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| Joyce Hoffman The Tales of a Stroke Patient |
SSTtattler: An excerpt from Joyce's book The Tales of a Stroke Patient.
Since I had my stroke, my life has been bombarded with rules and regulations, right ways and wrong ways. And it's not getting any better.
"Don't sleep on your side. You'll fall off the bed." "You have to take the Coumadin [a pill] the same time everyday." "You shouldn't eat any of the foods on the new list." "You have to eat food before you take this medication." "You should walk around the house after an hour of sitting down." "You have to take a nap every day for one hour."
So many things in my life of do's and don'ts. <Sigh>. But without any doubt in my partially-altered mind, the most rules come with the mother of all machines--the MRI.
Thump. Rat-a-tat. Ping. Thawk. In case you're thinking of comic books and graphic novels, and the virtual sounds associated with these noises, <buzzer sound>, you're wrong. Those sounds are coming from the huge, medical machine, Magnetic Resonance Imaging (MRI), which I had the mispleasure of using a bunch of times.
I'm willing to bet that most of my readers, here in the US and across the world, never had an MRI. If you ever have an MRI, just think good thoughts because if you don't, listening to this mammoth machine work its magic will cause you much stress or make you go in your pants, or both, at least the first time, that is. So in the interest of educating you, my dear readers, here goes.
An MRI scan is the best way, short of cutting you open (a gruesome thought, indeed), to see inside your body, using a magnetic field and pulses of radio wave energy to make images of organs and structures. In many cases, an MRI may show problems and give different information that cannot be seen with other imaging methods, like an X-ray, a computed tomography (CT) scan, or an ultrasound.
Some of the problems detected on the MRI, like bleeding, tumors, injury, infection, and blood vessel diseases, could be life-saving if the progression of the condition has not gone too far. For example, I had bleeding on my brain with my stroke. So the doctor ordered several MRIs to determine if the bleeding would get to a point where I was a goner. But I'm still here. Whew! An MRI is also called for if an organ is too large, too small, too damaged, or even absent.
You will need to remove all metal objects such as dentures, hearing aids, credit cards (the MRI magnet may erase the information on the cards), jewelry, watches (which may stop running), hairpins, pens, pocketknives, metallic zippers and fasteners, and eyeglasses, all of which may fly across the room or attach themselves to the powerful magnet used for the test. So better to tell the truth than wear your lucky necklace.
Banned items include cochlear (inner ear) implants, brain aneurysm clips, recently placed artificial joints, and certain brands of artificial heart valves and vascular stents. Iron pigments in tattoos or tattooed eyeliner (like my idiotic sister-in-law has) can cause skin or eye irritation. The imaging center usually gives you a list of rules anyway.
The table used for the test is hard and the room is cold (the environment is not designed for YOU). An intercom allows you to speak to the technician, who's operating the scanner and "majored" in MRI, just in case you feel sick or if you want to order lunch. (Just kidding about the lunch).
You will need to take off all or most of your clothes, but you may be allowed to keep on your underwear if it is not in the way. That's a good thing. If you wear a bra, you have to take it off, too (woo-hoo), because it has metal fasteners. You will be given a gown to use during the test. That's really a good thing.
Some people feel claustrophobic inside the MRI and if this keeps you from lying absolutely still, you can be given a sedative to help you relax. (WOOS alert)! Open MRI machines may help you with your nerves, but they are not available everywhere and the pictures may not be as good as those from a standard MRI machine. So suck it up!
And now for the sounds. You better wear ear plugs to help reduce the stress of the noise and/or going in your pants. But after 8 MRIs, I got used to it. Inside the scanner, you will hear a fan and notice air moving. You'll hear loud sounds (Thump. Rat-a-tat. Ping. Thawk.) as the MRI scans are being taken. You may be asked to hold your breath for short periods of time.
A few MRIs have special headphones and televisions that help the time pass by more quickly. I've never had those conveniences, but to make the time pass faster, I used to think about my old row house in Philadelphia and the constant drilling on the pavement in the multi-shared driveway. That was over forty years ago, but it helped me.
Sometimes, contrast material (dye) may be injected during the MRI scan to show images more clearly. The most common type of dye used is gadolinium. Allergic reactions to the product are rare, and the technician operating the machine will monitor your heart rate and breathing. There have been no documented, significant side effects for the dye and neither for the magnetic fields and radio waves used on human bodies. And the MRI contains no ionizing radiation.
If contrast material is needed, the technician will put an IV line in your arm. The dye may be given over one to two minutes. Then more MRI scans are taken. An MRI test usually takes 30 to 60 minutes, but you may be tired or sore from lying in one position for a long time. I was both, every time.
The pictures are usually interpreted by a radiologist. But sometimes, the technician was a nightmare. I usually ask, with a smile and a grin, how long have they been working as an MRI technician. If it's under six months...well, permit me to demonstrate:
The needle for the dye didn't inject into my bloodstream for the third time. I pulled my arm away and said, "So tell me. How long have you been doing this--injecting dye, I mean."
The technician said, "For four months. I'm really starting to get the hang of it." And I was really starting to feel like a pin cushion.
She tried again and still couldn't get the needle into my vein. If I'd been taking heroin, I'd want my money back.
Instead, I said, "You've had four tries. Please get me a radiologist."
She said, "How about one more time."
"I don't think so."
She left in a huff. The radiologist, who showed up right away, got the correct spot immediately. I don't think she followed the rules.
There is no recovery time, unless you need sedation (WOOS alert again). After an MRI scan, you can resume your normal diet, activity, and medications, but you may be asked to drink a lot of water to flush any dye out of your system. Another rule.
After every MRI test, I felt a sense of accomplishment, like I had climbed Mt. Everest or something like it. And I, once more, achieved to get all the rules right. But the big question was: When were the rules and regulations, right ways and wrong ways, the do's and don'ts, going to stop? I think never. <Ding>. Right answer.
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