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I've studied the styles, approaches, and philosophies of several experts throughout my life. Here's my distilled answer of years of research. These have worked for me in helping me achieve and maintain a physique that makes me feel content, secure, and confident.Overarching Strategic ThoughtsWhat works for you will not work for everyone else. Results vary from person to person.Following fads, quick fixes, and crash diets without understanding basic nutrition, biology, physiology, and chemistry will lead to long-term failure, discouragement, and resignation. Understanding and adopting principles will ensure long term success. Tactics and tools will always change, but principles are long lasting.The goal is not to become an expert, but to know enough to self-correct.Don't get caught up with clever marketing and labels - paleo, gluten free, atkins, etc. It's all marketing. Follow principles and science, not hype and marketing. I'm an advocate for paleo, but it's just a label. It's a template, a starting point for you to tinker and customize to fit your genetics and goals.The field of health and nutrition is still like the wild, wild west. It's like peeling one layer of the onion at a time. We're uncovering wisdom. One day they say coffee is bad, the next they say it's a lifesaver. Please be patient with science.Case in point: In 1799, George Washington had the world's best doctor tend to him when he awoke at 2am unable to breathe. Their number one recommendation? Bloodletting. By 10pm he was dead with 40% of his blood was gone. Doctors mean well, but often don't know well.There are not a lot of black and white rules in the health and nutrition world. Look for areas of agreement instead of discourse.General agreements include: eat lots of vegetables, avoid over processed human-manipulated foods, and don't drink and smoke. Almost everything else is in the grey area.Listen to the experts that encourage experimentation. Run like hell from the experts, including myself, that press upon you a one-size-fits-all solution.There is a study for every argument out there. If two people are arguing, each person can grab their phones and google a research that backs up their claim.You have to do your own due diligence, follow the right people, recognize patterns and trends, and come to your own conclusions. Embrace trial and error. A lot of error.Any claim can be backed up by some research. It doesn't matter who is wrong or right.Do you want to be right or do you want to be effective? Divorce hype from principles and you'll be more educated in making the right choices. Choose what is most effective and empowering.Example: many "experts" will argue that the paleo diet is ineffective, difficult, and grounded on baseless assumptions. Paleo promotes eating real foods that are minimally processed and nutrient dense.Learn how to distinguish between hype and science. Pay little attention to article headlines; they're optimized for clicks, not truth.Learn how to understand scientific research and distinguish between good and bad experiments. If you're lazy like me, just follow certain experts you trust and they'll break down theFollow the money trail for every product, study, and diet. Example: You should not trust a study funded by Coca Cola, fast foods, or pharmaceutical companies.Example (sort of): I worked alongside a national heart health organization. It became clear as crystal that when there were more news coverage on heart attacks, sales would increase for us. As a business owner, I saw a strong correlation between heart-related injuries and my profits. Make your own conclusions.I am not a doctor. Please consult with a doctor before trying anything listed below.DietProcessed foods are the enemy. They may look like food, smell like food, taste like food, but they're not food. They're more like edible products.Processed foods are optimized to make you overeat. They're loaded with sugar, salt, chemicals, and other questionable ingredients that you cannot pronounce. They are void of nutrients and are processed quickly by the body, leaving you always feeling hungry and craving for more. Cravings lead to addiction. Addiction leads you to buying more. Manufacturers win. You lose.The food industry optimizes their products for sales, not health. They do not have health on top of mind. That does not mean that they are inherently evil people. That's just how the system is setup. If you and I were in their positions, we'd have the exact same goals.Food manufacturers are not to be demonized, but our food and health system should be. If you and I were to switch places with food manufacturers, wouldn't we do the same and optimize foods for sales and profit?Avoid packaged, edible products with more than 5 ingredients. Use your own discretion per product. Avoid foods with ingredients your grandmother cannot pronounce or recognize.Follow this simple phrase: eat real food, not too much, and mostly plants.Don't count calories. We count calories, when we should be counting chemicals. Counting is very stressful, archaic, and doesn't work. Calorie in is not calorie out. You have to account for the 70+ hormones that impact your weight.The body is a very adaptive, complex organism and will regulate itself and respond to environmental inputs as it needs to. Sometimes that response is cancer, which is just another way the body protects itself. You won't be counting calories if/when you have cancer.If you do decide to measure calories, recognize that they're not created equal. 100 calories of gummy bears will not nourish you like 100 calories of grass fed steak. You have to take into account of nutrition density. Nutrient dense foods will keep you full and eating less for the long haul.Fat has been mistakenly demonized. Eat more high quality fats like grassfed butter, ghee, coconut oil, avocados, and some nuts. It's the cleanest source of fuel for your body and brain compared to protein and carbohydrates.You'll stay satiated for a much longer period of time when you consume more fats compared to carbs. You'll lose more weight and have more energy too.Sugar, along with processed foods, is the main driver of obesity. Avoid sugar as much as possible. This will be the key to you obtaining the body and health you want.You can survive 100% fine without consuming a molecule of sugar in your life. It's not necessary.Fructose in large amounts is not good for you. I forgot the science, so don't quote me here. Too much fructose will cause liver damage, obesity, and diabetes. The by product from too much fructose is triglycerides."Triglycerides can build up in liver cells and damage liver function. Triglycerides released into the bloodstream can contribute to the growth of fat-filled plaque inside artery walls".In the old days, fruits would grow towards the end of summer. Humans would feast on fruits to get some extra fat before the cold winters. Nowadays, we have access to fruits 24/7. I have not fact checked this scientific claim, but