Help assuage my health paranoia.

August 28, 2008 5:27 PM

My doctor has me coming in for a brain CT scan for, what I think, is just a digestive issue. Do I have any reason to freak out? Because I am.

For background on the problem, see this question. Blood tests and a sonogram negate any possibility of gall bladder issues, but we haven't gotten any allergy (gluten, sucrose, fructose, etc.) tests yet. After the doctor asked me if I got headaches, I said yes, I do, usually alongside the nausea. But these are not migraines or even bad headaches, usually... they are minuscule tension-y headaches that usually don't even require Advil. I rarely get headaches anyway, but these have never been a point of concern for me.

Anyway, I mentioned that and he wanted me to get a CT, just to make sure it isn't a brain tumor. (Which, he said, was "very very very unlikely" but he wanted to check.) While I'm more than glad to get the CT to assuage any current and future fears, UHHH -- should I be concerned? Ever since I scheduled the appointment I've been worrying. Brain tumors are very rare, right? And tiny headaches and nausea don't usually indicate a tumor, right? This is a one-in-a-million chance, right?

Basically, if you could help assuage my fear that would be super, because I kind of feel like this has suddenly been thrown on me and I hadn't even thought about it before and I don't know if I should really even worry. And googling sure as hell doesn't help.

posted by elisabethjw to health & fitness (10 comments total)

Long ago I worked at a support service for people with brain tumors and their families. There is a smidgen of a chance that a tumor is responsible for your symptoms. Your doctor is being thorough, which is a pleasant exception to the norm.

Best wishes and luck in identifying the culprit. I know it's impossible, but try not to be afraid of hypotheticals.
posted by foxy_hedgehog at 5:32 PM on August 28, 2008

The radiation from current CT-scan use may cause as many as 1 in 50 future cases of cancer.

Not to scare, just making sure you're aware of the risks, as I've found many doctors do not mention that CT scans are rather high-radiation.
posted by trevyn at 5:36 PM on August 28, 2008

Well, I spent a week freaking out about my smidgen-of-a-chance-it's-a-brain-tumor MRI, and that's a week of my life I will never get back, even though it was not, in fact, a brain tumor. I think that they have to rule out the worst possible case scenario, in part so they don't get sued in the one in a million chance that it is a brain tumor, but I don't think they usually say the reassuring things unless they mean it. If your doctor thinks you really might have a brain tumor, you will know it, because your doctor will not tell you not to worry about it.

Do not google. Do not. Trust me. Block google from your computer for the next week if you have to. It will freak you out in the 99.999% likelihood that you do not have a brain tumor, and it's not going to help you in any way in the highly unlikely event that you do. Just say no to google.

For what it's worth, I have headaches and nausea and I don't have a brain tumor. I think that headaches and nausea are a whole lot more common than brain tumors are!
posted by craichead at 6:02 PM on August 28, 2008

This EXACT thing happened to my cousin...same symptoms, same story...she even had a CTscan (which showed nothing) and she was eventually diagnosed with 'migraine of the gut' (it may have a more technical name but that's how she described it). She never had awful headaches, either but instead it was centered in her gastro. She now treats her condition using a combination of migraine medications and is doing wonderfully. Let me add that she suffered for a couple of years until a doctor finally put the pieces together. Good luck!
posted by KTrujillo at 6:02 PM on August 28, 2008

thanks so much, KTrujillo--luckily I have less than 24 hours before the CT (I'm headed back to college soon so everything's been sped up). Some theorizing in the "make myself feel better camp" I've been doing, that anyone can feel free to correct: my symptoms have been ongoing for about 3/4 month, but have definitely not become worse in those months. Actually, it's gotten slightly better. In the case of a brain tumor (or most of them, of course, but particularly the severe ones), I wouldn't be feeling better on my own...would I? It would be getting progressively worse?
posted by elisabethjw at 6:13 PM on August 28, 2008

most of the "here, try cutting this out of your diet" kind of changes take a while. doing a CT scan is fast. since you're going away soon, i can see wanting to do the quick differentiating tests first.

while hoofbeats generally mean horses rather than zebras, it makes much more sense to do a quick test to make sure it's not a brain problem and then get down to the longer term possible tests for adjusting diet and checking allergies and such.

to quote the governor of the great state of california, "IT'S NAD A TUMAH"
posted by rmd1023 at 6:57 PM on August 28, 2008

Hoofbeats generally mean horses, but brain tumors can press on parts of the brain which control your digestive system and things which, if awry, would cause nausea, such as your auditory system and visual system. It is entirely possible your problems are caused by a brain tumor. Seldom the case, but a brain tumor is possible.

I'm a neuroscience student, not a physician, so PLEASE get an answer from your physician.
posted by kldickson at 5:36 AM on August 29, 2008

In my very limited experience, a CT scan is routine in cases of headaches where the cause is not immediately obvious. (IANAD). I had headeaches for years, which the doctor said basically ruled out the possibility of it being a tumour, but they did a CT scan just to be absolutely sure. Also, the scan gives them a chance to see how your sinuses and the rest are formed, (again, IANAD, I may be wrong) which can also provide clues to headaches in some cases.

Don't worry at all. Headaches are hardly ever tumours, but a scan is the only way for them to be absolutely certain (rather than waiting until people collapse or something), so that's what they do. (Just like how most women don't get cervical cancer, but a Pap smear is a relatively non-invasive way to check for signs, so it's done across the board. Just to be rule it out.)
The worst part will be that it's kind of boring. You'll be just fine, I'm sure :-)
posted by different at 8:15 AM on August 29, 2008

trevyn: "Not to scare, just making sure you're aware of the risks..."

Then why not also cite the same source used for that quote in the wikipedia article, which states that the Estimated Lifetime Attributable Risk of Death From Cancer (in percent) as a result of a head CT scan is 0.01% or less for someone age 20 and up?

There's also: "...it has been estimated that about 0.4% of all cancers in the United States may be attributable to the radiation from CT studies.2,34 By adjusting this estimate for current CT use (Figure 2), this estimate might now be in the range of 1.5 to 2.0%."

Look, every medical procedure has risks. Medications have risk of allergic reaction or side effects. Surgeries have risks of infection or complications. Exercising regularly carries risk of injury, and not exercising has risks too.

Having this CT scan carries a risk of causing cancer, but not having the CT carries a risk of a brain tumor becoming too large to easily remove before it's discovered.

That said, the real thing to take away from this discussion is to talk to, and ask questions of, your doctor. Why does he want a CT scan? Are there other options (such as MRI or other tests) available? If the chance of a brain tumor is so insignificant, why does he think it's worth the (small) risk of a CT?
posted by CrayDrygu at 5:32 PM on August 29, 2008

Is the scan equipment in your doctor's office? I'm not saying this is what your doctor is up to, but advising unnecessary tests is one way for him/her to justify expensive equipment that makes the practice "state-of-the-art" so that it draws more patients and the rent gets paid. Or, sending you to an outside facility that is within a healthcare consortium your doctor belongs to is their "recommended" procedure (or treatment pipeline, more likely), even if it's not really warranted. It's another reason healthcare costs are spiraling out of control. I'm sure the scan is well-intentioned, but we all need to be asking questions about diagnoses, treatment and alternatives to expensive testing in order to keep docs and insurance companies honest. Ask questions! And good luck.
posted by thinkpiece at 3:06 PM on August 30, 2008