Next time, take the pill

Turns out I had to have an MRI this week. My first. It’s for something that will turn out to be pretty inconsequential, so I’m not too fussed. But I was fussed about the MRI – based on what I had heard anecdotally, the experience was going to trigger all of my neurotic buttons.

A few years back, a colleague described to me her MRI experience, in some detail. Arguably too much detail. She was undergoing fertility treatments. By the time she’d finished telling her story (she wasn’t keen on it at all), I could tell my blood pressure had shot off the charts. I was crawling under my skin just hearing about it. Being told not to move, being encased in a tight metal tube, the obligatory itchy nose you can do nothing about, the (incorrect) perception of suffocation. Check check check. All of my triggers.

I don’t like to be told not to move, and I don’t like a tight space with no room to move. I think this dates back to my brother picking on me as a kid – he used to hold my arms over my head, and it freaked me out big time (bigly, as Trump would say). Sometimes squeezing into the cramped middle seat of an airplane can trigger me. Even sitting still for a haircut can sometimes make me itchy all over, muscles spasming in protest. Being squished into the corner of an overcrowded subway car definitely gets me going, and I have to focus, and breathe, and realize that I can get out at the next stop if I have to.

I was packed on a sardined subway car back in January 1999 – during Toronto’s big “we called the army in” snow storm that we were forever mocked about. And the subway car just stopped. Ice on the tracks or something had to be dealt with. Probably stopped dead for 8 minutes, no personal space, people on all sides of me, breathing other people’s air, cocooned in layers of wool, sweat running down my back, nowhere to go. I nearly lost my mind. I can actually start hyperventilating just thinking about it.

So when the MRI presented itself, I was concerned. Went through the checklist with my doctor’s nurse – do you have a pacemaker, any metal shards in your eyes, diabetes – no, no, no.

Are you claustrophobic? YES!

No worries, dear, the doctor will prescribe you an anti-anxiety medication to take before the test. Someone will have to pick you up afterwards, it makes you a bit loopy.

Fine.

I received no instructions on just when to take the pill. The instructions from the hospital’s MRI clinic said to bring the medication with me, and to show up early.  So I figured they’d tell me when to take it.

I showed up super early. I asked when I should take it. The admitting clerk said she’d tell me. And then she didn’t.

I’m looking at the signs all over the waiting room saying outpatients, like me, may be bumped for inpatients, since the hospital is a stroke and trauma centre and they need the MRI for emergencies. Hardly anyone in the waiting room. Let’s hope this goes smoothly, let’s just get it over with.

Just as I was thinking, better take the pill now, there’s my name being called. Pavlovian, I spring up, leave my purse (and pill bottle) with hubs, and off I went.

After I got gowned, as the technician started to tell me about the injections I’d get (contrast, etc.), I realized, WAIT, I need to go get my anti-anxiety pill. And the technician scoffed. You won’t need that. You’re getting a pelvic MRI – I’ll send you in feet first, he said. Your head will be sticking out the back, you’ll be fine. It’ll be better this way, he said.

Hmmmm.

So, how long does this thing last anyway?

THIRTY-FIVE TO FORTY MINUTES.

Waaaaa? That’s about twice as long as the worst case scenario I allowed myself to contemplate.

OK, I better go get my pill.

We’re ready to take you now. You won’t need it. How do you even know you’re claustrophic? You’ve never even had an MRI. You can even sleep through it, we put headphones on to cancel out the noise. What do you do for a living? You’re a lawyer? Think about a file, it’ll be fine.

So, steamrolled more than persuaded, and trusting that if this guy saw people melt down 12 times a day, he’d be telling me to take the pill, off I went into the MRI room.

Lie down on the table, feet first. OK. Another guy (not my “you’ll be fine” technician) presses the button to move the platform into the MRI. My legs go in, my torso goes in, my shoulders go in, and about 80% of my head goes in. And I freak out.

WAAAAAIT. I thought my head was going to be outside. Nope, this is how it is.

I need my pill.

Too late, it takes 20 minutes to kick in (someone finally tells me).

Positioning dude takes the pillow from under my head so that my face isn’t right up against the top of the machine, and that gives me a bit of breathing room. If I look straight up and back, I can see outside the MRI to the flourescents on the ceiling. I’m not completely entombed. I’ve got a call button in my hand just in case, although the unspoken message is you’re not encouraged to use it.

I like to think I can handle shit, and I also want to get this over with and not screw with the queue (even though, I’m in the machine at least 1/2 hour early). Let’s just get this the fuck over with.

So it goes. They run the imaging tests in 3-4 minute bursts. They tell you when each one is starting, ask you if you are OK after each one. Each burst has a different rhythm – it’s like you’re in a dance club, and sometimes it’s heavy metal, and sometimes it’s more punk, and sometimes it’s disco. One sounds like that song from the Flat Eric video. I’m thinking about my very musical brother-in-law, who’s probably had a dozen MRIs. He may actually enjoy this. I’ll have to ask him.

I imagine I can feel the magnet pulling on my cells, tickling my insides. The magnets are so strong in some bursts that the platform under me vibrates.

Complicating matters is no water 5 hours before the test. I am a fish. I drink water all day long, I use lip balm about 80 million times a day. I don’t like dry lips, dry mouth, dry throat. I’m having trouble swallowing, as you do when you’re dry, when you’re stressed. Makes you feel like you are suffocating, can’t breathe.

I’m breathing super heavy at first. Panicked, trying to calm myself down.

Is it better to close my eyes, will that help me relax? Close my eyes, just dark.

Definitely not. With my eyes closed, my focus goes entirely to my dry throat, my difficulty breathing. Is my chin itchy, are my eyes watering, will tears start to fall and I can’t flick them away? Am I breathing so heavily that the test will be ruined (DON’T MOVE).

Much better with eyes open, other things to focus on – the machine, the label on the machine, the ceiling.

I try to think about how to organize a deck I have to do, presenting my recommendations on a governance review. Bang bang bang, go the magnets. Yeah, this is not the place to organize complex material, and rest assured, I didn’t bill for it.

What is comes down to is this: all you have in those 35-40 minutes are your thoughts, and who wants to go there?

There were probably 7-8 bursts of the 3-4 minute intervals, and then I got pulled out – yay!! For the MRI contrast dye to be injected. Then only 2 more, I was assured. But with the last burst, I’d get an instruction to breathe in, breathe out, and then hold my breath until the machine told me to breathe again. OK, how long do I not breathe?

TWENTY-FOUR SECONDS.

That’s probably a challenge when I’m zen. I’m not zen.

The whole thing took a fucking eternity.

Once it’s over, and they’re taking me out, “it’ll be fine” asks how it was. Not my favourite thing, I underplay. But see, you didn’t need the pill. As he helps me sit up and stand, he says, you’re shaking. Yup.

Maybe this dude at a downtown TO hospital sees way too much drug abuse. Overdose. Undoubtedly in fact. Fentanyl, opioids, I get it. Maybe he’s anti-medication because he’s done the math and concluded, it’s not worth it. It’s better without it.

Lorazepam, now that I google it, can be addictive. Intended for short-term use only.

Like for a 40-minute test that triggers all my buttons and, quite frankly, freaked me out.

Next time, I’ll take the pill.