it makes sense to me.Ladies will definitely not like this. Long term consumption of fructose accelerates the development advance glycation end products. The acronym is - AGE. Guess what they do? They speed up the aging process and cause more wrinkles. Sorry, off topic, but avoid fructose because it'll make you obese and wrinkly.Go for the berries - strawberries, blueberries, raspberries, blackberries. They have the highest nutrition density with the lowest amount of fructose.Why do you think they're always so expensive compared to the cheap restaurant fruit salads of cantaloupe, melon, pineapple? The latter is chock full of crappy sugar with little nutrition. It's all about the berries!Dairy, gluten, and eggs are the most reactive foods out there. If you're unsure if they're reactive to you, then run experiments, track biofeedback markers (hunger, energy, cravings, sleep), and decide if you should continue consuming them.I love pastured my eggs. Milk is the devil. Gluten is the devil's shit. That's not to suggest that your body is completely tolerable of the above mentioned.Gluten can cause long term damage to your gut lining. You get something called leaky gut. Foreign particles can pass through your gut lining and enter your bloodstream.White blood cells will protect you, but are somewhat blind and can begin attacking non-foreign objects in your body, hence autoimmune disease (when the body attacks itself). (fact check what I just said here in case)No one ever complains about drinking too much water. Or eating too much vegetablesStick to organic if possible because the downsides would appear to outweigh the positives. Pesticides, like Roundup, cause the stomachs of insects to explode. They're supposedly safe for humans, but I personally would not want to consume something that makes stomachs explode.MovementExercise not entirely necessary, but movement, frequently and for long periods, is absolutely necessary. I still enjoy my crossfit workouts, but they're not necessary for the regular citizen.Sitting for long periods leads to obesity, inflammation, and lower life expectancy. Stand and move as much as possible.Sedentary is death. Movement is life.There is a difference between being grotesque and being fit.Body builders and athletes have different goals and metrics for success. Body builders aim for size, symmetry, tone, and other cosmetic metrics. They're not optimizing for performance.Athletes aim for power (= (force x distance) / time), speed, strength, and more performance-oriented metrics. There are exceptions to all generalizations.What does this mean? Define what success looks like to you and reverse engineer it. Determine your metrics of success, else you'll never get the results you want.Walking is the most natural movement to humans second to breathing, and blinking if you want to get more technical. Studies show that it trumps running in terms of burning fat because you're operating at the right level of cardiovascularThe most effective and best fat burning exercise is what you enjoy and will continue to do for long-term.Long distance running in moderation, like anything, is fine. Excessive long distance running is very dangerous, leads to inflammation, and can cause long-term injuries. There are always exceptions to any generalizations.Unfortunately, society has cornered women into a category of only aerobic and feminine activities that are sub-optimal for human performance.Although zumba, dancing, yoga, and running are good forms of exercise, lifting heavy weights is much more effective in helping women burn fat, develop lean muscles, increase energy, improve sleep quality, and promote bone health (lifting weights increases bone density for women and lowers chances of osteoporosis)This is one of my most favorite sites: CrossFit Chicks. Several reasons why women should lift.Is she fit or grotesque? You decide. More importantly, decide what success looks like to you.Chemicals206 Million Pounds of Toxic Chemicals Dumped Into U.S. Waterways in One Year, Study Finds There's a study for everything. What do you want to believe?BPA and other endocrine disruptors are chemicals that affect the body's endocrine system and causes developmental, reproductive, neurological, and immune problems. They're found in plastics and household products.Women experience worse effects than men when it comes to being exposed to these chemicals. Hormonal disruptive chemicals will cause you problems such as disease and infertility. Lack of fertility is the biggest indicator of the fall of the human race. Don't go infertile.Whatever you put on your hair, skin, and nails should be safe enough to eat. Your skin is the largest organ on your body. The liver is the second. You wouldn't want to put random chemicals on your liver, right? Don't do it for your skin.This area isn't my specialty, but I err on the side of safety by getting rid of as many chemicals in my house as possible. They're unnecessary risks. For 95% of things in your house, there is a safer, cheaper, DIY product you can obtain. Search for "DIY toothpaste", "DIY cleaner", "DIY detergent", etc.Avoid using non-stick cookware. When they reach a high enough temperature, the fumes may potentially cause cancer and other issues, including obesity. Get a cast iron or stainless steel pan instead. 5 Artificial Chemicals That Are Making You Fat (Found in Your Home)Water is the ultimate and universal solvent. Whatever water comes into contact with, it will become one with water (Be water my friend). It won't happen immediately, but over time it will.Even the water in your glass cup is reacting with the glass, but it's not apparent. This is why you want to avoid plastic water bottles, steel cans, and other questionable containers. Glass and stainless steel are the least reactive and convenient materials around.What's in your detergent?SleepSleep is your Vitamin S. You need it daily.There is no award for getting less sleep than your coworkers.Lack of sleep wreaks havoc on your body. Your metabolism will slow down. Your hunger will increase. Your energy levels will fall. Your cravings will spike up. Inflammation will increase. Your fat loss decreases. You'll decision-making will be impaired and you'll succumb to temptations more easily, like donuts.Quality of sleep is much more important than quantity. Sleeping 10 hours after a night of drinking will not help you perform as well as 6.5 hours of a good night's rest.Make your room as dark as possible. Any ambient light will lower the quality of your sleep. Block out any LEDs or slivers of light from your windows.Leave your phones, televisions, and anything with a screen out of your bedroom.Blue light from your electronics will lessen the quality of your sleep by disrupting your melatonin production. Stop looking at your screens 2 hours before you go to bed.That's a tall order to fill. It's ideal and difficult to start with. Try shutting off your screens 30 minutes beforehand and go from there.Use technology to give you data on your sleep. This is