My doctor ordered a CT Heart Coronary Calcium Score. When I made the appointment (for this coming Friday), they said I will have to remove my CGM to have the test done.
I guess that’s that, but I was curious if removing it was really necessary or if it’s just something the person making the appointment is instructed to say and whether there was any chance the radiologist might let me keep it.
I have had several CT Heart Coronary Calcium Score (CAC scans) both with and without dye. If near replacement time, I remove my G7. If recently inserted, like in the past couple of days, I leave it in. Basic CAC scans don’t tell you much, however, AI enhanced CAC scans are totally awesome as they can not only show a picture of all your primary arteries, but the picture shows location, quantity of plaque and most importantly the type of plaque (Hard or soft)
The best company I have found that AI enhances CAC scans is Cleerly, and you can see their information here:
Boston Heart Diagnostics has a product that competes with Cleerly, and I have tried both on the same CAC scan and was the most impressed with Cleerly
I recently had a cat scan and I was told I can keep both my pump and cgm on. However for MRI everything must be removed including jewelry. Not because it will be ripped off by magnets like we were once told, but because any metal can heat up and burn you. Even the platinum wire from a cgm could do that.
Not only did I keep my cgm and pump on for my ct scan, but they also worked through the procedure.
I do wonder how people with implanted metal screws and joints manage this
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I’ve had several CT scans of pelvis abdomen and chest, with and without constrast, this year. With the G6 and G7 on the upper arm it is not in the frame. Arms are held back out of the unit. As to pump I take it off and put it in the next room. This is probably not necessary, but I’d hate to have it get fried, unlikely though that may be.
Thank you guys. It definitely seems like it would be fine to leave it on. I guess it will come down to a question of how insistent the people working that day are and how resistant I am.
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Thank you for the suggestion of cleerly. I’ll ask my doctor how open she is to it when we go over the results of this week’s test. Do you know what the ballpark cost of Cleerly is? The coronary calcium score is not covered by insurance but isn’t crazy expensive, relatively speaking ($135)
Base CAC without dye is normally about $99, is not covered by insurance, and is not very useful as it does not tell you if your plaque is soft or hard. The more expensive CAC with dye is normally covered by insurance. I am on Medicare and Medicare has covered it for me. The Cleerly AI enhancement was $750 when I had it done a couple of years ago, and it is not covered by insurance. For several years, I had the basic CAC done every 1-2 years and I was starting to panic because my score was climbing every year. Clearly did the AI and confirmed that my growing plaque was a hard plaque, growing slowly and not an issue at all. Soft plaque is deadly. To stop my plaque from increasing, my cardiologist said that my ABOb needs to be below 50. Normal people need to be below 99 and that is when I learned that my historical APOb in the 60-65 range would not keep my plaque from growing.
I suggest that you talk to your doctor about having your CAC scan done with dye at a hospital that partners with Cleerly. You can go to the Cleerly website, put in your zip code, and they will give you the nearest facility. Then when your doctor gets the CD and has your initial CAC score, you and your doctor can evaluate if you should do the AI enhancement. That way you only spend the $750 if if is really necessary.
$750 is not cheap, if needed, but will allow you to make the lifestyle and medication changes you would need to prevent a heart event proactively rather than deal with it when you have an issue, especially if you are growing plaque in your LAD (Widowmaker artery). This is the silent killer.
Let me know if you want to get more into the weeds with this or if you want me to recommend some educational videos on this matter.
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When they ask you to take it off you can say the Dexcom G7 User guide states it is safe in some conditions. It’d be interesting if you can get the doc sending you for the test to do the paperwork to get your insurance to pay for a replacement sensor.
https://dexcompdf.s3.us-west-2.amazonaws.com/en-us/G7-CGM-Users-Guide.pdf Page 6
Contraindications
No MRI/CT/diathermy — MR unsafe: Don’t wear any Dexcom G7 CGM System component during magnetic resonance imaging (MRI) or high-frequency electrical heat (diathermy) treatment. However, it’s safe to have a CT scan if you keep the sensor out of the scanned area and cover the sensor with a lead apron during the scan.
