Sean Mahan, MD

Hair loss is typically related to chemotherapy, which can make your hair brittle, causing it to "break" and fall out. Radiation therapy is usually focused on a single area, and it will usually NOT cause general hair loss, unless the beam of radiation is directly aimed at an area where you have hair. Then it may damage the hair cells just in that location. There is another type of radiotherapy where you are giving a pill that contains radioactive material to ingest. This is how we often treat thyroid conditions. This type of radiation also does not typically cause hair loss.

There are several types of radiation treatment. Your son should just wear normal clothes. If they need him to take something off for the procedure, they will give him a gown or scrubs to wear. Radiation will not affect his clothes at all, and it will be fine to wear his clothes if they allow him.

Fluoroscopy is basically the same thing as making a video with your cell phone, except that it uses a fluoroscopic camera that takes a video of what you look like on the inside using X-rays. Just like any other video, we can take a picture of you standing up, sitting down, or lying down.

Yes. Dental implants are not a contraindication to getting a CT scan, and they are not a problem at all.

I would say that chemotherapy and radiation treatments are two types of medical treatment that come with risk. They are typically used to treat very severe diseases. In medicine we measure treatments and diseases, and we do a "risk: benefit analysis." If the risk outweighs the benefit, then the treatment is worth it. As these two treatments are used to treat very serious and often fatal diseases, such as cancer, you could say that these treatments actually extend the lifespan of patients with these diseases. So the answer is not simple. These treatments do come with a risk, and then can shorten the lifespan of a person who does not have the diseases for which they are meant to be used. However, for people who have the diseases that they are meant to be used for, they can extend these patients' lifespans.

No. X-ray has no ability to see brain swelling at all. If you want to see brain swelling, the best imaging tests are either CT scan or MRI scan, depending on the patient's situation.

No. Sometimes X-rays can show evidence that a muscle might be injured, but you really need a much more sophisticated imaging study to see muscle damage. The best imaging study is MRI, which shows muscles the best.

In general, getting a CT scan should be avoided in a pregnant woman, especially in the first trimester. Fortunately, we have good alternatives, like MRI, which is considered safe during pregnancy at all stages. A patient should ask their doctor if they can get an MRI instead. If not, they may be able to wait till the delivery to get their CT scan. Also, there are some diseases where we need to find an answer because there is a serious situation where we need more information that may affect the mother or baby's health. In those instances, the benefit of getting a CT scan may outweigh the risks. However, those instances are unusual, and should be treated on a case by case basis. Here is the link to the ACR guideline that states that MRI is safe during pregnancy at all stages: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwikmbfOhKPrAhVjkuAKHYyzDhMQFjABegQIDBAD&url=https%3A%2F%2Fwww.acr.org%2F-%2Fmedia%2FACR%2FFiles%2FPractice-Parameters%2Fmr-fetal.pdf&usg=AOvVaw0JCdORdWDny_Hk9sZ4JIS-

Without having seen your MRI, it sounds like there are "white matter lesions." White matter lesions can be normal in a person, and you get more and more of them as you get older as part of the normal aging process. However, they can also be a sign of something bad going on. Certain disease cause white matter lesions that are very bad, like cancer and multiple sclerosis. What they sometimes do in these cases is repeat the MRI scan, but this time they do it with contrast to see if any of the white matter lesions "light up." Certain disease light up with contrast, like cancer, infections, and active multiple sclerosis lesions. They are repeating this scan WITH CONTRAST to make sure you don't have any lesions that "light up." If they don't light up, then that's good. But the only way to know for sure is to do the scan, so it is important to get the scan.

With today's CT technology, most scans can be done with a "helical technique," which allows us to do the CT scan in 30 seconds. So you only have to remain calm for 30 seconds - which I realize might be difficult for some people, especially if they are using a contrast injector that is also injecting you with contrast. If you ask the referring doctor for a prescription of an anti-anxiety drug, such as Valium or Xanax, they might be willing to prescribe you the drug to help you get through the scan. Alternatively, perhaps listening to music during the scan may help. Many places will allow you do that. If these don't help, just try to hold still for the 30 seconds of the scan. It will be over before you know it.

CT scans generally don't have to put a whole person in a hole at the same time, so people with claustrophobia generally do well with CT scans - which is different than MRI, which has a much greater problem with claustrophobia. Also, since CT scans can be done in 30 seconds, most people can tolerate going through the CT scanner, since it is less than a minute. I have seen people with such severe claustrophobia that they could not go through the CT scanner, but this is extremely rare. I have only seen in twice in my 30 year career, but certainly it can happen.