something I use: Hello. It gives me data on my sleep quality, when I wake up, the ambient light, and the ambient sounds that occur during my sleep.There is no award for getting less sleep than you coworkers. Very important.MindsetWhen people give you advice, they're simply talking to their younger selves. Here's me talking to myself.All the above advice is meaningless unless you develop and master your inner game. If you don't are not happy with what you have now, then when you finally achieve that perfect body, you will continue to feel incomplete, not good enough, unfulfilled.There's a story of a super model who thought of herself as extremely gorgeous. However, she was too attached to her looks. As she grew older and her physical beauty fleeted, her happiness left with it as well. So caught up with appearance, she had forgotten about her beautiful experiences, relationships, and future ahead of her. She died alone and miserable.On the other side of the world, a woman also recognized that she was beautiful. However, she understood that all is impermanent, including herself. As she aged, she learned to let go of her appearance. She stopped trying to grip fiercely on to the past and how things used to be. She was able to live in the NOW, the present moment. By being present, she felt her wholesome spirit with all her wisdom and inner beauty. She focused on sharing her gifts with the world. She passed away peacefully.If you are too attached to your appearance, then your happiness will go with it. If you can be happy with nothing, then you can be happy with everything.Express gratitude as often as possible. Say gratitude when you wake up. Say gratitude when you sleep. Say gratitude that you have a job to go to on Monday. Say gratitude for the roof over your head, the kitchen filled with food, and the car that may or may not be running outside. It's impossible to be grateful and stressed out simultaneously.I'm extremely grateful I suffered from physical ailments early on. Had it not been for those misfortunes, I would not be here typing out pages upon pages of nuggest of wisdom.What are you grateful for right now?As you take your next breath, someone out there is having their last. Millions of people are dying to have the body you have.When someone judges you, it says more about them than you. As we grow up, our parents, friends, and the world tell us what is perfect and what is not. If someone told you when you were young that you're imperfect, that probably changed the way you view the world.From that point, you will judge others based on that newly adopted belief. It's all programming caused by others. It's unfortunate, but there's an upside.If it's all programming caused by others, then you have the power to reprogram yourself too. You can start by choosing reject those limiting beliefs. You can decide to adopt more empowering beliefs that make you feel good. Start by letting go of limiting beliefs and what people have said you should be likeHow you do anything is how you do everything. How you love yourself is how you love others. How you judge others is how you judge yourself.If you only love yourself under certain conditions (I'll love myself when I'm skinny. I'll love myself when I'm pretty. I'll love myself when...), then you subconsciously apply the same conditional love to your friends, your family, partners, and childrenOnly when you accept yourself and your imperfections can you begin to accept others and their imperfections. It starts with you.Forgive your parents, your family, your friends, the middle school kid who called you ugly, fat, and/or stupid. Self-acceptance begins with forgiveness.That kid didn't intend to hurt you. Someone had defined to her what perfect was and she tried to make you fit into that image. She didn't know any better. She didn't choose to take on that belief.Try not to make assumptions. Try not to take anything personally.When you forgive, you empower yourself. When you resent and act out of anger, you give away all of your power away. Resentment is like drinking poison hoping the other person will die.When you resent someone, she controls you and your thoughts. You acknowledge that the world has done you wrong and you cannot or will not do anything about it. You become a victim.You'll never win with a victim mentality. We can choose to be a victim or empower ourselves. We are always at choice. Always.Final ThoughtsOnce you've developed a good understanding of health and nutrition at a micro level, widen your scope of consciousness and consider health and nutrition at the macro level, which is the entire supply chain of where your products/foods come from and where they end up.Nutrition 2.0 is about consideration of the production side of food and sustainability.Where does your food come from? Where do your cleaning products come from? Are they environmental safe or toxic? Where do they end up?A product's story doesn't end when you throw it away in the garbage. Recognize that someone or something will take care of it. It may end up.Hope this was helpful. Best wishes to you and achieving the body you want. We're all working our way up Maslow's Hierarchy of Needs. I know when your needs are taken care of, then the next level you'll want to achieve is betterment for your friends, family, community, and planet. That's when real fulfillment will be achieved. :)If you're interested in reading more similar advice, visit my site at www.evanvpham.com.Email me at [email protected] if you want to chat any further. Happy to geek out further. I can tell you what I personally do day to day and why.

Q. What is nuclear medicine radiology?What is nuclear medicine?Nuclear Medicine Radiology (nuclear radiology) - InsideRadiologyStanford Nuclear Medicine and Molecular Medicine Residency ProgramWhat’s the difference between a Radiologist and a Nuclear Medicine Physician?Nuclear Medicine (pancreaticcentre.com.au)What is nuclear medicine?Last updated Mon 10 April 2017By Yvette BrazierRadiation is used in nuclear medicine and radiology. In nuclear medicine, radioactive materials known as radioisotopes, or radiopharmaceuticals, are introduced into the body. In radiology, X-rays enter the body from outside.According to the Center for Nuclear Science and Technology Information, about one-third of all procedures used in modern hospitals involve radiation or radioactivity. The procedures offered are effective, safe, and painless and they do not need anesthesia.Nuclear medicine in diagnosisA radiologist is a qualified doctor who specializes in radiology.Nuclear medicine is used to diagnose a wide range of conditions.The patient will inhale, swallow, or be injected with a radiopharmaceutical. This is a radioactive material. After taking the substance, the patient will normally lie down on a table, while a camera takes pictures.The camera will focus on the area where the radioactive material is concentrated, and this will show the doctor what kind of a problem there is, and where it is.Types of imaging techniques include positon