Radiology Information :

Ontario Ministry of Health :

www.health.gov.on.ca

Breast Cancer facts and Figures :

www.cancer.org/Research/CancerFactsFigures/BreastCancerFactsFigures/breast-cancer-facts-and-figures-2011-2012

Nearest hospital :

www.trilliumhealthpartners.org

Nearest hospital :

www.trilliumhealthpartners.org

Nearest Pharmacy :

1) ARE WE ON SCHEDULE ?

In 90% of cases, taking in to account registration time of 10-15 mins, cases are done within 5-15 mins of appointment time. If we encounter complex, difficult or poorly prepared patients, your appointment could be delayed 15-45 minutes. Please accept our apologies for such situations beyond our control .

You can also help to minimize delays as follows: Be on time for your appointment with fully completed Requesition and Health card. Follow preparation instructions as explained on the back of the requesition. In difficult or complex cases, inform us when booking and bring help if needed. Ensure that you mention ALL exams marked for you on the requesition to be booked. If you have any questions, ask a technologist .

2) PREGNANT OR MAY BE (X-ray):

Please inform technologist  BEFORE X-RAY.

3) EXAM DIFFICULTY, CO-OPERATION & CONSENT:

We encourage patients to understand their examination. Please ask us if you are not sure. When you present for your examination, your consent is implied . Some exams may involve difficulties and discomfort due to precise positioning requirements. To minimize discomfort/pain, please inform us of specific limitations /contra-indications and how we can help.

4) PREPARATION FOR SOME EXAMS (back of requisition):

You can avoid frustration, delays  or even rebooking by checking and following the preparations correctly.

5) RADIOLOGY REPORTS / EXAMINATION RESULTS :

For timely report dispatch, ensure that we have the correct information of your doctor including fax number (some signatures are not always clear). Reports go direct to your doctor, usually with in 2-5 business days. Some cases may take longer if they need to be compared with previous exams, or if a more sub-specialized radiologist has to read them. If your Doctor has not received the report within this time frame, please call us to resend the report.
Your doctor's analysis depends on results of ALL your tests (not just one test). We will try to expedite the results when possible for urgent cases. Please do not ask the technologist for results as they are not qualified to provide this. 
If concerned with a persistent condition, please discuss with your doctor. It may be a good idea to follow up with the doctor's office within 1-2 weeks of your test (depending on their policy).

6) NEED PICTURES FOR THE SPECIALIST:

To comply with privacy act , we require proof that the borrower is the patient or acting on behalf of a patient before releasing any records (Please bring health card).

We are now digital. All current images are now stored digitally. These can be copied to a CD for another specialist, but allow approximately 15 mins (we copy this only when you are here). To borrow mammograms over 12 months old, please give us 2-3 days notice to get from storage. The CD can be viewed on most modern computers with certain system requirements. Should your specialist not be able to view the CD , then we can print these to a laser film for a fee. The advantage with the CD is that it is easier to carry and you can keep it for future reference. Note: If you have follow-up exams or additional work up in another institution, (e.g Trillium Health Centre) and they request your previous from us for comparison or additional work up, we will provide these (unless you tell us otherwise) as a convenience and medical responsibility .

7) SOME ONE WENT AHEAD OF YOU AND WHY:

We do General X-Ray, Gastrics (UGI & Barium Enema), Ultrasound, Mammograms, Bone Density- all in different rooms by different staff. Some pre-booked cases have priority for that room. Occasionally we may choose to do a faster simple case ahead to give extra time to you .

8) RESTRICTIONS , LIMITATIONS ,WEIGHT LIMITS:

Only exams licenced for this facility (by Ministry of Health) and prescribed by authorized physicians can be done here. Weight limits may apply for some (not all) exams. If you are over 300 lbs, please tell us . Note: About 90% of all gastric x-ray tables are rated for 300 lbs or less.

9) OUR EQUIPMENT, STANDARDS, RADIATION SAFETY:

This facility's equipment undergoes the required testing and preventative maintenance, according to HARP ACT; inspected periodically by X-Ray Inspection Service of Ministry of Health; assessed periodically by College of Physicians and Surgeons .

