Tuesday, 15 July 2014

claim the side effects of thyroid medication

Thyroid Replacement Hormones


What are thyroid replacement hormones and how do they work?

Thyroid replacement hormones are medications used to treathypothyroidism, a condition in which the 
production
 of thyroid hormone in the body is abnormally low. Thyroid hormones increase cellular metabolism (activity of cells) that is responsible for growth, development of tissues, maintenance of brain function, body temperature regulation and several other cellular processes. Low levels of thyroid hormones in the body can result in many problems given the numerous activities that they mediate. The thyroid gland, a gland found in the lower neck is responsible for the production of thyroid hormones. It produces two main hormones, thyroxine (T4) and triiodothyronine (T3). The hormone responsible for most of the biological effects in the body is T3. When T4 is released into the blood by the thyroid gland, most of it is converted to T3 which is responsible for the cellular metabolic processes. Commercially available thyroid hormones are either natural or synthetic (man-made). Desiccated thyroid or thyroid extract (Armor Thyroid, Nature-Throid), a natural thyroid hormone is derived from beef or pork. Levothyroxine sodium (for example, Synthroid, Levoxyl and Levothroid), is the synthetic version of thyroxine (T4), liothyronine sodium(Cytomel, Triostat), is the synthetic version of tT3 and liotrix (Thyrolar) is a synthetic thyroid hormone containing a mixture of T4and T3.

What are some examples of thyroid replacement hormones?

The following is a list of the thyroid replacement hormones that are available in the United States:
  • thyroid extract (Armour Thyroid, Nature-Throid, NP Thyroid, Westhroid,
  • Westhroid-P [DSC], WP Thyroid)
  • levothyroxine sodium (Levothroid [DSC], Levoxyl, Synthroid, Tirosint, Unithroid, Unithroid Direct)
  • liothyronine sodium (Cytomel, Triostat)
  • liotrix (Thyrolar)

For what conditions are thyroid replacement hormones used?


Thyroid replacement hormones are used to treat hypothyroidism (low production of thyroid hormone) and myxedema, a condition that is caused by prolonged hypothyroidism. Thyroid replacement hormones prevent thyroid hormone release from cancerous thyroid nodules and are used therefore to treat thyroid cancers. They also are used to manage thyrotoxicosis, a condition in which there are high levels of thyroid hormones resulting from over-active thyroid glands and too much thyroid hormone. Thyrotoxicosis may progress to hypothyroidism or cause the growth of goiters necessitating the use of thyroid replacement hormones.

Are there any differences among the different types of thyroid replacement hormones?


There is conflicting evidence regarding which hormone replacement therapyshould be preferred. The American Association of Clinical Endocrinologists recommends that clinical hypothyroidism is best treated with synthetic T4 levothyroxine (for example levothyroxine and sodium [Synthroid, Levoxyl and Levothroid]). There is variability between the absorption and distribution of generic T4 compared to brand name preparations. Hence it is recommended that patients remain with specific brand names during treatment. There is also variability between generic formulations and brand names of pure T3 (liothyronine [Cytomel, Triostat]), combined T4/T3 formulations (liotrix [Thyrolar]) and thyroid extracts from animal sources (Armour Thyroid, Nature-Throid etc.). Emerging information shows that combination of T4/T3 therapy may have some advantages over T4 in cognitive performance and mood but studies are not conclusive.