emission tomography (PET) and single-photon emission computed tomography (SPECT).PET and SPECT scans can provide detailed information about how a body organ is functioning.This type of imaging is particularly helpful for diagnosing thyroid disease, gall bladder disease, heart conditions, and cancer. It can also help diagnose Alzheimer's disease and other types of dementia and brain conditions.In the past, diagnosing internal problems often needed surgery, but nuclear medicine makes this unnecessary.After diagnosis, and when treatment starts, PET and SPECT can show how well the treatment is working.PET and SPECT are also offering new insights into psychiatric conditions, neurological disorders, and addiction.Other types of imaging involved in nuclear medicine include targeted molecular ultrasound, which is useful in detecting different kinds of cancer and highlighting blood flow; and magnetic resonance sonography, which has a role in diagnosing cancer and metabolic disorders.Nuclear medicine in treatmentRadioactive agents my be swallowed in pill form, inhaled, or injected as part of a person's treatment.Radioactive techniques are also used in treatment. The same agents that are used in nuclear imaging can be used to deliver treatment. The radiopharmaceutical can be swallowed, injected, or inhaled.One example is radioactive iodine (I-131). It has been used for over 50 years to treat thyroid cancer and hyperthyroidism, or an overactive thyroid. Now, it is also used to treat non-Hodgkin lymphoma and bone pain from some kinds of cancer.Iodine-131 (I-131) targeted radionuclide therapy (TRT) introduces radioactive iodine into the body. As the thyroid cells or cancer cells absorb this substance, it kills them. I-131 can be given as capsules or in liquid form.In the future, it may be possible to embed chemotherapy into medication imaging agents that will attach only to cancer cells. In this way, the chemotherapy would kill only the target cells and not the nearby healthy tissue. This would reduce some of the adverse effects of chemotherapy.Radioimmunotherapy (RIT) combines nuclear medicine (radiation therapy) with immunotherapy. Immunotherapy is a treatment that mimics cellular activity in the body. Combining the two types of treatment means the nuclear medicine can be targeted more directly to the cells that need it.Various radionuclides are used. The most common one is I-131, or radioactive iodine therapy (RAI). Other options include 90Y-ibritumomab tiuxetan, or Zevalin, which is used to treat different types of lymphoma. 131-I-tositumomab, or Bexxar, is used to treat lymphoma and multiple myeloma.Experts in nanotechnology, advanced polymer chemistry, molecular biology, and biomedical engineering are investigating ways to deliver the drugs to the correct site without affecting surrounding tissues.Theranostics is an approach that integrates nuclear medicine techniques for diagnosis and imaging with those for treatment. By combining molecular targeting vectors, such as peptides, with radionuclides, it can direct the radioactive substance to the target area to diagnose and deliver treatment at the same time.What to expectA person who is going for diagnosis or treatment with nuclear medicine should be sure to inform the health professional if they are pregnant or breastfeeding, or if they may be pregnant.Nuclear imagingThe patient may have to wear a gown, or they may be able to wear their own clothes, but they will have to remove jewelry and other metal-base accessories.TherapyAfter having radioactive treatment, a person should avoid physical contact with other people as much as possible for 2-5 days, which may involve taking time off work.When a patient has treatment for the thyroid with I-131, no special equipment is used.A single, prepared dose will be taken by mouth. This is a one-time treatment.The patient should not eat or drink after midnight on the day of the treatment. If the treatment is for a thyroid problem, the doctor will normally advise them to stop taking their regular thyroid medication between 3 and 7 days before the treatment.The patient may be able to return home after the dose, or they may have to stay overnight in the hospital.However, because the body will not absorb all the radioactive iodine, it will continue to leave the body over the next 2 to 5 days.The individual should avoid contact with other people as far as possible, and especially with infants and pregnant women.This may mean taking time off work. They should also prepare their own food, avoid sleeping with another person, flush the lavatory twice after use, and wash their clothes and laundry separately.Most of the iodine will leave the body through the urine, but it is also excreted through tears, sweat, saliva, vaginal discharge, and feces.Women are advised to avoid becoming pregnant for 6 to 12 months following treatment.Anyone who plans to travel immediately after treatment should get a letter from the doctor, as radioactivity may show up on scanning machines at airports.Safety in nuclear medicineToo much radiation can potentially damage organs or tissues or increase the risk of cancer.However, when used for diagnosis, the level of radiation exposure is around the same as a person receives during a routine chest x-ray or a CT scan. As a result, nuclear medicine and imaging procedures are considered non-invasive and relatively safe. Their effectiveness in diagnosing disease means that the benefits normally outweigh the risks.Treatment with nuclear medicine involves larger doses of radioactive material.For example, a nuclear medicine lung scan would expose a person to 2 millisieverts (mSv) of radioactivity, while cancer treatment would expose a tumor to 50,000 mSv.This additional dose may affect the patient, and side effects are possible.However, since the treatment often targets potentially fatal diseases, the benefits tend to outweigh the risks.As technology advances, scientists hope that treatments will be more directed toward the tumor or disease, and less likely to affect the person as a whole.The Nuclear Regulatory Commission (NRC) and the U.S. Food and Drug Administration (FDA) closely regulate the use of radioactive materials for nuclear medicine to ensure the safety of patients.Nuclear Medicine Radiology (nuclear radiology) - InsideRadiologyStanford Nuclear Medicine and Molecular Medicine Residency ProgramWhat’s the difference between a Radiologist and a Nuclear Medicine Physician?July 7, 2015 by PaactusaIn fact – What the heck in Nuclear Medicine?