If my alarm goes off before 7am, there must be a damn good reason for it, preferably one that has something to do with traveling somewhere fun to eat wonderful things. In the case of last Tuesday, I rose at 6:08 to travel five miles across town for a brain MRI. Hardly fun or wonderful but a necessary twice-a-year ritual thanks to my current disease modifier, Tysabri.
Tuesday’s was my thirteenth MRI since 2010! (Hat tip to Google Calendar for that statistic.) I bet if you added up all of my MRIs since 2004, you’d find that I had logged a full day in the tube. It isn’t quite enough to fulfill Malcolm Gladwell’s 10,000 hour rule, but I daresay I’m pretty good at it.
MRIs begin with extensive questionnaires about the metal in your body. It is wise to take these questions seriously, because the M stands for Magnet(ic) — and you do *not* want to forget to mention (and remove!) a nipple ring before encountering a super strong magnet. (I was once in the waiting room with a mother and teenage daughter; the latter had *just* gotten an eyebrow ring and much drama ensued.) If your procedure involves contrast, as mine always does, there are also multiple forms to sign about understanding the risks, which are minimal for folks with normal kidneys.
Since I’m only wanted for my brain (sigh, just like high school), I get to keep my pants on (see previous parenthetical), removing my belt and wearing only a hospital gown on top. I addressed the toll gowns can take on your psyche in Diagnosis Part Two. If you’re a lady or a confident man, I highly recommend going for a pink gown if the option is offered. Pink will perk a person right up. Sadly, I was stuck in drab blue this time around. The dressing rooms at my MRI center are much like the dressing rooms at any department store, except instead of a door each enclosure has a curtain. This makes clothes changing the most stressful part of the procedure for me, since the only thing between me and falling into the hallway, bra akimbo, is fabric and my questionable core strength. My most recent visit was a success in the not-flashing-the-techs realm.
All 20+ MRIs I’ve gotten have been at the same place. The welcome I receive isn’t quite an enthusiastic, Cheers-worthy “Rebecca!” but it is warm and familiar (so much so that when I express dismay at having forgotten to bring phone for a photo for this very blog, the tech offers to use his phone and text me). Richard, who has been my tech on many occasions, fetches me from my dressing area with a new guy named Sergei, Richard kindly offering his arm. We cross the hall together, and I hop on the table without being told, making sure the wedge pillow that supports my legs is at just the right angle. MRIs’ accuracy depends on stillness, and comfort is key to stillness. If you twitch, there may need to be do-overs. Do-overs mean more time in the tube. No one wants that.
Knee pillow in place, I accept earplugs and lie back gingerly to place my head in its plastic enclosure. Richard offers a blanket, which I accept. (Comfort! And modesty! I’m braless in a chilly space — you can do the math.) I am asked an arm preference and offer up my left, which Sergei tries, unsuccessfully, to find a good vein in. It’s not contrast time yet, but they like to have everything ready so that they can simply inject the agent at halftime. My right arm is more cooperative. Saline is injected, and Richard says his usual spiel: “You may get a weird taste in your mouth or smell an unpleasant smell.” The smell is like rubbing alcohol, and I am always amazed and delighted that an injection can inspire the sensation of scent. Much about *my* body sucks, but bodies in general are cool!
Richard adds pads to each side of my head until I’m immobilized. The plastic grate comes down over my face. I think of Hannibal Lecter and Darth Vader even though awkward football player is more apt. I am handed my panic button, a small bulb on the end of a rubber tube to squeeze if I freak out. I wiggle a little to make sure I’m as snug as I can be given the circumstances. “What sort of music would you like?” Classical. “Is one blanket enough?” Yep. Let’s do this.
I slide into the machine with my eyes open. There is a mirror above my head that allows me to see into the control room where the techs sit. I can also see my toes wiggle, which helps orient me. The plastic wall of the machine is maybe six inches above me. It’s snug. If you suspect it might freak you out, for heaven’s sake, tell them you’re claustrophobic and take the drugs. My current drug-free tactic is the early morning appointment; my natural grogginess allows me to zone out, sort of like hitting the snooze bar repeatedly if your alarm were relentless patterns of eardrum-shattering sounds. Like that car alarm that cycles through a series of uniquely annoying noises but in a lower register. Classical music is piped into the room, then stops when Richard speaks to me through the PA system: “We’ll start with some tests, okay?” Sure! Ahnt-anht-anht-anht-chukka-chukka-chukka. It begins.
My godmother used to make up songs to the sounds of her MRIs, which I think is adorable but never worked for me. In the early days when I had to spend longer in the tube and had yet to discover the glory of the morning appointment, I used to do show choir routines in my head. Scans tend to last three to eight minutes, and trying to remember choreography to a Cole Porter medley I learned in 1992 was a great way to distract myself until the next break when I could wiggle, cough, and scratch my nose.
Four scans in, it’s halftime. I slide back out into the open air. A syringe is screwed into the catheter in my right arm, and the contrast is injected. The catheter is removed. Gauze is taped to the injection site. My arm is replaced under the blanket. I slide back in. Rinse and repeat.
An hour has passed when I emerge for good, bleary-eyed and eager to sit up. I am encouraged to exercise caution and do so. I hand over my earplugs, accept an arm, and head back to the dressing room to put on my well-person drag and face the rest of the day. Before I leave, I am handed a DVD containing images from the morning’s scans plus the ones from the fall for comparison. I’m going on three years without significant new lesions and hope that trend continues.
Before returning to the office, I treat myself to a bacon and egg sandwich in the same crappy little cafe where I processed my diagnosis 13 years ago. No Camels this time.