months. I have about 100 mrem/month. Looking at the guidelines, california radiology health branch allows for 5 rem or 5000 mrem/year. I don't do a ton of procedures or anything, but somehow I'm the highest value for this surgery center, and there are 3 other pain providers. I average probably only 15-20 procedures per week, including may 1 scs trial a month, 3 rfa's a month. How am I generating the highest values, or is this still considered low? I must have poor technique or something. I try not to use live that often, but I am used to always using the foot pedal which mean I must be close.

Anyways, my question is, any other providers care to share their numbers?

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Most likely no one else there wears their badge consistently and you do

Thats funny just got my readings today for last 3 months and was wondering how I "stacked" up.

Mine were 18 total but Im super serious about avoiding radiation exposure.

nvrsumr said:

Thats funny just got my readings today for last 3 months and was wondering how I "stacked" up.

Mine were 18 total but Im super serious about avoiding radiation exposure.

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What do you do that other providers don't to minimize radiation exposure?

Not saying other docs dont understand radiation exposure risks etc.. I think some people get a bit lazy after awhile.

1/2 dose on the c-arm
new machine
36in extension tubing
I only use the footpedal so no ******ed rad tech zaps me and keep it a couple feet from the table to force me to step back with each shot
manipulate multiple needles(if multilevel) with each fluoro exposure.
Dont take as many laterals as I probably should
leaded glasses(obviously doesnt change dosimeter)
I dont take a "perfect" last pic for record keeping
start with a good enface needle view and dont dick around


My average fluoro times are short but my overall procedure time is mildly prolonged by doing the above. Im not the busiest guy either. 15 cases a week. SCS <1 minute per lead, Lumbar RF 5s per level, Cervical RF 7s per level, Lumbar MBB 2s per level(with contrast neurogram), LTFESI 8s per level, CTFESI 20s per level(damn DSA), CESI 5-10s, SI <5s.

Plus I do stuff with US now that I used to do with fluoro-knees, shoulders, hips, piriformis etc...

I've found some machines weren't on pulse. I'm also amazed how infrequent collimation is used. I'll have the tech spin the fluoro to oblique and laterals and walk to the other side of the OR to let him shoot the spots. inverse square law

daphilster78 said:

Just got briefed on my radiation dosimetry report for last 6 months. I have about 100 mrem/month. Looking at the guidelines, california radiology health branch allows for 5 rem or 5000 mrem/year. I don't do a ton of procedures or anything, but somehow I'm the highest value for this surgery center, and there are 3 other pain providers. I average probably only 15-20 procedures per week, including may 1 scs trial a month, 3 rfa's a month. How am I generating the highest values, or is this still considered low? I must have poor technique or something. I try not to use live that often, but I am used to always using the foot pedal which mean I must be close.

Anyways, my question is, any other providers care to share their numbers?

Click to expand...

I was 216 for the quarter, a little but up from last quarter which was 180. So about 65 to 70 a month, also I leave my badge on my lead and I leave it in the fluoro room, but well over 6 feet away from field. I do probably twice th numbers you quote, so not a huge amount, but not nothing, like 30-40 a week,Von average. I am pretty radiation phobic. I have seen much higher from colleagues out there.

You are still quite safe with that number, I believe, but pushing the thrhold for level I believe. 1250 for level 2500 for level 2, and 5000 for level 3,cat which you may have a problem. But I ain't no radiation physicist. take you badge with you for the next month see if the numbers are lower. I had a partner a few years ago who did about the number of cases as me, and had 5 times the radiation...

Collimate tight, half or quarter dose, limit the live to the contrast injection...If you don't already

i believe I am at a total of 1-2 REM over 6 years, which increases cancer risk by 5%.

Have your c-carm serviced and check.

This data was kind of reassuring...

Health RiskEst. life expectancy lost

Smoking 20 cigs a day 6 years
Overweight (15%) 2 years
Alcohol (US Ave) 1 year
All Accidents 207 days
All Natural Hazards 7 days
Occupational dose (300 mrem/yr) 15 days
Occupational dose (1 rem/yr) 51 days

http://www.physics.isu.edu/radinf/risk.htm

stim4u said:

i believe I am at a total of 1-2 REM over 6 years, which increases cancer risk by 5%.

Have your c-carm serviced and check.

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It's currently being debated if low levels of radiation are sufficient to produce health effects or if there needs to be a certain "threshold" dose achieved before anything bad happens.

One thing that is generally agreed upon is how you receive the dose matters. For instance, receiving 5 rem of radiation in 5 seconds is going to hit your DNA hard and fast and might have more chance of producing harmful effects by not allowing repair enzymes or mechanisms to intervene.

5 rem over a year is much more different, now your body has time to repair itself, and further, the radiation is dispersed over different areas.

i agree most of the studies on malignancy is retrospective in nature, rodent based, and case reports of radiologists, interventionalist and so forth. I am receiving something like 1 REM exposure per 5 years, and over a 20 year career will reach 20-30 REM exposure. My guess this has some cancer risk compared to the general population, but akin to air plane pilots.

I have seen the pioneer pain physicians-- the ones that have been doing flouro guided procedures since the 90s- have issues. many have skin cancers on the side closest to flouro.

scary but one pain doc that does procedures in the same surgery center developed a brain tumor-- they think astrocytoma not gbm. an ent at the same surgery center devoleped esophogeal CA and died this year. another ortho at the same surgery center got hodgkins lymphoma and is good now. another pain doc at the center recently got diagnosed some kind of lymphoma. all of this happend within the past 3-4 years.

maybe there are carcinogens in your sugery center water...two hit hypothesis?