Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

26 Shevat 5760 - February 2, 2000 | Mordecai Plaut, director Published Weekly








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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

I'd like to discuss what to expect in each kind of examination that a patient may undergo.

Regular X rays do not hurt, of course. Shielding is often necessary, which is a heavy lead robe worn over areas of the body that could be affected by radiation. Most X rays give off little radiation, but shielding is always a good idea.

In pregnancy, one must weigh the special risks. Missing a minor fracture of the ankle may not justify an X ray. Let me remind women that leaving a child alone in a room for X rays while you stand outside because you are pregnant may be very stressful for a child, as the machines are big and scary. Consider having your husband go instead, or bring an older child/friend and have them wear a shield.

Barium swallows examine the upper digestive system, and require the swallowing of a bad tasting liquid and taking serial x-rays over a few hours. Constipation is common afterwards. IVPs examine the urinary tract after the injection of a dye which is excreted in the urine. This exam also takes a few hours. A barium enema is extremely uncomfortable. You may want to ask your physician if colonoscopy is possible instead. It too is uncomfortable, but you are under sedation for it and it reveals a lot more information.

Ultrasounds are painless and may even tickle. They are routine in pregnancy now, and are the best test for gallstones. Most people complain that the gel used to help transmit the sound waves is very cold. Ultrasounds are now done internally for both men and women. They reveal a lot of information. In nonpregnant women, abdominal ultrasounds of the lower abdomen require a full bladder, which is also uncomfortable.

Cat Scanning, or CT is a painless test as well, but the equipment requires a cold room, so be prepared. Today's CT scans are a lot faster, so the actual time spent in the suite is less than in the past.

MRIs are also painless, but the early ones were extremely claustrophobic: patients had to stay still with their head in a small box for a long time. The MRIs in the US have improved on that, but I do not know if in Israel they have.

All nuclear medicine scans require the injection of a radioactive material, so that does hurt. They also require that the patient be still for a long time. Few scans are done quickly. Be aware.

Bronchoscopy looks at the breathing tubes, gastroscopy looks at the upper digestive tract and colonoscopy looks at the lower tract. They are all a little uncomfortable. The first two are performed with local numbing of the throat, whereas the last is with sedation that makes you forget what happened.

Cyroscopy examines the bladder, and hystoscopy examines the uterus. These require a greater amount of sedation and are usually done in the operating room.

Laparascopy is an interesting test. It is done by making a small incision below the belly button, and inserting a lot of air in the belly. Then a scope is put in and the whole abdomen can be looked at for problems. This can even save a person from an operation for appendicitis. Amazing to me. What do you think? Write me in care of the Yated.


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