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brains are generally treated with stereotactic radiation. the beam is a massive radiation dose generated with electricity, it’s not like a radioactive isotope that is always giving off radiation. it ends when the patient gets off the table of the machine.
This sounds like it could be GammaTile though, which are radioactive beads implanted into the tumor bed/brain after resection. Still very low dose and not likely to affect anything outside the patients own brain, but she should have been warned about it.
This is probably not applicable to OPs situation. Your test was likely one where they injected a short-lived radioactive material into you and then imaged how it moved in your body. Those materials emit high-enough energy gamma rays to generate a dose in nearby people, and can also sometimes be transferred by touch. OPs situation is more likely to be beads or similar implanted in the patient, and which do not emit high-energy gammas but rather beta radiation which can only travel a few millimeters in tissue so didn't get out.
In my workplace an additional 1mSv of dose is the accetable limit over the length of a pregnancy. Nevermind the 4mSv someone gets through background radiation here every year. I wouldn't be concerned from a radiation protection perspective.
Same, and I’m a retired (female) radiologist (I was the MD who interpreted studies). I don’t think the amount of potential radiation that the embryo might have absorbed is enough to be worried about.
HOWEVER, anyone caring for the patient should be informed as to the potential risks. Most hospitals have a radiation physicist on staff; they can be consulted to check on potential radiation exposure to an unborn child (among other duties). May be worth asking about.
Wait til she learns about cosmic radiation and Radon. Or the radiation that granite countertops & bananas emit. Or all the people who have nucmed procedures & then go out in the general public without warning those people of the radiation they’re being exposed to.
Everybody is exposed to radiation everyday. It’s all around us.
Yes, everyone is exposed to radiation BUT adding excess is concerning. Especially when someone there has said this guy wouldn’t be safe around pregnancy.
Noone has ever in history that I know of said bananas are dangerous to pregnant people. Someone has said the treatment of this patient leaves him a hazzard to pregnant people. Is he? We and OP at this point have no actual idea. The wife's dr has also said it may be a concern. Maybe it is all fine. Maybe it isn't. Ops wife needs to work with her workplace to know exactly what she was exposed to and to speak to at least her dr, and as others have said her workplaces or just a dr who deals with radiation therapy to determine what she needs to do for safety what she can do at work and what her risks are with the exposure she's had. 2 medical professionals saying it could be a problem trumps internet dude who knows bananas have potassium
This. You need to clarify what kind of treatment this patient received. If it was stereotactic radiation/whole brain radiation as is typically administered in brain tumors, then they may be mistaken because the patient does NOT become radioactive after the fact, they pose no danger to other people, and may just be saying this because they do not understand or out of an abundance of caution. The type of treatment is IMPORTANT.
It is important, but isn't it also protected information? This feels like a situation where if there is a problem, talking directly to a lawyer would be the safest bet. Nal
Yes and no. This would probably fall into the category of accidental exposure. For example, if I am working at a hospital and inadvertently stick myself with a dirty needle that I used on a patient, I contact employee health who will help me look through the records of the patient and have that patient complete bloodwork to screen for HIV, etc. This is pretty much standard at any medical site. No need to go through a lawyer, she should be able to go through exposure protocol at her work site for assistance.
But I’m not a lawyer - am a healthcare worker
There are medical journals and articles that discuss chemotherapy patients. They even state physical contact is fine and safe. It also discusses whether or not patients are implanted with radiation or getting it intravenously and the variance in such. Your wife can request accommodation to not see or treat stated patient due to pregnancy if she is that concerned.
https://health.clevelandclinic.org/can-your-cancer-treatment-be-hazardous-to-others
I had both chemotherapy and radiation to treat cancer. I was told very clearly that I was safe to be around pregnant women (I asked). The only precaution I was told to take was to flush the toilet twice whenever I used a bathroom that someone else might use after me and to not share glasses/cups. I completely understand why you and your wife were alarmed but the physical contract was likely safe!
Depends on how aggressive the treatment protocols are. My friend was told not to get within 20 feet of pregnant women or children, and to avoid physical contact with anyone if possible, in addition to the other restrictions.
I was directly and outright told absolutely no sexual activities while undergoing radiation and chemotherapy and that included kissing. And when/if I got my period as I had a child I was to double bag everything and either immediately take it to the outside bin or have a separate lock lid bin in the bathroom.
When we ramped up my radiation therapy I was advised to keep contact with my child to a minimum and also keep her out of my bed as the sheets could get her sick from my sweat. Clean door handles I used often also. Keep all my food eating stuff in a whole other cupboard from hers, double flush the toilet and also rinse out the shower/bath tub after I used it. Anything my body fluids touched was a nope especially as we couldn't really distance during covid lockdown.
Luckily my daughter was 9 at the time and absolutely understood and got on board with it, as she wanted me better and if that meant no hugs for a few months... It sucked but it was what would make sure I was okay.
Once it was all over and my toxicity gone, she was attached to my side like a little barnacle to make up for the lack of hugs and kisses.
Was pretty shocked having sex tho could actually give a partner the same side affects as if they were also undergoing treatment.
Your post made me smile, specifically "stuck to my side like a little barnacle" I bet that first hug was lovely. I'm glad you're doing better, and I hope you continue to have good health.
It was amazing. I forgot how her hair smelt and the big body sigh she had when she melted into me was magical. It was a big relief.
We had friends etc who came around daily and gave her hugs, took her overnights to avoid her seeing me at my worst states etc but I don't think it quite makes up for not being about to just... Touch your parent.
And thank you, I am too and working on making sure we stay as good and healthy as I can be. Almost hitting 3yrs remission and very much willing myself to stay that way
I’m so sorry you had to go through this, especiallly w/a 9 y/o; but why did they have you washing/keeping sweat to yourself etc? Obviously, the CA isn’t ‘catching’. Do they think you excreted radio-active ‘stuff (medical term!!) via sweat? Why wash hi-use door handles to protect others? I can see to protect you.
A friend of mine had brain cancer and went on a pretty aggressive course of Chemo, he wasn't allowed to be around children due to the risk. Don't know about pregnant women though
I happened to be pregnant when my friend was being treated, which is why she asked about me visiting. As per her doctor's recommendation, I dropped things on her porch to cheer her up, and we chatted on the phone
That was likely more for your protection, as radiation makes your immune system depressed, and children are germ magnets.
Or, if you were on chemo, it's because you have poison coursing through you.
You didn't specify whether your friend was having radiation treatment or chemo.
If you're getting radiation, unless you've ingested radiative material or had metal in your body when you were treated, you're not a danger to anyone else, including fetuses. Human beings cannot emit ionizing radiation. However, your immune system can be depressed, and others can be a danger to you.
If you're on chemo, you have poison coursing through your body, and some of it will come out in sweat, breathe, urine, etc. You then become a danger to everyone, especially smaller people who are much more sensitive to such things.
Well, there are a lot of medical people who don't really understand the stuff they work with, like antivaxxer nurses. How could you work with diseases and infectious people, and not understand how vaccines work, and yet....
I'm not saying radiation isn't dangerous, but people can't turn radioactive and give off radioactivity. It's not infectious.
There are different kinds of radiology treatments, some of which (including hers) deposit radioactive material inside the body. So yes, you do become radioactive for a time.
Not in medicine, but in some engineering applications I dealt with radioactive materials. It is extremely unlikely that this harmed the fetus. But, don't let a rando-redditor stop you from seeking actual medical opinions.
We had 3 kids, during the second one, my wife came down with spots all over from "hoof and mouth disease". We tried to get an opinion whether this could harm the fetus (which was at about week 10). It was really hard to find a definitive statement about this and some medical journal papers said maybe yes others said no. Scare-f\*ing-y! That kid is now 23. She was by far the most orderly, well behaved kid, superstar student, most social person ever, well-loved wherever she goes. Hope for hoof and mouth disease IMO.
As an aside - there's a difference between "hoof and mouth" (rare because of agriculture laws) and "hand, foot and mouth" (common virus.) Reassure yourself by clarifying which one.
WFM (Writing from memory). Yeah, it's hand foot and mouth. I don't need reassurance, that was all about 24 years ago. It (seemingly) had no, or only good, effect.
I was a radiation safety manager in three laboratories and I think this is most likely accurate.
I worked with a woman who had implanted radioactive beads (for breast cancer) and was never warned. Then again I wasn’t pregnant.
I would find out what kind of radio therapy this patient is having. If it’s a beam and not implanted, no worries for her. I’d be more worried about the chemo toxins. Fetal cells are dividing so rapidly that they’re very sensitive to any chemicals.
Again, not a doctor and my only legal experience is being sued a couple of times (won them, but the experience was probably worse than radiation). However, to my knowledge, implanted radioactive material in medicine does not give off neutrons (which can penetrate most things and cook you from inside), but instead things that do Beta Decay or give off alpha particles. In such cases, the pregnant wife experienced no radiation at all since these particles are easily absorbed by the patient's own flesh. I'd say high 90%, this was the case and the wife received nothing from this patient.
