Breaking your ankle can be a very devastating injury which can involve significant time off your feet depending on the extent of your injury. The below question and answer format will give you much of the information you need to know about treatment if you or someone you know sustains a broken ankle.
FAQ (Frequently asked questions):
1. What should I do if I think I broke my ankle?
You should be treated immediately. If a local podiatric surgeon is not immediately available in his/her private office, a hospital emergency room is the best place to go. Pain medication will be administered and X-rays will be taken. If a fracture is confirmed and the fracture segments have moved apart significantly, pain medication will be given and a manual (closed) reduction to put the segments closer together will be attempted. If surgery isn’t needed, then an above or below the knee fiberglass cast will be applied and crutches, a walker and/or wheelchair will be given as no weight can be applied to the foot.
2. How do I know if I have a broken bone vs. a bad sprain?
There is no way of knowing whether you sprained your ankle instead of fracturing it without getting an X-ray. Blisters, swelling, pain, bruising and redness with either a fracture or a sprain may be present. Pain directly on the bones of the ankle with direct touch is a clinical test but often times even in a sprain there is pain everywhere even on the bone. X-rays are the only way of knowing for sure if you broke a bone. If you sustained a very intricate fracture, your doctor may also order a CAT scan.
3. Will I need surgery?
If the bones cannot be manually reduced or put back together, than surgery will be performed. This surgery for an ankle fracture is called an open reduction with internal fixation (ORIF).
4. How long does it take to recover?
Bony healing typically takes 6-8 weeks to occur. However depending on your overall health, other factors such as smoking, diabetes, poor nutrition and poor circulation can delay this process.
5. How long will I be in a cast?
Regardless of if you have surgery or not, a cast will be in place for at least 6-8 weeks in order to give the bone enough time to heal
.
6. When will I be able to walk normal again?
This depends on the severity of the fracture but typically one will be able to ambulate in a sneaker after 8-10 weeks. Even then, the ankle will still be somewhat swollen.
7. How long will I be out of work?
It depends on the type of work you do. If you have a very accommodating job and can sit most of the time, then you may be able to return as soon as 2-3 weeks after treatment. While at work you need to keep your foot elevated on another chair. You should keep ice applied for 20 minutes every hour when awake. Most people will need to take at least 4-6 weeks off from work, but if you have a job where you need to stand and walk, then you will need to take at least 3-4 months off from work. You may qualify for short-term disability or workman’s compensation (if the injury occurred at work).
SAQ (Should ask questions):
1. What bones are involved in an ankle fracture?
The ankle consists of the end of the tibia bone called the medial malleolus, the end of the fibula bone called the lateral malleolus and the bottom of the ankle called the talus bone.
2. Are certain people prone to breaking their ankle?
Oftentimes, an ankle fracture involves a simple, unintentional slip, fall or accident. Other times it involves a twisted ankle injury from someone who has frequently sprained his or her ankle in the past. These people have chronic ankle instability and have high arches that are unstable on uneven surfaces. This leads them to sprain their ankle a lot and even fracture it if the force of the sprain is high enough.
3. How can I prevent an ankle fracture if I am prone to this?
If you have high arches, have sprained your ankle in the past and feel unstable on uneven surfaces, you need the proper support to prevent not just another sprain but a fractured ankle. Good, sturdy shoes as well as a pair of functional customized orthotics (inserts) to straighten out the foot and offer stability are best to prevent a fracture or sprain.
4. What determines if I need surgery for the ankle break?
If the bony segments of the fracture are shifted enough more than 2mm and closed manual reduction cannot close the gap enough, you will need surgery/ORIF. Also surgical repair of the ligaments may be performed if the ligaments are torn as seen as a wide gap of the bones on X-ray.
5. Will I have long-term pain after the ankle is healed?
Just as in other joints, the ankle joint should be comprised of healthy cartilage that covers the bone to allow for up (dorsiflexion) and down (plantarflexion) motion. A break of the ankle usually involved a break or injury to the cartilage as well. Therefore and theoretically, someone who sustains an injury to the ankle joint (intra-articular fracture) may develop chronic ankle arthritis called osteoarthritis or degenerative joint disease. Arthritis involves cartilage damage where the bones rub together causing inflammation and pain. You might not have severe arthritis, but if the cartilage is slightly damaged you may have persistent but occasional pain and stiffness in cold or rainy weather.