Claim the Side Effects Of Ultrasound Therapy

Various Types of Ultrasound Therapy

Ultrasound therapy is used for treating many conditions such as cancers, tumors, dental conditions, and many others. In most of these, ultrasound is used physically, to establish diagnosis or to provide an image of certain internal organs or parts of our body, making it easy to track down any problems or possible illnesses. However, it can also be used when fighting tumors or relaxing one’s body, though these cases are far less frequent.
The Good Side
The ultrasound has two good sides. Firstly, it is an excellent tool for fighting cancerous cells, cysts, tumors, bacteria and numerous others. Secondly, it is known to speed up the healing process of our organism significantly, some claiming that in certain situations it provides even a 30% faster healing process.
The Bad Side
Unfortunately, there are those as well. One of them is the so called “cavitation”. This mainly manifests through pain and burning sensation the patient feels during exposure. Namely, the gas in the nuclei of our tissue cells gets heated, thus causing this pain and discomfort or even nausea, breathing problems and disorientation.
We see that even though most doctors claim this therapy to be completely safe and recommended, there may be certain problems caused by it. Regardless, any overexposure to these sound frequencies may be dangerous. That being said, if pain and or kind of discomfort are felt during the ultrasound treatment, one should complain immediately and stop the treatment since the frequencies, if wrong, may cause permanent tissue damage and may even harm one’s nervous system.
Furthermore, this therapy should not be applied over certain body parts or under some specific conditions. Pregnant women or women having their periods should not have their pelvic regions, their lower abdomen or back exposed to ultrasound treatment. Also, our eyes, sex organs or female breasts are not suitable for this treatment. Ultrasound frequencies should not be applied over certain bone fracture, skin wounds or malignant tumors of any sorts. Additionally, people with pacemakers or breast implants should avoid ultrasound as well.
Finally, even though the ultrasound treatment has proven to be quite effective, some still doubt it’s worthiness claiming that it does nothing that other similar treatments involving heat or stretching could not do. There have also been cases of diverse efficiency, where the therapy worked on some people, while on others it did not.
The most important thing is that it can and is beneficial and life-saving in some cases. Nevertheless, one should bear in mind all the negative sides of it and be careful, using only the best the ultrasound treatment has to offer.

Natural childbirth IIa: is ultrasound necessary & effective in pregnancy?



In the first article in this series on natural childbirth, I presented evidence that – contrary to popular belief – hospital birth is no safer than home birth.
I’d like to begin this next article by telling you what it is not. It is not a blanket condemnation of ultrasound, nor is it a judgment of women who choose routine ultrasound during their pregnancy. It is not an argument against using ultrasound to investigate suspected problems, or to detect potential abnormalities, provided the woman is adequately informed.
The purpose of this article is to clarify the issues surrounding ultrasound’s use in clinical practice, to critically examine the clinical benefit of routine prenatal ultrasound, and to raise awareness of the potential risks associated with repeated ultrasound scans.
This was going to be a very long article, so I decided to split it into two parts. In part A I will discuss the use of ultrasound in clinical practice and examine whether it improves birth outcomes. In part B, I will review studies on the safety of ultrasound as it is used today, and make recommendations for expecting mothers.

History of ultrasound and use in clinical practice


Ultrasound was originally developed in WWII to detect enemy submarines. After the war in 1955, a surgeon in Glasgow named Ian Donald began to experiment with it for medical uses. Using beefsteaks as “control” subjects, he scanned the abdominal tumors he had removed from his patients and found that different tissues gave different patterns of sound wave echo. He quickly realized the potential of ultrasound for examining a growing baby in utero.
Initially, ultrasound was used only to investigate possible problems. For example, if there was bleeding in early pregnancy, it would be used to determine whether miscarriage was inevitable. Later in pregnancy, if breech or twins were suspected, ultrasound would be used to confirm that suspicion. In these cases, ultrasound can be very useful for a woman and her caregivers.
However, over the years ultrasound has come to be used as routine scan at 18-20 weeks for all women. This is referred to as “routine prenatal ultrasound”, or RPU for short. It involves scanning all pregnant women – whether a problem is suspected or not – in the hope of improving birth outcomes.
As often happens in medicine, techniques which may be of value to a small percentage of people slowly become adopted for routine use without prior study of benefits. A perfect example of this is the alarmingly common prescription of statin drugs for women, children and men without pre-existing heart disease, in spite of the fact that they’ve only been shown to be effective for a small segment of the population: middle-aged men with pre-existing heart disease.

The problem with this approach, of course, is that when we perform a procedure or administer a treatment to a segment of the population without properly testing it beforehand, we are essentially conducting an uncontrolled scientific experiment on that population – often without their understanding and consent. And in this case, we are performing that uncontrolled experiment on two of the most vulnerable populations: pregnant women and babies in the womb.

Ultrasound scans


For many women, ultrasound scans are the highlight of pregnancy. It's very exciting and moving to 'see' your baby in the womb, often moving his or her hands and legs.
Hospitals routinely offer women at least two ultrasound scans during their pregnancy. The first is usually when you're around 12 weeks pregnant and is sometimes called the dating scan, because it estimates when your baby is due (the estimated date of delivery, or EDD).
The second scan usually takes place between 18 weeks and 21 weeks. It's called the anomaly scan because it checks for structural abnormalities (anomalies) in the baby.
Ultrasound scans use sound waves to build a picture of the baby in the womb. The scans are completely painless, have no known side effects on mothers or babies and can be carried out at any stage of pregnancy. Talk to your midwife, GP or obstetrician about any concerns you have.

