Anyone in the medical field or have experience with a head injury? YES, I’ve discussed with my MD. I’m curious because of conflicting advice.
I hit my head needing stitches. No other signs of concussion (no black out, blurry vision, memory loss, etc.). Over one month later, the area remains swollen, sore, with minor headaches. There’s no apparent infection, but definitely uncomfortable. I ‘m away for an extended holiday, so cannot re-visit my regular MD , but was worried that things were not progressing or perhaps with unrealistic expectations. So, I made an appointment with a local medical office as precaution. They want me to have a head CT. No reason was given other than they felt it should have been done for a head injury when stitched. After first agreeing, while waiting for insurance approval, I tried to research.
My own Dr. does not like unnecessary radiation, especially if the added knowledge is unlikely to change the recommendation. I tend to agree with that approach. Literature also advises against a head CT unless there is sufficient reason. I do not have any of the symptoms usually listed for sufficient reason. Very slow or stalled recovery not listed.
I’ve also had at least 3 other nearby CT’s over the last 7-8 years, and having too many is not advised either. I explained all my reservations & asked the local MD office for other potential approaches, but cannot get beyond the gate keeper nurse, who just repeats that the Dr. would not recommend a CT if they didn’t think it was the appropriate next step. I’m obviously not happy with communication with the local MD, but because I’m visiting, I doubt there is enough time to seek another office at this point.
Of course I can choose to ignore, and wait until home, but that’s 1 month away. Thoughts? Are 4 head/neck CT’s in 8 years too many? Am I just being impatient w/ a head injury, since I don’t know what to expect? Am I being too sensitive about yet another CT?
I would find a doctor who would address my reservations and get prior authorization with my consent for testing and treatment we agreed upon. This doctor you are trying to see doesn’t sound like such a MD.
I really dislike providers who won’t address my concerns and tell me how the particular test ordered will change treatment.
If you have had no loss of motor or cognitive function, I don’t understand the rationale for asking for CT images. If your symptoms are localized, and if your ‘minor headaches’ are not inhibiting your activities, wait for your return to your primary - UNLESS something changes.
I am not familiar with 360 xrays, but I get dental xrays every other year, rather than every year that my dentist and hygienist generally recommend. But they are fine with me doing it every other year.
I had a bad fall, you could hear my head hit the floor. Like you, no symptoms (mine didn’t even hurt.) You betcha I wanted a CT. It showed no issues related to the fall and I then had an MRI. The way I feel about it is, it’s your brain in there. At my age, I don’t want issues cropping up in 10 or 20 years that could have een avoided.
My layman’s guess is the injury/tear/bleeding that needed stitches- and those stitches- may be causing the residual issues, as the affected layers heal and any internal swelling subsides. YMMV.
If I had a doc who did not recommend a look-see after a substantial fall, then I’d be worried. Truly. This isn’t just some ordinary bruise. Sure, I’ve had multiple CTs.
Mominva, I notice that’s pediatric. So I looked at a few similar adult sites and am surprised the CTwasn’t truly indicated, per my lack of symptoms and a doc exam.
Results of concern? Not really. Nothing related to the fall. Evidence of an old incident, common. In my history with this doc, he usually doesn’t jump to unneeded tests.
I work as an x-ray tech and radiation exposure is a real concern, especially CT scans which give the highest doses. ER’s often order these scans and some I feel are unnecessary, this can be due to concerns of possible future litigation or maybe to pad the bottom line. The reason ER’s use CT versus MRI is often speed. A CT scan can take 10 minutes, while a MRI can take 30-45 minutes. Some patients have a pace maker or other implanted medical devices which prohibit them from getting a MRI altogether.
Regular diagnostic x-rays tend to give a lot less dose, especially in your extremities (arms and legs). The torso and the spine require more, quite a bit more if one is obese. Oncology patients will often receive multiple CT scans during the diagnosis and post treatment. The most “radio-sensitive” parts of a persons body are the thyroid and reproductive organs.
I don’t practice this type of medicine but when a patient comes to me to break a tie in second opinions I usually ask what do you really want to do? Finding a doctor that agrees with you is not always the correct thing to do. If your still having headaches after a month after hitting your head (you don’t say how hard or how you hit your head) and your cut is not healing you need to do two things. Have the doctor look at your injury site and make sure you don’t have a suture reaction or infection and yes get a CT. Does having headaches a month after hitting your head sound normal to you? It’s not. Plus your history of 4 head /neck ct’s… What did they show? This is more complicated then it seems and having subdermal hematoma could cause headaches,etc. If it’s me I am having the CT.
Thanks all! Prior CT’s due to thyroid surgery and/or checking enlarged lymph nodes. Not full head scans, but not minimal radiation either. Stitches are healing just fine except for a goose egg. Headaches feel more like sinus headaches. It also feels like I may have slightly fractured my nose (not crooked, but very sensitive). Time needed for that. It just didn’t seem like it was progressing as I would expect – but never having head stitches, I didn’t know what to expect, or what is prudent for a head injury. Frankly a CT seemed overkill to me based on what I read, but nor did I want to be foolish. There’s a fine line between blindly following Dr’s orders, or self-diagnosing, but I also believe the patient knows their body best, and I do get irritated when Dr’s don’t fully listen.
Due to a benign brain tumor I’ve had far more CT scans than you’re talking about. Then there was the extra radiation to kill the tumor.
In the end I’m dealing with odd issues blamed on that radiation (due to elimination of other causes and some pure guessing pending which issue). I’ll fully admit those issues are irritating at best - mentally straining on bad days. They cause me to wonder if I should have done the radiation at all, but on the other hand, for me, the other end result was death. That kind of weighs the balance pretty heavily.
I’d suggest you look at your potential end result without the CT scan as you weigh your choices. One more scan is hardly going to put you close to my count (somewhere in the upper 20s or lower 30s - I’ve lost count). Aside from the issues blamed on radiation, everything else with my body is just fine - pretty darn good actually as reported from some of the tests.
Oddly enough, I was more or less promised my thyroid would die and yet, as of Sept’s numbers, it’s doing better than most people’s. The one thing I’ve learned from all of this (BT included), my body reacts strangely. I won’t suggest what I’d do in your situation. I’m just relating mine. I’m not really sure what I’d actually do in your situation TBH. Best wishes to you as you consider your options.
Perhaps the question to ask the physicians is, will the results of the proposed test cause different decisions to be made with respect to future treatment or lack thereof? If so, what types of decisions could be affected?
I had to change my primary care provider because part of her compensation is based on additional tests performed within the group. She would order a CT for a stomach virus. I said I would wait ten days and see if the pain went away before a CT scan.
Part of the reason for refusing unnecessary CT scans or other x-rays is that you never know when the extra tests may be a required part of treatment in the future.
My son has had two concussions and never had a head CT…I’m posting this to question the “should have had a head CT when the injury first happened” statement by the second doctor. I realize you didn’t have a concussion and your injury sounds external to the skull, but just thought I would let you know.
My quick self diagnosis for sinus related headaches is if it gets excruciating when you bend over…