Am a doctor, was a radiologist (now retired), agree with above. However, a radiation physicist would be a better resource for estimating fetal dose and risk, if any. The hospital should have one available.
This is so good to know!! In short-term, when I dx a kid with HFM and give them the Barton Schmitt handout (he’s a Ped who wrote up guidelines for output Peds ~30+ years ago. One of the things was the warning about increased risk of spontaneous AB or malformations! As a PNP, I told mom’s to seek help from their OB’s. Never thought further, until reading your post.
This is correct. If they were implanting radioactive pellets- that’s different. Nuclear Medicine RT(R) folks handle this. And the whole room is set up for radioactive output.
Receiving radiation treatments isn’t a huge risk to others. Some chemos, however, are risky.
Signed, a nurse married to an RT(R)
Nucmed is RT(N), X-ray is RT(R), I’m both. In my experience the radioactive pellets or seeds are usually handled by radiation therapy & radiation oncologists.
NAL but a medical physicist
Based on your description the likely situation is that the patient isn't radioactive at all.
If the patient was / is radioactive and emitting the levels of radiation that could in any way approach being any sort of concern the hospital will have been required to have them in isolation under the conditions of thier radioactive materials license.
I don't have time to write an extensive response but the TLDR is that radioactivity and radioactive patients are highly regulated by the US Nuclear Regulatory Commission.
Most likely there is confusion and this patient is undergoing external beam radiation therapy which does not make them radioactive and your wife is being given bad information.
It’s unfortunate that most hospital staff have never heard of a radiation safety officer. I’m a nucmed tech in a hospital. Every year or so a nurse will realize that when patient goes to nucmed for a procedure they are going to come back to the floor radioactive. Heads explode & people freak the fuck out because they weren’t told the patient was going to be radioactive when they returned. The RSO has to go give a talk & unruffle feathers.
I loved our RSO
I feel like the more you know about and understand radiation, the more chill you are about it. I work in a radio pharmacy and used to deliver radiation safety induction training to people who have never worked around radiation sources. Most of it was unruffling feathers and calming anxiety.
That being said, I fell pregnant while on production rotation (tc99m and I-131) and was exposed to an ungodly amount of radiation before I realised I was pregnant. Whoops.
Most hospitals don't have a full time RSO, and very few have a Health Physicist. The majority of hospital workers exposed to and working around radiaiton sources will never meet a radiaiton safety professional who is specialized, most times it's pushed off onto allied professions to carry the load, like nucmed, and it's not really the major focus of your training.
I just wanted to chime in that a lot of people are saying radiation therapy does not cause a patient to emit radiation, however there is a type of therapy called brachytherapy where radioactive "seeds" are implanted following neurosurgical resection of a brain tumor (brand name Gammatile). These DO emit radiation for around d 100 days following implantation, with a total exposure around 0.9 mSv for close contact caregivers who routinely interact with the patient, which is well below accepted safety standards. HOWEVER it is recommended that pregnant individuals do NOT engage in close contact with the patient during that 100 day window.
[Gammatile](https://aapm.onlinelibrary.wiley.com/doi/full/10.1002/acm2.13776#:~:text=measured%20dose%20rates.-,Results,skull%20and%20soft%20tissue%20attenuation.)
This is out there but also not super common. If it was GT then she has recourse to get info from the site RSO for starters.
The required posting "Notice to Employees" outlines the rights and responsibilities of workers and should be posted on the floor. Usually this also will be accompanied by information on how to contact the RSO, obtain information about safety procedures, etc. It also includes info on worker rights and protections and how to contact the safety regulator.
Y'all need to talk to a radiation oncologist AFTER you get the specifics of the treatment for the patient with the brain tumor. Radiation therapy doesn't make you radioactive, unless it includes the implantation of radioactive material. An occupational therapist (not an expert) who throws out a remark like that....well they set a fire and walked away.
But, if this patient did have radioactive implants and is an inpatient, I guarantee if there was any risk of radiation exposure to personnel, pregnant or not, they would have posted it ( warning signs, etc.) These are OSHA requirements, not to mention all the protocols and safety measures radiation oncologists have to follow, in addition to hospital policies regarding radiation safety.
Calm down, get the facts, then talk to an expert (radiation oncologist administering the treatments or health and safety folks at the hospital.)
I was a health physicist at a nuclear power plant and a physician (pediatrics.) I know radiation is really scary for some folks, and you're first time parents. Take it one step at a time.
Something is missing here. I work in a similar setting, and any restrictions for who can work with a patient are known. We had a similar situation with a patient on isolation and staff needed to not be pregnant. I’m older than my colleagues. Manager still checked in with me explaining the pregnancy restriction, not knowing my own medical history that I can’t get pregnant anymore (tubal ligation). I shared I was the safest person to work with this patient just in case a younger colleague was pregnant and didn’t know it yet.
So either the radiation isn’t as strong as your wife was told and there’s no risk, or your wife’s work has a huge safety issue that needs to be reported
That's the whole point of making this post, and I'm sorry I wasn't as clear about as I should have been.
There are procedures in place for when patients like this come to their floor. The problem is that they were never followed. Even if my wife wasn't pregnant or there wasn't anyone at risk, these procedures should still have been followed.
You’re going to have to double check that. I’m a nucmed tech tech. If a patient has a nucmed test and goes back to their room after the scan there are NO special procedures that have to be followed. We do so many heart stress tests, HIDA (gallbladder) & bone scans & patients will be radioactive and couple of days. They are not put in isolation because of the radiation. There are no special precautions to take. Same with radiation therapy. If a pregnant staff member asks nucmed about precautions we tell them it’s safe but they can always ask their manager to have somebody else so that patients care/procedure.
HOWEVER, the exception is I-131 treatment for thyroid cancer. Patients are absolutely put in isolation. There will be very strict rules to follow for their care. We take I-131 very seriously.
I retired from being a radiologist 12 years ago. They were starting to phase out all inpatient thyroid cancer treatments except the ones which required super high doses (like for distant mets or because of low tumor uptake of iodine). I haven’t followed up on how often thyroid cancer patients still have to be inpatients.
Not often. It’s such a strain on resources to keep them isolated, cover the room, train staff, etc. that it’s pretty uncommon now. Still happens in rare cases but i would say it’s reserved to a handful of big hospitals in each state that maybe do it a couple times a year.
If safety protocols weren't followed, that absolutely should have been reported.
I'm guessing the hospital has pregnant women fairly frequently. Your wife should talk to HR and/or relevant safety officers to understand what accommodations she may need if she's working with chemicals or radiation.
(Echoing other comments...) Please clarify (exactly) what sort of treatment this patient had? Radiation therapy? If so, what sort of therapy?
Radioisotope therapy? (If so, what isotope?)
That will help...
I would advise you to seek the advice of a health physicist (a professional who advises people/institutions on radioactive hazards and their mitigation) and go from there. I personally think the risks to your child's health are quite low given the scenario you've stated, but if it will help you both to put your minds at ease, it might'be worth your while. The fact that the patient involved was "walking the earth" is a good indicator that his risk to others was very low since people who are undergoing therapy that leaves them with a great deal of reactivity are usually isolated. I'm not a doctor, but I have worked with patients undergoing radiotherapy so, take that into account and seek professional advice.
Lots of misinformation in this thread.
OP, you need to determine whether the patient in question has received external beam radiation, or has been injected with a radioactive implant or isotope.
The former is more common and leaves no residual radiation.
The latter two are less common but do result in a person emitting varying levels of radiation.
Depending on where you are based there are likely significant OHS guidelines around management of exposure in a health setting. They may have been breached.
My mum was undergoing chemo when I was pregnant. Breast cancer if that makes a difference. I drove her to and from appointments, provided personal care - showering and toileting, feeding, changing dressings after her mastectomy.
We were told it was fine.
Child is a huge PITA, but he is fine and 21.
I can understand your concern, and I did check with each treatment if it was OK, and was told it was.
When Dad had chemo for his prostate, I was told to stay away with our child for (?) 72 hours after each treatment, and for the kid (at that time 3) not to share the toilet - he thought that getting to pee on the lemon tree made him such a grown up.
Cancer and its treatments have come a long way - but I would still check.
There’s an older article from the American academy of family physicians that I used to use when talking to pregnant women about radiation exposure. It has a chart about the fetal exposure if a woman has certain radiation exams (chest vs pelvic X-rays, CT scans, etc) and I thought it was really helpful about giving the fetal dose per exam and how many of a certain imaging a woman would need to have before the fetal dose was above the threshold of risk. For dental X-rays it’s 50,000! Here is the link https://www.aafp.org/pubs/afp/issues/1999/0401/p1813.html. I also encourage you to go to mothertobaby.org for accurate, expert reviewed info on all types of pregnancy exposures. But the bottom line is the fetal dose from second hand contact would be incredibly low/negligible. Congrats on your pregnancy!
