10 december 2020
All original writing
2014, 2015, 2016,
2017, 2018, 2019,
2020, 2021, 2022,
2023, 2024
Dr Ian McLauchlin
MRI CARDIAC STRESS PERFUSION SCAN
“Have you got any bits of metal in your head?”
To see ourselves as others see us, eh?
“No, we have to find out for the magnetism.”
Ah, personality is it?
I’d waited weeks for this and now the day had arrived. Faulty heart valve and very short of breath. Exeter Nuffield Hospital. A pleasant Thursday. “Sign here, and here, credit card here, PIN here. Is that the price you were expecting?” Four figures, that looks about right. And no decimal points. There, that’s your part of the bargain done. Go and sit down and we’ll have a think about our part.
Before long, the first part of their bargain appeared, in the shape of a Health Worker. “I’m Lorraine.” I’m not. Took me to this room where I had to sit on a trolley covered in a roll of paper, the trolley not me.
“Are you OK with blood tests?” she asked. I am if you are. She wasn’t. Poked around in right arm with needle, looking for blood. “I'll just have to get a colleague.”
“Hello, I'm not Lorraine either.” Poked around in left arm with needle. Poked some more. Four hands better than two but not quite enough. Can I help, I have spare hands?
Eventually filled a phial. No, with blood. Good that’s that over. Need to go and sit in a different waiting area.
People in dark red uniform walked past, giving me a pitying look. Eventually one of them, of the female variety, called my name. Right, here we go.
“Got any metal in your head, or anywhere else?” Coronary artery stent – yes, artificial stapes – yes, sub machine gun – who wants to know? 3-
A man in a darkened room sat in front of a screen, no three screens. He turned round and looked at me, pityingly again. “I'm Alex." Hi Alex. I think we're going to be seeing a lot of each other in the next couple of hours, but you'll be seeing more of me than I’ll see of you.
When did you weigh yourself? Couple of days ago. Not that we don’t believe you but can you stand on these scales? Now I don't know whether you've tried to stand on square bathroom scales that are right up against the wall . . . Had to take a short run at it and stop just before my nose hit the wall. There were nose marks already there. I should have told them about it but they had complete control of me by this time.
Right, take all your clothes off. No not now, in this little room over here. There was a little room with lockable cupboard and gown which opened down the front. It wouldn’t close down the front. I had to hold it, tightly.
We first need to do some tests on your heart. Oh good, sounds promising, even though my heart wasn’t in it. Electrodes, ECG. Again. If I had a pound for each ECG, I’d . . . . have quite a few pounds by now. Alternatively, could be chocolate biscuits or even ECG tokens. Mind wandering now . . .
“OK, walk into this room and sit here right next to this Scanner with barely room to move inside it." That’s good as I think I’m going to be inside it, barely.
“Right, lie down." Did that. “We’re just going to shave parts of your chest and rub them hard with this alcohol/sandpaper mixture.” Whatever turns them on. They stuck various electrodes on the freshly prepared areas.
“Now, lift your knees up.” They slid a supportive pad under them.
“Now we’re going to cannulate this left arm.” Cannulating meant sharp scratch, another sharp scratch, squeezing and pummelling, shoving double-
Then a grid encapsulated in rubber was strapped to my chest and to the table. This was to stop me making a run for it. Or it could have been to receive signals during the scan. BP cuff next, then oxygen sensor on finger. Headphones on. They can talk to me, tell me to Breathe in, Breathe out, Hold Your Breath (BIBOHYB). Check whether I'm still OK, laugh at me etc. Then pads under my arms. Finally, a rubber panic bulb to hold. If I'd had that earlier I’d have pressed it hundreds of time by now.
OK, this is it. The table moved me into the tight tube. A thick grey line was above my head about two inches from my nose. I must have travelled about a yard. A fan blew cold ‘fresh’ air onto my face. To remind me what fresh air, the outside world and freedom was. Fresh air that I’d never breathe again, neither in nor out. Lots of clanking. The start of 50 minutes from hell.
Silence for a while. Then countdown noises in headphone followed by BIBOHYB. How long do I hold my breath? I started counting seconds. Got to 15 and Breathe Normally (BN). A succession of all of that, sometimes holding breath for shorter periods, sometimes longer. Longest I counted was about 20 seconds. Didn’t know if I could hold that long but managed it. Phew. Then I was aware I needed to swallow. BIBOHYB – oh no. Managed to do it without swallowing than swallowed like mad, thinking that one swallow doesn’t make a summer. Not in MRI land anyway.
Lots of clanking and odd noises in headphones. Lots of BIBOHYB. If you’re claustrophobic you’re in Big Trouble. I am a bit but imagined myself somewhere else.
At various stages my tummy wobbled due to some unseen but loud force. Magnetism playing tricks I guess. It did it a few times. Wonder whether they’ve injected the adenosine yet. They said that some people feel a bit of something, others feel nothing. Been in that tube for ages. Surely it should be over soon.
OK, it’s been over half an hour and we're shortly going to inject the stress chemical. It'll take a few minutes but when we stop, it'll disperse very quickly. Are you OK?" Do I have a choice? And oh no, I/they haven’t even reached that stage yet. Wonder what it’ll feel like. Mmmm. A bit of a tight chest. A lot of a tight chest, but manageable. A very tight chest, hardly manageable. “Right, we’re going to stop it now.” Oh good. Couldn't have managed much more. Then a metal band clamped itself hard across my chest and shoulders. My muscles cramped, my eyes watered, my head spun and the pain was tremendous. I almost passed out. Do I squeeze the panic bulb? While I was considering that, the feelings passed and the chest clamp relaxed.
Lots more scans. “We’re going to inject the contrast agent now.” Oh good. Hope it's a huge contrast with no pain. It was gadolinium. Well that's a metal so they must have injected a compound. I hope. Lots more clanking and BIBOHYB. By this time I’d stopped caring. Clank away. I’ll breathe in whatever way you want. Hold my breath for 20 minutes if you like. Return from a foreign beach even.
OK we’re on the home straight now. Good. I’m glad they are. What about me? How long have I been in here? 40 mins? 50 mins? Will I ever get out? Just a few more scans
After the best part of an hour I was finally out of that machine. Phew. What an ordeal. Much worse then I expected. But I'm out. More pummelling and squeezing of cannulated arms both sides. Removal of BP cuff and everything else. Pressure applied to cannula entry points.
Can you move? NO. Can you draw your legs up? NO. Can you rollover? I'll try. Feel as though I’m going to roll off onto the floor.
Finally with help, managed to sit up. Thanked the three people, called the MRI machine a bastard out loud and to its face, stood up, wobbled, sat down again. Eventually managed to walk a few steps. Changed back into clothes with great difficult, especially putting trousers back on which took forever with assistance of a grab bar on the wall.
Hobbled out of the suite towards a waiting room. Sat down. Marvelled that I was back in the land of the living and no clanking tube to be seen or heard. Did a wee, a long one. Had a cup of tea. Sat around for a bit longer still, getting used to this thing called almost upright. This thing called no chest pain. This lack of an all encompassing narrow tube with wide grey line showing you the escape route but with no arrow and no means of escape.
Now just have to wait for the results, while BIBO but, thankfully, no HYB.
31 may 2022