Monday, March 30, 2015

Ninety Minutes Inside An MRI Machine!


If that title sounds like and conjures up images of `Around the World in Eighty Days', this author begs to (a) violently differ and (b) be forgiven.  That is not the intention, since the aftermath of taking temporary residence inside an MRI machine for any length of time cannot be pleasant, period.  Especially if the specimen subjected to the vicious experience is usually stricken by the sight of a doctor and the all-enveloping antiseptic smell hanging like an unseen dome inside a hospital or clinic.

You have heard of `White Coat Syndrome' (WCS)? Simply stated, it is that churning feeling you get when you think someone has inserted a hand directly into your innards and started squeezing, just as you are entertaining thoughts of an encounter with a doctor.  What it does is this - if you are going for a blood pressure check, it shoots your BP rocketing up; if the issue is something to do with the heart, your palpitations increase dramatically; if your lungs are causing problem, your breathing becomes shallow and erratic; if it is diabetes, your system has suddenly upped the quantum of sugar manufactured internally.  In short, WCS unfailingly exacerbates the symptoms, if not the problems themselves, you are approaching the doctor to mitigate.  This author assumes that his readers are not such naive softies as to believe that anything can be cured - so, mitigate it is!  Then the wise doctor, who has known you for twenty years and has done nothing at all otherwise to cause fright in you, examines while you apprehensively watch his furrowed brows and creased face.  And wait for him to either tut-tut or cluck-cluck (all doctors are not predictably uniform in their reaction and each one has his staunch preference - not that two of them agree on anything else) condescendingly, by way of prefacing his remarks.  Then, with a pitying look on his face and a vague smile (he has perfected the art of being always pleasant to the patients) he finally delivers his cheerful judgement `So, what have you been doing, it has gotten worse'!  Result is another half a kilo of tablets per month.  Remember, this is not because the problem has gotten more acute, but WCS has sabotaged things for you.

Why that detailed rendering of what WCS is?  Just to provide the essential background, as any half-decent author will do, so that his audience gets full value for time committed, in understanding and appreciating the story.   What do you think happens when someone, suffering acutely from WCS as well as claustrophobia, is forcibly inserted into an MRI machine, ashen-faced with fright and shuddering from uncontrollable emotions?  Read on and you will find out.  Disclosure time.  The temptation was to write this in third person and get away with that.  But an honest author does not economize with truth nor does he attempt to misrepresent.  So here goes (there is no dignified way of saying this, I guess) - the WCS infused patient who gets into the MRI machine in this story is the author himself!  The context was the need for an MRI to inspect the plumbing in the nose, to see how bad the deviated septum was.  Knowing the highly perceptive and intelligent readers following this blog, they would have guessed facts anyway, given that such clarity and attention to detail can emerge only from a life-changing and intimate personal experience!

Just to frighten me a bit more and make me feel less than normal, they forced me to change into the hospital attire, as if I was going in for a complicated surgery.  The prepping process included a short list of do's and dont's, delivered in a monotone by a bored technician - Do not shift the body (I wondered how one did that, since there was not even wiggling space inside).  Do not shake your head or neck, lest the picture scrambles.  Breathe, only if you have to. Already petrified, I tentatively asked what happened if the picture quality was patchy.  I should have known.  `You have to go back for another hour again, and that is chargeable', as if they were giving me a pleasure-ride!   My dear wife hissed `Don't behave like a kid, get on with it'.  Already the doctor, who happened to be a cousin of hers and she had mirthfully discussed this scene and giggled heartily, while all I could do was frown in silence because I had more sinister things gnawing at me.

I was launched into the capsule head first and my dear wife robustly waved me off as if I was on a Mars mission.  Very helpfully the technician told me it would take forty five minutes and gave me a calling bell.  He asked me to press the button, if I wanted the process to stop for some reason.  Now, I was all the more worried as to why that would happen, but before I could ask for elucidation, somebody said `okay, go'.  As soon as the machine commenced operations, it let out a high-pitched whine to let everyone know who would be in control.  Then started the vibrations, which were abnormally high in the estimate of the technician and the doctor attending.  They hastily concluded that the patient's own involuntary body tremors were adding to the machine's.  So, the patient was peremptorily pulled out and told in uncertain terms that unless he co-operates, they would have to sedate him and the readings would be sub-optimal in that case.  Which meant, the lease period for occupancy of the machine for the patient would have to increase, if required, along with the charges.  That promptly eased the tremors somewhat and the process re-started. 

The inside of the machine was obviously built strictly for utility, not for entertainment.  There were many contraptions all around,  making the same whirring sound following some algorithm as they kept moving about busily.  Just to jazz things up a bit, there were disco-like lights overhead, angrily flashing here and there, as if they were upset and disappointed at what they found inside my head.  In five minutes, I have had enough and pressed the calling bell button.  It worked and I was overjoyed to realise that someone was indeed outside and the machine was stopped.  The technician impatiently asked me what was wrong and was downright annoyed when I said I was just testing to see if the calling process works - only for emergency purposes.   He threatened not to stop during the process even if I had a problem since I was abusing the facility.

I decided to grit my teeth and go through with the hellish experience, despite being rattled by many doubts and questions:
-- What if everyone outside went for collective lunch or tea and there was no one to respond to the calling bell?
-- What if there was an earthquake or fire and everyone scooted, leaving me inside, blissfully ignorant of reality?  I did not see any way of scrambling out on my own.
-- What if the process is finished but the technician could not retrieve me because he had a heart-attack or was otherwise disabled?

I also made mental note of all the very practical enhancements that I figured were necessary to the MRI machine, in order to make it a more wholesome experience:
-- Fit the inside with TV Screens (HD, if possible) with a few channels and provide ear phones to the patient (Time-pass, if not entertainment).
--For those who do not appreciate TV, provide a teleprompter kind of screen and e-book to read.
-- Make glass windows on both sides so that the patient can see he has not been left unattended (Reduction of anxiety in the patient, helps control fear).
-- Have a hole through which the patient can put out his hand and this can be held by a pretty and gentle nurse throughout the process (Reduces stress and makes the expeirence somewhat acceptable)
-- Enhance the machine to accept brief breaks, without punitive levies, so that the patient can take a walk around the room for fresh air, when claustrophobia overwhelms him.

May be, I was being unacceptably busy with my hyper-active imagination as well as analytical bent of mind.  The picture quality was way below normal level and I had to go through the same process again for another forty five minutes.  When I finally emerged at the end, there was resounding applause from all those present, fit for returning astronauts.  When I gave the list of my questions/doubts as well as the suggested improvements, the doctor glowered and wanted to send me back for another MRI of my scattered brain!  I have never been back there, but I hear they have framed those notes and displayed inside the MRI room; of course, without disclosing the name of the patient, out of sheer pity!  Very considerate of them!

 



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