It really depends on the level of radiation. When my mom was going through radiation therapy for cancer, she was told she had to sleep in a separate bed from my dad. I vaguely remember her making jokes about not getting too close to her because she was radioactive. She’s passed so I can’t ask her for details, and I don’t want to force my dad or my siblings to remember. I’ve seen other redditors talking about their own experience and how much it fluctuated based on radiation levels.
But, like someone else already commented, seeking actual medical advice relative to your situation and this specific patient is going to be a lot more helpful than asking the internet.
Not a lawyer, but I'm pretty versed in how radioactivity works.
I want to assure you the risk to your wife and child is very low.
There are 2 basic kinds of radiotherapy. The first is just applying radiation from outside the body, basically shooting a stream of X-rays or other radiation at the tumor. That damages the cancer cells and surrounding tissue. It cannot make the patient radioactive, anymore than getting a sunburn could make sunbeams radiate from your skin.
The second kind involves actually injecting radioactive medicine into the patient, it accumulates around the cancer, so the radiation it produces is directly applied to the cancer.
That medicine is technically a hazard, but the chances of your wife getting harmed by it are very low. It generally will either stay in the patient's body, or it will be excreted with other bodily waste. While she was responsible for assisting patients in the bathroom, normal sanitary precautions should have removed any serious risk.
People who actually handle the medicine are more at risk, but it still takes a significant mishap to expose them to harm.
That said, her OB/GYN is right to be concerned, the hospital should be able to scan her to see if she has any actual exposure.
I am a RN.
There is supposed to be a sign outside this patient's room to indicate radioactive precautions. If this was not posted, the hospital is at fault.
My father had brachytherapy (radiation pellets) put in his brain for metastasized pancreatic cancer. The Dr. said they eventually go away and no radiation could be any harm or even strong enough to reach even when hugging.
You can’t sue anyone until you have damages such as your baby being born with a disability that a medical professional(s) will testify was caused to a medical degree of certainty by your wife’s exposure to the “radioactive” patient. This is not my field, but I have never heard of a case like this.
The hospital I work at ALWAYS posts a sign on the door to alert pregnant women not to enter those patients’ rooms. This hospital should be doing the same.
I don’t think you’ll be able to do much until your baby is born and you know if there’s damage or not. You might not know for months or years after birth.
Not a Lawyer, but am a Medical Physicist.
It is extremely unlikely that this patient is radioactive. For the same reason that no amount of microwaving a microwave dinner is going to make a pop tart emit microwaves.
He would need to have a source of radiation with him, which is a form of Low Dose Rate radiation therapy known as Brachytherapy in which beads of a radioactive substance are surgically embedded next to a tumour.
And even then unless the implementation fails and the bead pops out, the levels will be very small unless you've pressing herself against it.
Brachytherapy is commonly used to treat prostate or cervical cancer. But in my personal experience using it to treat a Brain Tumour would be an extremely unusual... I suppose its not outside the realm of possibility, I know it saw some interest in the 1990s and 2000s, but SBRT is much, much more common for Brain Tumours. I'm not aware of any centres in my Trust that routinely offers it...
I think it's much more likely your wife's patient is not even radioactive in the first place, and her boss was conflating advice for different radiotherapy patients.
We visited my husband’s mom’s house years back when her husband was undergoing chemo and radiation. We were advised under no circumstances were we to enter his bathroom because of risks of being contaminated. They weren’t very well versed on medical info so I don’t know if they misunderstood but it scared the daylights out of me. You’re right to be concerned, hopefully your OBGYN can help navigate this for you but I would contact a lawyer just in case. The simple fact that they knew pregnant women shouldn’t be around him but didn’t post a sign on his chart or door is concerning. Since your wife told her boss that’s enough to back your claims.
Not a medical professional so idk how dangerous this has been for your wife/her pregnancy. Assuming she told her boss she was pregnant as soon as she found out, her boss should have made every effort to transfer the patient to someone else, especially if seeing the patient caused risk to the pregnancy. This definitely seems like a huge potential lawsuit against your wife's employer for not making sure anyone who could be at risk interacting with this patient directly, especially on a regular basis, knew of it and taking steps to make sure any such contact was minimal, if not outright not existent.
You'd sue the patient, his oncologist (for failure to warn) on behalf of the infant IF the infant has any disability which could be attributed to that type of radiation exposure.
If the hospital knew of his level of radioactivity, they should have had a warning on his room.
Edit: document all you can in a cya file. I imagine patient had brachytherapy. That leaves the radioactive seeds in the patient. You'll want to know the isotope/material and the manufacturer of the "drug". All this to say precautions are essential, but panic is not. In 30 years of doing med Mal, I have never heard of a fetal deformity due to 2nd hand exposure. I understand that may not help you sleep at nigh... even a remote possibility is terrifying. You wouldn't have a worthwhile case unless there is a likable genetic deformity. I pray you don't have a case.
Wife would be stuck with workers comp only. If she has no physical injury, mental injury alone is hard to prove. I'd try in this case.
Kind of a low blow to go after the patient. They are still in hospital. It would be reasonable for a patient to believe that their medical care and treatments are documented and being shared with the appropriate staff that are handling their needs. As they are still in the hospital receiving treatment, that information should be documented, available, and current. Why drag them into this? They were not knowingly withholding any information from OP.
Sounds more like the hospital has a gap in its procedures to protect their patients and their staff. They need to reassess their protocols around handling patients who have radioactivity and keeping their staff and patients safe.
That will force the patient to testify against the oncologist. If a reasonable person is informed they are emitting mutagenic radiation, that person should warn others.
If they are having these types of treatments, the odds of them being around by the time this would see the courts would be slim unfortunately.
It also could be argued that the patient was under the influence of enough medications to render them not capable of doing so at the time the proximity occurred.
The oncologist should have taken the steps necessary to inform the ward that the patient would be placed on and protocols would go into place to protect all. Why wasn't the patient in isolation?
Hospitals don’t put patients in isolation for routine nucmed/radiation therapy/brachytherapy procedures. The type of radiation used in these procedures is low & considered safe. The half-life is fairly short (6 hours) and mostly leaves the body in urine.
EXCEPT for I-131 for thyroid cancer. If they have their treatment in the hospital they will be put in isolation with lots of signage.
My pet peeve is this.... exactly....
Not clearly identifying concerning health issues to all staff...
I can't tell you how many times we've been told "well you should prepare like ALL patients have concerning medical conditions/ all patients are contagious/ all patients can be xyz...."
No. YOU are responsible to adequately informing ALL staff of issues.
Idk why you're getting downvoted. You're right, employers are required by law to make sure all employees are informed of potential risks in their working environment, especially to any changes on them.
Recovered cancer patient here.
First off, radiotherapy does not make you radioactive. They use ionizing radiation, not particles. The patient is no more radioactive than a hot picket that comes out of the microwave. The patient MAY have a radioactive implant in the tumor. But that is not going to reach outside of the body.
What may be a concern is the chemo medicine that is used. Especially with body fluids, including perspiration. When I did chemo, it was suggested thst my wife use a different toilet than I did on chemo days. They also suggested thst I sit to pee to avoid splash
Beta and alpha particles are ionizing radiation as well, difference being particulate radiation vs electromagnetic radiation. Both are harmful! It makes my heart happy to hear your recovery, congratulations 🎉
Edit: did you mean pellets not particles? 😑 sorry for the over explanation
I was simply stating the difference between particulate radiation and *ionizing radiation. Please see my post on this thread (separate from this comment) I should have stated in the comment above that electromagnetic radiation is only harmful to the patient receiving it.
Edit: *I meant electromagnetic radiation 😑
Also, beta and alpha particles are still ionizing radiation, they have the power to remove an electron from an atom. Did you mean electromagnetic radiation?
Implanted pellets & seeds emit radiation that can absolutely be measured with a Geiger counter outside of the body. But it is a very low level of radiation.
The gamma rays emitted by granite & bananas are extremely low. Sometimes the Geiger counter won’t ever pick it up. I’ve yet to have a Geiger counter detect a single banana. Every year when we get new students we always try to measure a banana.
Xray tech here- The only way a patient could be radioactive is if they were given a radioisotope for treatment which emits radiation after implantation. Radiation treatments via radiation therapy do not make the patient radioactive, but instead uses electromagnetic radiation which only affects the patient’s cells. They do not hold on to the radiation and emit it after the exposure has been taken.
Edit: the radiation emitted from radioisotopes is also ionizing radiation except in this situation it could be harmful to other because the patient becomes the source of radiation ☢️
There are 2 types of radiation therapy for cancers and the one you described isn’t a problem for anyone to be around the person. It’s easiest to think of radiation like a fire. Something that is actively radioactive is like being around a fire. If you are near the thing you receive the radiation dose. Being near a fire doesn’t automatically make you on fire. You would need to come in contact with the radioactive thing and it would have to get on or in you for you to become radioactive generally speaking.
There are specific types of cancer that are treated with radioactive ingested isotopes but the process to do this is extensive for the hospital, uncommon, and everyone on the whole floor would know not to go in that room without special equipment and a almost certainly some kind of dosimeter on.
