RadProtection Co., Ltd., Singapore (2026)

03/01/2026

Don’t you want to leave the world a little better than you found it?

As the years pass, that question pulls harder. For me, it’s become very specific: leave interventional medicine safer for the people coming after us. Not by talking about radiation protection, but by actually changing it.

A close friend of mine, Dr. Lindsay Machan, and I share a running joke. When we’re invited to speak about radiation safety, it’s almost always the final session on the final day. The room is 95% empty.

That’s not an accident. Safety is still treated as a checkbox. A line item. Something the industry can point to and say, “We addressed it.”

But a handful of people pushing from the margins isn’t enough. This doesn’t change without a movement.

As scientists and physicians, we like to say we follow the evidence. And the evidence is clear and every major regulatory body has stated: there is no safe dose of ionizing radiation. Yet we continue to work in environments that expose us to avoidable risk, even though technologies exist right now that can dramatically reduce it.

Every meaningful innovation follows an adoption curve. The only real question is where you stand on it.

Are you leading? Doing everything within your power to protect yourself, your colleagues, and your patients?

Or are you waiting? Waiting for more CVD, more strokes, more cataracts, more cancers, more chronic orthopedic injuries before reconsidering what you’ve been told is “just part of the job”?

This is the choice in front of us: lead the change, or quietly accept that more harm will occur.

The science is clear. The technology is here. What’s left is the will to act.

Stay safe.

02/01/2026

We try to donate food or hold fun events for the less fortunate on a regular basis. This Christmas we decided to deliver food to families in need. There were 9 people living in the first house. All the families were very welcoming and grateful. Our team really enjoys doing these events even though they give up their free time on a Sunday.

When we talk about nutrition in the developing world, we often default to Western solutions: supplements or cold-chain seafood. But on the ground, those supply chains don't exist in a lot of places I work.

It's more interesting to find the solutions that don't need an industry to sustain them.

Take Portulaca oleracea, better known as Purslane. In the agricultural world, it's often public enemy number one. We spend billions on herbicides to eliminate it. Yet, in the nutrition world, it checks every box we are looking for: it's drought-tolerant, rich in antioxidants, and is one of the few leafy vegetables with significant levels of Omega-3s.

But the real power lies in the pairing.

Purslane doesn't need to be a solo act. When you combine it with simple, widely available staples— like tofu, tempeh, or soybeans—the impact compounds. A simple bowl of tofu and purslane (with perhaps some mustard greens) can meet the majority of vegetarian Omega-3 needs as well as many other nutrients important for health.

No supplements. No imports. No cold chain. Just crops that are already growing in the village.

Innovation isn't always high-tech.

Sometimes innovation is just plant literacy. It's knowing that Purslane (clear sap) is food, while its lookalike Euphorbia or Spurges (milky sap) is poison. It's recognizing that we can solve nutritional deficits by simply eating what we’ve been spending money to get rid of.

It’s time we stopped ignoring indigenous, climate-resilient crops just because they don't have commercial lobbyists.

We will do our part to grow and educate people on Purslane.

Stay Safe and Happy Holidays.

01/01/2026

The $40 New Year's Resolution That Could Save Your Life, and more than 99% of people haven't done it.

Most New Year’s resolutions fail by February. We join a gym, start a diet, and promise to be healthier.

But for 1 in 5 people, the biggest threat to their heart health isn't something a treadmill or salad can fix.

It’s Lipoprotein(a) or Lp(a).

Modern medicine is a paradox. We will spend millions on a heart transplant or robotic surgery, but we won't spend $40 on the one-time genetic test that identifies a killer hiding in plain sight.

Why this matters right now: Unlike cholesterol or blood pressure, you cannot diet or exercise your way out of high Lp(a). It is 100% genetic. You are born with it.

If you have it, your risk of dying from cardiovascular disease doubles or triples—regardless of how many miles you run this year. It's insane that less than 1% of people worldwide have been tested for this.

The Hidden Risk for Radiation Healthcare Workers: If you work in interventional medicine, this resolution is non-negotiable.

Lp(a) fills your blood with oxidized phospholipids (inflammation).

