5 ms·

I went to the doctor complaining of constipation. He sent me for a CT scan which showed that I was literally full of shit. The prescription was for a large dose

I went to the doctor complaining of constipation. He sent me for a CT scan which showed that I was literally full of shit. The prescription was for a large dose of MiraLax. Now I wonder if the risk of the CT scan was really justified given that plenty of people already tell me that for free and without radiation.

ceejayoz 2y ago
Yeah, a plain old abdominal x-ray might've sufficed to diagnose that. Or the pre-x-ray technique of abdominal palpation.
- delichon 2y ago
  The same scan found a large goiter which led to surgical removal of a malignant thyroid tumor. So I have mixed feelings.
  - ceejayoz 2y ago
    An abdominal CT found a goiter?
    - delichon 2y ago
      They did chest too because I also had some higher up pain on my side. That also resolved with the bowel flush.
  - MaKey 2y ago
    Sounds like the CT scan was a clear win then.
  - pama 2y ago
    If its any consolation, having diagnosed a malignant papilary or follicular thyroid tumor (surprizingly) is correlated with equal or slightly increased lifespan compared to the population that did not have this tumor—maybe it is because of having more frequent or better access to healthcare, which is harder to control in such epidemiological studies. It is one of the few positive known relationships with cancer.
    - delichon 2y ago
      Only after the procedure my ENT told me that if she were to pick a cancer to get it would be this one, and that the experts are trying to rename it from cancer to neoplasm because of its relative benignity. But I hadn't heard that it could actually be a positive. That underlines the mixed blessing of screening tests.
      - liamwire 2y ago
        It also underlines the second-order risks of unneeded diagnostic screenings, even those that don’t include ionising radiation and its ilk, as the surgery you may otherwise have not had is itself not free from risk. Of course the case generalises out from there as well to not only this specific cancer.
    - vharuck 2y ago
      Yup, this is something that shows up¹ for melanoma, thyroid, and prostate cancers: those who are diagnosed when the cancers are in situ (haven't left the tissue of origin) have better 5-year survival chances compared to people of the same age, race, and sex. Likely because, if people are diligent enough about their healthcare to report early warning signs and get the recommended screenings, those people also have much healthier lifestyles. If there were a way to control for lifestyle, I'd imagine the "benefit" would disappear or become a small but clear negative. 1: You won't find relative net survival above 100% in the CDC's statistics. That's because they calculate survival rates using daily differences in death hazards derived from life tables of people with cancer and those without. Add up the differences across all days, do some exponential math, and voila: relative net survival rates. But, if the relative risk for a day is negative (i.e. those without cancer have a higher risk of death), then they set the relative risk to 0 instead for that day. Which is ridiculous, IMO. It's forcing a distribution of actual events to match an idealized model.
ramraj07 2y ago
A. Newer CT scan machines use lower radiation doses. B. If you're getting only one scan a year you're fine and within yearly limits of radiation dosage considered acceptable. Remember that you'll get comparable levels of radiation even if you commute through the grand central station every day. This paper is for lack of a better word, crap. It's becoming sensational for the conclusion it makes and I'm afraid it's now going to create more harm because of that.
- behnamoh 2y ago
  > B. If you're getting only one scan a year you're fine and within yearly limits of radiation dosage considered acceptable. But doesn't it make a difference if that "acceptable yearly limit" is spread out throughout the year as opposed to a few minutes of CT scan session?
  - odyssey7 2y ago
    I really don’t buy it if someone says the opposite.
  - DiggyJohnson 2y ago
    Tf is going on in Grand Central?
    - itishappy 2y ago
      Granite.
  - dmd 2y ago
    Yes, the term is DDREF - Dose and Dose Rate Effectiveness Factor.
- declan_roberts 2y ago
  What about contrast? I've heard it's really hard on your thyroid.
  - 2y ago
trillic 2y ago
Same. The CT is to rule out diverticulitis and in my case, since the pain was located in my lower right abdomen, appendicitis. I was just full of shit, as usual. Now I eat salads and drink more water when I am at elevation.
david38 2y ago
Why would you go to the doctor for that instead of first trying one of the many known solutions? * a tablespoon of epsom salt * a tablespoon of mineral oil * several OTC products
- delichon 2y ago
  I did try a boatload of OTC products, and eventually went to a generalist and then a specialist when it became severe and chronic. The OTC products recommend that on their labels. I now manage it with careful diet and a daily dose of polyethylene glycol.
AaronAPU 2y ago
I had a CT scan ordered for abdominal discomfort which had been making sleep a nightmare for years. I started taking ag1 and Metamucil and the stomach discomfort has completely gone away over a span of weeks/months. The resulting dramatic improvement in sleep cascades to just about everything in my life and different recurring health problems keep disappearing now. It’s crazy how many problems can be caused by apparently just not getting enough fiber. Never ended up getting the CT scan, which probably would’ve been expensive and involve some small degree of risk.
- pengaru 2y ago
  pro-tip: start your days with an unripe banana, at least slightly greenish. If it's sweet it's too ripe for medicinal value. Beats any processed supplement or other OTC drugs IME.
gus_massa 2y ago
Someone I know got partial constipation, lack of apetite and stomach reflux. After some month of triying to fix the reflux, they discovered it was intestine cancer when the cancer was big enough to block almost all the flow. IIUC from a sibling reply, you already used a few laxative, so perhaps a CT scan was the next step.
stuckkeys 2y ago
lol. Well executed.
amy214 2y ago
why a CT and not a X-ray? did they need to see the gestating turds in 3D?
- s1artibartfast 2y ago
  not a doctor, but a CT could show mechanical obstruction or twisted intestines in a way X-ray would not. I imagine the doctor already assumed the shit was there, but wanted to understand why. I further imagine prescribing a megadose of laxative might be harmful if someone cant expel the shit.
  - bobmcnamara 2y ago
    I really wonder if there's value in straightening the tract in post. Sometimes something at 45 degrees doesn't really view well in the slices.
    - s1artibartfast 2y ago
      CT isnt constrained to 90 degree slices and can be viewed at any arbitrary angle, or in 3D without further processing. This video [1] is a presentation on bowel CT with great images. For those interested in X-ray, compare the X-rays at 14 minutes with the CT at 10. Also worth noting, that X-ray is being recommended as a quick diagnostic before moving to CT https://youtu.be/ZvDOkrn2ygQ?t=630 https://youtu.be/ZvDOkrn2ygQ?t=630
      - bobmcnamara 2y ago
        I knew the math wasn't limited to 90 degree slices. I've had a few CT scans, and twice when I got my copy the DICOMs were a bunch of 90 degree TIFF slices. It wouldn't surprise me if the radiologist had the raw beam data and could slice it however they chose.
        s1artibartfast 2y ago
        the Tiff slices is just post process storage. A good DICOM reader can view those tiffs in any direction. After all, if you have the tiffs, you already know the grayscale for every pixel in the XYZ space. You just need to grab the right pixels from each slice
jijijijij 2y ago
But did those words really get through to you like an energetic photon? I think, it's quite ionic how frequently the last strand has to break before we realize, we should have been radicalized by people, not high voltage discharge events.

