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Re: MRI exposure WAS Re: [IPk] Animas Vibe

Hi Nanette 
I thought that advice was specific to animas vibe
I certainly didn't follow it with earlier pumps etc except for MRI of course
(The device seems ok except that the coating is a bit chipped)
Apparently this is not a good thing
 Anyway I don't like being accused of scaremongering. I have been in hospital
recently with a cerebrovascular accident which happens particularly as you know
to people with long term diabetes I have had it for 42 years now
 I lost coherent speech for 6-8 hours and though otherwise treatment was
excellent very few staff including consultants without specialism in type 1
diabetes knew anything about it still less about pumps
And there were no specialists on hand at the time until much later
My family was very worried
 That may not be the case in israel but it seems to be here (probably because of
staff shortages) and presented a real danger to someone rather confused at the
 It is that I was warning about for others in extremis -hardly scaremongering I

Sent from my iPad

 > On 26 Feb 2014, at 07:57, Nanette Freedman <email @ redacted>
> Maybe it's time for me to put my medical physicist hat on again, just
> to give a little perspective on this.
> MRI and insulin pumps or CGM's (all of the current devices) is an
> absolute no - and I'm pretty horrified that MRI staff should not be
> aware that any electronic device could potentially be transformed to
> electronic minced meat by an MRI - that is a real risk.
> Unlike MRI, x-rays and most other medical imaging procedures do not
> involve a very high magnetic field, which is the real risk for
> electronic devices like pumps. I sometimes wonder if the reason
> certain pump companies warn you about all medical imaging procedures
> is because they do not know and/or do not trust the patient to know
> the difference between the different medical imaging modalities, and
> better safe than sorry.
> As far as x-rays are concerned, as long as you keep the pump out of
> the field of view that is being imaged there really should be no
> problem - and this precaution is not because I would be worried about
> the x-rays affecting the pump, but because the presence of the pump
> might distort the image and result in an image with impaired quality
> for diagnosis.
> And CT, which is 3-D x-rays, and involves a lot more energy and
> radiation dose than a regular planar x-ray, also should be no problem,
> with the same proviso as for x-rays.
> However if you have a lengthy CT procedure with high energy - like CT
> angiography - then the energy is even higher, and there was once one
> case reported to the FDA in the US of a person whose insulin pump was
> affected. I do not know if the insulin pump was in the field of view
> or outside it. But clearly this is a risk one would not want to take,
> and again I assume it is because of this that the pump companies
> prefer to err on the safe side in their recommendations.
> While each of us has to decide for themselves whether or not to keep a
> pump on during an x-ray, ultrasound, or even regular CT, Nuclear
> Medicine procedures like bone scans, or even SPECT/CT or PET/CT, it's
> better to avoid scaremongering - one might land up having an x-ray
> when very unwell or after an accident in a situation where one could
> not do anything about it - and there is no need to fear that this puts
> you "at risk in extremis". My only plea as a medical imaging
> professional is that if you do keep the pump on (as I do generally,
> but would make an exception for CT angiography where I would remove my
> pump) then try to make sure the pump is out of the field of view so
> that you don't get uninterpretable images!
> Nanette
 >> On 26 February 2014 00:36, Christine Bousfield <email @ redacted>
>> I do know that!
>> I had a hard time persuading staff who thought differently and I was very
>> unwell
>> But also with ct scans and X-rays
>> There is such ignorance around re type 1 and pumps
>> We are really at risk  in extremis
>> Christine
> .
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