Radiation exposure generates those exact same oxidized phospholipids.

The Result: A synergistic inflammatory storm that we are completely ignoring.

The Good News for 2026: We are on the cusp of a revolution. Results for groundbreaking drugs are on the horizon.

Pelacarsen (Results expected 2026)

Olpasiran (Results expected 2027)

Help is coming. But you need to know your number first.

Your 2026 Action Plan:

The Resolution: Get tested.

The Cost: ~$40 (Less than one month of that gym membership).

The Frequency: Once. In your entire life.

Don't just promise to "be healthier" this year. Be smarter.

Start 2026 by checking the one metric that diet can't touch.

Dad Joke: I was going to tell you a joke about a blood test... But I realized it was probably in vein.

Stay Safe.

30/12/2025

Sorry to be the Holiday Party Pooper, but your Belly Fat is a Radiation Bomb.

That second glass of wine and the loaded plate at the hospital holiday party aren't just adding holiday weight. For those of us working in the scatter field, they are turning your visceral fat into a permanent, radiation-damaged inflammatory organ that actively sabotages your DNA repair.

Perfect Stomach Storm

While you’re celebrating the season, three forces are converging to compromise your long-term health:

Occupational Radiation: Triggers DNA strand breaks and free radical damage.

Holiday Alcohol: Creates acetaldehyde, which glues your DNA strands together (crosslinks).

Metabolic Overload: Excess calories shut down the NAD+ levels your body desperately needs for cellular repair.

Why Your Belly Fat is Different (and Deadly)Visceral fat isn’t just stored energy; it’s highly radiosensitive.

The Zombie Effect: Radiation triggers SASP (Senescence-Associated Secretory Phenotype), turning fat cells into pro-inflammatory zombies that secrete IL-6 and TNF-alpha.

The DNA Shutdown:

These cytokines don't stay in your gut; they impair your body's ability to use repair proteins system-wide.

The Vicious Cycle:

Radiation Damage → Zombie Fat Cells → Chronic Inflammation → Impaired DNA Repair → Higher Sensitivity to Future Radiation.

The Asian Factor: 2X the Risk If you have East Asian ancestry, the danger is exponentially higher due to the ALDH2 mutation: The Flush is a Warning: Inability to break down acetaldehyde leads to massive DNA crosslinking. Higher Risk: You may accumulate dangerous visceral fat at a lower total body weight than your colleagues and at a lower BMI.

Your Holiday Defense Protocol (Outside the Lab)You can't always control the scatter, but you can control your metabolic terrain.

The 80% Rule (Hara Hachi Bu): Stop eating when you are 80% full to prevent the massive insulin spike that shunts lipids directly to visceral depots (I know, not easy).

Limit the number of alcoholic drinks (I know, not easy).

Protein First: Eat your protein and fiber before the carbs and sweets to blunt the metabolic Double Hit (EASY!).

Mitochondrial Fuel: Support your DNA repair enzymes with NAD+ precursors or MitoQ (no human data and no testing in occupational exposure, just mechanistic logic) and Berberine to help reduce that specific visceral depot.

The Bottom Line: You can’t eliminate occupational radiation, but you can choose not to carry a "radiation bomb" around your midsection.

Enjoy the Holidays but

Stay Safe and Healthy.

30/12/2025

A New Year, a New Target: Inflammation

The American College of Cardiology has just formally placed inflammation at the center of cardiovascular disease.
That reframes prevention for patients and for clinicians alike.

What This Means for Radiation-Exposed Clinicians

Chronic inflammation is a core, causal driver of cardiovascular disease.

Not a modifier.
Not a downstream bystander.
A primary biological mechanism influencing atherosclerosis, plaque instability, heart failure, and vascular aging.

This matters deeply for those of us working in radiation-rich clinical environments.

What the ACC Statement Clearly Confirms (Facts)

According to the ACC Scientific Statement:

• Inflammation is causally linked to cardiovascular disease progression
• hsCRP is a validated biomarker of residual inflammatory risk and predicts events even when LDL is controlled
• Reducing inflammation through lifestyle and selected therapies lowers cardiovascular risk
• CVD should increasingly be viewed as a systems-level inflammatory disease, not just a lipid disorder

These points are now considered clinically actionable, not theoretical.

