Today, I completed the three phase bone scan with the purpose of providing further diagnostic evidence that my left foot had indeed suffered a fracture in the vicinity of the fifth metatarsal. As a brief reminder, the first doctor (a Physician Assistant or PA) I saw ordered a standard X-ray, and when that turned up negative suggested that I schedule this bone scan and wear supportive shoes.
The next day was painful enough that I borrowed one of my roommate's CAM boots, went the emergency room and convinced them to provide me a CAM boot that fit. The ER resident and radiologist confirmed that my X-Ray was indeed negative for fracture and sent me on my way with the new CAM boot and a flyer describing the treatment for a sprained foot.
Today was the three phase bone scan. The first phase involved a flow study in which I was injected with a radionuclide and then my feet were placed in a detector that could sense where soft tissue and "increased uptake" of the radioactive liquid. The liquid came in a lead lined syringe, encased in a lead lined container (a pig), and had a half life of 6.02 hours. After the first round of scans, the technician handed me a card explaining what I'd been injected with and informing law enforcement personnel that I might have enough of the isotope in my system to set of radiation monitoring security systems for the next three days. It also explained this was A-OK and in compliance with Nuclear Regulator Commission guidelines for the use of medical radiation...my get out of Guantanamo free (and hopefully fast) card.
The second phase of the test consisted of waiting three hours as my body flushed the radioactive substance from my soft tissue and allowed the bones to absorb the material in a process called uptake. The technician exhorted me to drink plenty of water and urinate as often as possible in the next three hours. On the way out of the lab area we passed a bathroom labeled "Hot Patient Restroom." Naturally, I asked the tech if I was required to come back to the lab to urinate since I was a card carrying radioactive human. Without a lick of irony he said, "No. That's not required. Just be sure to flush twice and close the lid of any commode after you are done." I suppose it heartening to realize that the solution to (radioactive) pollution really is dilution.
I spent phase two of the scan drinking water, peeing, and participating in a conference call that was marginally productive. I was pretty quiet until just before I had to return for phase three of the scan, at which point, I tossed a bureaucratic grenade related to an organizational chart that kicked off a spirited discussion, exited the call, and returned to the lab for some additional testing. My three hours of uptake and flushing had been completed.
Phase three of the test was another round of three longer duration scans including two views of my feet and a complete lower body scan of my legs and feet from the top of my pelvis down. By this time, the radioactivity had settled in my bones, and the increased uptake in the vicinity of the heel side of the fifth metatarsal of my left foot indicated a clear fracture area.
The nuclear medicine doctor ( a fancy radiologist) indicated the scan had probably revealed I had a Jones Fracture of the bone, and he was glad to see I was wearing a boot. The foot sprain had been confirmed by the flow scan, and the fracture by the bone scan. It was like winning the jackpot of left foot injuries. The doctor also said that he had hoped I'd have crutches. I thought, "Here I am in a hospital, and I was hoping that you might have some crutches for me if you think I might need them." I said, "I have some at home," and he said, "I recommend that you use them and follow up with your referring PA.
That's where I stand. I have fractured and sprained foot and a CAM boot. Tomorrow I follow up with the PA to be told to schedule some more imaging as well as an appointment with either a podiatrist or orthopedic surgeon.
I'm looking forward to tomorrow and seeing the next step in how this all works out.
The next day was painful enough that I borrowed one of my roommate's CAM boots, went the emergency room and convinced them to provide me a CAM boot that fit. The ER resident and radiologist confirmed that my X-Ray was indeed negative for fracture and sent me on my way with the new CAM boot and a flyer describing the treatment for a sprained foot.
Today was the three phase bone scan. The first phase involved a flow study in which I was injected with a radionuclide and then my feet were placed in a detector that could sense where soft tissue and "increased uptake" of the radioactive liquid. The liquid came in a lead lined syringe, encased in a lead lined container (a pig), and had a half life of 6.02 hours. After the first round of scans, the technician handed me a card explaining what I'd been injected with and informing law enforcement personnel that I might have enough of the isotope in my system to set of radiation monitoring security systems for the next three days. It also explained this was A-OK and in compliance with Nuclear Regulator Commission guidelines for the use of medical radiation...my get out of Guantanamo free (and hopefully fast) card.
The second phase of the test consisted of waiting three hours as my body flushed the radioactive substance from my soft tissue and allowed the bones to absorb the material in a process called uptake. The technician exhorted me to drink plenty of water and urinate as often as possible in the next three hours. On the way out of the lab area we passed a bathroom labeled "Hot Patient Restroom." Naturally, I asked the tech if I was required to come back to the lab to urinate since I was a card carrying radioactive human. Without a lick of irony he said, "No. That's not required. Just be sure to flush twice and close the lid of any commode after you are done." I suppose it heartening to realize that the solution to (radioactive) pollution really is dilution.
I spent phase two of the scan drinking water, peeing, and participating in a conference call that was marginally productive. I was pretty quiet until just before I had to return for phase three of the scan, at which point, I tossed a bureaucratic grenade related to an organizational chart that kicked off a spirited discussion, exited the call, and returned to the lab for some additional testing. My three hours of uptake and flushing had been completed.
Phase three of the test was another round of three longer duration scans including two views of my feet and a complete lower body scan of my legs and feet from the top of my pelvis down. By this time, the radioactivity had settled in my bones, and the increased uptake in the vicinity of the heel side of the fifth metatarsal of my left foot indicated a clear fracture area.
The nuclear medicine doctor ( a fancy radiologist) indicated the scan had probably revealed I had a Jones Fracture of the bone, and he was glad to see I was wearing a boot. The foot sprain had been confirmed by the flow scan, and the fracture by the bone scan. It was like winning the jackpot of left foot injuries. The doctor also said that he had hoped I'd have crutches. I thought, "Here I am in a hospital, and I was hoping that you might have some crutches for me if you think I might need them." I said, "I have some at home," and he said, "I recommend that you use them and follow up with your referring PA.
That's where I stand. I have fractured and sprained foot and a CAM boot. Tomorrow I follow up with the PA to be told to schedule some more imaging as well as an appointment with either a podiatrist or orthopedic surgeon.
I'm looking forward to tomorrow and seeing the next step in how this all works out.
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