Although having a scan in pregnancy is usually a happy event, be aware that ultrasound scans may occasionally detect some serious abnormalities, so you should be prepared for that information.
The dating scan and anomaly scan are offered to all women, but you don't have to accept them. Your choice will be respected if you decide not to have the scans, and you'll be given the chance to discuss it with your maternity team before making your decision.

What can an ultrasound scan be used for?

An ultrasound scan can be used in several ways:
  • To check your baby's size. At the dating scan, this gives a better idea of how many weeks pregnant you are. Your due date will be adjusted according to the ultrasound measurements.  
  • To check whether you're having more than one baby.
  • To detect most abnormalities. 
  • To show the position of your baby and the placenta. For example, when the placenta is low down in late pregnancy, a caesarean section may be advised. 
  • To check that the baby is growing normally (this is particularly important if you're carrying twins or you have had problems in this pregnancy or a previous pregnancy).

What happens during an ultrasound scan in pregnancy?

You may be asked not to go for a wee (urinate) before you have the scan. A full bladder pushes your womb up and this gives a better picture.
You then lie on your back and some lubricating gel is put on your abdomen. A small device is then passed backwards and forwards over your skin, and high-frequency sound is beamed through your abdomen into the womb. The sound is reflected back and creates a picture, which is shown on a TV screen. 
Ask for the picture to be explained to you if the image seems confusing. It should be possible for your partner to come with you and see the scan. Many couples feel that this helps to make the baby seem real for them both. You may be able to have a picture of your baby – there might be a small charge for this.

The 20 week (anomaly) scan

This is a detailed ultrasound scan, usually carried out when you are between 18 weeks and 21 weeks pregnant. The scan checks for major physical abnormalities in your baby, although it can't pick up every problem.
The anomaly scan is carried out in the same way as the dating scan, with gel on your tummy and the sonographer passing the ultrasound device backwards and forwards. Sometimes, the sonographer doing the scan will need to be quiet while they concentrate on checking your baby. However, they will be able to talk to you about the pictures once they've 
completed
 the check. Most hospitals welcome partners into the scan room. You need to check this with your hospital.

Is it a girl or boy?

If you want to find out the sex of your baby, you can usually do so during the 20 week scan.
Tell the sonographer that you'd like to know your baby's sex at the start of the scan. Be aware, though, that it's not always possible for the sonographer to be 100% certain about your baby's sex. For example, if your baby is lying in an awkward position, it may be difficult or impossible to tell whether your baby is male or female.
Some hospitals have a policy of not telling patients the sex of their baby. If your hospital does not routinely inform parents about their baby's sex, you may be able to pay privately for a scan to find out. Speak to your sonographer or midwife to find out more.

Some hospitals will sell you a copy of your scan image so you can show everyone the very first pictures of your baby.

Claim the Side Effects of Radiation Therapy

Side Effects of Radiation Therapy

Radiation therapy reduces tumors by directing streams of high-energy particles at cancer cells. As the powerful rays pass through the patient's skin, tissues and muscles before reaching their intended target, they can also damage healthy cells and cause skin changes, bladder irritation, fatigue and nausea.
Most side effects develop as tissue damage accumulates over several sessions of radiation therapy. A single cycle may last up to eight weeks, during which the patient may begin to notice side effects. As treatment progresses, side effects are often more severe.

Side Effects of Radiation to the Chest (Pleural Mesothelioma)

  • Difficulty Swallowing
  • Shortness of Breath
  • Potential Scarring of the Lungs (Fibrosis)
  • Cough
  • Breast Tenderness (In Females)

Side Effects of Radiation to the Abdomen (Peritoneal Mesothelioma)

  • Nausea/Vomiting
  • Diarrhea
  • Cough
  • Bladder Irritation
Side effects of radiation therapy are most often temporary and limited to the treatment site. However, some may also be chronic, appearing months or years after the patient has finished treatment
Advanced methods of delivering radiation therapy can help reduce the amount of surrounding tissue that is exposed to radiation, but some side effects may still occur in the area where the radiation entered the body. Side effects of radiation are typically more constrained than the side effects of chemotherapy, which can affect the entire body.