6. Will I need physical therapy?
Yes, most patients whom are in a cast for 6-8 weeks will develop weakness and visible calf atrophy or a smaller calf. These muscles need to be strengthened and the ankle needs to be moved to increase ankle range of motion. A formal therapy program of 2-3 times per week for at least 1 month is needed at a therapy facility for optimal healing.
7. What is the difference between a podiatric surgeon and orthopedic surgeon? Who should I see for my ankle injury?
Seek treatment from a podiatric foot and ankle surgeon as they are uniquely qualified to not just perform the surgery but also to carry out the long-term care of patients by addressing the biomechanical conditions affecting the foot and ankle. Unlike orthopedists, a podiatric foot and ankle surgeon, in addition to the general medical training, focuses on the foot and ankle from the beginning of their medical training.
By Dana Waters, DPM
Podiatric Surgeon in Hillsborough and Piscataway, NJ
Monday, November 14, 2011
Monday, October 31, 2011
Charles Woodson: Clubfoot to Super Bowl
Being born with a congenital deformity can be devastating. As a parent, you may struggle to understand why, how, and what should be done. It is incomprehensible to allow your child to suffer or struggle and you shouldn’t have to sit by and be helpless. When Charles Woodson was born with clubfoot, his parent probably never conceived that their son born with a foot deformity would someday be a successful football player. Clubfoot is a congenital foot deformity that occurs in about 1 in every 1,000 births and is twice as common in young boys as girls.
Clubfoot can be identified at birth and the foot will have an appearance of turning inward. The medical name for the deformity is Talipes Equinovarus. The exact cause of clubfoot is still widely debated and unknown. No genetic component has been discovered but statistics show that children whose parents or siblings have clubfoot are twice as likely to be born with club foot.
The child does not experience any pain, but if left untreated, the ability of the child to ambulate in the future is very limited. Disability would be inevitable. Over the last 25 years the treatment protocols have been debated. The current standard of treatment involves a series of casting starting shortly after birth. This treatment method is referred to as the Ponsseti technique. The cast is changed by a trained physician weekly and a series of manipulations and stretching are performed. Casting can be as few as 4 weeks but the amount of time taken correct the deformity is dependent on the complexity of the deformity. Most children also need their achillies tendon lengthened, a minor procedure done through a minimal incision. Fallowing correction of the deformity, the child will need to be in a series of braces that help maintain the correction. Less than 20 percent of children treated by casting will need surgery in the future to correct any residual deformity.
Though the child is bound to braces and continued foot care up the age of four, the deformity and treatment has little effect on the child’s development. By the time the patients is gearing up to ambulate, the braces are worn minimally, mostly while the child is asleep. Most children go on to have a normal childhood with few, if any, limitation. Often the only residual defect is the clubfoot having a slightly smaller size than the normal foot. If treatment is delayed, children may be subject to more invasive surgery and longer recovery times but surgical procedures for clubfoot have been well studied and discussed in the literature with good success.
From Clubfoot to athlete, there have been many professions who were born with the congenital deformity who grew up to be successful athletes. Charles Woodson is a Super Bowl Champion. Kristi Yamaguchi is a gold medal figure-skater. From MVP baseball players to star soccer players, people born with clubfeet have proven to overcome their congenital deformities.
Clubfoot can be identified at birth and the foot will have an appearance of turning inward. The medical name for the deformity is Talipes Equinovarus. The exact cause of clubfoot is still widely debated and unknown. No genetic component has been discovered but statistics show that children whose parents or siblings have clubfoot are twice as likely to be born with club foot.
The child does not experience any pain, but if left untreated, the ability of the child to ambulate in the future is very limited. Disability would be inevitable. Over the last 25 years the treatment protocols have been debated. The current standard of treatment involves a series of casting starting shortly after birth. This treatment method is referred to as the Ponsseti technique. The cast is changed by a trained physician weekly and a series of manipulations and stretching are performed. Casting can be as few as 4 weeks but the amount of time taken correct the deformity is dependent on the complexity of the deformity. Most children also need their achillies tendon lengthened, a minor procedure done through a minimal incision. Fallowing correction of the deformity, the child will need to be in a series of braces that help maintain the correction. Less than 20 percent of children treated by casting will need surgery in the future to correct any residual deformity.
