CT Scans: Learn from My Story

This is going to be a really long post, but I’m hoping some of you parents out there can bear with me and learn from my experience—and also what I consider to be my mistake. CT scans can certainly be a useful diagnostic tool to detect illness or injury in your child. But, there are some serious risks and implications that parents need to consider prior to subjecting your child to these tests. I learned this the hard way and still regret it.

A couple of months ago, Will and I were playing in our front yard. He was riding his toy tractor up and down the side walk. Our driveway has a steep incline down to our garage door, and Will was sitting on his tractor at the top of this hill. Before I knew it, he started going down the hill and couldn’t stop himself. Needless to say, he sped down the hill and slammed into our closed garage door (fortunately missing the stone column between our two garage doors). He hit the door hard with his head, flipped off the tractor and landed on the driveway, head down.

Screams ensued and I ran down the hill to pick him up. There was no visible bleeding or injury, but he did have a red welt on the side of his head starting to form. And, because he hit his head so hard, I wanted to have him checked out to make sure everything was okay. We hear so much about head injuries, particularly after actress Natasha Richardson died from a head injury this past spring. We, as parents, are conditioned to be very wary of any hit to the head.

It was after 5:00pm, so I took Will to the local urgent care facility. By this point, Will had stopped crying and was acting normally, but I still wanted him to be checked out. The doctor saw Will and did a few basic tests (looking into his eyes to make sure they weren’t dilated, checking his ears for bleeding, making sure Will could follow the doctor’s finger movements, etc.), and the doctor declared that Will seemed fine, but you could never be sure. “But because of his young age, you really should take him to the emergency room to get a CT scan to rule out an internal injury,” he said. I was shocked. I wasn’t expecting this and I wasn’t crazy about putting Will through that, but then again, how could I say no? If the doctor is telling me this is something I need to do, and as a mother I want to do everything possible to make sure my child is okay, I need to do this test, right?

So, we left the urgent care office, but I was still hesitant about making the trip the emergency room and all that would entail. I called Billy, my husband, to fill him in and he was surprised, too, at the doctor’s suggestion. “Are you sure we need to do this?” he asked. I told him I didn’t know what to do. Billy decided to call his mom who’s a nurse and get her opinion on the matter.

Meanwhile, I was torn between going to the hospital and heading home. Will seemed fine, but I still had that nagging thought in the back of my brain of “what if he’s not fine and really does have a head injury?” Who wants to be the mother that didn’t do what the doctor told her and then ended up with a tragedy on her hands?

So, I headed to the hospital, still not sure what to do. Billy called me back and said his mom suggested waiting—if Will seemed fine, was acting normally and didn’t have a visible injury, why put him through the test and the unnecessary radiation that comes with a CT scan (and let it be noted, she was the first and only one who raised the radiation factor as a concern during the entire process)? I decided to call Will’s pediatrician to get her opinion on the matter. Since it was after hours, I was put through to their nurse hotline. After twenty minutes of waiting (I was sitting in the hospital parking lot at this point with Will wanting to run around and me a ball of stress), I finally talked to a nurse who basically told me I should just do what the doctor told me (and didn’t offer any other insight). I finally said screw it, we’re doing the test. I called Billy back to let him know and he was still unsure if this was the right thing to do, but he supported my decision.

I took Will into the emergency room, signed us in, and after about a 45 minute wait we got called to the back. We sat down with an admissions nurse who asked a bunch of questions about what happened. After that, we were admitted and put into a room to wait for the doctor.

While we were waiting, the nurse on duty came in and took a look at Will. She sort of mumbled something about him being fine, but that the doctor would be there soon. He came in, examined Will, gave him some Tylenol with codeine to relax Will prior to the test, and said someone would be there soon to take us back for the CT scan.

When we got back to the room for the scan, they put a little apron over Will’s torso and laid him on the table. For a CT scan, only the part of your body being scanned is enclosed (it’s not like an MRI where your entire body goes into a tube). Will did really well, and the test took about five minutes max. I was relieved when it was done.

