THE MRI DIDN’T NEED TO SUCK

It’s been well over a year since I somehow sustained what seems to be a rotator cuff injury. Initially the pain was so acute that months of constant naproxen wasn’t controlling it. My chiropractor sent me to my GP who thankfully shot it full of steroids, reducing the pain enough that I could stop cradling the arm and wishing I could just put it in a protective sling.

There have since been exercise regimes, useless physical therapists, repeated chiropractic sessions and then finally a second shot of steroids. The acute phase passed into chronic limitations.

Finally I was referred to the ortho-surgeon who sent me to have this MRI, that strange magnetic imaging done in the kind of tube which causes claustrophobics to have to dose with sedatives, but which reminds me of an iron lung, something I was just talking about with my cousin Bob the other day.

Quite reasonably informative instructions had earlier arrived in the mail. They included a list of no-nos that were repeated by someone calling from the clinic a few days ago and then again by a form I am given upon arrival. Metal and MRIs apparently don’t get along so they ask – all these three times – whether I’ve got an aneurysm clip (luckily I don’t even know what it is), shrapnel, a penile implant or tattooed eyeliner – and those are just four of the couple dozen of points on the checklist.

Contrary to the pre-visit info’s promise that “When you arrive for your exam…a technologist will review this information with you and answer any questions you may have regarding your MRI,” I am put into a dressing room to strip off (no metal at all: not bra fasteners, snaps, eyelets) and promptly taken in for my MRI. No discussion, no opening for questions, and shamefully, no introductions.

I am made to lie down while the offending shoulder is isolated and wrapped by the technician, a pillow is shoved in an awkward way under my neck and NoName tosses some fat padded headphones onto my head in a lopsided manner. She thrusts a panic button into my hand and I am told some music will play in the headphones. Slam, bam, thank-you ma’am and the mechanism begins to suck me into the pipe.

“Hey,” I say, nervous at the idea of something about to be pumped into my eardrums that is not in my control, “don’t put the music on high volume.”

“Tell us when,” one of them says, beginning at a reasonable level and hiking it up in speedy increments before I can even respond.

“We’ll start now. Stay still for two minutes,”-  I have no idea which of them is speaking – and a clanking rattles my body like a giant hostile vibrator.

“Okay in there?” at the end and I quickly say, “No.” They pull me out. I complain that the headphones are impossibly uncomfortable and the pillow in just the place to strain my back. NoName rips the headphones off my scalp and hastily shoves two earplugs in the general direction of my ear-openings. My pillow is pulled down a bit better on one side but not the other and, wham!, I’m rolling back inside.

One earplug falls out within the first few seconds and the other is kinda resting there doing nothing when the rattle, bang, clank  of the machine begins again.

At the end, I speak up again and luckily they hear me. Sick of me, they roll me back out. “The ear-plugs aren’t plugging.”

“Do you want the headphones again?”

“Okay, but so that they are comfortable and without music.”

NoName shoves them back on. This time they’re very tight and have folded my right ear in half. “My right ear,” I say and NoName snaps it open for a second with sighs of exasperation. It lands back over my ear and in I go.

For twenty or thirty minutes I am left with my own thoughts, wrapped in this clanking, clacking magnetic tube, the music still blaring despite my request. A little dust ball settles into my nostril, nestled among my nasal hairs and tickling me. But I’m not allowed to move. I try to breathe out through my nose to see if that dislodges it, but it only highlights my sense that there’s something stale and nasty in the air I am being forced to breathe. My neck is half-cramping, my shoulder is aching and I’m starting to lose feeling down in my hand.

Finally, it is over. I’m slid out, the headphones are snatched from my ears by NoName while the technician has an uncharacteristic moment of pity. “Do you want a hand getting out?” I grip her hand and sit up, dizzy and sore.

“Go back and get dressed,” NoName barks, waving vaguely to the right as I stand dazed at the doorway. I dress and make it to the parking lot, sit in my car for a few minutes and then gingerly return home. My blog is my revenge.