Sources:
ACC Scientific Statement on Inflammation and Cardiovascular Disease (2024–2025)
Ridker et al., CANTOS, COLCOT, LoDoCo trials
ACC.org consensus summaries

The Missing Conversation: Occupational Inflammatory Inputs

The ACC statement does not discuss occupational radiation exposure.
But it does establish a principle that matters:

If inflammation drives disease, then chronic inflammatory inputs matter, even at low dose and over long timeframes.

Ionising radiation is a known inducer of:
• Endothelial dysfunction
• Oxidative stress
• Mitochondrial injury
• Persistent inflammatory signaling

This is well documented in radiobiology and occupational health literature.

The implication is not alarmist.
It’s preventive.

Translating ACC Science Through the RadPro 3 Pillars

Pillar 1: Reduce Radiation Output

Lower radiation output means fewer ionisation events, less endothelial injury, and less inflammatory initiation at the source.

Pillar 2: Block and Absorb Scatter

Scatter radiation is diffuse and systemic, exactly the exposure profile associated with chronic inflammation rather than deterministic injury.

Room-level shielding reduces inflammatory load for everyone, not just the primary operator.

Pillar 3: Reduce Biological Impact

If CVD is driven by inflammation, protection cannot stop at lead equivalence.

Biological resilience matters:
• Vascular health
• Mitochondrial protection
• Thermal and metabolic stability
• Cumulative systems stress

Radiation safety is not just about cancer prevention.
It is increasingly about cardiovascular and systemic health over a career.

The ACC has clarified the biology.
Our responsibility is to apply it upstream.

Radiation safety is cardiovascular prevention.

Stay safe.

29/12/2025

I’m only human—give me a break.

New data suggests that an operator’s physical state—specifically fatigue, hydration, and even room temperature—directly dictates their occupational dose.

Here is why your "Human Factors" matter:

Fatigue is a Dose Multiplier: Fatigue degrades spatial reasoning. Studies show that a tired operator takes longer to complete complex cannulations. Because Fluoroscopy Time (FT) is linearly correlated with Dose Area Product (DAP), a 20% drop in efficiency due to exhaustion is a 20% increase in your annual scatter dose.

The "Heavy Apron" Trap: Wearing 7kg of lead isn't just a back-saver issue. Surface EMG data shows it accelerates trapezius fatigue, leading to "postural drifting." When you're tired, you're less likely to maintain the optimal position behind lead glass or table shields.

Hydration & Repair: Radiation damage is largely an "indirect effect" via water radiolysis. Dehydration doesn't just make you sluggish; it slows the metabolic clearance of cellular toxins and hinders the aqueous environment required for DNA repair enzymes like LIG1 to function at peak speed.

The Cold Room Effect: We keep interventional suites cold for infection control, but hypothermia has been shown to postpone DNA damage repair. For the operator, cold hands mean lost dexterity, leading to more "pedal time" to get the job done.

The RadPro Takeaway: Radiation safety isn't just about the equipment; it's about the operator. If we want to truly minimize dose, we must advocate for ergonomic exoskeletons or off body shields, proper hydration breaks, and fatigue management.

A healthy operator is a low-dose operator.

Stay Safe.

-Fatigue/Dose: Variability in Fluoroscopic Time during Interventional Procedures (SCIRP, 2024).
-DNA Repair/Cold: Hypothermia postpones DNA damage repair in irradiated cells (NIH/PMC, 2020).
-Efficiency: Reduced Fluoroscopy Time with Physician-Controlled Fluoroscopy (PMC, 2021).
-Ergonomics: Assessment of passive exoskeletons for lead aprons (ResearchGate, 2025).

28/12/2025

The Double Hit: Why Perimenopause is a Radiation Safety Crisis

If you are a female radiation worker in your 40s or 50s, you are facing a biological perfect storm that isn’t in any radiation safety manual.

It’s called the Double Hit.