Factors that Affect a Patient's Likelihood of Developing Side Effects from Radiation Therapy

  • Patient's overall health
  • Additional treatments
  • Area of the body receiving radiation therapy
  • Daily dose of radiation administered
  • Total dose of radiation
  • Genetics

Skin Problems

Temporary skin irritation is the most common side effect of radiation therapy. Skin problems from radiation therapy closely resemble a sunburn. These complications can include rashes, redness, a tight feeling or swelling. Radiation-related irritation, known as radiodermatitis, is most common at the point where the radiation beam was focused. Pleural mesothelioma patients, for example, will notice the skin irritation in their chest area, while peritoneal mesothelioma patients will notice it in the skin on their abdomen.

Skin Symptoms

  • Darkening of the skin
  • Peeling
  • Redness, Tenderness or Irritation
To manage skin irritations from radiation therapy, adopt a skin care regimen designed to alleviate some of the pain and irritation. Keep the irritated area clean and moist. Excessive washing may lead to further dryness, so wash gently and only when necessary using lukewarm water and mild soap. Pat “ not scrub “ the area with a towel to dry it. Avoid scratching the area or 
applying
 traditional cosmetic lotions; use a mild unscented cream instead. Patients should avoid sun exposure or tanning beds during this portion of their treatment.

Quick tip! Wear loose-fitting clothing of light, breezy materials such as cotton to protect the irritated skin and reduce itching.

Bladder Irritation

When radiation is directed at the abdomen, the bladder may be affected by the powerful rays, resulting in bladder irritation. Radiation therapy may make it difficult to completely empty your bladder, urinate at normal intervals or control the flow of urine from your bladder when you cough or sneeze. It may also cause cystitis, or an inflammation in the bladder. In rare cases, urine may appear bloody or the bladder may begin to cramp or spasm. These side effects may appear within three to five weeks of treatment.
Although bladder irritation typically resolves itself within two to eight weeks of the last radiation therapy session, doctors can prescribe antibiotics to reduce infection-related issues. Patients can also take several steps to reduce the irritation as it occurs. Consuming six to eight cups of water, broth or juice per day so that urine runs clear, as well as avoiding caffeinated beverages, alcohol, tobacco and spicy foods can help alleviate bladder pain, burning and spasms.

Fatigue

Fatigue is also common during radiation therapy. It is typically most severe two to four hours after a radiation session. It may also peak between the third and fifth week of treatment as the healing process uses more and more of the patient's energy. Fatigue usually disappears several weeks after a patient completes their entire radiation therapy regimen.

Nausea and Vomiting

Nausea and vomiting are less common than other radiation therapy side effects. In a study of 22 malignant pleural mesothelioma patients who received palliative radiation therapy, only one patient experienced nausea and vomiting in the three month span after treatment. These side effects are most common in patients who receive radiation to the abdomen and sustain damage to their gastrointestinal tract, but they are also common in patients receiving othertypes of mesothelioma treatment, especially chemotherapy.
Anti-nausea medications are available for mesothelioma patients receiving radiation therapy. One of the most common anti-nausea drugs for cancer patients is ondansetron (Zofran).

Nutrition Recommendations to Manage Radiation-Induced Nausea

Patient Eating Right

Reduce Consumption

  • Large Meals
  • Fried, Greasy or Spicy Food
  • Foods with a Strong Smell

Increase Consumption

  • Small Meals and Snacks
  • Nutrient-dense Foods
  • Soft, Easily Digestible Foods such as Toast and Eggs
Radiation therapy damages cancer cells. Healthy cells in the treatment area can also be damaged, even though steps are taken to protect normal tissue as much as possible. Side effects are caused by damage to healthy cells. Different cells and tissues in the body tolerate radiation differently. The cells most affected are rapidly dividing cells, such as skin cells, cells lining the mouth and gastrointestinal (GI) tract or blood cells in the bone marrow.