ceejayoz 2y ago

Yeah, a plain old abdominal x-ray might've sufficed to diagnose that. Or the pre-x-ray technique of abdominal palpation.

delichon 2y ago
The same scan found a large goiter which led to surgical removal of a malignant thyroid tumor. So I have mixed feelings.
- ceejayoz 2y ago
  An abdominal CT found a goiter?
  - delichon 2y ago
    They did chest too because I also had some higher up pain on my side. That also resolved with the bowel flush.
- MaKey 2y ago
  Sounds like the CT scan was a clear win then.
- pama 2y ago
  If its any consolation, having diagnosed a malignant papilary or follicular thyroid tumor (surprizingly) is correlated with equal or slightly increased lifespan compared to the population that did not have this tumor—maybe it is because of having more frequent or better access to healthcare, which is harder to control in such epidemiological studies. It is one of the few positive known relationships with cancer.
  - delichon 2y ago
    Only after the procedure my ENT told me that if she were to pick a cancer to get it would be this one, and that the experts are trying to rename it from cancer to neoplasm because of its relative benignity. But I hadn't heard that it could actually be a positive. That underlines the mixed blessing of screening tests.
    - liamwire 2y ago
      It also underlines the second-order risks of unneeded diagnostic screenings, even those that don’t include ionising radiation and its ilk, as the surgery you may otherwise have not had is itself not free from risk. Of course the case generalises out from there as well to not only this specific cancer.
  - vharuck 2y ago
    Yup, this is something that shows up¹ for melanoma, thyroid, and prostate cancers: those who are diagnosed when the cancers are in situ (haven't left the tissue of origin) have better 5-year survival chances compared to people of the same age, race, and sex. Likely because, if people are diligent enough about their healthcare to report early warning signs and get the recommended screenings, those people also have much healthier lifestyles. If there were a way to control for lifestyle, I'd imagine the "benefit" would disappear or become a small but clear negative. 1: You won't find relative net survival above 100% in the CDC's statistics. That's because they calculate survival rates using daily differences in death hazards derived from life tables of people with cancer and those without. Add up the differences across all days, do some exponential math, and voila: relative net survival rates. But, if the relative risk for a day is negative (i.e. those without cancer have a higher risk of death), then they set the relative risk to 0 instead for that day. Which is ridiculous, IMO. It's forcing a distribution of actual events to match an idealized model.