A landmark paper published just days ago in Aging and Disease (Rabinovici et al., December 2025) confirms what geroscience has long suggested: Hormone Replacement Therapy (HRT) is a premier geroprotective intervention. It targets all 12 hallmarks of aging, acting as a natural "biological shield" against the very damage ionizing radiation causes.

But as perimenopause hits, that shield thins. Precisely when many clinicians are at the peak of their careers—and their radiation exposure—their cellular defense system goes offline.

The Mechanistic Overlap
Radiation exposure and estrogen decline damage the exact same pathways. According to the 2025 research, the decline in ovarian function initiates systemic biological deterioration well before the final period.

Mitochondrial Decay: Radiation "leaks" the power plant; estrogen loss stops the repair.

Vascular Stiffening: Both forces accelerate endothelial aging and arterial calcification.

The Zombie Cell Effect: Without estrogen, radiation-induced senescent cells accumulate faster, driving chronic inflammaging.

HRT as Radioprotection?
The research emphasizes a "window of opportunity." Starting HRT within 10 years of menopause onset doesn't just manage symptoms—it restores the cellular repair crew needed to fix DNA breaks caused by that 2 PM complex case.

The Pillar 3 Defense: Hardening the Target
For the clinician on HRT working in a radiation environment, standard wellness isn’t enough. Based on the RadPro Pillar 3 framework, here are the targeted supplements to consider to amplify your biological armor:

Fuel the Repair: NAD+ precursors and Ubiquinol (CoQ10) provide the energy required for DNA repair enzymes (PARP) to function under radiation stress.

The Nrf2 Prime: Sulforaphane pre-conditions your cells to survive oxidative stress before you even step into the lab.

Metabolic Safety: DIM and TUDCA ensure your liver processes hormones into "clean" pathways, preventing radiation from reacting with toxic metabolites.

The Bone-Vessel Sync: Vitamin K2-MK7 ensures HRT-driven calcium goes into your bones, not into your radiation-stressed arteries.

The Bottom Line
We’ve spent decades focusing on lead aprons (Physical Defense). It’s time we focus on the woman inside the lead (Biological Defense). Stop treating "aging" and "work exposure" as separate problems. They are happening in the same cell, at the same time.

Reference: Rabinovici J, et al. "Perimenopausal Hormone Replacement Treatments as a Geroprotective Approach - Adapting Clinical Guidance." Aging and Disease, Dec 2025. doi:10.14336/AD.2025.1391.

Standard Safety Disclaimer: This post is for informational and educational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new supplement or hormone protocol. Supplements can interact with medications and may not be suitable for everyone.

27/12/2025

The 1977 playbook isn't enough for 2025 risks.

Look closely at the contrast between these two images.

The Past (Image 1): This is how most of us were trained. The Stochastic vs. Deterministic framework. The ALARA principle. The Holy Trinity of Time, Distance, and Shielding. This framework was formally standardized in 1977 (ICRP 26). It assumes a binary world: you either get a random cancer later or a burn now. If you stay behind the shield, you are "safe."

The Present (Image 2): This is the biological reality we now understand. Modern radiobiology shows us that risk isn't just about dice-rolling for cancer. It’s about systemic, chronic damage to our most vital organs that happens even at "safe" levels:

Brain Impacts: It’s not just about tumors anymore. We now must consider neuroinflammation and accelerated neurodegeneration leading to cognitive decline. Cardiovascular Damage: Chronic exposure accelerates vascular aging, increasing stroke and heart disease risk. Systemic Drivers: Mitochondrial dysfunction and chronic inflammation that affect the entire body.

The Hard Truth: We are managing 21st-century biological risks with a safety philosophy that is nearly 50 years old.

The 1977 model treated the body like a dosimeter, not a complex biological system. It didn't account for the fact that radiation accelerates the aging of your brain and arteries.

We need to stop pretending that ALARA is the finish line.

Is your safety program stuck in the vintage classroom of 1977, or are you addressing the neurological and vascular risks of 2025?

Stay safe.

26/12/2025

Living and working in "The Radiation Window"

50 years from now, our successors may look back at the 'Fluoroscopy Era' with disbelief. They will likely ask: "You stood inside the radiation field just to see?"

