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26 | James Hubbard's My Family Doctor | The Magazine That Makes Housecalls Q housecalls Senior Pictures By hELEnE PaVLoV, M.D., F.a.C.R. My dad, who is 82, needs a CT scan. What do we need to keep in mind—or what questions do I need to ask—to make sure we're getting a good imaging provider? AnSWER Imagine taking your el- derly father for a simple X-ray. He's in a wheelchair. When you get there, there's no ramp, no rails to help him stand, no attendant to help you get him into the gown. And then he has to lie on a cold metal table for 20 minutes while getting imaged. Now imagine the opposite. How nice. Getting an MRI, CT, ultrasound, bone scan or X-ray can be uncom- fortable and frustrating for people with decreased mobility. But they can seek an imaging provider who un- derstands their special needs and can help ensure that the experience flows easily. Ideally, the department or center should be dedicated to patients with similar conditions, such as orthope- dics or oncology, so the requested ex- amination is routine and performed often. At these dedicated centers, the personnel are usually experienced in positioning patients with decreased range of motion in order to acquire the best image. Beyond that, here are some ques- tions to ask when looking for an im- aging provider for seniors. • Do the radiologists and supervis- ing physicians have subspecialized training for the requested imaging? • Are there patient liaisons who can help facilitate the process, help put on an examination gown and provide knowledgeable answers to questions or concerns? • Does the facility have footstools, handrails, grips and other devices to steady patients while standing for weight-bearing images? • Are wheelchairs available? • Is there convenient parking access and a ramp to the door? • Are higher chairs available in wait- ing areas, which are more comfort- able for patients with hip and back conditions? • Does the center have handicap-ac- cessible bathrooms and toilets with elevated seats? • Are the pictures digitally acquired? Can they send them to your refer- ring physician through an online network called a PACS system? This process eliminates the need for you to hand-carry X-rays to the doc- tor's office. If your doctor requires copies of digital images, the facility can burn them onto a CD, which is easier to transport. • If not routinely provided, ask for padding on the X-ray and CT tables. • What's the image retake rate? A fa- cility focused on specific conditions typically has fewer image retakes, which means less time in radiology and less radiation. It's generally ac- cepted that the repeat rate should be less than 5 percent. Finally, if the technologist doesn't ask, volunteer the information if your parent has had surgery or has any internal fixation devices. People with surgical screws, nails, pins or artificial joints may require special imaging protocols. Offering the information upfront may negate the need for re- peat examinations. Hopefully, these tips will make your experience as pleasant as a trip like this can be. Board-certified radiologist helene Pavlov, M.d., F.a.c.R., is radiologist-in-chief at the Hospital for Special Surgery, which focuses on orthopedics, in New York City. aging