Thursday, January 16, 2014

MiM Mail: Radiation risks

Dear MiM,

I am a third year radiology resident and desire to have another child.  I currently have two boys, ages 4 and 2.   My job requires performing fluoroscopy procedures (3-4/day to include HSG's) and I am concerned about trying to conceive while working with radiation.  Its hard to really discuss this topic with the health safety officer as I am only trying to conceive and am not yet pregnant.  This weighs heavily on my mind as I have recently turned the dreaded advanced maternal age.  I have read that its an all or nothing kind of thing within the first two weeks post conception and I am hoping by wearing double lead I am not increasing my risks for miscarriage.  Looking for any advice or guidance as not many women have this issue (=.

Thank you!

3 comments:

  1. There are a couple of older post about this on the site. Here's one of the most recent ones http://www.mothersinmedicine.com/2011/05/pregnant-in-cath-lab.html

    ReplyDelete
  2. When my wife was a radiology trainee. She maintained good relationships with the supervisors of training and other residents/registrars swapping Fluro, interventional and angio procedures for non-ionizing procedures like US guided biopsies. As you know with regards to radiation safety and the ALARA principle, u want to get thru with lowest exposure as possible. When you become an attending/consultant, u get to choose what you do and the way you do them, e.g. many CT guided procedures can be done reasonably fast with radiologist remaining outside the room.

    In the mean time, spare a thought for surgeons and interventional cardiology trainees who seems to get a lot more exposure with their supervisors as pedantic as radiologists when it comes to radiation protection.

    Oh, also watch ur back get two piece lead as you dont want to risk popping a disc then not being able lug around a newborn. Good luck !

    ReplyDelete
  3. My experience is anecdotal but there are no real randomized controlled studies of radiation exposure to pregnant women in medicine as there are so few of us. I am a general surgeon and the mother of three children. My first two sons were delivered full term when I was 32 and 35. I worked up to within days of delivery and continue to maintain a busy office and operative practice. My daughter was also born full term when I was 37 with transposition of the great vessels. I did not know I was pregnant when I performed two infusaports for my breast cancer patients using fluoroscopy and lead. I was five weeks pregnant and as we recall our embryology, this is when the aortic and pulmonary artery outflow tracts should spiral. I do have "guilt" that my career which I love contributed to my daughters heart defect. I was reassured by her pediatric surgeon that my only risk factor was my advanced maternal age. Fast forward sixteen years and she is not only my pride and joy but also playing varsity basketball. This experience has made me a more empathetic surgeon as I have been on both sides of the operating table. But I will always wonder, we all make great sacrifices to balance medicine and children and at times have we sacrificed too much? Of note both my breast cancer patients who I placed infusaports are also thriving.

    ReplyDelete

Comments on posts older than 14 days are moderated as a spam precaution. There may be a delay between submitting your comment and its publishing. Thanks for commenting!