…By Jan Manarite, VP of Advocacy & EducationAs I stated in my previous blog, a Radiologist is a physician you probably never meet, yet still impacts the understanding and treatment course of your cancer. He reads and interprets your imaging or your radiology exams, such as CT, MRI, and X-ray.A Nuclear Medicine physician also reads and interprets imaging, but some types of imaging are not called radiology – they are called nuclear medicine, or nuclear imaging. In prostate cancer the most common nuclear imaging exams are Bone Scans, and all types of PET Scans. These are considered nuclear medicine because the patient receives an injection that is radioactive, called a radio-pharmaceutical as part of the imaging. (An MRI or CT Scan can sometimes require an injection, but it is not a radiopharmaceutical, so they are not nuclear medicine.)Another way to state the difference between imaging with radiology vs nuclear medicine, is that radiology is designed to see anatomy (shapes & sizes), while nuclear medicine is designed to see physiology (cells, molecules, chemical interactions, etc.). If you’ve ever had a PET scan (nuclear imaging) for your prostate cancer, you may have had it “fused” with a CT scan (radiology). That’s because the PET is better at visualizing cancer cells, but the CT scan is better at visualizing anatomy such as organs, bones, etc. Since no medical imaging is 100% perfect, using 2 different techniques together often improves the accuracy of the exam.Another unusual thing about Nuclear Medicine, is that it includes both imaging, and treatment – because a radiopharmaceutical can be used for either. And the radiopharmaceutical (injection) is what makes something “nuclear medicine”. So nuclear medicine physicians not only deal with imaging, but they also administer a few treatments. In prostate cancer, this is mainly one treatment right now, which is Xofigo (radium 223). Xofigo was FDA approved in 2013 for men on hormone therapy, with rising PSA and bone metastases (see full Xofigo information here).So if you are scheduled to start Xofigo, you may have a clinic visit scheduled to see a nuclear medicine physician, who you may have never met before in your cancer care. The only other type of doctor who administers Xofigo is a Radiation Oncologist – See previous blog post.In the world of prostate cancer there are many twists and turns on the journey. The medical system is often complicated, and sometimes overwhelming. Understanding the medical system can help you navigate your journey. Knowing a little about the different physicians might be of help. So if you hear the word nuclear medicine, know that it includes both imaging and treatment in prostate cancer. And know that it’s slightly different than radiology when it comes to your imaging. Use this information to formulate better questions for your nurses, or medical oncologist. Better questions always bring better answers. Stay empowered.colins mr-spect epilepsy workNuclear Medicine (pancreaticcentre.com.au)INTRODUCTIONNuclear Medicine is the use of radioactive molecules (radionuclides) for the diagnosis, staging, therapy and monitoring of the response of a disease process. A nuclear medicine test which may be used in the diagnosis and staging of pancreatic cancer is Positron Emission Tomography (PET). A sugar molecule tagged with a radionuclide is used to build a picture of which organs are using the most sugar. Tumours are one of the most sugar avid tissues and a PET scan can show the extent of the tumour & whether it has spread locally or more distantly.PET SCANPET stands for “positron emission tomography”. It is a nuclear medicine imaging test in which a small amount of liquid radioactive material is injected into your body and is used to diagnose a variety of diseases, including many types of cancers, heart disease and other diseases. The radioactive substance most commonly used in PET scanning is a simple sugar (like glucose) called FDG, which stands for “fluorodeoxyglucose”. It is injected into your bloodstream and accumulates in your body where it gives off energy in the form of gamma rays. These are detected by the PET scanner and a computer converts the signals into detailed pictures or images showing how tissue and organs are working. If you are having an FDG PET, your sugar metabolism (how sugar is used by your body) is imaged. This is commonly used for cancer imaging as tumours need sugar to grow.PET scanners are now commonly combined with computed tomography (CT) scanners, called PET-CT scanners. CT imaging uses X-ray equipment to create detailed images of slices of the inside of your body. The PET-CT combination allows any abnormality on the PET scan to be precisely located within the body, allowing for more accurate diagnosis of any problems. The PET or PET-CT scanner looks like a large box with a circular hole in the middle.You will usually be in the PET imaging department for between two to three hours. The time on the PET scanner is typically 30 minutes but time is also needed for preparation.When the scan is completed you will be asked to wait while the images are checked to make sure they are clear. Occasionally, there is a need to obtain more images following this check.PET scanning is a powerful diagnostic test that is having a major impact on the diagnosis and treatment of disease. It provides unique information which may assist in making a diagnosis, in determining treatment or providing a prognosis, that is, the likely outcome of any disease.Nuclear medicine tests, including PET scanning, can provide information on how tissue or organs are working, which cannot be obtained from other imaging techniques. PET scans may detect disease earlier than other types of scanning by identifying early changes to tissue and organs.PREPARING FOR THE SCANYou will receive specific instructions based on the type of PET scan you are undergoing. If you are unsure about any aspect of preparation you should contact the centre where your PET scan is going to be performed.It is important that you let staff at the hospital or radiology practice where you are having the scan done know if you are (or think you could be) pregnant or are breast feeding.This study may not be suitable for pregnant women because of the radiation dose to the growing foetus. Please discuss this with your doctor.Women who are breastfeeding and people who are the primary or sole carer for small children may need to make special preparations for after the test, to stop breastfeeding for a short time, and to avoid close contact with young children. This is due to the small amount of radioactivity your body may release for a while after the test. Talk to your referring doctor or the nuclear medicine practice where you will have the test for details. The Australian Radiation Protection and Nuclear Safety Agency has recommendations about breastfeeding and close contact with children after nuclear medicine tests.Bring with you to your appointment any previous X-ray or radiology images you have, as comparison with these by the nuclear medicine physician (a specialist doctor), who looks at and interprets your PET scan, can be very helpful.Generally, you will be asked not to eat or drink anything for several hours before the PET scan because this may alter your sugar metabolism and may affect the quality of the images or pictures. Drinking water is usually acceptable. If you are diabetic, you will be provided with specific instructions and may need to stop taking some diabetic medications before having the