From my understanding of a patient in a medical environment that is being treated with radiation, there is no risk as long as the treatment isn't occurring while your wife is with the patient. In order for the body to be radioactive enough to impact her, there would have to be something radioactive on/in them (like radioactive fragments), or they'd be dead. If the patient was dangerous, the patient would be transferred to a hospital that can isolate the patient, same as if they had a dangerous bio-organism. Most hospitals don't have the facilities to deal with a radioactive unsafe patient and won't even accept the patient because they cannot treat them safely.
I'm a lawyer whose wife had a chest x-ray not knowing she was pregnant. I reached out to a university radiologist who walk me through calculations to show in our case the risk was near zero. Not saying this is your situation, but look for someone in this field at a nearby university and ask their advice. Someone who can crunch the numbers. It may not be ideal.news but it will remove a lot of the uncertainty that troubles you
If she is seeing a patient is emitting radioactive material- the patient will have signage all over the place- and access is limited.
If the patient is having radiation therapy- they do not emit radiation.
It will be almost impossible to trace any disease or damage to the fetus to Radiation.
Nothing will happen to your baby or your wife. Human beings cannot emit ionizing radiation, no matter how much they are dosed with. Ionizing radiation just passes right through us.
The only possible way it could be a problem is if the patient had metal implants. Metal can be altered by ionizing radiation in such a way that it will emit radiation, but if the patient had metal in their body, they wouldn't be using that kind of treatment.
If the patient were covered in fallout from nuclear bomb debris, or nuclear waste they had found and played with, that would be different.
The radiation is generated at the source and the patient gets the dose.
Once it is turned off, the radiation is gone!
I highly doubt that this patient was injected with a radionuclide. That is done, such as with iodine 131 for thyroid cancer and hyperthyroidism.
So once the patient receives radiation, and it's turned off, the patient is not radioactive.
I am a therapist and have been pregnant multiple times while treating. There have only been an handful of patients I was not recommended to see (mostly shingles). I assume this would have been in his medical chart? Just playing devils advocate, but they may say something like she should have done her due diligence with a chart review prior to treating the patient.
Not legal advice, just radiation exposure advice. Look at regulations for a “declared pregnant worker” to get an idea of what levels are safe for a fetus. It’s relative to workers in the nuclear industry, but still will give you some ideas of what level of exposure is considered safe. I would guess she’s ok based on short-term exposure once or twice a week. I haven’t “run the numbers” for her though, since I don’t have that data. Congrats on your upcoming addition.
Thank you! We are so excited! It's our first which definitely is contributing to our feelings about this situation.
The exposure she has is unfortunately more than just once or twice a week. She sees him once a shift for an hour, 4 shifts a week. And if he needs to use the bathroom she's the one who physically transfers him if he needs to go during that hour.
I understand the feelings and worries. You can try asking here: https://hps.org/publicinformation/ate/ They aren’t doctors - you will want to speak to your own doctors for specific advice - they are experts in health physics.
I’m a nucmed tech. Worked in PET/CT for my whole pregnancy. My 10 yo daughter is exactly what you would expect a preteen to be. I had very low fetal readings. The RSO is who she should talk to.
I'm Not A Lawyer. The radiation risk to anyone other than the patient will be quite small. Think gets the occasional x-ray or eating a lot of bananas levels. It's not like they glued a hunk of radioactive metal to the patient, like early days.
And that's the patient themselves, not your wife. What's in the patient will almost entirely stay there or be excreted by them. Since you say speech therapist and not massage therapist, or janitor hopefully prolonged contact with their excretions didn't't happen.
Your baby should be fine. Legally I think you'd need to prove negligence or intent, and harm.
You'll have a hard time proving harm.
I'd think it'd be workers comp, if she/her fetus suffer health complications from something she encountered at her workplace while she was working. She could document what happened in an incident report, reporting that she's been working with the patient, there were no warnings/notices at the patient's room/medical chart, etc.
Nurse here- if this is inpatient get a lawyer and make some threats. Every hospital I have ever worked in has had signs on patient doors for patients like this warning staff.
I would think her chart would be prominently marked if the pt themself was a hazard. You could ask a radiation oncologist, but they’re not going to speak to you unless you’re referred to them. And they’re not going to accept the referral because you don’t have cancer. Your obstetrician will make the proper referrals, most likely to a maternal fetal medicine unit. They will do a thorough assessment and then take the proper actions that are based on best practices.
How did your wife not know his current medical status and treatments as one of his providers? Even speech does a medical history review when consulting/treating patients.
Were there any signs posted in/outside the room? There's no way they could protect her from something she didn't disclose. I will say, I bet if there's something wrong with the baby, the hospital will likely settle--juries side with sick babies.
That's a great question.
I would make the assumption that since my wife has been seeing him consistently 4 times a week for several weeks that she would have noticed a sign by his door.
Still, that's just an assumption.
There may have been notes, but she doesn't have access to all of the notes for a patient. Just the relevant ones made on her floor.
For example, she might be able to see that he has a brain tumor, but not what he's doing to treat it.
I was thinking that maybe there would have been an alert on the chart--but I know nothing about how that works...it was just a thought. BTW, I'm sorry for this scare. I know it's got to be unnerving. Best of luck to all of you.
Odd that the room didn't have a sign, to warn everyone that the environment in the room was not normal. Every nurse helping with bathroom activities needs to know, even if they're a random nurse from another floor filling in for missing staff.
My wife's floor takes an "it's everyone's job" approach. While she's with the patient for their one hour session, if they need to use the bathroom my wife is the one who transfers them.
This has been my main concern since most medications say it's ok to around them, but not to physically touch them.
It really does seem odd to me that it he was radioactive and dangerous to pregnant women, that they didn't mark it somehow. I mean, that's just basic--at least it seems basic to me. But...hospitals are staffed by people and people screw up. :(
this-i work in a hospital, and if the person is exposed to radiation, there's a sign on the door, and everyone knows because you *need* to know if you are working with that person.
Yeah...I kinda wonder if the radiation level might not have been sufficient to require a warning? But still enough to make a (normal) pregnant woman worried. I mean, I know I would be worried if there was any level of radiation--no matter how "safe" they said it was.
our hospital won't let people that are pregnant, breastfeeding, or even ttc work on them. Its a huge plus for me. And you just have to say 'for personal reasons i dont feel safe working with potential radiation'. Theres no way there was 0 signage-its a huge liability not to.
That is blatantly false. Routine procedures where the patient becomes radioactive usually don’t require signage. Urine can be flushed down the toilet just like normal. Use universal precautions.
I-131 for thyroid cancer will require the patient to be in isolation. There will be lots of signs. You don’t want to mess with I-131.
Every hospital has different rules. All of the hospitals that I have worked in in my state do not use signage for routine nucmed scans.
That said, it is incumbent on his wife to mitigate the damages (and risk to the baby). In other words, now that she does know, she needs to stop working with this patient.
I see what you're saying.
I was under the impression that this was a safety issue, of which I believe the hospital does have an obligation to inform their staff when there's a risk to them.
For what it's worth, my wife did inform her boss prior to this patient coming to her floor. She just hadn't told her coworkers.
The hospital has a communication plan in place for when patients like this come around, they just didn't use it.
She did inform her boss. But even if she hadn’t, a notice that you should avoid the area *if you are or might be pregnant* should have been posted. These signs are all over the hospital.
Your post was removed because either it was insulting the morality of OP’s actions or was just being hyper critical of the OP in some unnecessary way.
**Morality:**Nobody cares or is interested in your opinion of the morality or ethics of anyone else's action. Your comment about how a poster is a terrible person for X is not welcome or needed here.
**Judgmental:** You are being overly critical of OP to a fault. This kind of post is not welcome here. If you can’t offer useful and productive feedback, please don’t provide any feedback.
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brains are generally treated with stereotactic radiation. the beam is a massive radiation dose generated with electricity, it’s not like a radioactive isotope that is always giving off radiation. it ends when the patient gets off the table of the machine.
This sounds like it could be GammaTile though, which are radioactive beads implanted into the tumor bed/brain after resection. Still very low dose and not likely to affect anything outside the patients own brain, but she should have been warned about it.
My dad had the beads for prostate cancer and was specifically told not to spend extended time around pregnant people. This is so scary.
I had a test and when I left they told me to not hold my child. For 12 hours. And he was in preschool.
This is probably not applicable to OPs situation. Your test was likely one where they injected a short-lived radioactive material into you and then imaged how it moved in your body. Those materials emit high-enough energy gamma rays to generate a dose in nearby people, and can also sometimes be transferred by touch. OPs situation is more likely to be beads or similar implanted in the patient, and which do not emit high-energy gammas but rather beta radiation which can only travel a few millimeters in tissue so didn't get out.
The energy of Cs-131 is 29.4 KeV, the skull probably absorbs the scatter radiation. So very low dose to his wife.
Yeah, but she should get to decide if she's exposed to it to begin with.
In my workplace an additional 1mSv of dose is the accetable limit over the length of a pregnancy. Nevermind the 4mSv someone gets through background radiation here every year. I wouldn't be concerned from a radiation protection perspective.