We went back to the room to wait for the doctor to come in with the results. Sure enough, everything turned out fine—we were free to go. As we were packing up our things, the nurse came back in. I happened to ask her about the radiation exposure Will just received and she replied, “Yeah, it’s a problem.” What? What?!? This was the first time anyone during this entire process (other than my mother-in-law) brought up any issues with the CT scan and radiation. She went on to tell me she worked for years at a children’s hospital and that more and more doctors are ordering CT scans for kids—unnecessarily, often because of fear of law suit—and it’s a rising concern about children and cancer rates.

Needless to say, I walked out of there pretty upset. When I got home, I started to do more research about CT scans in general and sure enough, there is a real concern about these types of scans, the high amounts of radiation that they expose people to, and cancer rates. I sort of knew there was a risk associated with these tests, but I didn’t realize how much radiation they delivered. Every time someone receives one of these scans, their chance of getting cancer goes up. This is even more of a concern in pediatric patients because the effect of radiation is a cumulative thing over a lifetime. So, the earlier someone is exposed to these tests, the higher the lifetime cancer rate. And, in young children the radiation has an even more profound effect on the growing cells/brain of a child, so there’s that to worry about, too.

Another thing for parents to be aware of is the amount of radiation their child is receiving from one of these tests. Many hospitals don’t “dial back” the radiation levels on their machines to accommodate for a child’s smaller body, which means that your child could potentially receive an exponentially greater amount of radiation than is necessary. X-rays also expose your child to radiation, which unfortunately, Will has had several of those, too. But, the dose of radiation from an x-ray is minimal in comparison with a CT scan. A CT scan is the mack-daddy of tests and radiation doses—the highest of any test out there.

Needless to say, I have been upset about this since it happened. I basically submitted my child to a test that increased his cancer risk, even more so because he’s so young. It makes me sick to think about—I should have listed to my mother-in-law-- but at the time I made the decision with the information I had. What makes me so mad about this entire situation is that not once during this process did any of the doctors or nurses give me information about the risks associated with CT scans. Not the urgent care doctor, not the nurse on the hotline, not the nurses or doctors at the hospital. So what’s a parent to do?

If your doctor orders a CT scan, make sure it’s absolutely necessary. Are there other diagnostic tests that can be done instead to determine a problem, like an MRI (which is magnetic imaging, not radiation) or an x-ray (which is radiation, but in extremely smaller doses)? If your child hits his or her head and seems fine afterwards (is consolable, has no visible injury, maintains the same appetite, continues to play, etc.), you may want to just watch them. Or, take your child to a children’s hospital instead of a regular hospital in these instances. According to the nurse who told me how dangerous these CT scan can be (after I had already subjected my child to the scan), at a children’s hospital they are more aware of the effects these scans have on small bodies and are not as quick to order them. She said with a case like Will’s, they probably would have just sent him home. And, if you do have to have a CT scan , make sure the hospital’s equipment is set up to give a lower radiation dose to your child, vs. an adult-sized dose. Also, try to avoid unnecessary x-rays—even dental—for your child (and you!).

Obviously, there are instances when CT scans are a critical, necessary and potentially life-saving tool to diagnose illness and injury—I’m not saying to boycott them. The risks and benefits of the tests just need to be weighed. And parents need to be aware of the risks associated. I’m pretty sure if someone along the way had mentioned the risks to me (just like they do when I get Will vaccinated—heck, I get sheets of information about the benefits and risks of vaccinations), I would have declined the test. I just felt in my gut that Will was fine, and I should have listened to that. I’m sure there will come a day when he will need more tests like this (kids don’t go through life without injuries and illness), and I’ll have to weigh the risks and benefits again. I just wish I had made a different decision this time around so that he didn’t already start his young life with a higher cancer risk.

Here are some good articles and resources of information. Please check them out—these tests pose risks to adults, too:
How Dangerous are CT Scans? Time Magazine
CT Scans Linked to Cancer Wall Street Journal
Public Health Notification: Reducing Radiation Risk from Computed Tomography for Pediatric and Small Adult Patients FDA.gov