Showing posts with label CT scan. Show all posts
Showing posts with label CT scan. Show all posts

Friday 10 August 2012

...With Many A Winding Turn...

I've just returned from another day at my (relatively) local transplant hospital, after the last tests as described in my last post.  These appointments were for a "CT Angiogram Renal/Abdominal", a Glomerular Filtration Rate (GFR) test and a Renal DMSA; as expected it was quite a long day, but I must compliment the hospital for making it a relatively stress-free experience, as all three appointments were conducted at the times specified and I was not kept waiting unnecessarily.  Sadly, the necessary bit of waiting involved two waits of 90 minutes and three waits of 60 minutes, but there was no getting around those.  The good side of this is that I have now finished reading "Pilgrim's Progress" (at last).

The abdominal CT ("Computerised Tomography", in case you wondered) scan in Radiology was first. You lie down and are moved feet-first into a large doughnut-like machine which is basically a rotating X-Ray with some clever software to build up a 3D picture of whatever part of you they are interested in.  Part of this 30 minute procedure is three timed injections of a surprisingly large quantity of an iodine solution; the radiographer fitted a cannula into my left arm to save me looking like a pin cushion after the whole day; I was surprised that radiographers could do this, and she was cautious as she got someone in to check it. I spent some time trying to calculate the quantity of iodine based on the size of the transparent container and eventually came up with 125ml ("almost an armful!").   I assume that the iodine goes to/through my kidneys and is picked up by the X-rays thus highlighting the interesting features like the number and position of arteries. You are warned that this iodine can have three effects: a hot flush, a metallic taste in your throat, or the feeling of sitting on a warm car seat (although I don't have such a device in my car so could only guess); this last one has also been described as a feeling that you are wetting the bed!  I had only a hot flush on my palms and a slightly warm feeling in my nether regions. 

The other two appointments were done in the adjacent "Nuclear Medicine Department".  The GFR test starts with an injection and then the four subsequent blood tests (using the same cannula) will give an accurate figure for how well my kidneys are working - I think this is for future reference, as the eGFR has already told them that they work OK.  For the Renal DMSA, you are injected with a small amount of radioactive fluid and after the 90 minute wait they do a scan which picks up the radioactivity and shows the distribution of arteries etc around your kidneys.  (I think this confirms the CT scan.)  Because of this radioactivity, you are shown to a different waiting area (with toilets marked "radioactive hazard"!) when you come back for the scan - this is to protect the staff like the receptionists who otherwise would suffer a particularly large unwanted dose over a long period from many patients like me hanging around near them.  In doing the scan you lie down and they move a large scanner down to your body; I wondered if it had some sort of safety stop on the maximum travel as otherwise it could be a new way for someone to try and kill James Bond!  Or perhaps by this time I was starting to fantasize.  NB For this scan of my abdomen, I had to remove my shoes (why?) and was moved under the scanner to a position where my feet stuck out the other end in a draught! Just a small point...

I mentioned the Renal DMSA in my last post.  Since then I have found out (from Wikipedia) that DMSA stands for dimercaptosuccinic acid, which makes me no wiser.  It has the chemical the formula HO2CCH(SH)CH(SH)CO2H if you're into that sort of thing.  Slightly worryingly, the Wikipedia articles on DMSA and dimercaptosuccinic acid do not mention its use for assessing kidney function, while the article on Renal Function does not mention DMSA at all.  More questions for the list!  [NB I also mentioned Di Franks' excellent website last time.  I have also found that in fact she has covered the same topic of eGFR and Renal DMSA in some useful detail - see this link.]

In one of my long waits, I visited the Transplant Co-Ordinator to ask a couple of questions.  Since this is my last visit to this hospital, I also wanted to thank her in particular for making my testing so painless (both literally and metaphorically).  They will send my results to London and my further participation (if any!) in this process will all be there, so I won't see her again but I will keep her informed.  As far as I am concerned, the Churchill Hospital in Oxford have been excellent throughout this process of tests, and I think they have all been wonderful to me - nurses, radiographers, phlebotomists and receptionists have all been happy, helpful, efficient, professional and just right in their approach to me. Well done, I say.

Finally, on being picked up by my wife, I kissed her after greeting her with the ultimate chat-up line: "Hiya.  I'm Radioactive Man!"


Friday 13 July 2012

The Road is Long....

I'm very pleased to say that I have just received notification of three appointments for 10th August - that's going to be another busy day! These appointments are for a CT angiogram, a Glomerular Filtration Rate (GFR) test and a Renal DMSA.

The fact that I have progressed to this stage means that the tests two weeks ago were all fine - there would be no point in having an expensive CT scan if they weren't.  The other two appointments are to done in the "Nuclear Medicine Department" which sounds a bit worrying but isn't, apart from the fact that it isn't shown on the hospital map!  The "Nuclear" bit is because for each of these they inject you with a small amount of radioactive fluid.

I don't yet know what DMSA stands for, but the test "demonstates the location and function of my kidneys".  At least I know now that the GFR test will provide a real GFR figure, not an estimate, which is what eGFR means as the "e" in "eGFR" is for "estimated".  The neph at my tests explained why that is; the more extensive multiple blood sample test will give a truer figure than the single blood sample which was done then.  In this test they take blood samples at intervals after the injection in order to monitor how well your kidneys are dealing with it.  So this test lasts for up to five hours!  Since the Renal DMSA also requires a 1.5 hour wait for another blood test after the injection, it's going to be a long day; this time I will definitely be able to read more of my book, which I didn't last time as they were so quick.

Going back to the last set of tests, I had a strange feeling being tested by some specialist for something that I know very little about.  I just feel so detached from the process and watch with an interest which hardly accepts that I am actually the subject of their investigations.  I noticed this earlier this year during my colonoscopy (see this previous entry) - it was really strange being able to see the inside of my own lower intestine on a TV screen!  I rather think that the hospital specialists think that I am a bit odd - perhaps I am - as I meekly accept my fate at their hands and do precisely whatever they ask me to, without argument or apparent concern.  However, I don't think that this will apply much at the next tests as the last two will simply be injections and blood samples, with a lot of waiting.

Finally, here's a link to a very useful website all about kidney donation, which has lots of information, stories of experiences, blogs and links.  I have found that most of this sort of thing on-line is from the USA, but this one is British which is useful as the health systems are pretty different; it started with the story of Dianne Franks who in 2010 made a non-directed living kidney donations in the UK not long after that was legalised. [Edit: in fact, Di's comprehensive website gives an explanation of DMSA (above), so I'll cover that next time.]