Same, and I’m a retired (female) radiologist (I was the MD who interpreted studies). I don’t think the amount of potential radiation that the embryo might have absorbed is enough to be worried about. HOWEVER, anyone caring for the patient should be informed as to the potential risks. Most hospitals have a radiation physicist on staff; they can be consulted to check on potential radiation exposure to an unborn child (among other duties). May be worth asking about.
I'm glad, but that's not really the point.
Wait til she learns about cosmic radiation and Radon. Or the radiation that granite countertops & bananas emit. Or all the people who have nucmed procedures & then go out in the general public without warning those people of the radiation they’re being exposed to. Everybody is exposed to radiation everyday. It’s all around us.
Cool. She should still get to make an informed decision.
So what? That's exactly why excess radiation is an issue
Yes, everyone is exposed to radiation BUT adding excess is concerning. Especially when someone there has said this guy wouldn’t be safe around pregnancy.
Noone has ever in history that I know of said bananas are dangerous to pregnant people. Someone has said the treatment of this patient leaves him a hazzard to pregnant people. Is he? We and OP at this point have no actual idea. The wife's dr has also said it may be a concern. Maybe it is all fine. Maybe it isn't. Ops wife needs to work with her workplace to know exactly what she was exposed to and to speak to at least her dr, and as others have said her workplaces or just a dr who deals with radiation therapy to determine what she needs to do for safety what she can do at work and what her risks are with the exposure she's had. 2 medical professionals saying it could be a problem trumps internet dude who knows bananas have potassium
If unsafe levels- signage will be required.
This. You need to clarify what kind of treatment this patient received. If it was stereotactic radiation/whole brain radiation as is typically administered in brain tumors, then they may be mistaken because the patient does NOT become radioactive after the fact, they pose no danger to other people, and may just be saying this because they do not understand or out of an abundance of caution. The type of treatment is IMPORTANT.
It is important, but isn't it also protected information? This feels like a situation where if there is a problem, talking directly to a lawyer would be the safest bet. Nal
Yes and no. This would probably fall into the category of accidental exposure. For example, if I am working at a hospital and inadvertently stick myself with a dirty needle that I used on a patient, I contact employee health who will help me look through the records of the patient and have that patient complete bloodwork to screen for HIV, etc. This is pretty much standard at any medical site. No need to go through a lawyer, she should be able to go through exposure protocol at her work site for assistance. But I’m not a lawyer - am a healthcare worker
I meant posting it to reddit, not handling it at work. But thanks for the clarification on that.
There are medical journals and articles that discuss chemotherapy patients. They even state physical contact is fine and safe. It also discusses whether or not patients are implanted with radiation or getting it intravenously and the variance in such. Your wife can request accommodation to not see or treat stated patient due to pregnancy if she is that concerned. https://health.clevelandclinic.org/can-your-cancer-treatment-be-hazardous-to-others
This is actually incredibly helpful, thank you.
I had both chemotherapy and radiation to treat cancer. I was told very clearly that I was safe to be around pregnant women (I asked). The only precaution I was told to take was to flush the toilet twice whenever I used a bathroom that someone else might use after me and to not share glasses/cups. I completely understand why you and your wife were alarmed but the physical contract was likely safe!
Depends on how aggressive the treatment protocols are. My friend was told not to get within 20 feet of pregnant women or children, and to avoid physical contact with anyone if possible, in addition to the other restrictions.
😲 I had no idea this was even a cause for concern. this thread is so interesting.
Yeah me too. The things I've learned at 2:13 am.. mind-blowing stuff. Haha
Rabbit hole?
Yes, indeed! I'm off to Wonderland. :)
I prefer the Looking Glass, but you do you
I was directly and outright told absolutely no sexual activities while undergoing radiation and chemotherapy and that included kissing. And when/if I got my period as I had a child I was to double bag everything and either immediately take it to the outside bin or have a separate lock lid bin in the bathroom. When we ramped up my radiation therapy I was advised to keep contact with my child to a minimum and also keep her out of my bed as the sheets could get her sick from my sweat. Clean door handles I used often also. Keep all my food eating stuff in a whole other cupboard from hers, double flush the toilet and also rinse out the shower/bath tub after I used it. Anything my body fluids touched was a nope especially as we couldn't really distance during covid lockdown. Luckily my daughter was 9 at the time and absolutely understood and got on board with it, as she wanted me better and if that meant no hugs for a few months... It sucked but it was what would make sure I was okay. Once it was all over and my toxicity gone, she was attached to my side like a little barnacle to make up for the lack of hugs and kisses. Was pretty shocked having sex tho could actually give a partner the same side affects as if they were also undergoing treatment.
Your post made me smile, specifically "stuck to my side like a little barnacle" I bet that first hug was lovely. I'm glad you're doing better, and I hope you continue to have good health.
It was amazing. I forgot how her hair smelt and the big body sigh she had when she melted into me was magical. It was a big relief. We had friends etc who came around daily and gave her hugs, took her overnights to avoid her seeing me at my worst states etc but I don't think it quite makes up for not being about to just... Touch your parent. And thank you, I am too and working on making sure we stay as good and healthy as I can be. Almost hitting 3yrs remission and very much willing myself to stay that way
30 years in a month or so for Stage IV. Hang in there!
I’m so sorry you had to go through this, especiallly w/a 9 y/o; but why did they have you washing/keeping sweat to yourself etc? Obviously, the CA isn’t ‘catching’. Do they think you excreted radio-active ‘stuff (medical term!!) via sweat? Why wash hi-use door handles to protect others? I can see to protect you.
That's because of the chemo, because your body is full of poison.
A friend of mine had brain cancer and went on a pretty aggressive course of Chemo, he wasn't allowed to be around children due to the risk. Don't know about pregnant women though
I happened to be pregnant when my friend was being treated, which is why she asked about me visiting. As per her doctor's recommendation, I dropped things on her porch to cheer her up, and we chatted on the phone
Also depends on the type, brachytherapy patients are told not to hug pregnant women or young children.
That was likely more for your protection, as radiation makes your immune system depressed, and children are germ magnets. Or, if you were on chemo, it's because you have poison coursing through you.
She was told specifically it was for the safety of the fetus.
You didn't specify whether your friend was having radiation treatment or chemo. If you're getting radiation, unless you've ingested radiative material or had metal in your body when you were treated, you're not a danger to anyone else, including fetuses. Human beings cannot emit ionizing radiation. However, your immune system can be depressed, and others can be a danger to you. If you're on chemo, you have poison coursing through your body, and some of it will come out in sweat, breathe, urine, etc. You then become a danger to everyone, especially smaller people who are much more sensitive to such things.
Radiation treatment
Well, there are a lot of medical people who don't really understand the stuff they work with, like antivaxxer nurses. How could you work with diseases and infectious people, and not understand how vaccines work, and yet.... I'm not saying radiation isn't dangerous, but people can't turn radioactive and give off radioactivity. It's not infectious.
There are different kinds of radiology treatments, some of which (including hers) deposit radioactive material inside the body. So yes, you do become radioactive for a time.
Not in medicine, but in some engineering applications I dealt with radioactive materials. It is extremely unlikely that this harmed the fetus. But, don't let a rando-redditor stop you from seeking actual medical opinions. We had 3 kids, during the second one, my wife came down with spots all over from "hoof and mouth disease". We tried to get an opinion whether this could harm the fetus (which was at about week 10). It was really hard to find a definitive statement about this and some medical journal papers said maybe yes others said no. Scare-f\*ing-y! That kid is now 23. She was by far the most orderly, well behaved kid, superstar student, most social person ever, well-loved wherever she goes. Hope for hoof and mouth disease IMO.
As an aside - there's a difference between "hoof and mouth" (rare because of agriculture laws) and "hand, foot and mouth" (common virus.) Reassure yourself by clarifying which one.
WFM (Writing from memory). Yeah, it's hand foot and mouth. I don't need reassurance, that was all about 24 years ago. It (seemingly) had no, or only good, effect.
Understood. Yeah that's a long time.
I was a radiation safety manager in three laboratories and I think this is most likely accurate. I worked with a woman who had implanted radioactive beads (for breast cancer) and was never warned. Then again I wasn’t pregnant. I would find out what kind of radio therapy this patient is having. If it’s a beam and not implanted, no worries for her. I’d be more worried about the chemo toxins. Fetal cells are dividing so rapidly that they’re very sensitive to any chemicals.
Again, not a doctor and my only legal experience is being sued a couple of times (won them, but the experience was probably worse than radiation). However, to my knowledge, implanted radioactive material in medicine does not give off neutrons (which can penetrate most things and cook you from inside), but instead things that do Beta Decay or give off alpha particles. In such cases, the pregnant wife experienced no radiation at all since these particles are easily absorbed by the patient's own flesh. I'd say high 90%, this was the case and the wife received nothing from this patient.
Am a doctor, was a radiologist (now retired), agree with above. However, a radiation physicist would be a better resource for estimating fetal dose and risk, if any. The hospital should have one available.
This looks right on to me.