Though the child is bound to braces and continued foot care up the age of four, the deformity and treatment has little effect on the child’s development. By the time the patients is gearing up to ambulate, the braces are worn minimally, mostly while the child is asleep. Most children go on to have a normal childhood with few, if any, limitation. Often the only residual defect is the clubfoot having a slightly smaller size than the normal foot. If treatment is delayed, children may be subject to more invasive surgery and longer recovery times but surgical procedures for clubfoot have been well studied and discussed in the literature with good success.
From Clubfoot to athlete, there have been many professions who were born with the congenital deformity who grew up to be successful athletes. Charles Woodson is a Super Bowl Champion. Kristi Yamaguchi is a gold medal figure-skater. From MVP baseball players to star soccer players, people born with clubfeet have proven to overcome their congenital deformities.
Saturday, October 8, 2011
As Does Ryan Howard’s Achilles Tendon Goes Pop, so Does the Phillies Season
The favorite Philadelphia Phillies lost their playoff series last night to the St. Louis Cardinals. On the very last play, Ryan Howard, the Phillies first baseman, was running out a ground ball. On the way to first base, Howard crumbled to the ground. “I heard my Achilles Tendon pop,” he said.
That pop that Howard describes is a sign of an Achilles Tendon tear. You might say well, he has all off season to recover, but Achilles Tendon ruptures are not to be taken lightly. Since the Achilles is the largest and the strongest tendon, it is also the hardest tendon to heal after an injury. The tendon attaches the big calf muscle to the back of the heel bone, also known as the calcaneus. When the calf muscle contracts, the tendon allows you to point your foot and stand tiptoe. The tendon is necessary to run, walk and put your foot down.
How does the Achilles Tendon Tear?
Tears are really not that common and usually occur in Men over 40 or in athletes who perform a ballistic movement, like Dan Marino did several years ago, when he pushed off his foot to throw a pass. The athlete pivots, jumps or runs in a very quick fashion.
The injury can also happen in these situations.
1) You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
2)You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon.
3)You fall from a significant height.
When the injury occurs, a loud pop sound usually happens. It is sometimes sounds like a gun shot went off. Sometimes the tendon doesn’t fully tear, and you get a partial rupture. Partial tears can lead to a full blown rupture if left untreated. In young athletes, surgery is usually needed to repair the tendon if it was fully ruptured. Partial tears can be treated with initial immobilization and physical therapy.
Rehabilitation after surgery can be from 3-6 months. Most professional athletes, like Ryan Howard, would need about three-four months before being ready to play their sport.
Another way to get a tear of the tendon is to ignore pain in the area. It is very common to develop Achilles Tendinitis, which is a swelling along the tendon. If one ignores this pain and continues to stay very active, the inflamed tendon can tear. So, it is very important to see your podiatrist if this happens.
That pop that Howard describes is a sign of an Achilles Tendon tear. You might say well, he has all off season to recover, but Achilles Tendon ruptures are not to be taken lightly. Since the Achilles is the largest and the strongest tendon, it is also the hardest tendon to heal after an injury. The tendon attaches the big calf muscle to the back of the heel bone, also known as the calcaneus. When the calf muscle contracts, the tendon allows you to point your foot and stand tiptoe. The tendon is necessary to run, walk and put your foot down.
How does the Achilles Tendon Tear?
Tears are really not that common and usually occur in Men over 40 or in athletes who perform a ballistic movement, like Dan Marino did several years ago, when he pushed off his foot to throw a pass. The athlete pivots, jumps or runs in a very quick fashion.
The injury can also happen in these situations.
1) You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
2)You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon.
3)You fall from a significant height.
When the injury occurs, a loud pop sound usually happens. It is sometimes sounds like a gun shot went off. Sometimes the tendon doesn’t fully tear, and you get a partial rupture. Partial tears can lead to a full blown rupture if left untreated. In young athletes, surgery is usually needed to repair the tendon if it was fully ruptured. Partial tears can be treated with initial immobilization and physical therapy.
Rehabilitation after surgery can be from 3-6 months. Most professional athletes, like Ryan Howard, would need about three-four months before being ready to play their sport.
