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Chapter 1: What are the origins of X-rays and how were they discovered?
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Chapter 2: How do X-rays work and what is their role in medical imaging?
He's a survivor. Yeah, his career's just fine.
So x-rays is what we're talking about, right? Yep, that was the lightest part of this podcast. I like this one. This one, it's one of those things where if you can just hang on by your fingernails, it can click and then you lose it again. But that means that it could click again later on. That's what I like about it. Good.
I'll leave that to you. I got lots of other stuff about it that I totally understand.
Good, good. So have you ever broken anything and needed an x-ray or something? Or has it all just been dental stuff?
You know what, dude? Never broken a bone. Knock wood. You better knock on wood. Yeah. I mean, I've had, my injuries were always stitches. I was always getting busted open. Oh, yeah? Rocks and sprinklers, and I was always getting cut. Yeah. And sewed back up, but I never broke a bone.
That's great. Yeah. You should probably knock on wood one more time just to be safe. Yeah. So, yeah, all of my x-rays, too, have been just going to the dentist or whatever. You never had a bone broken?
No.
I don't want to say because I don't even know if knocking on wood will do it. On laminate Ikea wood? That would just be so horribly interesting if both of us broke a bone after this.
Yeah, and we're at the age where you should break bones when you're a kid, where you're like, eh, whatever, I get a cast. At this age, it's a drag.
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Chapter 3: What are the differences between X-rays and other forms of radiation?
No. He was just like, I'll just call him X-rays as a placeholder.
And he didn't patent anything. He never made money off of it.
And his wife had hand cancer as a result.
Really? No. Oh, I was laughing, but... No, she didn't. That would be very sad.
It was just a joke. You can proceed with the laughter.
Plus, I've never heard of hand cancer.
It's got to be out there.
And then a couple years later, they were already using it in the Balkan War. It was the first time it was really put to practical use.
The first Balkan War?
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Chapter 4: How do X-rays interact with different types of tissues in the body?
Yeah.
But if it's a little more, this is what doesn't make sense to me, it doesn't kick the electron up and then the photon carries on in a diminished energetic state. It just doesn't do anything. It doesn't interact with that. It has to be exact. Say like the energy differential between orbits is eight. Yeah.
So a photon has to have an energy of eight or else it's not going to do anything with that atom.
That's right. Okay. Yeah. And so, depending on the, well, let's say you have a radio wave. They don't have very much energy, so they can't move electrons between these orbitals. They just pass through things. X-rays are super powerful. There's lots of energy, so they can pass through things, which is key if you want to check out your bones from outside of your body.
It is, and we're gonna explain exactly how right after this.
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Chapter 5: What are the potential risks associated with X-ray exposure?
That's right. Right? So all you're seeing is the result of x-rays that made it through the tissue, were absorbed by the bone, so those don't make it to the plate. The ones that make it to the plate cause the chemical reaction that gives you your negative, your x-ray. And it's pretty simple, really, if you think about it, at least in principle.
It's also extraordinarily difficult to conceive of, but if you understand the principle behind it, it makes utter and complete sense.
Yeah, and it's a pretty focused shot that they're using there. It's not like they don't fill the entire room with x-rays. They've got a thick lead shield around the whole device, and it contains everything. It's got a little small window that's just going to let that narrow beam pass through a series of filters and basically hit you wherever they want to hit you.
Yeah, and the reason that they use lead is because lead is an extremely dense element, yes, right? Sure. Oh, God, I hope so. With a very high atomic number, which means it can absorb tons of energy, right?
Yeah, that's why you're gonna wear a lead apron. If you're getting your skull done, you're probably gonna wear an apron on your chest, let's say.
Sure. So this lead is being bombarded with X-ray photons and electrons, and it's just taking it. It's fine. And it's not able to pass through because it doesn't have high enough energy. But yes, when they put that little window in the x-ray generating machine, it passes right through there in a concentrated beam. And Chuck, let's talk about the machine, right?
So, and this is basically what we use as x-ray machines is essentially what Rootgen made, was experimenting with when he accidentally discovered them. Because if you look for x-rays, they propagate naturally. But I think like 20% of the x-rays on Earth come from humans. Yeah, like we generate a lot of x-rays. They don't come, like you don't find them normally on Earth.
They're coming from outer space to us. Hence x-ray astronomy. But the ones here on Earth that are generated on Earth, it's not like rocks put out x-rays or something like that. We do. We humans do. Humans in lead aprons put out x-rays. And they use this machine like Röntgen made.
Yeah, what you have in the machine, you have an electrode pair, a cathode and an anode, and that's inside a good old-fashioned glass vacuum tube, which it's amazing how vacuum tubes are still the best way to do many of these things.
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Chapter 6: How do modern X-ray machines generate images?
When it takes that hard left, it emits the photon, like you said.
That's right. And like I said earlier, there's a camera on the other side of the patient, and it's going to record that pattern of light when it passes through the body. And it's not so different from a regular camera. And in the end, you're just going to get a picture, like I said, a negative image.