Side effects can occur with any type of treatment, but not everyone has them or experiences them in the same way. General side effects of radiation therapy can occur when radiation is given to any area of the body, but will depend mainly on:
  • the specific area or organs being treated
  • the size of the area being treated
  • the type of radiation therapy
  • the amount of radiation given
  • the treatment schedule
  • a person’s overall health
  • other medicines the person is taking
    • Other medicines include:
      • prescription and over-the-counter drugs, including creams and ointments
      • vitamin or mineral supplements
      • herbal remedies and other natural health products
      • complementary and alternative therapies
    • Taking other medicines during radiation therapy may:
      • cause side effects or make the side effects of radiation therapy worse
      • affect how well radiation therapy works

Side effects can happen any time during, immediately after or a few days or weeks after radiation therapy. Most side effects generally go away within 2 months of finishing treatment. However, some side effects may continue after treatment is over because it takes time for healthy cells to recover from the effects of radiation therapy. Late side effects can occur months or years after treatment. If doses of radiation are high enough, some cells may not be able to repair themselves. As a result, some side effects may last a long time or be permanent.

It is important to report side effects to the radiation therapy team. Many side effects can be relieved by medications, a change in diet or other measures. Doctors may also grade (measure) how severe certain side effects are. Sometimes radiation treatments need to be adjusted if side effects are severe.
Fatigue is one of the most common side effects of radiation therapy. Fatigue may be caused by anemia, poor appetite or depression. It may also be related to toxic substances that are produced when cancer cells break down and die. During radiation therapy, the body uses more energy to heal itself, so fatigue will not always be relieved by rest. Making frequent, daily trips for radiation treatments can also be tiring.

Radiation therapy to any area of the body can make a person feel more tired than usual, but fatigue is more common when larger areas of the body are treated. Anemia is more likely to occur when the treatment area includes where blood cells are formed in the bone marrow, such as the pelvic bones.

Fatigue usually occurs during or after the second week of radiation therapy. Symptoms of fatigue may increase or become more severe over the course of treatment. Fatigue usually goes away gradually after treatment has ended, but some people continue to feel tired for several weeks or months after radiation therapy.

Skin reactions occur because external beam radiation travels through the skin to reach the area being targeted for treatment. The skin in the radiated area may become red, dry or itchy. It may change colour (become darker or tanned looking). Most skin reactions occur within the first 2 weeks of receiving radiation therapy. They usually go away a few weeks after treatment, but some skin changes, like skin darkening or scarring, can be permanent. Some people do not experience any skin reactions with radiation therapy.

Radiation therapy can affect a person’s appetite in a number of ways. Radiation therapy to the head and neck area can cause temporary changes in taste or smell, which can make foods seem less appetizing. Some people lose interest in food completely and don’t eat, even though they know they need to. Loss of appetite is a common problem and can lead to weight loss. Some people may gain weight from frequent snacking to control nausea during treatment.

Loss of appetite typically occurs after side effects like mouth sores, dry mouth, difficulty swallowing and nausea or vomiting develop (about 2–3 weeks into treatment). It may continue for 2–3 weeks or longer after treatment has ended. Maintaining good nutrition during and after radiation therapy is important to help a person recover from treatment.

Hair loss (alopecia) only occurs in the area being treated with radiation therapy. Thinning or loss of hair can occur in any area where radiation is directed. The extent of hair loss and regrowth varies from person to person and depends on the dose of radiation.

Hair loss can begin about 2–3 weeks after radiation therapy starts. Smaller doses of radiation usually result in temporary hair loss. Permanent hair loss is more common at higher doses. When hair regrows, usually about 3–6 months after radiation therapy is finished, the colour or texture may be different and it may grow back thinner or patchy.

Hair should not be permed, straightened, dyed or coloured during treatment. These products contain chemicals that can damage hair. It is best to wait until new hair growth becomes established and hair returns to its original state. Ask the radiation therapy team about when it is okay to use these products again.

Radiation sickness is characterized by loss of appetite, nausea and vomiting. This is a common side effect if the stomach and abdomen are in the treatment area. It can also occur as a general side effect regardless of the area being treated. Radiation sickness is due to toxic substances that are released when tumour cells break down and die. Radiation sickness usually goes away a few weeks after external beam radiation therapy is finished.

Bone marrow suppression is a condition in which one or more of the main types of blood cells are decreased.
  • A low white blood cell count (neutropenia or leukopenia) increases the risk of infection.
  • A low platelet count (thrombocytopenia) increases the risk of bruising and bleeding.
  • A low red blood cell count (anemia) causes fatigue, paleness and malaise. (Radiation therapy doesn’t usually affect red blood cells very much, except when there is bleeding and blood loss.)