My recommendations to these people:
•    Introduce yourselves.
•    Explain what’s coming and answer questions.
•    Check if something you’ve applied (like headphones) or placed (like pillows) is in the right place before you start the procedure.
•    Listen to your patient.
•    Be a bit on the nice side (Yes, I’m talking to you NoName and technician.)

P.S. I told my senior and elder fitness students that I had an MRI on Saturday and they said, On the weekend?? Are you out of your mind?

Comments

[Verandah]

Dear Katzela,

Medicine is the adversary system, not law, I have often thought. It takes two to tangle successfully with most treatments. At best, saints have cared for my dear ones; at worst,perps or somnambulists. When it's a wrangle and we have to call in Dr. T.M. (Thundering Mandible, you know who I mean) to troubleshoot or pry an apology. I am sorry not to be by your side. Love, V

[Sue Katz]

Funny, V, but somehow I feel you ARE at my side - throughout life. Yes, nice to have a big Dr Rumble to rumble. Luckily my contact with the medical world is very occasional only. Kisses.

[Joan Price]

What a horrifying experience, and yes, your blog is your revenge. Please make a copy of it and put it in the hands of NoName's supervisor as well as whatever patient feedback opportunity this medical office provides. And let us know if someone responds!

[Allen Young]

I have been very fortunate to have mostly good experiences with modern medicine, and I lean strongly toward that boogeyman "modern Western medicine" rather than "alternative medicine" -- though I am a major aficionado and consumer of massage therapy. Sorry about your lousy MRI. I have a friend who is an MRI tech, and I will send a link to your column to him. I know he often complains about cranky patients, difficult doctors, and a very tight working schedule that does not allow him enough time to make patients comfortable. And now his hours have been reduced!

[Sue Katz]

Thanks Joan. I'll probably take up your advise - but again, after I get my results and know that I don't have to get back there soon. It wasn't really so much horrifying as aggravating - nothing worse than rudeness when you're in a vulnerable position. Thanks again.

[Sue Katz]

Funny enough, Allen, a nurse friend of mine was just saying the same thing: that these folks are under-resourced and very pressured. But some consideration would have saved them and me time. I'd be curious to your friend's reaction to the blog. Thanks, luv.

[Greg Morris]

Sue, I just had my MRI...and it was very pleasant...first it was an open machine, not the tube..second, I gave them a Bonnie Raitt CD, which they played. It was almost like transendental meditation. So, ask for the "open" machine next time, or come on down to Arlington VA where we have thses advanced systems.

[Sue Katz]

Greg, sounds like you were in much more control of the situation than I was. The closed tube didn't bother me - being treated as invisible by humans did. Bonnie Raitt? Cool.

[Charles Light]

Hi Sue: Enjoyed the MRI column. I went in for one about two years ago after I had hurt my shoulder in a fall. Contrary to your experience the staff was very nice (Franklin County Hospital in Greenfield), but the claustrophobia killed me, I hit the panic button and took a walk. The pain wasn't so bad that I was even considering an operation, so it was relatively easy to do. And it seems to have healed by itself, albeit over a two year period.

[Sue Katz]

Chuck, did you ever go back and finish the MRI? Mine healed itself over the last 15 months or so to a great degree, but far from completely, so I just got sick of the limitations. I hope you're keeping warm and safe in this relentless winter.

[Rita Connolly]

Well..a bit different take here. First, I agree that introductions, more care to make comfortable and listening to pt ("don't play the music") makes perfect sense and is what we would all want. But the state of health care in the US is so disasterous that is only likely to occasionally happen. Health care workers are squeezed at every end,,,more patients, work faster, fewer staff, unbelievable supervisors...oops fewer pt's because many have no insurance and they aren't coming in except to ER's...so does the work slow down....no the staff is cut back and takes on higher work loads. Until/unless we someday have true single-payer health care this is only going to get worse. In the meantime, people like you and me....old enough to be pushy/young enough to be able to do that, insured, speak English as first language, fairly savey about making our way through beaurocracies (?spelling), filing out reams of paperwork, can come up with the co-pays, etc. etc., are best served if we always remember to approach these situations prepared to be be our own advocates...stop things, introduce self and ask for names, insist on being comfortable and that the moment or two is taken to accomplish that (acknowleging how busy they must be is often well taken). Dealing with an MRI or my recent colonoscopy (now there's a fun time for all!)is good time to practice those self-advocacy skills. More threatening or worrisome procedures, bring a friend to help with that.
And instead of sending a complaint (or the blog copy)to the supervisor, how about a well crafted letter to those working there describing the problems you experienced and the rather simple things that would have made it better....written in the spirit of believing that people would rather do better but get lost in difficult situations.
(full disclosure...I'm a nurse in a major metropolitan jail intake facility..every year we fight City Hall to maintain public funding for the health care and keep it away from for-profit companies. Our patients are very difficult, have horrible lives, endless mental and physical health problems and NO health care except us usually. We have been cut and cut and cut. I am not always smiling either.)