Another way to get a tear of the tendon is to ignore pain in the area. It is very common to develop Achilles Tendinitis, which is a swelling along the tendon. If one ignores this pain and continues to stay very active, the inflamed tendon can tear. So, it is very important to see your podiatrist if this happens.
Wednesday, August 31, 2011
Sprained Ankles Raising the Cost of ER Visits!
There is nothing cheap about healthcare and going to the ER can cost you an astonishing amount of money! In 2008 the average Emergency room bill was $1,265. What can you do when it is an emergency? How do you tell when you actually need to go to the emergency room and what can wait for an appointment?
A recent study published in Clinical Orthapaedics and Related Research took a closer look at lower extremity emergency room visits. They analyzed a total of 119,815 patient visits in 2009 and the most common injury was not an emergency! According to the study the most common diagnosis in the ER for the lower extremity is strains and sprains. This accounted for 36% percent of these visits. An ankle sprain was the most common injury with an incidence of 206 per 100,000 visits. But how do you know the difference between a sprain and a fracture?
Ankle sprains can be very painful and lead many to question: “Did I break something?” Ankle sprains are most common in young individuals with teenagers having the highest ER visits with such injuries than any other age group. Parents are often the ones making the critical decision if the injury warrants the visit to the ER. And If moms are still like my wonderful mom, they are better safe than sorry. The incidence of an ankle fracture is 49 per 100,000, much less than an ankle sprain. The symptoms are extremely similar consisting of pain and swelling and often an audible pop will be heard. Some like to use weight bearing as a guideline but I have seen both ankle fractures walk through the door and I’ve also seen ankle sprains unable to bear weight.
A team of doctors took up the challenge of differentiating between fractures and sprains in Ottawa, Canada and devised the Ottawa Radiograph Rules. They found that only 15% of foot and ankle x-rays in the ER revealed fractures. After implantation of their guidelines, they reduced the number of x-rays by 35%. These rules help determine when x-rays are necessary because of a highly suspected fracture, and when x-rays were unnecessary due to certainty of a simple sprain injury. In simplest terms the guidelines include bone tenderness and inability to bear weight.
The lesson here is that you don’t need to go to the ER to be diagnosed with a sprain or even an ankle fracture. Many specialties have time built into their schedule for emergency visits and many practices even have weekend hours. Depending on your insurance, you may not need a referral to see a foot and ankle specialist and you will cut your cost significantly by avoiding the costly ER. Nearly all podiatric practices have immediate access to x-ray in the office to make the appropriate diagnosis. Injuries can be painful and scary and it is always better to be safe than sorry but you don’t have to go the ER and get charged an arm and leg.
A recent study published in Clinical Orthapaedics and Related Research took a closer look at lower extremity emergency room visits. They analyzed a total of 119,815 patient visits in 2009 and the most common injury was not an emergency! According to the study the most common diagnosis in the ER for the lower extremity is strains and sprains. This accounted for 36% percent of these visits. An ankle sprain was the most common injury with an incidence of 206 per 100,000 visits. But how do you know the difference between a sprain and a fracture?
Ankle sprains can be very painful and lead many to question: “Did I break something?” Ankle sprains are most common in young individuals with teenagers having the highest ER visits with such injuries than any other age group. Parents are often the ones making the critical decision if the injury warrants the visit to the ER. And If moms are still like my wonderful mom, they are better safe than sorry. The incidence of an ankle fracture is 49 per 100,000, much less than an ankle sprain. The symptoms are extremely similar consisting of pain and swelling and often an audible pop will be heard. Some like to use weight bearing as a guideline but I have seen both ankle fractures walk through the door and I’ve also seen ankle sprains unable to bear weight.
A team of doctors took up the challenge of differentiating between fractures and sprains in Ottawa, Canada and devised the Ottawa Radiograph Rules. They found that only 15% of foot and ankle x-rays in the ER revealed fractures. After implantation of their guidelines, they reduced the number of x-rays by 35%. These rules help determine when x-rays are necessary because of a highly suspected fracture, and when x-rays were unnecessary due to certainty of a simple sprain injury. In simplest terms the guidelines include bone tenderness and inability to bear weight.