scan.You need to wear comfortable, loose clothing and will generally be changed into a hospital gown. It is important that you are not wearing metal, including jewellery, watches, zips and bra hooks as these can affect the quality of the images produced.WHAT HAPPENS DURING THE SCANAfter you arrive at the hospital or radiology practice, a nurse or nuclear medicine technologist will explain the procedure and prepare you for the PET scan. You will be asked to change into a gown. A small needle will be inserted into a vein, usually in your arm or the back of your hand, to fit an intravenous line (a thin plastic tube) through which the liquid radioactive material is injected. A brief medical history will be taken to ensure the optimal (or best) scanning method is used and to also help with subsequent image interpretation. Your blood sugar level will be checked, as high or low blood sugar levels can alter the appearance of the scan. The radioactive substance is then injected into your vein through the intravenous line.If you are having an FDG PET scan, you will be asked to rest quietly in a bed or arm chair, avoiding movement or talking for 90 minutes. During this time you will be alone as there is limited room for visitors, and it will prevent your friends or relatives from receiving unnecessary radiation exposure. You may be asked to drink some contrast material that moves through your stomach and bowel and helps to improve the interpretation of the scan. Occasionally, depending on the medical indication (symptom or condition), a catheter (a thin flexible tube) may be placed into your bladder to help improve image quality.You will then be moved to the scanning room and positioned on the PET scanning bed. It is important to remain as still as possible during the scan as movement can result in reduced image quality and the images may be blurry. Therefore, if you are uncomfortable after being positioned on the bed please tell the nurse or technologist.If you are having a PET-CT, the CT scan is performed first and takes less than 2 minutes. The PET scan takes approximately 30 minutes but the time will vary depending on the regions of your body being scanned.The intravenous line will be removed before you leave.GALLIUM DOTATATE SCANNuclear medicine uses radioactive materials to diagnose or treat diseases. An octreotide scan is one that uses radioactive material to detect certain types of cancers arising from the neuro-endocrine systems (this means cancers that relate to the interaction between the nervous system and hormones from the endocrine system – glands that produce hormones in the body). It shows where the cancer started (the primary site) and any places it has spread to (called metastases).Liquid radioactive octreotide (gallium dotatate) is injected into a vein, travels through the bloodstream and attaches to any cancer cells in the body. A radiation detecting device, a gamma camera, detects the radioactive octreotide and makes pictures showing where the cancer cells are.pancreas | Image | Radiopaedia.orgPREPARING FOR THE SCANIt is important that you let staff at the hospital know if you are (or think you could be) pregnant or are breast feeding. This study may not be suitable for pregnant women because of the radiation dose to the growing foetus. Please discuss this with your doctor.Women who are breastfeeding and people who are the primary or sole carer for small children may need to make special preparations for after the test, to stop breastfeeding for a short time, and to avoid close contact with young children. This is due to the small amount of radioactivity your body may release for a while after the test. Talk to your referring doctor or the nuclear medicine practice where you will have the test for details. The Australian Radiation Protection and Nuclear Safety Agency has recommendations about breastfeeding and close contact with children after nuclear medicine tests.Sometimes you are required to stop taking certain medicines such as somatostatin or octreotide therapy prior to having the procedure. Please ask your doctor to explain what this entails in your situation and for specific instructions.Drink plenty of fluids prior to and throughout this procedure and up to one day after having the procedure. This encourages the excretion of the radioactive tracer that is not absorbed and is also useful in obtaining better pictures.WHAT HAPPENS DURING THE SCANThe procedure begins with an injection of a small amount of radioactive material into a vein in your arm. You will be asked to return in four hours for a scan of your whole body.Upon your return, you will lie on a special table that allows pictures to be taken of your whole body. A camera will be positioned above and below your body which can take pictures at the same time.The camera, which can detect radioactivity, will travel from your head to your toes, recording pictures as it goes. None of the equipment touches your body. This process takes about 40 minutes. It is very important that you stay still during the scan.Next, a special set of pictures called a SPECT scan, a three dimensional image, is taken. For this set of pictures, the camera will be set up to travel in a circle around your whole body. Sometimes a separate set of SPECT scans is made for the chest and the abdomen (stomach) area.Later, after you have left the hospital or radiology practice, the technologist will work with the pictures to create three dimensional images.The scan takes place over 3 sessions:The first session on the first morning can take up to 1 hour.A nuclear medicine technologist will prepare the radioactive material when you arrive. This takes just over 30 minutes. The technologist and nuclear medicine consultant will discuss the scanning procedure with you.You will have a small plastic needle inserted into your arm so the radioactive octreotide can be injected into your blood stream and be absorbed into your body.You are required to return to the nuclear medicine department 4 hours later for the second session to take the first images/pictures of your whole body. This can take from 1 to 2½ hours, depending on the number of images that are required.The third session occurs the following day. You will be given a time to return the next morning for the same images of your whole body as well as more SPECT, three dimensional, image(s) of your body. This session will also take from 1 to 2½ hours to complete but you do not have another injection.RADIATION THERAPYRadiation therapy aims to kill cancer cells but avoid damage to the structure and function of nearby healthy tissue.Radiation therapy is a safe, effective way to treat cancer. It is a well established treatment. Radiation therapy offers clear benefits to patients. It allows organ preservation, preserves quality of life, reduces pain and improves survival.COMPUTER GUIDEDTechnological advances mean that radiation oncologists can see 3D images of tumours. This means they can direct radiation beams very precisely so less normal tissue is affected. Intensity Modulated Radiation Therapy (IMRT) and Image-guided Radiation Therapy (IGRT) allow radiation oncologists to better see and target tumours.The radiation dose can be closely fitted to the tumour. This reduces radiation dose to important structures like the spinal cord or parts of the brain.Radiation therapy is a vital part of curing about 40% of all cured cancers.