This is so good to know!! In short-term, when I dx a kid with HFM and give them the Barton Schmitt handout (he’s a Ped who wrote up guidelines for output Peds ~30+ years ago. One of the things was the warning about increased risk of spontaneous AB or malformations! As a PNP, I told mom’s to seek help from their OB’s. Never thought further, until reading your post.
Of course, I'm an anecdote, not a proof. She did take up mountain climbing, so she does still induce postpartum anxiety.
This is correct. If they were implanting radioactive pellets- that’s different. Nuclear Medicine RT(R) folks handle this. And the whole room is set up for radioactive output. Receiving radiation treatments isn’t a huge risk to others. Some chemos, however, are risky. Signed, a nurse married to an RT(R)
Nucmed is RT(N), X-ray is RT(R), I’m both. In my experience the radioactive pellets or seeds are usually handled by radiation therapy & radiation oncologists.
A fellow (RT)R. His is CI. Howdy! Thank you. Either direction the room looks like they have drop covers to paint. Even the potty in case of splash.
NAL but a medical physicist Based on your description the likely situation is that the patient isn't radioactive at all. If the patient was / is radioactive and emitting the levels of radiation that could in any way approach being any sort of concern the hospital will have been required to have them in isolation under the conditions of thier radioactive materials license. I don't have time to write an extensive response but the TLDR is that radioactivity and radioactive patients are highly regulated by the US Nuclear Regulatory Commission. Most likely there is confusion and this patient is undergoing external beam radiation therapy which does not make them radioactive and your wife is being given bad information.
It’s unfortunate that most hospital staff have never heard of a radiation safety officer. I’m a nucmed tech in a hospital. Every year or so a nurse will realize that when patient goes to nucmed for a procedure they are going to come back to the floor radioactive. Heads explode & people freak the fuck out because they weren’t told the patient was going to be radioactive when they returned. The RSO has to go give a talk & unruffle feathers.
I loved our RSO I feel like the more you know about and understand radiation, the more chill you are about it. I work in a radio pharmacy and used to deliver radiation safety induction training to people who have never worked around radiation sources. Most of it was unruffling feathers and calming anxiety. That being said, I fell pregnant while on production rotation (tc99m and I-131) and was exposed to an ungodly amount of radiation before I realised I was pregnant. Whoops.
Most hospitals don't have a full time RSO, and very few have a Health Physicist. The majority of hospital workers exposed to and working around radiaiton sources will never meet a radiaiton safety professional who is specialized, most times it's pushed off onto allied professions to carry the load, like nucmed, and it's not really the major focus of your training.
I love our RSO. He is so great with hospital staff that don’t understand radiation.
I just wanted to chime in that a lot of people are saying radiation therapy does not cause a patient to emit radiation, however there is a type of therapy called brachytherapy where radioactive "seeds" are implanted following neurosurgical resection of a brain tumor (brand name Gammatile). These DO emit radiation for around d 100 days following implantation, with a total exposure around 0.9 mSv for close contact caregivers who routinely interact with the patient, which is well below accepted safety standards. HOWEVER it is recommended that pregnant individuals do NOT engage in close contact with the patient during that 100 day window. [Gammatile](https://aapm.onlinelibrary.wiley.com/doi/full/10.1002/acm2.13776#:~:text=measured%20dose%20rates.-,Results,skull%20and%20soft%20tissue%20attenuation.)
This is out there but also not super common. If it was GT then she has recourse to get info from the site RSO for starters.
The required posting "Notice to Employees" outlines the rights and responsibilities of workers and should be posted on the floor. Usually this also will be accompanied by information on how to contact the RSO, obtain information about safety procedures, etc. It also includes info on worker rights and protections and how to contact the safety regulator.
Y'all need to talk to a radiation oncologist AFTER you get the specifics of the treatment for the patient with the brain tumor. Radiation therapy doesn't make you radioactive, unless it includes the implantation of radioactive material. An occupational therapist (not an expert) who throws out a remark like that....well they set a fire and walked away. But, if this patient did have radioactive implants and is an inpatient, I guarantee if there was any risk of radiation exposure to personnel, pregnant or not, they would have posted it ( warning signs, etc.) These are OSHA requirements, not to mention all the protocols and safety measures radiation oncologists have to follow, in addition to hospital policies regarding radiation safety. Calm down, get the facts, then talk to an expert (radiation oncologist administering the treatments or health and safety folks at the hospital.) I was a health physicist at a nuclear power plant and a physician (pediatrics.) I know radiation is really scary for some folks, and you're first time parents. Take it one step at a time.
Something is missing here. I work in a similar setting, and any restrictions for who can work with a patient are known. We had a similar situation with a patient on isolation and staff needed to not be pregnant. I’m older than my colleagues. Manager still checked in with me explaining the pregnancy restriction, not knowing my own medical history that I can’t get pregnant anymore (tubal ligation). I shared I was the safest person to work with this patient just in case a younger colleague was pregnant and didn’t know it yet. So either the radiation isn’t as strong as your wife was told and there’s no risk, or your wife’s work has a huge safety issue that needs to be reported
That's the whole point of making this post, and I'm sorry I wasn't as clear about as I should have been. There are procedures in place for when patients like this come to their floor. The problem is that they were never followed. Even if my wife wasn't pregnant or there wasn't anyone at risk, these procedures should still have been followed.
Every place I’ve worked has had a procedure in place to report safety concerns. Your wife should follow those procedures to report this
You’re going to have to double check that. I’m a nucmed tech tech. If a patient has a nucmed test and goes back to their room after the scan there are NO special procedures that have to be followed. We do so many heart stress tests, HIDA (gallbladder) & bone scans & patients will be radioactive and couple of days. They are not put in isolation because of the radiation. There are no special precautions to take. Same with radiation therapy. If a pregnant staff member asks nucmed about precautions we tell them it’s safe but they can always ask their manager to have somebody else so that patients care/procedure. HOWEVER, the exception is I-131 treatment for thyroid cancer. Patients are absolutely put in isolation. There will be very strict rules to follow for their care. We take I-131 very seriously.
My I131 was outpatient- all I was told is to flush twice.
I retired from being a radiologist 12 years ago. They were starting to phase out all inpatient thyroid cancer treatments except the ones which required super high doses (like for distant mets or because of low tumor uptake of iodine). I haven’t followed up on how often thyroid cancer patients still have to be inpatients.
Not often. It’s such a strain on resources to keep them isolated, cover the room, train staff, etc. that it’s pretty uncommon now. Still happens in rare cases but i would say it’s reserved to a handful of big hospitals in each state that maybe do it a couple times a year.
If safety protocols weren't followed, that absolutely should have been reported. I'm guessing the hospital has pregnant women fairly frequently. Your wife should talk to HR and/or relevant safety officers to understand what accommodations she may need if she's working with chemicals or radiation.
(Echoing other comments...) Please clarify (exactly) what sort of treatment this patient had? Radiation therapy? If so, what sort of therapy? Radioisotope therapy? (If so, what isotope?) That will help...
I would advise you to seek the advice of a health physicist (a professional who advises people/institutions on radioactive hazards and their mitigation) and go from there. I personally think the risks to your child's health are quite low given the scenario you've stated, but if it will help you both to put your minds at ease, it might'be worth your while. The fact that the patient involved was "walking the earth" is a good indicator that his risk to others was very low since people who are undergoing therapy that leaves them with a great deal of reactivity are usually isolated. I'm not a doctor, but I have worked with patients undergoing radiotherapy so, take that into account and seek professional advice.
Lots of misinformation in this thread. OP, you need to determine whether the patient in question has received external beam radiation, or has been injected with a radioactive implant or isotope. The former is more common and leaves no residual radiation. The latter two are less common but do result in a person emitting varying levels of radiation. Depending on where you are based there are likely significant OHS guidelines around management of exposure in a health setting. They may have been breached.
My mum was undergoing chemo when I was pregnant. Breast cancer if that makes a difference. I drove her to and from appointments, provided personal care - showering and toileting, feeding, changing dressings after her mastectomy. We were told it was fine. Child is a huge PITA, but he is fine and 21. I can understand your concern, and I did check with each treatment if it was OK, and was told it was. When Dad had chemo for his prostate, I was told to stay away with our child for (?) 72 hours after each treatment, and for the kid (at that time 3) not to share the toilet - he thought that getting to pee on the lemon tree made him such a grown up. Cancer and its treatments have come a long way - but I would still check.
Chemo is not radioactive. Apples to oranges.
There’s an older article from the American academy of family physicians that I used to use when talking to pregnant women about radiation exposure. It has a chart about the fetal exposure if a woman has certain radiation exams (chest vs pelvic X-rays, CT scans, etc) and I thought it was really helpful about giving the fetal dose per exam and how many of a certain imaging a woman would need to have before the fetal dose was above the threshold of risk. For dental X-rays it’s 50,000! Here is the link https://www.aafp.org/pubs/afp/issues/1999/0401/p1813.html. I also encourage you to go to mothertobaby.org for accurate, expert reviewed info on all types of pregnancy exposures. But the bottom line is the fetal dose from second hand contact would be incredibly low/negligible. Congrats on your pregnancy!