10) HARD X-RAY TABLES – Why ?

• For Strength, easy cleaning, and for use in flat / upright positions.
• To easily slide the patient for the exact positioning required.
• To Protect and maintain the associated electronics.

If you have a specific condition that would be difficult with the hard table, please check with us.

11) SOME ULTRASOUND INFORMATION:

According to present knowledge, there is no harm with medically necessary ultrasound exams administered by qualified people.

Accompanying the patient to the room when an ultrasound is done , is up to the discretion of the technologist doing the exam. Most sonographers need high level of concentration with out any distraction to do a better study. Thus they prefer to call in any accompanying person towards the end of the exam, if requested and if appropriate (for eg: in pregnancy cases).

There may be some sensitive situations, where persons other than patient may not be allowed – Please don't be offended in such case. Your doctor can explain the reasons in such cases on a doctor to patient level. Please don't ask the technologist for results- they are restricted by their licence conditions.

Please follow the instructions very carefully on the back of the requisition. If your exam require drinking of water, it is very important to follow that faithfully. Some times the indicated preparation may need to be modified on some patients. Poor preparation may result in poor exam, and/or prolonged waiting time or rebooking for you. It also causes workflow disruption.

The ultrasound gel is messy & cold but harmless and washes easily. You may wipe it off with the gown you are wearing or paper towel. Warming the gel encourages bacteria growth and also dilutes it making less optimal for ultrasound wave penetration.

In case of incomplete preparation or lateness (at times, it may not even be your fault), the tech (where possible & depending on workload) may offer the favor of accommodating you. In this case, please note, that it will be as time allows. If this causes inconvenience/ frustration to you, we will be happy to rebook you.

12) BONE DENSITY ( OSTEOPOROSIS TESTING):

Why?. 1 in 4 women will experience a serious fracture after age 50 (Mayo Clinic Data). For men, risk is about 1/3 of women until age 65 and is equal to women after age 65. Bone Density test results are labeled as Normal, Osteopenia (low bone mass), or Osteoporosis.

Is there TREATMENT for OSTEOPOROSIS & HOW THEY WORK? YES. Check with your Doctor as to what is best for you. Some drugs work to minimise bone loss and some work to build bones.

Tell me about the machine here: "G.E Prodigy Advance" in here is one of the best and the most comprehensive Bone density machine in Mississauga with the following features:

• Dual Site (Lumbar Spine and Hip)- most commonly done.
• Forearm Bone density- in case of unreliable or unattainable results for Spine and/or Hip BMD.
• Total Body Bone density-in case of unreliable or unattainable Spine and/or Hip BMD results.
• VFA- Vertebral Fracture Assessment.

13) MAMMOGRAM OR BREAST ULTRASOUND:

This is a C.A.R accredited mammography centre and OBSP mammography screening centre.

Our new Philips Digital Mammophy unit has some Exceptional Advantages:

• It is a Microdose system - uses about half the radiation compared to most other units.
• It has much better detail compared to most other units.
• It is a digital unit which helps to minimize recalls.
• It has been hailed as a more comfortable unit for patients due it's curved positioning surface.

Initial mammograms are called screening tests. In about 10% of cases after these tests, the radiologist may recommend for additional views/tests. Do not be alarmed by this and do not draw any conclusions from this. It is intended to see a specific area, to a better advantage.

14) WHAT ARE SOME OF THE BENEFITS PROVIDED BY CLINICS LIKE THIS:

• Faster and more Efficient services with saving of tax dollars
• Takes away some pressure from busy hospitals, and help them fund more important and complex areas which are better served in the hospitals.
• Most clinics provide a better personal attention, a stable experienced staff pool, and a wider latitude in convenience .

15) SOME QUESTIONS ABOUT DIAGNOSTIC IMAGING :

• How does the Technologist find the correct part for imaging?
• What are some of the difficulties encountered with some cases ?
• What are some of the options/ additional imagings available?

Most inside organs are related to certain outside landmarks. It could be a prominent bone area or certain dimples in the skin. Similar to a surgeon, we use these landmarks by sight or touch to find the correct organ or area of interest inside the body.

