Thursday, April 02, 2009

The Ol' Shoulder (Part 2)

Pricey. Hahaha. What a wonderful gift for understatement. The hospital called me a few days before my appointment to do the pre-registration, and mentioned the actual price: $2500. Ulp. My insurance contracted with the hospital to knock the price down to $1700, and then mentioned a 10% discount if I paid the whole thing up front. Um, yeah, I'll... consider that. I kicked myself once again for not having done this last year, when our deductible had already been met.

The day arrived, and I felt claustrophobic just thinking about the procedure. I was fairly sure I could survive that long in the machine, but the idea of that confined a space made me nervous. I wondered if I could get nitrous oxide, like at the dentist. I hastily wrote back to the alarmed Twitter and Facebook crowds who didn't think my status update was an adequate explanation, and headed out the door to my appointment.

While I was checking in, about thirty firefighters trooped out. "What was that about?" I asked. "Oh, they're just learning about MRIs." I went back to my paperwork for a minute as that processed. "Wait, why do firefighters need to know about MRIs?" The clerk smiled. "I asked the same question. It's in case they needed to do an evacuation, and a firefighter went in there with a fireaxe... it would fly out of their hands and into the machine. And if someone was in the machine, that... would be very bad." Flying axes. I got the picture. (A little digging on-line came up with the MRI safety video that they probably got to watch. Turns out there's more to be aware of than just the magnet.)

While I was on the phone with the bank, trying to arrange my finances, two intense, wiry, black-scrubbed guys kept poking their heads around the corner. "Yes, this is your four o'clock" the clerk assured them. "They're just impatient," she explained to me with a tone of amusement and affection.

Finances arranged, I got to go back into a waiting room where I was quizzed about anything that might make my MRI experience unfortunate. No, no pacemaker, no implants, no screws, I'm not pregnant. I had to stop and think about the question of having metal in my eye. I've made my share of sparks on a bench grinder, and... well, had I gotten some in my eye? I couldn't remember any specks that got in that I couldn't get out. When they offered to to an orbital X-ray, I figured I'd remember something that big, and said we were safe. I hoped I was right.

I made a metal note to always wear eye protection from then on out, in case I ever had to have another MRI.

Next stop was a locker room, where I was lightened of anything metal. My ring and the rivets on my jeans were allowed, but everything else had to go in the locker. No wallet, no keys, no camera, nothing electronic that I wouldn't want erased. We passed from there through two enormous doors with larger-than-life warnings about strong magnetic fields.

There was a room within a room; the outside one was dark and purposeful with glowing computer screens, enormous stacks of music CDs, and a stereo; the inside one, light and restful, with the smooth curves of the MRI machine trying to relax you. The pretty blue fluorescent skylights didn't quite set off the menacing bulk of the machine, but they were a nice touch.

"So, what would you like to listen to?" I hadn't been expecting that question. One look at the two guys and their towering collection of CDs made me think that Styx and 'Stones figured heavily into their musical heritage, but I managed to find a token Third Day album that I'd never heard among their collection, and chose that.

They slipped a coil over my shoulder that looked like a football shoulder pad, and strapped me down with pieces of shaped foam, stretchy fabric, and a blanket. "You have to be totally still for the whole test, and you may as well be comfortable. You'll be in there for about half an hour." I took serious stock of any pressure points, adjusted my pillow, and they slid me into the machine.

At this point, I have to stop and include a photo, because Deborah complains if I have an entire screen of text without a picture.

There wasn't much to say for the view. I was facing up, and I could see bits of the room in my peripheral vision, but the net effect was of staring at a blank wall, or the side of an old beige computer. A bulky set of hearing protectors/headphones were slipped on, and I got a squeeze ball to alert them if something wasn't right. They left.

The music started. At first, I thought it was just the way the album started — vague, echoey, and muffled. Then I realized it was the headphones. Good grief, I thought, a multi-million dollar machine, and they can't put in a decent set of headphones? Then I remembered: I was lying underneath an enormous magnet. Normal headphones wouldn't work here; the sound was being piped in, literally, like the old stethoscope-style headphones they used to have on airplanes. I settled back and listened to the words as the machine fired up.

Well I won't pretend to know what you're thinking
And I can't begin to know what you're going through
And I won't deny the pain that you're feeling
But I'm gonna try and give a little hope to you
Just remember what I told you
There's so much your living for

There's a light at the end of this tunnel
There's a light at the end of this tunnel for you
For you

How appropriate. And I appreciated that hadn't stuffed me into a tunnel with a closed MRI. I couldn't see out of it, but someone was taking my pain seriously, and trying to find answers.

Meanwhile, there was definitely something going on in the massive structure above me. Whirs, clicks, bumps, ratcheting sounds. And then the loud ones: Braaap, braap, braap, braap, braap, like a school fire drill, and then, over there, a rat-tat-tat-tat-tat-tat-tat-tat-tat that reminded me of playing video games on an 8086, back when they were called "IBM clones." Some of the frequencies made my left eyelid twitch, and I couldn't figure out if it was the sound itself, or the things the machine was doing to every atom in my body. My eye started to burn a bit, and I wondered if I should squeeze the bulb. I wondered for long enough that I decided it must be OK, given that I was still wondering, and nothing worse had happened.

I was also starting to really appreciate how much body-related imagery Third Day put into their lyrics:

This is the body
This is the blood
Broken and poured out
For all of us

Hah, I thought to myself, I can just imagine the guys in there, looking at the screens, saying, "This is the body, and this is the blood, and see, here is where it's broken..."

After quite some time, and a few interruptions in the music to tell me I was doing great, just a little while longer, I was done. They slid me out and unwrapped me, and I was very glad I'd taken the time to make sure I was comfortable. I got to see some of the images (which looked like black-and-white photos of steaks; somehow this was uncomfortable — humans aren't used to thinking of themselves as being made of meat) and zoom up and down my shoulder in tiny sliced cross-sections. They said they weren't allowed to interpret the images, but that didn't stop me from drawing some tentative conclusions of my own — namely, that I hadn't seen anything obviously wrong.

As we were getting ready to head back to the locker area, I asked them how strong the magnet was in layman's terms. "Bigger than the ones they'd pick up cars with," said one technician. The other smiled knowingly, and pressed the locker key back into my hand with a firm instruction that I was not to let go of it. We walked back into the magnet room, and he placed my clenched fist into the machine. It was incredible: the tiny key writhed in my hand and twisted painfully against me as I crossed unseen magnetic boundaries. It took considerable strength to twist it around. Not to be outdone, the first technician then removed his shoe, and indicating that it had a few small staples in it, stuck it to the underside of the magnet, where it wobbled improbably, end over end, dancing about on it's own. "That's 0.7 Tesla," he told me, "some of the 4 Tesla machines, they've got videos of them levitating mice." What I'd been playing with wasn't even one Tesla. Whatever Nikola Tesla got up to, he certainly didn't have a wimpy unit of measurement named after him!

Fun and games (and a lot of very cool technical explanations that I mostly followed) done, we made arrangements for the results to be sent to the doctor within a day or so. Until then, I just had to wait and tell stories. Telling stories is a good way to pass the time.

To be continued...


Carolina Kerr said...

Wow. I had an MRI done on my ankle last year and I didn't find out a quarter of what you did. Amazing.

Michelle said...

What an experience. I really didn't know much about MRIs so very informative blog!