I am truly sorry for the loss of your pet, or your friend's pet if you are asking because of a real life situation. It saddens me to read that story and think of all the pain and suffering on all levels. The horrified owner, the crushed nurse, the devastated veterinarian. Everyone suffers, everyone in the home of the pet, everyone at the clinic… and unfortunate incidents such as this are a tiny reason why the suicide rate is so high among veterinary professionals. We take it INCREDIBLY personally when this happens. We do our best to provide the safest procedures and products possible.Ok, as to your question… Well, yes. You pay your bill. Services were performed, drugs, medications, equipment, staff, inhalants, etc… were used. Unfortunately complications can and sometimes do happen. Sometimes avoidable, sometimes not. Miserable each and every memorable and unfortunate time it occurs.So, the only thing I can advise to you as well as anyone avoiding procedures your pet needs due to fear of anesthesia / medications / etc… is that it is very important that you know the best way to minimize the risk and prevent this in the future. It is imperative that you do all the suggested blood screening and monitoring. There are reasons your veterinarian wants your pet to have an IV catheter and fluids run during its procedure, they want its blood pressure monitored, they want an EKG, PaO2, temperature & Cardio-pulmonary rate monitor in use. They want a warm air patient care system in use, they want adequate pain and inflammation used. They offer you the optimal scenario underwhich your pet will have the best chance of a positive outcome. Even with all the screenings, unforeseen things can happen.It is important that you are have any procedure for your pet preformed at a reputable veterinarian. Generally it is ideal that you DO NOT base the place you take your pet for an anesthesia on cost / price. I see many owners price shopping for the lowest possible cost. This makes me cringe. I work at many clinics. The clinics providing the lowest, cheapest priced procedures, often allow you to forgo preanesthetic blood screening to save you money, they utilize no cardio-pulmonary rate monitor, allow you to refuse iv catheter and fluids, they allow you to cut corners willingly to protect your pocketbook instead of your pet. It is more important that you are doing this procedure for your pet at a veterinarian that has limits… like no blood work - no anesthesia!!I recommend that you not go price shopping for the lowest possible cost when it comes to the heath of your pet. Not if you really love it. Now…If you are spaying or neutering 25 stray, unvaccinated, dumped, feral cats that would just as soon scratch your eyes out and share one of their 250 different contagious / infectious / parasitic / pathogenic / zoonotic diseases with you, I completely understand. Because you are not concerned about those cats and you don’t value them at $250 each… Many veterinarians will work with you on that kind of scenario. They really do want the best for the animals both domestic and wild, for you and your pet. We ARE pet owners too, we work CRAZY, hard, long hours for our income too. We get it. We understand. Nobody wants to lose a beloved pet under andesthesia.Now, It is very rare for a pet to pass away from aesthetic complications at the clinics where I routinely work. As a matter of fact, I’ve lost two goats, one black lab and a golden retriever under anesthesia and one shitzu in recovery in 20+ years. I will NEVER forget the family members, the phone calls, the saddened assistants, the tears, the kids, the pets, the willingness of the owners to TRY to save their animals and the shock of the phone call. The crushing and deflating feeling of the loss of those pets. We see more animals being sedated to go for grooming that come back with problems than we do for scheduled, screened, monitored, planned surgeries. We perform some rather large, invasive, extensive surgeries. It is devastating to a veterinarian to have a pet/other person's animal have postoperative complications and absolutely crushing to have them pass away. This is a horrible, dreaded and intentionally avoided, unwanted and unfortunate risk.I cannot imagine being the human surgeon, anesthesiologist, practitioner who has to say to a family: I'm sorry, your grandparent / parent /sibling / child passed away from anesthetic complications. Dreadful. Ugh!!!In human medicine, they will not allow you to go under anesthesia without proper monitoring and blood profiles and diagnostic work ups. THERE IS A REASON FOR THIS. There are insurance companies and safety nets to make sure somebody pays for these procedures when a human is having anesthesia. Please be aware that there is not such a safety net in place for your pet. You are your pets safety net!!! You are the responsible agent.So, again, in my experience, it is very rare that any pet passes away on the table. If they do it generally means that we KNEW ahead of time that the pet was a poor candidate for anesthesia but that death was eminemt WITHOUT the procedure, so the risk was worth it. When one unexpectedly passes, it means there was an underlying condition that was not detected by routine screening, perhaps it was not able to be detected without CT, MRI, chest radiographs, cardiac doppler imaging / ultrasound, etc... it is NEVER something the veterinarian or their staff wants or is emotionally prepared to have happen. We have crash carts, emergency medications and trained staff for JUST that reason.Everyone wants your pet to live and the veterinarian took an OATH to end animal suffering and promote animal welfare.Just as in human medicine, there is a risk of passing away under anesthesia, even for short, elective, simple procedures. Any anesthetia does indeed carry risks. When you dropped your pet at the vet the day of or before its procedure, you should have signed a waiver that you were allowing this procedure to occur, that you understood this was not without risk and that your veterinarian would do all they could do to minimize that risk.Now, in order to minimize that risk completely it does require that you spend the extra money for blood screening, potentially chest x-rays, clotting times, kidney function, detecting the presence of parasites… These things are important. VERY IMPORTANT. Your veterinarian does not offer these to you to gouge you for money, they offer you the services to protect the health and safety of your animal. The more perioperative things they recommend that you decline, the riskier the anesthesia itself, the procedure, the duration of surgery becomes.I see people