The Dexcom G7 CGM System hasn’t been tested in those situations when used during an MRI scan, diathermy, or in the scanned area of a CT scan. The magnetic fields and heat could damage components of the Dexcom G7 CGM System, which may cause inaccurate sensor readings or prevent alerts. Without sensor readings or alerts, you might miss a severe low/high glucose event.
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I get CT scans of my chest every 6 to 12 months. I never remove my Dexcom or my Omnipod. Never had a problem.
The problem I do have is with scheduling at the radiology center my pulmonologist uses. In my opinion, their guidelines are outdated. I stopped the insanity simply by (sadly) lying and saying that I do not wear a CGM or pump. Then, when I show up for my appointment, I let the tech know. I have never had a tech have a problem with it.
Interestingly (at least to me) the radiology center my endocrinologist uses has no rules about CGMs or pumps, with the exception of an MRI, which is understandable.
Hope this helps - J
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seems like a profit-based corp. who pays for the CT CAC ?
The CT CAC is done by any hospital that partners with Cleerly and there are some in every state. Doctors can order the CT CAC with dye and it is normally paid for through insurance. Mine was paid by Medicare. I understand that the new Medicare coverage will include Cleerly Labs Plaque Analysis for patients with acute or stable chest pain with no known CAD, and CAD-RADS 1-3. CT CAC without dye is self-pay which gives you a base score, although not useful if you have plaque. Cleerly is a private profit-based corporation, which is funded through $472 million raised through 4 rounds of investment put up by 20 investors.
I have used their product and love the results. It is wonderful to now be able to see the location and type of arterial plaque noninvasively. The base fee for the Cleerly AI enhancement is $1,500 but they pretty much always offer it for sale for $750. As a diabetic, I like to be proactive about my health and this is the best product I have seen to date.
For full disclosure. I have used this product as a patient and have no financial interest in their company.
thank you very much for the details. Yes, a non-invasive option is a welcome advance. The price is not too bad and being proactive is a good idea. I wonder what the recommendations are (e.g., meds, endarterectomy) if there are findings ? Just musing. No reply needed !
My CAC score was increasing every year and as it reached almost 1000 I decided this was a good option and it was. The AI enhancement shows that mine is all a hard plaque so not very worrisome and that was a huge relief. My cardiologist that also treats diabetics advised me that although non diabetics need to keep their APOb under 99, I thought I was doing great being in the 60-65 range. She said no, that being on insulin, I will continue to develop plaque as long as my APOb is over 50.
So, these findings for me, were worth every penny. APOb under 50 is a challenge, but not impossible. I am now in and out of that range between 35 and 60.
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I had the scan this morning. I left my Dexcom on. My arms were over my head so it didn’t even go in the machine. While the receptionists seem to be following a script where great emphasis is placed on the removal of CGMs, the tech didn’t ask and showed no interest in my removing anything. My phone was in my pocket and he said that was fine. I took off my pump on my own initiative but that probably would have been fine, too.
Now that my anxiety about being without CGM is over, I can focus on worrying about the results…
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It is kind of a crap-shoot when going in for any scans, X-rays, ct/mri’s. Techs are sometimes clueless…anywhere from “just leave on your pump/cgm” to “everything comes off” …which is not helpful at all. You figure that if you call the manufacturer they’re gonna cover themselves and say remove it.
So it still leaves me in a fog.
Knowing how important my devices are in keeping me alive, I am even nervous at the airport security
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Here’s an authoritative review publication:
My wife has an MRI safe pacemaker. Medtronic pacemaker bodies are titanium but the leads to the heart can be stainless steel or titanium. Medtronic want’s to be on site to set the unit to default and return to the correct settings for that person after the MRI. She said sometimes the pacemaker will act up otherwise. From your link:
Titanium is a paramagnetic material that is not affected by the magnetic field of MRI. The risk of implant-based complications is very low, and MRI can be safely used in patients with implants. The titanium plates used in the craniofacial area, however, are made of alloys. More precise research is needed because the effects of MRI depend on the proportion of the constituents of the alloy.