Diagnosis - My First MRI
I was diagnosed with Crohn’s about the time same my roommate, Hannah, was diagnosed with her second bout of cancer.
On a cold December morning, I woke up early to get my first MRI of the bowel. An MRI uses a powerful magnetic field, radio waves, and a computer to produce detailed images of the small intestine. It helps the doctor diagnose inflammatory bowel disease such as Crohn’s. Because the procedure uses magnets, I removed all of my jewelry, including my nose ring and belly button ring; a choice I probably should have made before the year 2010 regardless. The machine looks like a person sized, space-age doughnut, with a narrow bed running through it.
The morning of the procedure I made the mistake of eating an orange prior to my arrival. Unbeknownst to me, I was supposed to fast for at least 4 hours before the procedure. My mother and I sat in the lobby of the office and waited. We adjusted uncomfortably in the boxy waiting room chairs and diligently filled out insurance forms. After a few hours, the nurse came back and instructed me to drink Barium, a thick filmy white solution, which would take another hour to pass through my system. Liquid Barium sulfate works by coating the inside of the esophagus, stomach, or intestines and allows them to be seen more clearly on an MRI. I took one sip of the milky ash and gagged. I kept trying to force the drink down but my gag reflex kept sending it back up. “I’m not sure I can drink this.” I said overwhelmed and defeated. The no-nonsense nurse rolled her eyes at me, “You’re going to have too,” she said. I’m sure she was used to patients far worse off then I being far easier.
I forced the barium down, trying to rush. If you drink the solution too slowly, it will pass through your system before the scan, rendering the whole disgusting ordeal a waste. After I glugged the Barium, they took me back to a smaller room to insert an IV of Gadolinium. The Gadolinium is a contrast medium that enhances and improves the quality of the MRI images. This allows the gastroenterologist to more accurately report on how the body is working and whether there is any disease or abnormality present. In order to perform the MRI, they needed to get this solution directly into my bloodstream. As I’ve mentioned before, I have weak uncooperative veins and do not do well with IVs. The nurse tied a blue rubber band around my arm and gently tapped. She tried the butterfly needle three times before my tears became so overwhelming I began to hyperventilate. “I can’t do this.” I wailed looking out the window at the looming MRI machine. “Ma’am, you have got to calm down," the frustrated nurse said. I’m sure she did ten of these a day and my bullshit weak veins were slowing her down. My mother called my father in a panic. They discussed the option of going to the hospital to get an IV put in there; which would take hours longer, require me to drink more barium, and cost three times as much as it was already going too. I felt like a little kid who could not handle a vaccine shot, sending the staff into frustrated sympathy.
I had all but given up when they called in Jose. A short plump hispanic man with friendly blue eyes and a subtle lisp. He laughed good naturedly when he saw my pathetic pin cushion arm and teared stained bloated red face. “Oh honey, just relax,” he said. He sat on the leather stool in front of me and managed to get the little IV needle in on the first try. “All ready to go,” He smiled. Surprised and relieved, my mother and I sang a chorus of thank yous.
The technician, a handsome light-skinned southern man, smiled and directed me to the machine. “Are you claustrophobic?” He asked. “No...” I said nervously. “You will need to wear this blindfold and whatever you do, do not take it off. Do you have a favorite music station? You will be in there for almost an hour, so I like to play what you find most relaxing. I’m going to put a button in your hand. If at any moment you absolutely have to get out of the machine, just press the button and we will pull you out. It is imperative that you do not move or try to adjust. It’s like we are taking pictures of your insides so the more still you are the better the images. Does that make sense?” I nodded nervously and adjusted myself on the thin strip of mattress. Button in hand, the technician gently laid a towel over my eyes, a blindfold over that, and large headphones over my ears. I realized I was going inside of the doughnut hole, a space not much wider than my own body. I tried to shake the feeling that I was slowly entering a narrow coffin. I willed myself to breath and not lift my arms, touching how close the machine was to my body would have sent me into hysteria.
Tracy Chapman blared in my headphones. “I remember we were driving, driving in my car,” she crooned. “Speed so fast I feel like I was drunk. I remember aaaaaaaaaaaaaa- aaaaaaaaaaaaaa- aaaaaaaaaaaaaa-” The song was interrupted by the loud buzzing of the machine. To this day when I hear the song “Fast Car,” I return to the blaring alarm of the MRI. After 50 minutes of Tracey singing in between the gong of the machine, I hear in my headphones, “You’re doing great Ro, I’m pulling you out of the machine now, just stay very still and keep relaxed.” Finally out of the machine I sat up my whole back drenched in sweat, lighted headed, and desperately ready to get out of there.
Later, I told my roommate about my trauma of the day. “Have you ever had an MRI?!” I asked incredulously, as if I were about to reveal something she did not already know. “It’s the worst!” Hannah looked at me deadpan. She laughed with a cutting high pitch. “Yea, I’ve had like a million MRIs, it’s not the worst.” I realized based the amount of medical intervention Hannah experienced, my MRI was a drop in the bucket. I looked at that afternoon as a terrible trauma to be endured and for her it was just one of many. Her optimism in that moment shook me. I panicked at the press of a needle and it was her new normal.
As Tracy Chapman said,
“We gotta make a decision
Leave tonight or live and die this way”
A few years later Hannah died, she never chose to live that way.