[Sue Katz]

Rita, thanks so very much for taking the time to inject your important, informed perspective. As someone who works with seniors/elders, I believe I understand what you mean about the vulnerability of those who cannot advocate for themselves. My situation was very mild and only reached the height of say "annoying." But of course so many less able folks get lost in the shuffle of cut-backs and overwork. Thanks for raising the bigger context - for it is the REAL context. The true outrage is the lack of single payer coverage for everyone and the crime is the profit motive of the insurance companies for whom health is a business not a service. Thanks again.

[Rita@Goldivas]

I think you should name the facility where you were subjected to this treatment. When I had an an MRI the technician (who did introduce himself), offered goggles that had an excellent slide show he had constructed of photos from his vacations to exotic places. That eliminated the claustrophobic feeling.

[Sue Katz]

Rita, sounds like you got an especially sweet technician. I have no interest in messing with anyone's employment, so I'll not publicly put out names. Nothing dire happened to me - just annoyance at the lack of them checking basic things - like was the headset actually sitting on my ears! Wonder what kind of hi-tech goggles he gave you.

[anita constantine-gay]

Sue, I went in to Mt Auburn Hospital for an mri 2 weeks ago. The technician was kind, gave me earplugs, gently put the pillows around my head. but, no one had mentioned the injection I needed. I decided before I got the injection, whatever it was, I should try a dry run into the machine. I have a bit of claustrophobia....the machine was sooo close inside I immediately freaked out, he was still patient with me and waited as I ran to my clothes locker to pop another lorazapam.... but it was going to take some time to kick in. the technician told me there are facilities with larger machines, where I'd be less enclosed. I decided to go with that idea. so I had to face my friend Jen in the waiting room,having run out of a test. very embarrassed,but I could not get past the feelng I was sliding into a coffin....I am scheduled to go to shields mri in framingham. I hope they are nicer than those you met...

[Sue Katz]

Yes, I've heard about those machines for folks with claustrophobia - and there's no need to be embarrassed at all because apparently it is quite common. Good luck on the Framingham experience - let me know how it goes.

[Ira C. Hock]

I've had many MRI's and can relate very well....however, my biggest enigma was when I read one report of my brain MRI which concluded..."nothing remarkable"...hmmmm

[Sue Katz]

Ira, it could've been worse - like if the report had left off the word "remarkable".

[Elaine]

Sorry to hear about your experience. I had an MRI 20 years ago and was totally unprepared for the experience. I thought it would be like getting an x-ray. I got no information beforehand and was shocked by the facility, which looked like a nuclear reactor, and the need to remove all metals from my body. The technicians were pleasant but clearly uncomfortable dealing with negative reactions to the machine and the deafening jackhammer noise it made. I didn't get earplugs. I was very upset and crying afterwards and sadly, like many healthcare professionals, they didn't want to deal with me. I went straight to my doctor's office and told her how I felt about the experience. She too was uncomfortable dealing with an emotional patient.
Fortunately, I have had many positive experiences with healthcare professionals since then.

[Sue Katz]

Wow Elaine, that sounds like it was harrowing. I think they have a much better grip on how to manage the client's experience now-a-days and I must say that they have been very responsive to the issues I've raised. I'm so glad your experience is far behind you. Thanks for writing.