Yeah, and if you hook it up with a computer that allows you to take x-rays basically in slices, you can come up with computerized tomography.
Yeah, aka CT. Right. A CT scan.
Exactly. If you get a breast exam, you're using a type of x-ray called mammography. Yep. And then there's a fluoroscopy, which the man in the extraordinarily dry presentation from Siemens said was basically like moving picture video. It's like a movie. Exactly. And then he showed us what a movie is with a flip book, right? That old flip book trick. And if you listen to this podcast, I'm sorry.
I just want to apologize for both of us, Siemens guy. Oh, yeah. Hats off to you for doing that at all. Yeah. Because he's probably saying, well, at least I was correct in everything I said. Exactly. That's a good point, sir. But with fluoroscopy, it's basically like a movie, an x-ray movie. And you would do this to make sure a heart is beating correctly because you wanted to see it.
But you have to have an additional instrument because, as we've said, x-rays will pass through tissue like heart tissue and muscle tissue and blood vessels and all the stuff you want to get pictures of using an x-ray. So you have to use something called a contrast media for it.
Yeah, a contrast agent is basically more dense than the soft tissue. So if you want to, let's say, swallow, it's usually like a barium compound.
If you want to examine like your blood vessels or your circulatory system, sometimes they can inject that or you might drink it to see if you're doing like a gastrointestinal, like a GI tract, you're going to swallow that stuff, which I've never had to do. I think my dad had to do that. I don't think it's super pleasant.
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Chapter 7: What are the various applications of X-rays beyond medicine?
It's a form of ionization or ionizing radiation. Right. So what can happen, like if just normal light hits an atom, it's no big deal. But when an X-ray hits an atom, it knocks electrons off of it, creates an ion, which is an electrically charged atom. And basically anything from cellular death to mutation can happen at that point. Yeah. And mutation can spread and it can cause cancer. Yeah.
Right, because stable atoms are neutral, right? Because they have an equal number of protons and electrons. You lose an electron, all of a sudden you have a positively charged ion and that negatively charged electron running around and it just causes trouble.
And you said light, visible light, can be absorbed and it's no big deal because visible light exists on a wavelength that's about in tune with the soft tissues of our body, right? So we know how to absorb it and it makes us tan and that's cool, right? Yeah.
But with these ionized atoms, these positively charged atoms going around in your body, it can cause a lot of problems, like mutations, like cancer, right?
Yeah, I mean, if you break that DNA chain, that's not good for your cells.
No, it isn't. And one of the results is the DNA can basically lose its ability to regulate itself, and the cell replicates more frequently than it should, and all of a sudden you have a tumor on your hands, and that can spread. It can also be a problem if that DNA break occurs in utero, because then that can lead to birth defects, which is why pregnant women shouldn't get x-rays.
And it can also just lead to plain old cellular death. If you have cellular death, then the tissues that are made up by those cells break down, and you have a problem on your hands with that as well.
So here's the deal. We get exposed to radiation every day just walking around on the planet. Yeah. It depends on where you live, but every year the average person is going to be exposed to anywhere from one to four. It's measured in millisieverts per year. Like I said, depending on where you are. I think in higher elevations it's less than at sea level.
So if you live in Denver, Colorado, you're going to be exposed to less.
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Chapter 8: How can patients minimize risks when undergoing X-ray procedures?
But then the article makes the point, like, it's still safer than the ultimate alternative, the thing that x-rays replaced, which was exploratory surgery.
Yeah, back in the day, if they thought you had cancer, they would cut you open and see. And this is definitely better than that.
Yeah, or a broken bone. Imagine getting that arm cut open just to see how it's doing. They're like, Nope, it's not broken. Right. And we haven't invented anesthetic yet, so jokes on you.
Good luck with your dentist, by the way, because I always get the feeling that the dentists are like, no, your insurance allows us to bill for so many per year, so that's how many you're going to get.
These x-rays are putting my kid through college. Yeah. You got anything else on x-rays? No. That was a fine amount of stuff. I'm feeling good about it. You feel good about this one? Sure. I do too. Yeah. If you want to know more about x-rays, you can check out this really informative article on HowStuffWorks.com.
It's got some great diagrams that explain a lot of the stuff we were saying visually. And you can type x-ray into the search bar at HowStuffWorks and it'll bring that up. Since I said search bar, it's time for listener mail.
This is from my buddy Poppy in Vancouver. Stuff you should know, listener, that I met while I was there. And Poppy, as this is to say, he's got a pretty cool job. He listened to the PTSD show and wanted to write in about another option that he works with. He's a registered acupuncturist in Vancouver with special training in trauma and addictions.
He has a program called Neurotrophic Stimulation Therapy, NTSD, and a large part of the program uses ear acupuncture and electroacupuncture to promote neuroplasticity in the brain. He says you can't necessarily directly fix the brain, but you can stimulate the ear nerves and will help the brain re-regulate certain functionality so it can heal itself.
He's been treating trauma and PTSD patients for several years, and the evidence for his efficacy is high. It can be done with acupuncture needles alone or in combination with a mild electrical stimulation. Remember we talked about...
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