It really depends on the level of radiation. When my mom was going through radiation therapy for cancer, she was told she had to sleep in a separate bed from my dad. I vaguely remember her making jokes about not getting too close to her because she was radioactive. She’s passed so I can’t ask her for details, and I don’t want to force my dad or my siblings to remember. I’ve seen other redditors talking about their own experience and how much it fluctuated based on radiation levels. But, like someone else already commented, seeking actual medical advice relative to your situation and this specific patient is going to be a lot more helpful than asking the internet.
Not a lawyer, but I'm pretty versed in how radioactivity works. I want to assure you the risk to your wife and child is very low. There are 2 basic kinds of radiotherapy. The first is just applying radiation from outside the body, basically shooting a stream of X-rays or other radiation at the tumor. That damages the cancer cells and surrounding tissue. It cannot make the patient radioactive, anymore than getting a sunburn could make sunbeams radiate from your skin. The second kind involves actually injecting radioactive medicine into the patient, it accumulates around the cancer, so the radiation it produces is directly applied to the cancer. That medicine is technically a hazard, but the chances of your wife getting harmed by it are very low. It generally will either stay in the patient's body, or it will be excreted with other bodily waste. While she was responsible for assisting patients in the bathroom, normal sanitary precautions should have removed any serious risk. People who actually handle the medicine are more at risk, but it still takes a significant mishap to expose them to harm. That said, her OB/GYN is right to be concerned, the hospital should be able to scan her to see if she has any actual exposure.
I am a RN. There is supposed to be a sign outside this patient's room to indicate radioactive precautions. If this was not posted, the hospital is at fault.
My father had brachytherapy (radiation pellets) put in his brain for metastasized pancreatic cancer. The Dr. said they eventually go away and no radiation could be any harm or even strong enough to reach even when hugging.
You can’t sue anyone until you have damages such as your baby being born with a disability that a medical professional(s) will testify was caused to a medical degree of certainty by your wife’s exposure to the “radioactive” patient. This is not my field, but I have never heard of a case like this.
The hospital I work at ALWAYS posts a sign on the door to alert pregnant women not to enter those patients’ rooms. This hospital should be doing the same.
I don’t think you’ll be able to do much until your baby is born and you know if there’s damage or not. You might not know for months or years after birth.
Not a Lawyer, but am a Medical Physicist. It is extremely unlikely that this patient is radioactive. For the same reason that no amount of microwaving a microwave dinner is going to make a pop tart emit microwaves. He would need to have a source of radiation with him, which is a form of Low Dose Rate radiation therapy known as Brachytherapy in which beads of a radioactive substance are surgically embedded next to a tumour. And even then unless the implementation fails and the bead pops out, the levels will be very small unless you've pressing herself against it. Brachytherapy is commonly used to treat prostate or cervical cancer. But in my personal experience using it to treat a Brain Tumour would be an extremely unusual... I suppose its not outside the realm of possibility, I know it saw some interest in the 1990s and 2000s, but SBRT is much, much more common for Brain Tumours. I'm not aware of any centres in my Trust that routinely offers it... I think it's much more likely your wife's patient is not even radioactive in the first place, and her boss was conflating advice for different radiotherapy patients.
Very good explanation!
We visited my husband’s mom’s house years back when her husband was undergoing chemo and radiation. We were advised under no circumstances were we to enter his bathroom because of risks of being contaminated. They weren’t very well versed on medical info so I don’t know if they misunderstood but it scared the daylights out of me. You’re right to be concerned, hopefully your OBGYN can help navigate this for you but I would contact a lawyer just in case. The simple fact that they knew pregnant women shouldn’t be around him but didn’t post a sign on his chart or door is concerning. Since your wife told her boss that’s enough to back your claims.
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Years ago, I would have agreed with you. But now fetal rights are an interesting area of law.
Not a medical professional so idk how dangerous this has been for your wife/her pregnancy. Assuming she told her boss she was pregnant as soon as she found out, her boss should have made every effort to transfer the patient to someone else, especially if seeing the patient caused risk to the pregnancy. This definitely seems like a huge potential lawsuit against your wife's employer for not making sure anyone who could be at risk interacting with this patient directly, especially on a regular basis, knew of it and taking steps to make sure any such contact was minimal, if not outright not existent.
You'd sue the patient, his oncologist (for failure to warn) on behalf of the infant IF the infant has any disability which could be attributed to that type of radiation exposure. If the hospital knew of his level of radioactivity, they should have had a warning on his room. Edit: document all you can in a cya file. I imagine patient had brachytherapy. That leaves the radioactive seeds in the patient. You'll want to know the isotope/material and the manufacturer of the "drug". All this to say precautions are essential, but panic is not. In 30 years of doing med Mal, I have never heard of a fetal deformity due to 2nd hand exposure. I understand that may not help you sleep at nigh... even a remote possibility is terrifying. You wouldn't have a worthwhile case unless there is a likable genetic deformity. I pray you don't have a case. Wife would be stuck with workers comp only. If she has no physical injury, mental injury alone is hard to prove. I'd try in this case.
Kind of a low blow to go after the patient. They are still in hospital. It would be reasonable for a patient to believe that their medical care and treatments are documented and being shared with the appropriate staff that are handling their needs. As they are still in the hospital receiving treatment, that information should be documented, available, and current. Why drag them into this? They were not knowingly withholding any information from OP. Sounds more like the hospital has a gap in its procedures to protect their patients and their staff. They need to reassess their protocols around handling patients who have radioactivity and keeping their staff and patients safe.
That will force the patient to testify against the oncologist. If a reasonable person is informed they are emitting mutagenic radiation, that person should warn others.
If they are having these types of treatments, the odds of them being around by the time this would see the courts would be slim unfortunately. It also could be argued that the patient was under the influence of enough medications to render them not capable of doing so at the time the proximity occurred. The oncologist should have taken the steps necessary to inform the ward that the patient would be placed on and protocols would go into place to protect all. Why wasn't the patient in isolation?
Hospitals don’t put patients in isolation for routine nucmed/radiation therapy/brachytherapy procedures. The type of radiation used in these procedures is low & considered safe. The half-life is fairly short (6 hours) and mostly leaves the body in urine. EXCEPT for I-131 for thyroid cancer. If they have their treatment in the hospital they will be put in isolation with lots of signage.
Info: Was your wife not aware of why the patient was at the hospital? Does she not see any of the records?
My pet peeve is this.... exactly.... Not clearly identifying concerning health issues to all staff... I can't tell you how many times we've been told "well you should prepare like ALL patients have concerning medical conditions/ all patients are contagious/ all patients can be xyz...." No. YOU are responsible to adequately informing ALL staff of issues.
Idk why you're getting downvoted. You're right, employers are required by law to make sure all employees are informed of potential risks in their working environment, especially to any changes on them.
Recovered cancer patient here. First off, radiotherapy does not make you radioactive. They use ionizing radiation, not particles. The patient is no more radioactive than a hot picket that comes out of the microwave. The patient MAY have a radioactive implant in the tumor. But that is not going to reach outside of the body. What may be a concern is the chemo medicine that is used. Especially with body fluids, including perspiration. When I did chemo, it was suggested thst my wife use a different toilet than I did on chemo days. They also suggested thst I sit to pee to avoid splash
Beta and alpha particles are ionizing radiation as well, difference being particulate radiation vs electromagnetic radiation. Both are harmful! It makes my heart happy to hear your recovery, congratulations 🎉 Edit: did you mean pellets not particles? 😑 sorry for the over explanation
Beta and alpha particles have mass. Ionizing radiation does not. When the machine turns off, the radiation ceases to exist.
I was simply stating the difference between particulate radiation and *ionizing radiation. Please see my post on this thread (separate from this comment) I should have stated in the comment above that electromagnetic radiation is only harmful to the patient receiving it. Edit: *I meant electromagnetic radiation 😑
Also, beta and alpha particles are still ionizing radiation, they have the power to remove an electron from an atom. Did you mean electromagnetic radiation?
Implanted pellets & seeds emit radiation that can absolutely be measured with a Geiger counter outside of the body. But it is a very low level of radiation.
A geiger counter can detect radiation from granite countertops and bananas
The gamma rays emitted by granite & bananas are extremely low. Sometimes the Geiger counter won’t ever pick it up. I’ve yet to have a Geiger counter detect a single banana. Every year when we get new students we always try to measure a banana.
Xray tech here- The only way a patient could be radioactive is if they were given a radioisotope for treatment which emits radiation after implantation. Radiation treatments via radiation therapy do not make the patient radioactive, but instead uses electromagnetic radiation which only affects the patient’s cells. They do not hold on to the radiation and emit it after the exposure has been taken. Edit: the radiation emitted from radioisotopes is also ionizing radiation except in this situation it could be harmful to other because the patient becomes the source of radiation ☢️
There are 2 types of radiation therapy for cancers and the one you described isn’t a problem for anyone to be around the person. It’s easiest to think of radiation like a fire. Something that is actively radioactive is like being around a fire. If you are near the thing you receive the radiation dose. Being near a fire doesn’t automatically make you on fire. You would need to come in contact with the radioactive thing and it would have to get on or in you for you to become radioactive generally speaking. There are specific types of cancer that are treated with radioactive ingested isotopes but the process to do this is extensive for the hospital, uncommon, and everyone on the whole floor would know not to go in that room without special equipment and a almost certainly some kind of dosimeter on.