ramraj07 2y ago

A. Newer CT scan machines use lower radiation doses. B. If you're getting only one scan a year you're fine and within yearly limits of radiation dosage considered acceptable. Remember that you'll get comparable levels of radiation even if you commute through the grand central station every day. This paper is for lack of a better word, crap. It's becoming sensational for the conclusion it makes and I'm afraid it's now going to create more harm because of that.

behnamoh 2y ago
> B. If you're getting only one scan a year you're fine and within yearly limits of radiation dosage considered acceptable. But doesn't it make a difference if that "acceptable yearly limit" is spread out throughout the year as opposed to a few minutes of CT scan session?
- odyssey7 2y ago
  I really don’t buy it if someone says the opposite.
- DiggyJohnson 2y ago
  Tf is going on in Grand Central?
  - itishappy 2y ago
    Granite.
- dmd 2y ago
  Yes, the term is DDREF - Dose and Dose Rate Effectiveness Factor.
declan_roberts 2y ago
What about contrast? I've heard it's really hard on your thyroid.
- 2y ago

trillic 2y ago

Same. The CT is to rule out diverticulitis and in my case, since the pain was located in my lower right abdomen, appendicitis. I was just full of shit, as usual. Now I eat salads and drink more water when I am at elevation.

david38 2y ago

Why would you go to the doctor for that instead of first trying one of the many known solutions? * a tablespoon of epsom salt * a tablespoon of mineral oil * several OTC products

delichon 2y ago
I did try a boatload of OTC products, and eventually went to a generalist and then a specialist when it became severe and chronic. The OTC products recommend that on their labels. I now manage it with careful diet and a daily dose of polyethylene glycol.

AaronAPU 2y ago

I had a CT scan ordered for abdominal discomfort which had been making sleep a nightmare for years. I started taking ag1 and Metamucil and the stomach discomfort has completely gone away over a span of weeks/months. The resulting dramatic improvement in sleep cascades to just about everything in my life and different recurring health problems keep disappearing now. It’s crazy how many problems can be caused by apparently just not getting enough fiber. Never ended up getting the CT scan, which probably would’ve been expensive and involve some small degree of risk.

pengaru 2y ago
pro-tip: start your days with an unripe banana, at least slightly greenish. If it's sweet it's too ripe for medicinal value. Beats any processed supplement or other OTC drugs IME.

gus_massa 2y ago

Someone I know got partial constipation, lack of apetite and stomach reflux. After some month of triying to fix the reflux, they discovered it was intestine cancer when the cancer was big enough to block almost all the flow. IIUC from a sibling reply, you already used a few laxative, so perhaps a CT scan was the next step.

stuckkeys 2y ago

lol. Well executed.

amy214 2y ago

why a CT and not a X-ray? did they need to see the gestating turds in 3D?

s1artibartfast 2y ago
not a doctor, but a CT could show mechanical obstruction or twisted intestines in a way X-ray would not. I imagine the doctor already assumed the shit was there, but wanted to understand why. I further imagine prescribing a megadose of laxative might be harmful if someone cant expel the shit.
- bobmcnamara 2y ago
  I really wonder if there's value in straightening the tract in post. Sometimes something at 45 degrees doesn't really view well in the slices.
  - s1artibartfast 2y ago
    CT isnt constrained to 90 degree slices and can be viewed at any arbitrary angle, or in 3D without further processing. This video [1] is a presentation on bowel CT with great images. For those interested in X-ray, compare the X-rays at 14 minutes with the CT at 10. Also worth noting, that X-ray is being recommended as a quick diagnostic before moving to CT https://youtu.be/ZvDOkrn2ygQ?t=630 https://youtu.be/ZvDOkrn2ygQ?t=630
    - bobmcnamara 2y ago
      I knew the math wasn't limited to 90 degree slices. I've had a few CT scans, and twice when I got my copy the DICOMs were a bunch of 90 degree TIFF slices. It wouldn't surprise me if the radiologist had the raw beam data and could slice it however they chose.
      - s1artibartfast 2y ago
        the Tiff slices is just post process storage. A good DICOM reader can view those tiffs in any direction. After all, if you have the tiffs, you already know the grayscale for every pixel in the XYZ space. You just need to grab the right pixels from each slice

jijijijij 2y ago

But did those words really get through to you like an energetic photon? I think, it's quite ionic how frequently the last strand has to break before we realize, we should have been radicalized by people, not high voltage discharge events.