The body has a number of organs superimposed and crowded in a small packet. To isolate the organs and show these to a better advantage we use a number of technics which include :

Different levels of breathing technics, side ways rotations, using an upward or downward angle, elevation or changed posturing of certain body areas, different strength of the x-ray or ultrasound beams etc. Some times, in spite of these technics, it may be hard to get the images of certain organs to the best visualization in some people due to their body habitus, considerable gas or stool in the bowels , anatomical variants, change of organs due to certain pathology, and patient's inability to provide the degree of co-operation required (due to age, mobility issues , difficulty in following instructions). In such situations, some of the options that can be additional or complimentary are: x-ray, ultrasound, CT scan , MRI, Nuclear scan.

16) GENERAL SAFETY: It is everybody's business.

Safety must be in everyone's mind and every one's responsibility. You are in unfamiliar area.

• Always watch for objects overhead /surroundings in an exam room.
• Do not wrap hands around the x-ray table edge - avoid getting fingers pinched.
• Ensure hands/ hair don't get caught with in moving parts.
• Do not sit up on table or get down from table unless you are given the O.K for that. It may take up to 10 minutes to check your exam after they are done.
• Chairs in an x-ray room are on rollers – be careful when sitting.
• Tell us if you feel dizzy on getting down from table, or need help in getting down/ up.

17) COMPLIMENTS , COMPLAINTS , CONCERNS AND FEEDBACKS:

Please discuss with the staff first and also speak to supervisor. To help us better our service, please give us specific & complete information in writing, and give it to receptionist or mail or fax to manager. Please be aware: unexpected issues, common health care policies, limited health care funding, lateness or poor preparations by patients, differences in staff personalities, emergencies etc may reflect on the services. We try to provide a good service, but imperfections of the human race makes it hard to meet unreasonable expectations.

18) OTHER INFORMATION:

a) We aim to be in the best 20% of all radiology facilities on the following:

• waiting time for appointments
• quality of imaging
• low radiation to our patients.
• waiting time for exams
• better equipment
• well qualified staff
• report turn around time
• special requests dealing

b) Some situations that we may be unable to help are:

• By law, the technologists are not allowed to give results to the patient.
• Accompanying patient to examination room is discretionary depending on the circumstance.
• When patients form an opinion of results based on facial expression of staff or questions raised.

c)Please be prepared to give additional clinical information to the technologist if requested.

This will help in a better exam over all. Some doctors may not always mark down the complete clinical history on the requisition.

1. Considerations of radiation protection in medical x-rays:

1) X-rays when used correctly, is one of the best and safest tools of diagnosis in modern medicine. If used incorrectly or carelessly, it does carry certain risks. Two philosophies behind the medical use of x-rays are :

• ALARA PRINCIPLE means , use x-rays, AS LOW AS REASONABLY ACHIEVABLE
  (considering social and economic factors and quality of diagnosis)
• BENEFIT VERSUS RISK. Consider if the net benefit of having an x-ray outweighs the risk of not having it and thus the potential for health betterment or health impairment.

BEIR (Biological Effects of Ionising Radiation) COMMITTEE REPORT states "Public must be protected from radiation, but not to the extent that the degree of protection provided, results in the substitution of a worse hazard for radiation avoided" . In the case of medical radiological procedures, the physician's opinion may be the dominant factor in the patient's decision involving acceptable radiation risks.

2. Comparison of risk estimates between medical x-rays & other life styles or activities (for one in a million risk ) * :

The information below was gathered from various sources and is not authoritative or advisory. They are given here as a general guide/examples only.

Risk of a significant damage from Medical x-ray * :                      One in a Million.
Background Radiation per year (natural) for each person :             3.0 mSv.
Estimated Medical X-ray Radiation per capita in Canada:               0.6 mSv.

*All these are estimated risks and is given in a book- Radiation Risks in Medical Imaging, by Joseph P. Whalen M.D, F.F.R; R.C.S. and Stephen Balter Ph.D (1985) . Some of these data may have changed since publication.

3. Is there a limit on medically necessary x-rays:

Because x-rays are to be taken only when medically necessary, considering benefit versus risk, there are no set limits, not even for staff.