Low blood cell counts occur because of radiation’s effect on blood cells made in the bone marrow. Blood cell counts are more likely to be affected if:
  • a person receives chemotherapy at the same time as radiation therapy
  • the pelvic bones (where many of an adult’s blood cells are made) are in the treatment area
  • total body irradiation (TBI) is given before a stem cell transplant

Drops in blood cell levels are rarely severe enough to cause problems. When there is a break from treatment for a few days, blood cell counts usually recover.

Reduced bone growth occurs because of radiation’s effect on the rapidly dividing immature cells of bones that lie in the treatment area. This is most noticeable in very young children because most of their bones have not matured to the point where they can withstand radiation. The child’s height or limb length can be shortened. Scoliosis (curved spine), kyphosis (hunchback) or spinal shortening can also occur. In addition, bones treated with radiation tend to break easily.

Each person reacts differently to a cancer diagnosis and will cope in different ways. Starting radiation therapy can lead to new worries and fears and may cause anxiety, sadness and depression. If you have these feelings most days, tell the healthcare team. They may prescribe medications or refer you to a professional, such as a 
social worker
 or psychologist.
Sleep problems, especially insomnia, are common during treatment. Signs of insomnia include:
  • being unable to fall asleep
  • waking up often during the night
  • waking up very early and being unable to go back to sleep
  • feeling sleepy during the daytime

Pain, anxiety, depression and some medications can affect sleep patterns. If you have problems sleeping during radiation therapy treatments, tell the healthcare team.

Some people may experience changes in their feelings about and attitudes toward sexuality as they go through radiation therapy. Some people are less interested in sex because of the physical and emotional stresses of having cancer and getting radiation therapy. Stresses may include:
  • being worried about changes in appearance
  • coping with side effects of treatment, including fatigue and hormonal changes
  • feelings of anxiety about health, family or finances

A partner’s fears and concerns may also affect the sexual relationship. Try to share feelings with each other and with the healthcare team. If talking about sex, cancer or both is difficult, a counsellor may be able to help develop a more open discussion.


Travelling to radiotherapy appointments

If you have a long way to travel each day to get to your radiotherapy appointment you may feel very tired, especially if you have side effects from the treatment. 
If you drive your own car or use public transport you can ask the radiographers to make your appointment time to suit you. They will do their best to make the appointments as convenient as possible. If you can, ask a family member or friend to drive you to the hospital, even just a couple of times a week. 
Car parking can be difficult at hospitals. You can ask the radiotherapy unit staff if they can give you a hospital parking permit or advice on discounted parking. Or they may be able to give you tips on freeplaces to park nearby.
If you need help with travelling, the radiotherapy staff can usually help to arrange transport for you. Some hospitals have their own drivers or can arrange ambulances. Some charities offer hospital transport. Look at the cancer organisations list for some names and addresses to contact.
 

Staying near the hospital

If you find it difficult to get to the hospital, you may need to stay in
  • The ward
  • A hostel ward in the hospital or nearby
  • Accommodation close to the hospital
 

Paying for travel costs

You may be able get a grant towards your travel expenses. People on low incomes can sometimes claim the costs from the Department for Work and Pensions. Look at our who can help section for advice about Government benefits. Some charities, such as Macmillan Cancer Support give travel grants. Ask the hospital social worker or one of the 
nurses
 or radiographers in the radiotherapy clinic about grants and how you can claim.
If you are taking part in a clinical trial, money may be set aside to help with your travel costs, although this is not common. You can ask the staff in the radiotherapy department about that.
 

The treatment room

Radiotherapy machines are very big and may make you feel nervous when you see them for the first time. The machine may be fixed in one position or able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers will explain what you will see and hear. 
In some departments the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.
A photo of a linear accelerator, which gives radiotherapy

Having external radiotherapy treatment

You can't feel radiotherapy when you actually have the treatment. It takes anything from 1 minute to several minutes. Because your position is so important, the radiographers may take a little while to get you ready. You can help by trying to relax as much as possible during this time.
Once you are in the right position the staff leave you alone in the room. This is so they are not exposed to the radiation. You will be alone for a few minutes or up to 15 minutes. The radiographers watch you carefully either through a window or on a closed circuit television screen. They may ask you to hold your breath or take shallow breaths during the treatment.