routinely declining $28 worth of preanesthetic blood work and screenings, I routinely see them wanting to not manage pain in their animal because it costs 14 more dollars. I routinely see people decline diagnostics and iv fluids because they just wanted to price shop and are happy to go to a lower priced clinic. If they understood the importance of this screening, I think they’d stay… I try to explain it to them. If they decline, well… it tells me that clients are more concerned about money than their pet, or they truly can't afford it. However, IF you come in with your hair done in an expensive fashion / manicured expensive nails / the newest edition iPhone / designer purses / driving a $90,000+ vehicle / wearing the newest designer fashions /expensive shoes / lots of jewelry / extensive high quality tattoos / wreaking of smoked cigarettes / etc… that clearly shows me you ARE willing to spend money on things, just not your pet. You pick things YOU don't need over an animal who loves you dearly. So when and if YOU come in decorated in or exhibiting any of those aforementioned items, but are unwilling to spend money on things that protect the safety of your animal. Well, it BAFFLES me. I am most displeased with your choice, I will try to let you know how important the function of your pet's kidneys, liver, pancreas, hydration and rbc status actually is, how it could adversely affect the outcome to NOT know clotting times if this is the first time your animal has had a procedure, how trying to save your pet in the advent of a complication can get REALLY expensive, time consuming and has an increased risk of poor outcome…. if you STILL decline, I will either move forward with the procedure or turn your pet away. I am the only one that has to sleep with my decisions in this world.We veterinarians tend to have REALLY big hearts and consciences & they consume us if we feel as though something went wrong, or maybe we missed it or could have prevented it or caught it if we had wanted one more test!!! The owner on the other hand simply says: my PET went in for a procedure and died. What the heck went wrong? They often say things like: that terrible vet killed my pet. They may blame the veterinarian, they may blame the drugs, or blame the procedure… But in reality many things need to be looked at closely to determine the cause of the pet's passing. It doesn't erase the heartbreak, the love sick, crushing feeling of losing a pet. It does not erase the anguish, suffering and grief felt by all the veterinary professionals involved, it doesn't bring the animal back. It's a no-win situation for everyone. It is dreaded, we do our absolute best to prevent ourselves from ever being in the situation. We don't want your pet to pass anymore than you do. We took an oath to protect your animal and above all do no harm. That is the veterinarian's intent.Take home message: what do you get when you go veterianry "price shopping"… well, your value isn't great, you get what you pay for, you risk saving $135 to go where there may not be licensed veterinary technicians, there may not a surgical assistant, there may not be skilled veterinary surgeons, there may not be adequate monitoring during procedure or recovery, there may not be adequate peri-anesthetic screening, diagnostics or monitoring. Those things cost veterinarians LOTS of money, we can't give it away for free. It is important we help you understand the value / risk of declining each of these items. Your pet matters to us.What do owners expect if their goal is to get low cost / cut rate services? Veterinarians have to attend an expensive series of educational institutions, they have to pay to take exams, they have to pay licensing fees, pay to attend professional Continuing Education courses each year, they have to pay to keep their license updates, they have to pay for phones, electric usage, radiographic equimpemt, ultrasonography equipment, they have to pay for computer systems and massively expensive software, they have to pay for specially built buildings, they have to pay for cleaning and disinfecting supplies, pay for daily use goods like toiletries, they have to pay their staff, they have to pay for blood work machines and equipment, they have to pay for anesthetic vaporizers, oxygen transport and delivery systems, they have to pay for endoscopes, microscopes, ophthalmoscopes, otoscopes, stethoscopes, they have to pay drug companies, food companies, courtiers, outside laboratories, they have to maintain a MASSIVE amount of inventory, items, staff, etc… to even have a place for you to bring your pet and to keep the surgical suite safe for them!! So, I hope you understand that your veterinarian you select has to do a very expensive amount of work before you can ever take your animal to them.Hopefully it is now it is evident why I dislike the idea of "Price shopping for medical care for your beloved pet"… owners don't understand what they’re giving up for that "savings". Therefore it is best to talk to your veterinarian about what services will be provided, what's the importance of doing these services that are considered optional, and why would your veterinarian refuse to do a procedure on an animal without this work up? Your veterinarian should be glad to talk to you about any and all of this.Now - truth time - If you are concerned as to why your pet passed away under anesthesia when it went in for a procedure, I urge you to please talk to your veterinarian. They are likely upset about it as well. But in this scenario, they are the most capable of answering the questions you have. We know that you are upset, we really hate that heart ache for you. We get it, we have felt it, we are pet owners too. We love our animals. We are glad that you trust your animal’s care to us. We care for your animals and want to provide the best services possible, we do this as economically as we can and we want the best for your pet. So, by all means, PLEASE talk to your veterinarian about this scenario if you have unanswered questions or are concerned. A necropsy can be ordered to see if an obvious cause of death exists. If the veterinarian fears a diet related cardiac issue, a toxic exposure, a shunt, an allergic reaction, an emboli, a brain bleed, bacteria abscess, blood sugar, heart attack, etc… you can have a cosmetic necropsy and biopsy samples, but they aren’t always as capable of detecting cause of death as a full necropsy. You can also have the remains cremated and returned to you if you wish. A necropsy doesn’t mean you can’t get your pet’s remains back.Again, very sorry for your loss if this question is based on a recent loss. It's no fun for anyone involved, but the owner is the one who need to have some insight, understanding, closure and support in this matter. There are often grief counseling services offered in communities at no cost. Even if they are human based, they are qualified to help you cope with the loss of a pet.My condolences. My heart goes out to you and all those that loved your pet.