We are the Bridge Generation—navigating the gap between the crude tools of the past and the sensor-based future.

THE PRESENT: The Danger Zone We currently work in a technological paradox. To perform life-saving miracles, we step daily into a biologically hostile environment. Fluoroscopy is indispensable today, but we must be intellectually honest about the cost. We are using ionizing radiation—a tool fundamentally at odds with long-term cellular health.

THE BRIDGE: AI-Optimized Radiation Before we eliminate radiation entirely, we are making it smarter. Technologies like Ikomed’s AEGIS (FluoroShield) are already changing the game. By using AI to track the "Region of Interest" and blocking peripheral radiation, we can reduce exposure by up to 84%. We are moving from "flooding the room" to precise, AI-guided imaging. BD's GeoAlign products can also reduce radiation output.

THE FUTURE: Sensor-Based Navigation Ultimately, the goal is to decouple precision medicine from occupational hazard entirely. We are moving from "shadow-based navigation" (X-ray) to "sensor-based navigation."

This shift is accelerating with technologies like:

Fiber Optic Shape Sensing (FORS) by Philips: Using light to see catheters in 3D without X-rays.

Electromagnetic Tracking by Centerline Biomedical IOPS: "GPS" for inside the vasculature.

Interventional MRI (iCMR) multiple companies: Seeing soft tissue in real-time with zero radiation.

The Takeaway: Our responsibility is to act as the guardians of this bridge. Whether through AI dose-reduction or sensor-based navigation, we must treat radiation not just as a tool to be managed, but as an active biological threat to be neutralized.

Our goal is to survive and thrive in the "Radiation Window".

Stay safe.

25/12/2025

Headline: All I want for Christmas is an infrared light.

We shield our body but starve our cells.

For decades, in radiation safety, we worked under the assumption that Melatonin was simply a sleep hormone manufactured by the pineal gland.

Emerging research confirms that over 95% of the body’s melatonin is actually produced directly inside the mitochondria. This Subcellular Melatonin doesn't make you sleep—it makes you resilient. It acts as a potent, on-site antioxidant, specifically scavenging the types of Reactive Oxygen Species (ROS) generated by ionizing radiation.

The Catch?

This mitochondrial production line requires Near-Infrared (NIR) light to function optimally — the exact spectrum provided by natural sunlight.

Modern Cath Labs, IR suites, and EP labs are lit almost exclusively by LEDs. These provide excellent visual clarity but emit Zero NIR energy.

We are effectively asking interventional staff to sustain cumulative radiation insults while working in biological darkness, depleted of their natural cellular defense mechanism just when they need it most.

A possible Solution: Re-introducing the Spectrum

For biological optimization, how about integrating NIR Photobiomodulation (PBM) stations to restore this Solar Deficit and improve staff antioxidant capacity? Cost $500-$1500.

Ideally, staff could go outside for 15-20 minutes in the morning and late afternoon but I've discussed this during talks and most doctors respond that it's not realistic.

Call for Research Collaboration

This mechanism represents an interesting frontier in occupational radiobiology.

I have developed a preliminary protocol for implementing this technology in a hospital setting in a way that is safe, operationally viable, and measurable.

Specifically, it would be interesting to look at gammaH2AX levels in peripheral blood lymphocytes pre- and post-shift. As a sensitive marker for DNA double-strand breaks, this would serve as the ideal "biological dosimeter" to quantify the protective effect of morning NIR exposure on interventional staff.

If there are any medical physicists, radiobiologists, or interventional department leaders in my network interested in researching this further—perhaps structuring a pilot study to measure oxidative stress markers pre- and post-implementation—please let me know.

I have ideas on how we can move this from compelling hypothesis to clinical evidence.

References:

Zimmerman, S., & Reiter, R. J. (2019). Melatonin and the Optics of the Human Body. Melatonin Research, 2(1).

Tan, D. X., et al. (2023). Melatonin: Both a Messenger of Darkness and a Participant in the Cellular Actions of Non-Visible Solar Radiation of Near Infrared Light. Biology, 12(1).