The lesson here is that you don’t need to go to the ER to be diagnosed with a sprain or even an ankle fracture. Many specialties have time built into their schedule for emergency visits and many practices even have weekend hours. Depending on your insurance, you may not need a referral to see a foot and ankle specialist and you will cut your cost significantly by avoiding the costly ER. Nearly all podiatric practices have immediate access to x-ray in the office to make the appropriate diagnosis. Injuries can be painful and scary and it is always better to be safe than sorry but you don’t have to go the ER and get charged an arm and leg.
Wednesday, May 11, 2011
Is Shaq’s 3 Month Achillies Recover Normal?
At 39 years old, Shaquille O’Neal has had quite the basketball career. This year, he has fallen on hard times. In February he suffered an achillies tendon injury and in April only 2 quarters after returning to the game, he goes out with a calf muscle injury. Is this the beginning of the end for the famous Shaq? Three months after the original injury and the Celtics are still Shaq-less.
The Achillies tendon is the largest and strongest tendon in the body and attaches the calf muscles to the heel. There are a few different achillies tendon injuries. First, the most minor injury is tendonitis. This is typically the result of overuse. Basketball players are extremely susceptible to such injuries since they frequently push off and jump off their toes. Thus, there Achillies is much over used. An achillies tendon can also become torn or completely ruptured. This is another injury commonly seen in basketball. This occurs when one pushes off or contact is made with an already contracted muscle. The tendon will tear in the weakest spot and if the force is strong enough, the tendon will completely rupture.
Since the achillies is the largest and the strongest tendon, it is also the hardest tendon to heal after an injury. Even tendonitis, the most minor achillies injury can sometimes lead to surgery! Statistics show that over 25% of all those with chronic achillies tendonitis go on to have surgery. For acute injuries, rest is the key. For low grade tendonitis, a 1-2 week rest is recommended. For higher grade injuries, a month of rest in needed for recovery. After the rest period, a slow progression back to your activities in recommended. Relative rest does not mean a break from all physical activity, but rather cease in activities that have high impact on the achillies and supplementing activities with appropriate bracing. Depending on the degree of injury will determine the level of rest needed for repair. Achillies tendon tears or ruptures often need surgical repair or a series of casting.
It is most typical for achillies tendon injuries to occur in men in their 40s. Weekend warriors commonly injure their achillies when they pick up a game of basketball after weeks, months or years of a less active lifestyle. Unfortunately, the recovery time with achillies tendon injuries is very cumbersome. Many spend a length of time in casts or in walking boots. A change of activities is necessary. This drives many crazy and anxious to get back to their activities. Many often rush the recovery and what was originally an acute tendonitis or a partial tear becomes a chronic problem.
Shaq is the oldest player in the NBA and may be now considering retirement. Achillies tendon injuries cripple a player’s season and for Shaq being near the end of his career, this may be the injury that fades him out of the basketball scene.
The Achillies tendon is the largest and strongest tendon in the body and attaches the calf muscles to the heel. There are a few different achillies tendon injuries. First, the most minor injury is tendonitis. This is typically the result of overuse. Basketball players are extremely susceptible to such injuries since they frequently push off and jump off their toes. Thus, there Achillies is much over used. An achillies tendon can also become torn or completely ruptured. This is another injury commonly seen in basketball. This occurs when one pushes off or contact is made with an already contracted muscle. The tendon will tear in the weakest spot and if the force is strong enough, the tendon will completely rupture.
Since the achillies is the largest and the strongest tendon, it is also the hardest tendon to heal after an injury. Even tendonitis, the most minor achillies injury can sometimes lead to surgery! Statistics show that over 25% of all those with chronic achillies tendonitis go on to have surgery. For acute injuries, rest is the key. For low grade tendonitis, a 1-2 week rest is recommended. For higher grade injuries, a month of rest in needed for recovery. After the rest period, a slow progression back to your activities in recommended. Relative rest does not mean a break from all physical activity, but rather cease in activities that have high impact on the achillies and supplementing activities with appropriate bracing. Depending on the degree of injury will determine the level of rest needed for repair. Achillies tendon tears or ruptures often need surgical repair or a series of casting.
