Q: I went in for an X-ray for a meniscus tear in my knee and asked for a lead bib to cover the family jewels. The technician said that I could have one if I wanted, but that the medical community is rethinking the need for shielding because it may cause more harm than good. What was he talking about? - Brian D., Chicago
A: In the past few years, radiologists and others have been rethinking the use of lead aprons, which were first used in the 1950s. Back then, radiation levels used in diagnostic X-rays were 20 times higher than today, and experiments with fruit flies showed radiation damaged their reproductive systems.
These days we know that X-rays, even the newer targeted beams, produce "scatter" and that doesn't just mean peripheral radiation that bounces around in the room the machine is in. It's been discovered that the scatter also happens when radiation from an X-ray (or CT scan) ricochets around inside your body. The current thinking is that a lead apron may trap some of that radiation inside your body and that it gets absorbed into tissue beyond the area being imaged. In that way shielding may actually increase your level of radiation exposure. This scatter can also degrade image quality.
Last spring the American Association of Physicists in Medicine issued this position statement: "Patient gonadal and fetal shielding during X-ray-based diagnostic imaging should be discontinued as routine practice." The reason is that diagnostic X-ray imaging is not (and scientists have been studying this for a long time) associated with any harm to gonads or a fetus.
Kaiser Health News reports that the National Council on Radiation Protection and Measurements is expected to support the "Abandon the Shield" campaign from Chicago's Lurie hospital, while hospital groups in Canada and Australia have already started. The movement is also underway in Great Britain. So your hospital group is on the cutting edge, Brian.
Q: My 15-year-old son is dragging around all the time and seems depressed. Is it possible he has chronic fatigue syndrome, and is there anything we can do about it? - Ramona, D., Brooklyn, New York
A: It's possible, but your son needs to be examined by a doc so he or she can rule out other issues that may be causing his sluggishness. According to the Centers for Disease Control and Prevention only about two in 100 children have chronic fatigue syndrome.
Unfortunately, those kids are often overlooked or misdiagnosed. In a recent study funded by the National Institutes of Health, researchers from DePaul University and Lurie Children's Hospital in Chicago screened over 10,000 children; 42 kids were diagnosed with chronic fatigue syndrome (or myalgic encephalomyelitis/chronic fatigue syndrome, ME/CFS). And fewer than 5% of the kids who tested positive for the condition had been previously diagnosed. African American and Latino kids with CFS were twice as likely to be undiagnosed than the rest of the study's population. In other words, this is a grossly underreported and underdiagnosed medical problem.
Doctors believe that ME/CFS develops following an acute illness like mononucleosis or influenza, perhaps because of an immune system dysfunction. Symptoms such as fatigue (obviously), extreme exhaustion, memory loss, sore throat, muscle and joint pain, and headaches may come and go, making diagnosis tricky.
The good news is that there's a diagnostic blood test in the works that's producing very promising results in trials. Until then, though, appropriate treatment depends on good diagnostic sleuthing by the doctor. Although there's no cure, once diagnosed, symptoms can be treated effectively.
If your son's symptoms are knocking him off his feet and he's missing school, his doctor may prescribe pain relievers, antidepressants or sleep aids that are appropriate and safe for someone his age. Graded exercise programs that build stamina are also useful and boost mood too. Assure your son that if he has CFS, you and the docs will help him get back on his feet.
Distributed by King Features Syndicate, Inc.
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