Tomazoni, S. S., et al. (2021). Photobiomodulation therapy ... in patients with severe COVID-19: A randomized, double-blind, placebo-controlled trial. Annals of Medicine, 53(1). (Demonstrating systemic anti-inflammatory effects).

23/12/2025

Schrödinger’s Cancer Patient: The Risk Assessment We Aren't Doing

A cancer patient close to me was just asked to decide on a monitoring modality: MRI, PET, or CT. They were handed a pamphlet listing "per scan" risk estimates and the standard "background radiation" equivalents.

This brochure failed on every level because it treated the patient like a healthy control subject. It ignored the "Triple Threat" already present in their body.

1. The Schrödinger Paradox
In physics, the act of observing changes the object. In oncology, using ionizing radiation (PET/CT) to "observe" a patient increases the probability of the very thing we are hunting: malignancy.

MRI: Non-ionizing. The observation leaves the biological system unaltered.
PET/CT: Ionizing. The observation adds new oxidative stress to a system currently fighting for its life.

2. The Bridge Analogy (The Blind Spot)
Providing a risk assessment for a PET scan without accounting for a patient’s history is negligence. It is like telling a bridge engineer, "This truck only weighs 5 tons", without checking how much weight is already sitting on the bridge.

Most cancer patients have a "Radiation Wallet" that is already overflowing.

The Heavy Tank: Many have undergone Radiation Therapy (therapeutic doses massive enough to induce cellular death or senescence).

The Rust: They are often on Chemotherapy, which works by chemically inhibiting DNA repair mechanisms.

3. Synergistic Toxicity
This is the biology we ignore when we quote "background equivalents." When you take a patient whose tissue is inflamed from Radiation Therapy and whose DNA repair crew is tied up by Chemotherapy, and you hit them with more ionizing radiation (PET/CT) for a monitoring check, you aren't just adding risk.

You are throwing gasoline on a smoldering fire. You are breaking the windows of a house while simultaneously tying the hands of the repair crew.

My perspective: If the diagnostic yield is comparable, the choice must be MRI.

We need to stop managing patient anxiety with vague averages and start managing their biological preservation. Don't add weight to a bridge when you don't know the structural load—especially when a weightless option exists.

I welcome thoughts and feedback.

Stay safe.

22/12/2025

I wasn’t always a radiation safety advocate. In the 90s and 2000s, I was just like everyone else.

I treated radiation exposure as "part of the job." The risks felt distant. Theoretical. Something that might matter decades from now, if at all.

Then a tragedy unfolded that changed everything.

In the 1990s, Roy Greenberg started working with our company. He became friends with many of us, including his best friend, John.

Roy was a brilliant vascular surgeon—technically gifted, intellectually fearless, and genuinely kind. He was a recipient of the Innovators Award, a recognition reserved for those who truly move the field forward.

But 12 years ago this month—in December 2013—Roy passed away from appendiceal carcinoma.

He left behind young children. A family. A future that should not have ended.

Roy, along with Ted Dietrich (another Innovators Award winner), believed their cancers were linked to occupational radiation exposure. They spent years in labs and operating rooms where safety was often minimized or ignored.

After his diagnosis, Roy didn’t rationalize it away.
He changed his behavior.
He started asking harder questions.

And he innovated.

He pioneered fusion imaging with his father. He developed BD GeoAlign catheters. He helped launch Centerline Medical.

These were just some of the ways he tried to make the environment safer for those coming after him.

Watching Roy fight for radiation safety while fighting for his life had a profound effect on me.

It stopped being theoretical.

Many people don’t worry about radiation because it hasn’t happened to them yet. Or to a close friend. Or to a mentor they admire.

Don’t make that mistake.

By the time it becomes personal, it is often too late to undo decades of cumulative exposure.

Roy’s story is the main reason I do what I do today, but it is only one of many stories I’ve encountered over the past 30 years. It’s why I speak up. It’s why I push for better protection, education, and design.

Radiation safety isn’t about fear. It’s about respect.
Respect for biology.
Respect for time.
And respect for the people standing beside us in the room.

Some lessons come at an unbearable cost. We owe it to those who paid it to learn from them.

Stay safe.

RadProtection Co., Ltd.

03/01/2026

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