It is most typical for achillies tendon injuries to occur in men in their 40s. Weekend warriors commonly injure their achillies when they pick up a game of basketball after weeks, months or years of a less active lifestyle. Unfortunately, the recovery time with achillies tendon injuries is very cumbersome. Many spend a length of time in casts or in walking boots. A change of activities is necessary. This drives many crazy and anxious to get back to their activities. Many often rush the recovery and what was originally an acute tendonitis or a partial tear becomes a chronic problem.
Shaq is the oldest player in the NBA and may be now considering retirement. Achillies tendon injuries cripple a player’s season and for Shaq being near the end of his career, this may be the injury that fades him out of the basketball scene.
Wednesday, April 20, 2011
Wendy Williams Loses Because of her Feet!
I am not a Dancing with the Stars nut but I did get a chance to see Wendy Williams’ feet and I must say they do not look good. With bunions, blisters, and swelling I am not sure how she managed to put her feet in stilettos and put on a show. That in itself is talent. Still, she was voted off and her dancing didn’t make the cut.
I haven’t done any professional dancing but I can respect the intense work it does on your entire body and on your feet. Spinning, stepping, dipping, swaying all push your body to use it in ways you are not used to and it also puts increased stress and strain on your feet. It is no secret that podiatrist do not promote heel wearing. Surely we wouldn’t promote heel wearing while spinning, stepping, dipping, and swaying across a glossy dance floor right? Well entertainment is entertainment. No one is going to line up to see a beautiful ballroom dance with sweeping elegant gown and well supportive athletic shoes. Seriously!!!!
I’ve worked with ballerinas and other professional dancers and it is just devastating what happens to a professional dancer’s feet. What they endure is unbelievable. There are things to keep your feet healthy if you are a dancer or are pursing to take up dancing as a new hobby. First, you have to know your feet. Are you prone to ankle sprains? Do you have a flat foot or a foot with a high arch? There are general precautions and taping techniques to prevent you from injuries depending on your foot type. Second, know your shoes. Not all heels are created equal. Most importantly, flip them over and take a look at the bottom. Dance floors are made slightly slick to help the dancer glide along the floor. Paired with the wrong shoe, the dancer may be gliding across the floor on their bum. Lastly, know when to stop. Your feet are a part of your body. You can push them too hard and do too much damage. They hurt for a reason! Your body is trying to tell you something.
When you are a non-dancer who goes to dancing 7 days week like Wendy Williams, there is no way you will make it without blisters, bleeding, and stiffness. The biggest mistake is going to long too soon. Dancing is like running. You have to take baby steps and work yourself up to the long hours and the advanced moves. Blisters go away with time, but some injuries will change how your foot functions.
I haven’t done any professional dancing but I can respect the intense work it does on your entire body and on your feet. Spinning, stepping, dipping, swaying all push your body to use it in ways you are not used to and it also puts increased stress and strain on your feet. It is no secret that podiatrist do not promote heel wearing. Surely we wouldn’t promote heel wearing while spinning, stepping, dipping, and swaying across a glossy dance floor right? Well entertainment is entertainment. No one is going to line up to see a beautiful ballroom dance with sweeping elegant gown and well supportive athletic shoes. Seriously!!!!
I’ve worked with ballerinas and other professional dancers and it is just devastating what happens to a professional dancer’s feet. What they endure is unbelievable. There are things to keep your feet healthy if you are a dancer or are pursing to take up dancing as a new hobby. First, you have to know your feet. Are you prone to ankle sprains? Do you have a flat foot or a foot with a high arch? There are general precautions and taping techniques to prevent you from injuries depending on your foot type. Second, know your shoes. Not all heels are created equal. Most importantly, flip them over and take a look at the bottom. Dance floors are made slightly slick to help the dancer glide along the floor. Paired with the wrong shoe, the dancer may be gliding across the floor on their bum. Lastly, know when to stop. Your feet are a part of your body. You can push them too hard and do too much damage. They hurt for a reason! Your body is trying to tell you something.
When you are a non-dancer who goes to dancing 7 days week like Wendy Williams, there is no way you will make it without blisters, bleeding, and stiffness. The biggest mistake is going to long too soon. Dancing is like running. You have to take baby steps and work yourself up to the long hours and the advanced moves. Blisters go away with time, but some injuries will change how your foot functions.
