How does radiation poisoning kill you, and why does it sometimes take weeks?
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Ok. So radiation primarily causes damage by breaking up DNA inside cells (or by creating free radicals that also radiate stuff and damage DNA). DNA is the instruction manual in every cell and has instructions both on how to produce things the cell need, what the body needs and how to make copies of the cell itself (and do what the cell does in the body) and to make special cells (like red blood cells and white blood cells).
1. The first hurdle is just cells surviving at all. Really intense radiation can kill you in hours or days (by killing intestines and nerv cells). This is generally because so many cells die that you just fall apart (dying due to bleeding).
2. The next hurdle is surving having your intestines being damaged. Intestinal epithelial cells (the surface lining of your intestines) live for 3-5 days (because they have to be replicated fast so that acid and bacteria and stuff doesn’t kill you. Did you lose too many of them? You’re dead. If you get this kind of damage your nerve cells also tend to be messed up.
3. After that there is the problem of infection. White blood cells is a key component to surviving bacteria and fungus and all that stuff and they’re very short lived. This is an ongoing danger as even a weakened immune system can be dangerous. Even if you survive your immune system might never fully recover. Your liver also has to handle all the cells dying. If the liver becomes overloaded with wasteproducts from wounded and dying cells you die from organ collapse (first the liver, then failure cascades cause other organs to shut down as well).
4. Finally (for acute radiation poisoning) there are the red blood cells. Your red blood cells live for 115 days (on average), and they’re continually created and dying. So if too many bone marrow cells (the cells that make red blood cells) have been damaged to replenish your red blood cells you’ll get weaker and weaker over that period. There will also be a continuing problem with bleeding inside the body until all the small blood vessels have been repaired (and until platelet, another blood cell, levels are back to the point where blood coagulates as normal).
5. Once 120 days are past the acute phase is over, although full recovery (fully repopulated bonemarrow so that you once again make red and white blood cells in quantities that a normal person do) may take up to 2 years.
6. After that the main problem is cancer. With so many cells damaged there is a pretty big chance that some of them will have gotten past the protection system the body has against critically damaged cells replicating. Cancer will be a threat for the rest of your life.
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