During my researches into Arachnoiditis and it's causes I managed to make contact with a senior, career long, radiologist. I cannot name this person and the following excerpt from one email shows why:
"I cannot take a public position but I am delighted to help you unofficially. I work with Prof (name removed) at (name removed) and he would not be pleased if I took a public position. (name removed) has written about arachnoiditis and appeared in several court cases. Sorry to appear a bit of a wimp. I will help as I can"
However, as you guys know my work and therefore, that it can be trusted, I can quote from our private email. Even in these statements, whilst trying to remain loyal to his boss and mindful of his position, he has made some very telling statements.
26th February 01
"I find it interesting that radiologists were still using Myodil when the risks were well known and water-soluble alternatives were available. The incident in the early 1980s when Myodil was used and not removed (I was present) and water-soluble agents were readily available. Humans stick to what they know even when it has been shown to be no longer appropriate."
8th Mar 01
Thanks for your e-mails. Its always very interesting to read what you write. It's so easy to see only the doctor perspective.
17 April 01
I was brought up in the post-myodil/pantopaque era and grew up with metrizamide. I started training in radiology in 1981 at (removed) Hospital. I was always led to believe that myodil should be aspirated after use and a spinal needle was designed specifically for this purpose.
I have in my collection a lumbar myelogram that I performed using metrizamide of a patient with post-myodil arachnoiditis with globules of myodil seen on the control film.
I do remember a patient (not at (removed)) who had a myelogram (about 1983) and the radiologist made the decision deliberately not to aspirate the contrast (!).
I also have a case of a nurse who had a myodil myelogram abroad and the contrast had been left in. I removed as much as I could.
The teaching is that the myodil was only absorbed slowly if at all. Myodil can be seen on radiographs taken after many years. Myodil to all intents and purposes is not absorbed and over a period of time causes arachnoiditis in a proportion of cases.
It is important to remember that prior to metrizamide/dimerX there was nothing else to use (also pre CT/EMI scan and NMR/MRI). Its all a question of relative risks.
18th May 01
It's always sad to read of the sufferings of back patients. When Myodil/Pantopaque was all that was available it had to be used.
I cannot understand why it was not removed from the patient more routinely particularly at a time when water soluble agents were available and the link with arachnoiditis was established .
When I first came to (removed) I was admitting about 2 patients a week for myelography (usually lumbar radiculography). This has all more or less been swept away by MRI. I now do about 2-3 myelograms a year.
30th Oct 01
Best wishes and as always good wishes for your activities.
In October of last year I was working on the video, "Arachnoiditis - Fighting Back", as an unpaid researcher. I had just asked him if he could recommend a spokesperson to comment on the issue of Arachnoiditis caused by iatrogenic factors, surely his profession would want to comment and give their own point of view. Despite his previously regular answers, none came through. I continue to try and contact him, but I had no joy. I wonder why he baled?
All that this correspondence proves is that the debate over contrast media and the link to arachnoiditis is still alive in medical circles. It also shows that the highest echelons of the medical profession are still very active in trying to keep a lid on this matter. The terrible truth is that the truth will always out, and, they have lost their battle of containment.