Thank you for your query at DoctorSpring.com
It is great that you have quit smoking. Quitting has lowered your
chances but they still do exist. But the first positive step that needed to be taken and which most people fail to do, you have succeded and hence the chances have been significantly lowered.
Total radiation exposure involved in ct urogram can be safely
administered every year without increasing your chances of getting
cancer. There have been lots of studies but conclusive evidence is lacking about the increased risk of cancer from such radiation exposure. In CT urogram it is slightly higher definitely, but a lot of patients have been advised yearly CT urogram based on their conditions, and they have not shown any signs of cancer. It is theoretically possible, but practially i am yet to come across a case like that.
Calcified granuloma can be normally seen in normal individuals and you
should stop worrying about it.
Hope this was helpful,
Patient replied :
Thank you so much for your answer. You've definitely eased my mind. As I understand it, I do not need to follow up on the granuloma with any additional scans since the doctor was absolutely sure of what it was. One final question. It's more general. Is it normal for your blood values to bounce around? My doctor has started sending me a copy of my blood/lab tests and I've noticed that sometimes, I am at the high end of the range and sometimes, the opposite, within just a few months of eachother. For example, my white count was 4.1 (which is normal according to her lab, but on the low end) but a few months before that, it had been at 7.7. Specifically, I am wondering why my rbc count is at the top of normal according to the lab. My red blood cells are 4.86 and that is actually at the very TOP of the range. The final thing I noticed is that a couple of months ago, my calcium level went as high as 10.1. It's now at 9.8. All of these numbers are within normal range, but are either at the very TOP of it or the very BOTTOM of it according to my lab. I struggle with Generalized Anxiety Disorder and I think this is why I have been panicing over health issues as of recent. I've had a lot of doctor's appointments and have really been on edge. I just wanted to be sure that these numbers weren't indicative of cancer or any other disease. Thanks for answering my questions.....I appreciate it! Robin
Thank you for the follow up.
Yes, it is absolutely normal for the blood parameters to be different at various times, in fact it can vary at different points in the same day. If it is in the normal range then there is nothing to worry about. We really don't give any importance to whether it is on the higher side of normal, or in the lower side of normal.
It is the same with calcium too. It all depends on the physiology of the body cells, how much vitamin d is the body getting, and in return how much calcium is it allowing to be formed.
In a nutshell, it can vary and that is absolutely normal. It is no way indicative of cancer.
Hope this was helpful,
Patient replied :
Thank you so much for all of your help and comforting answers. I have one last question, and then I promise to close out this discussion. Like I told you before, my anxiety has really been up lately, and my mind has been all over the place with regards to medical issues. SO.....I'll tell you really quickly what has gone on in the past 6 months, and I think you'll understand a bit of my anxiety.
February: Fell down our hardwood stairs from the very top and landed at the bottom on my head. Was conscious, but unresponsive. Didn't know who I was, my birthday, my family, etc... I do remember a blip of a moment of being in the ambulance on the way to the hospital and absolutely nothing of an 8 hour stay at the hospital. One of the reasons for me being nervous about radiation, is that during a period of two days (I had to go back the next days for significant side effects), I had a chest x-ray, a cervical spine CT and two head CTs.
March: Found out that hospital tests revealed blood tests of high liver enzymes. Went to my PCP who sent me to get my liver ultrusounded and it showed moderate to severe fatty liver. (I am a recovering alcoholic....have been sober for over 7 years, so this was not related to alcohol use.) Instead, my doctor said it was related to my weight, which had gotten up to 190 pounds. I am 5 feet 5 inches and that was considered obese for me. Since March, I have been walking 5 miles a day and eat a VERY healthy diet. It took about 4 months, but my liver enzymes came down and are totally normal. My weight is also down....by 60 pounds. I am at 130 pounds, YAY! During the midst of all of this, my doctor said that high liver enzymes and a fatty liver show a liver condition caused NASH and that it could progress to cirrhosis, liver failure, liver cancer and death. I was horrified. Since that time, I have talked to NUMEROUS doctors, including my PCP who say that they think this was a total misdiagnosis. I had just started a new medication before I fell a few weeks before, and that was what caused the fall due to a drop in my blood pressure. I was on it for a few more weeks before I quit taking it and my enzymes kept going up. As soon as I went off the medication, they started coming down. Like I said, I also have been exercising and eating right and losing weight, so who knows exactly what was going on. I just know that I have another liver enzyme check in January and probably another scan not long after that to make sure that the fat is disipating.
June: After 2 months of irregular, crazy, long, short, you name it periods, my doctor decided to do a hysterectomy but to leave my ovaries. Found a polyp and some other benign findings in pathology, but otherwise all good. Another scary time.....
July: 2 suspicious skin biopsies that turned out to be nothing.
August: Colonoscopy with three precancerous polyps. (I've had them before, so I know that I'll be okay as long as I keep on following up.)
August: Urogram with WEIRD finding of calcified pulmonary granuloma! As a former smoker, I was sure it was cancer.
At that time, a friend mentioned to me that I'd had a lot of CT scans this year and that they are a definite cancer risk. It totally freaked me out.
I have calculated all of the CT tests I've ever had, including three IVPs in my 20s and 30s.
My total medical mSv radiation accumulation over the 42 years old patientof my life is 55. Is this a huge number? From now on, I think I may ask for ultrasounds and/or MRIs as to avoid any further radiation. I feel like that is a lot for a 42 year old female.
So, as promised, my last question. How much does 55mSv raise my cancer risk? Most of the radiation (35mSv) has been since I was over 40. I'd really love to hear your opionion. I'm just so scared with the smoking history and the radiation exposure. I want to put this all behind me and get on with living a happy, carefree life. I want to enjoy my wonderful hubby and children and right now, I am worrying so much, that I just can't seem to do that. I am seeing a counselor for this. I started seeing her about a month ago and it seems to be helping.
Thank you again for all of your comforting knowledge.
It is good to hear that you have recovered from such a terrifying incident. Your worries are not unwarranted.
Excessive radiation exposure can cause cancer but usually if the exposure is less than 50mSV in a single year then the chances are very minimal, practically nil. Your accumulated exposure is definitely much less than that.
Stop worrying; move on with your life and limit exposure in future.
Let me know if I can assist you any further.
Dr Rajiv Goel,