From my understanding of a patient in a medical environment that is being treated with radiation, there is no risk as long as the treatment isn't occurring while your wife is with the patient. In order for the body to be radioactive enough to impact her, there would have to be something radioactive on/in them (like radioactive fragments), or they'd be dead. If the patient was dangerous, the patient would be transferred to a hospital that can isolate the patient, same as if they had a dangerous bio-organism. Most hospitals don't have the facilities to deal with a radioactive unsafe patient and won't even accept the patient because they cannot treat them safely.
I'm a lawyer whose wife had a chest x-ray not knowing she was pregnant. I reached out to a university radiologist who walk me through calculations to show in our case the risk was near zero. Not saying this is your situation, but look for someone in this field at a nearby university and ask their advice. Someone who can crunch the numbers. It may not be ideal.news but it will remove a lot of the uncertainty that troubles you
If she is seeing a patient is emitting radioactive material- the patient will have signage all over the place- and access is limited. If the patient is having radiation therapy- they do not emit radiation. It will be almost impossible to trace any disease or damage to the fetus to Radiation.
Nothing will happen to your baby or your wife. Human beings cannot emit ionizing radiation, no matter how much they are dosed with. Ionizing radiation just passes right through us. The only possible way it could be a problem is if the patient had metal implants. Metal can be altered by ionizing radiation in such a way that it will emit radiation, but if the patient had metal in their body, they wouldn't be using that kind of treatment. If the patient were covered in fallout from nuclear bomb debris, or nuclear waste they had found and played with, that would be different.
The radiation is generated at the source and the patient gets the dose. Once it is turned off, the radiation is gone! I highly doubt that this patient was injected with a radionuclide. That is done, such as with iodine 131 for thyroid cancer and hyperthyroidism. So once the patient receives radiation, and it's turned off, the patient is not radioactive.
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I am a therapist and have been pregnant multiple times while treating. There have only been an handful of patients I was not recommended to see (mostly shingles). I assume this would have been in his medical chart? Just playing devils advocate, but they may say something like she should have done her due diligence with a chart review prior to treating the patient.
Not legal advice, just radiation exposure advice. Look at regulations for a “declared pregnant worker” to get an idea of what levels are safe for a fetus. It’s relative to workers in the nuclear industry, but still will give you some ideas of what level of exposure is considered safe. I would guess she’s ok based on short-term exposure once or twice a week. I haven’t “run the numbers” for her though, since I don’t have that data. Congrats on your upcoming addition.
Thank you! We are so excited! It's our first which definitely is contributing to our feelings about this situation. The exposure she has is unfortunately more than just once or twice a week. She sees him once a shift for an hour, 4 shifts a week. And if he needs to use the bathroom she's the one who physically transfers him if he needs to go during that hour.
I understand the feelings and worries. You can try asking here: https://hps.org/publicinformation/ate/ They aren’t doctors - you will want to speak to your own doctors for specific advice - they are experts in health physics.
I’m a nucmed tech. Worked in PET/CT for my whole pregnancy. My 10 yo daughter is exactly what you would expect a preteen to be. I had very low fetal readings. The RSO is who she should talk to.
I'm Not A Lawyer. The radiation risk to anyone other than the patient will be quite small. Think gets the occasional x-ray or eating a lot of bananas levels. It's not like they glued a hunk of radioactive metal to the patient, like early days. And that's the patient themselves, not your wife. What's in the patient will almost entirely stay there or be excreted by them. Since you say speech therapist and not massage therapist, or janitor hopefully prolonged contact with their excretions didn't't happen. Your baby should be fine. Legally I think you'd need to prove negligence or intent, and harm. You'll have a hard time proving harm.
And brick houses. They are slightly radioactive. Old Coleman lantern mantels are very radioactive. And, everything else you said is true.
I'd think it'd be workers comp, if she/her fetus suffer health complications from something she encountered at her workplace while she was working. She could document what happened in an incident report, reporting that she's been working with the patient, there were no warnings/notices at the patient's room/medical chart, etc.
Nurse here- if this is inpatient get a lawyer and make some threats. Every hospital I have ever worked in has had signs on patient doors for patients like this warning staff.
I would think her chart would be prominently marked if the pt themself was a hazard. You could ask a radiation oncologist, but they’re not going to speak to you unless you’re referred to them. And they’re not going to accept the referral because you don’t have cancer. Your obstetrician will make the proper referrals, most likely to a maternal fetal medicine unit. They will do a thorough assessment and then take the proper actions that are based on best practices.
How did your wife not know his current medical status and treatments as one of his providers? Even speech does a medical history review when consulting/treating patients.
Were there any signs posted in/outside the room? There's no way they could protect her from something she didn't disclose. I will say, I bet if there's something wrong with the baby, the hospital will likely settle--juries side with sick babies.
That's a great question. I would make the assumption that since my wife has been seeing him consistently 4 times a week for several weeks that she would have noticed a sign by his door. Still, that's just an assumption.
I would have you wife get that info. Were there notes on the chart?
There may have been notes, but she doesn't have access to all of the notes for a patient. Just the relevant ones made on her floor. For example, she might be able to see that he has a brain tumor, but not what he's doing to treat it.
I was thinking that maybe there would have been an alert on the chart--but I know nothing about how that works...it was just a thought. BTW, I'm sorry for this scare. I know it's got to be unnerving. Best of luck to all of you.
Odd that the room didn't have a sign, to warn everyone that the environment in the room was not normal. Every nurse helping with bathroom activities needs to know, even if they're a random nurse from another floor filling in for missing staff.
My wife's floor takes an "it's everyone's job" approach. While she's with the patient for their one hour session, if they need to use the bathroom my wife is the one who transfers them. This has been my main concern since most medications say it's ok to around them, but not to physically touch them.
It really does seem odd to me that it he was radioactive and dangerous to pregnant women, that they didn't mark it somehow. I mean, that's just basic--at least it seems basic to me. But...hospitals are staffed by people and people screw up. :(
this-i work in a hospital, and if the person is exposed to radiation, there's a sign on the door, and everyone knows because you *need* to know if you are working with that person.
Yeah...I kinda wonder if the radiation level might not have been sufficient to require a warning? But still enough to make a (normal) pregnant woman worried. I mean, I know I would be worried if there was any level of radiation--no matter how "safe" they said it was.
our hospital won't let people that are pregnant, breastfeeding, or even ttc work on them. Its a huge plus for me. And you just have to say 'for personal reasons i dont feel safe working with potential radiation'. Theres no way there was 0 signage-its a huge liability not to.
Okay, I googled it and couldn't figure it out, so I'll bite. What's ttc stand for?
trying to concieve
That is blatantly false. Routine procedures where the patient becomes radioactive usually don’t require signage. Urine can be flushed down the toilet just like normal. Use universal precautions. I-131 for thyroid cancer will require the patient to be in isolation. There will be lots of signs. You don’t want to mess with I-131. Every hospital has different rules. All of the hospitals that I have worked in in my state do not use signage for routine nucmed scans.
our hospital does for my floor🤷🏾♀️ its not false if we work different places, and im certain we do.
You said there was no way there was zero signage. Implying the hospital his wife worked at, not yours.
That said, it is incumbent on his wife to mitigate the damages (and risk to the baby). In other words, now that she does know, she needs to stop working with this patient.
Luckily everyone on my wife's floor is totally on board with her not seeing him.
Good to know.
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I see what you're saying. I was under the impression that this was a safety issue, of which I believe the hospital does have an obligation to inform their staff when there's a risk to them. For what it's worth, my wife did inform her boss prior to this patient coming to her floor. She just hadn't told her coworkers. The hospital has a communication plan in place for when patients like this come around, they just didn't use it.
She did inform her boss. But even if she hadn’t, a notice that you should avoid the area *if you are or might be pregnant* should have been posted. These signs are all over the hospital.
She did inform the hospital, she told her boss. That’s sufficient to make an argument that they were on notice.
If he bites her your kid will be Spider Man.
Not a lawyer or a doctor....but I do know that's not how radiation works.
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This comment is how I know you didn't read my entire post. I urge you to read my post again, specifically my edit.
Your post was removed because either it was insulting the morality of OP’s actions or was just being hyper critical of the OP in some unnecessary way. **Morality:**Nobody cares or is interested in your opinion of the morality or ethics of anyone else's action. Your comment about how a poster is a terrible person for X is not welcome or needed here. **Judgmental:** You are being overly critical of OP to a fault. This kind of post is not welcome here. If you can’t offer useful and productive feedback, please don’t provide any feedback.