Friday, April 15, 2011
Is Japan’s Radiation in our Hospitals?
As we watch the devastation in Japan unfold, we are becoming more aware of the dangers of radiation. Remembering Chernobyl, many of us recall the nuclear disaster that affected much of Russian and Western Europe. These are serious nuclear accidents, but can we be exposed to radiation every day? How much is too much and what is it doing to our body?
Radiation is everywhere. Bananas, pistachios, and kitchenware all have radioactive particles. You cannot avoid being exposed to some levels of radiation every day. The amount is so small that it is not harmful to your body. Radiation exposure is measure in sierverts. Death is the result of exposure of 5,000 mSv and radiation poisoning is secondary to about 1,000 mSv. A banana contains 0.0001mSv. Smoking 1.5 packs a day exposes you to 13mSv/ year. The limit for nuclear power plant workers is 20mSv/year. The lowest clearly carcinogenic level is 100 mSv/year.
That is your everyday life but what about the hospital. X-rays and CT scans are sources of radiation. They are important diagnostic tools that allow physicians to see inside of your body without cutting you open. I take x-rays of most of my patients to better understand the biomechanical structure of their foot. X-rays are also an important tool during foot surgery. Am I putting my patients in radiation danger? An extremity x-ray exposes a patient to about 0.001 mSv. This is equivalent to the radiation you are exposed to in 3 hours of a normal day. A CT scan can be potentially more dangerous with exposures about 10 mSv. Some studies suggest about 2% of all cancers can be linked to over exposure due to multiple CT scans.
What should you do? It is important to understand that these diagnostic tests are often necessary to make appropriate diagnoses and treatments. These tests are safe when used properly. An MRI has no radiation exposure. Though there are more contraindication with use of an MRI because it can disrupt a pacemaker and the picture is distorted if metal implants are near the area of interest. If you are having a bad year and are seem to be in and out of the doctor’s office and having many tests, you should have a conversation with your doctors about radiation exposure. When you start to have multiple CT scans a year, there is a concern of excess radiation exposure. Very few people fall into this category.
Knowing the dangers of radiation, many safely protocols are set in place to limit exposure. In the hospital and in our daily lives, our radiation exposure is kept to a minimum. Unfortunately, nuclear disasters do happen. As danger lingers, our thoughts are with Japan.
Radiation is everywhere. Bananas, pistachios, and kitchenware all have radioactive particles. You cannot avoid being exposed to some levels of radiation every day. The amount is so small that it is not harmful to your body. Radiation exposure is measure in sierverts. Death is the result of exposure of 5,000 mSv and radiation poisoning is secondary to about 1,000 mSv. A banana contains 0.0001mSv. Smoking 1.5 packs a day exposes you to 13mSv/ year. The limit for nuclear power plant workers is 20mSv/year. The lowest clearly carcinogenic level is 100 mSv/year.
That is your everyday life but what about the hospital. X-rays and CT scans are sources of radiation. They are important diagnostic tools that allow physicians to see inside of your body without cutting you open. I take x-rays of most of my patients to better understand the biomechanical structure of their foot. X-rays are also an important tool during foot surgery. Am I putting my patients in radiation danger? An extremity x-ray exposes a patient to about 0.001 mSv. This is equivalent to the radiation you are exposed to in 3 hours of a normal day. A CT scan can be potentially more dangerous with exposures about 10 mSv. Some studies suggest about 2% of all cancers can be linked to over exposure due to multiple CT scans.
What should you do? It is important to understand that these diagnostic tests are often necessary to make appropriate diagnoses and treatments. These tests are safe when used properly. An MRI has no radiation exposure. Though there are more contraindication with use of an MRI because it can disrupt a pacemaker and the picture is distorted if metal implants are near the area of interest. If you are having a bad year and are seem to be in and out of the doctor’s office and having many tests, you should have a conversation with your doctors about radiation exposure. When you start to have multiple CT scans a year, there is a concern of excess radiation exposure. Very few people fall into this category.
Knowing the dangers of radiation, many safely protocols are set in place to limit exposure. In the hospital and in our daily lives, our radiation exposure is kept to a minimum. Unfortunately, nuclear disasters do happen. As danger lingers, our thoughts are with Japan.
