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Category Archives: ativan

On tests and techs and pain

I saw a breast surgeon, she said to get a bi-lateral breast MRI.

I waited to hear from her office, but really all they ended up doing was faxing the MRI order to the radiology center. She also emailed me a copy so I would have it on hand. I called and made the appointment myself, which is what I preferred to do anyway. I called and spent like twenty minutes on the phone with the scheduler trying to make sure I was getting in for the “wide open MRI”. I asked the same question about forty thousand times… you’re sure it’s the wide open MRI? Are you sure they let you do that for a breast MRI? It’s wide open, right? And that’s what you scheduled me for? I think the woman thought I was nuts, but the potential that I could get into a “wide open MRI” was enough that I was willing to wait over a week for the appointment.

I had the option to use anti-anxiety medication. I had some old-ish meds on hand, so that’s what I planned to take with me. But I hoped to not have to use it, considering the “wide open MRI” was supposed to look like this (based on the picture on their website!):

oasismri

Yeah, best laid plans.

I waited pretty well for the test. A few days before, I saw T and we actually did hypnosis (which she recorded and I listened to for the next two days) so I could get through the MRI test pain and anxiety free. I didn’t start getting nervous until the night before. The day of, I cried a couple of times, but when I went into the facility, I was okay. Nervous, but okay. They took me back and had me change into scrub pants (I had to ask for a size up because I’m just too bootilicious–actually, I needed more room in the thighs) and a hospital gown top open in the front. Then they made me sit and wait outside the MRI technician’s room, where I could see the techs performing the MRI before mine.

The male tech came in to talk to me about the test and why I was getting it. I told him I was nervous and asked if the MRI was indeed open on both sides. He frowned and said no, it was just wider inside than the old-style MRI. When he saw me shudder, he said, “I’ve had a 550 pound man in there, no problem! Does that make you feel better?” I said NO. He said, “Well, at least you’re honest! Haw haw haw.”

wide_closed_open_mri

The one on the left is the wide bore. It’s wider where you go in and shorter in length. They also send you in feet first so your head is closer to the air. Well, except I was getting my boobs MRI’d, so really I wasn’t that close to the air. More on that in a minute.

The male tech said the female tech was due back shortly and would be the person to get me on the table. I asked how long the test would take and he said once I was settled on the table it would be 35-45 minutes. He put my IV in (he wanted to put it in my hand, but I declined because YOWCH) and left me to sit while he finished with his current MRI patient. I sat quietly, I breathed, I went through the hypnosis stuff in my head. Then the female tech came in and announced, “This is going to be painful.”

WTF.

I said, “What?” She said that a lot of women have trouble with keeping their arms over their head for the whole test, and that it’s pretty uncomfortable. I said I understood, and she left to clean up the MRI from the previous patient and set it up for me. See, online you get this picture of a bi-lateral breast MRI:

breastmri5

So comfy. She’s got a pillow and a blanket and she looks like she could nap. Aww, isn’t that amazing?

Instead, what you are confronted with is this table, sitting there, staring at you, taunting you, just waiting to fill you with pain. It wants you to cry. I’m telling you, it wants you to weep.

mri2

Let me explain further, for your torturous enjoyment. You see those red arrows? They point to where your boobs go in. Nice and roomy, no problem. All good, yeah? But wait, look in between where your boobs go. See that white plastic piece there? Yeah, that one. The one that feels like it is made from concrete and is going to support the entire weight of your upper body for 35-45  minutes. Pressed solidly against what? Your sternum. You lay there, with your lower body slanted downward, but you have to have the majority of your body over that area where your boobs hang down. And it’s all resting on your sternum, on hard plastic. Narrow hard plastic. Narrow, unforgiving, hard plastic.

I had to climb onto the table and kneel down (both knees are bad, I don’t kneel on anything anymore), get positioned and then lay face down. And I nearly screamed out in pain. I have a very sensitive sternum and the muscles around it are also sensitive. I cannot even wear an underwire bra for more than an hour or two. I basically shot back up to my knees (my poor poor knees) and looked at the female tech for help. She said, and I quote, “I told you it was going to be painful.”

WTF.

I have never, in all the years I’ve been going through testing–and I’ve had a long history of lots of different and unusual tests–backed out on a test. But I looked the tech in the face and said, “I can’t do this.” I couldn’t put my weight down onto that plastic piece for more than a minute, how was I going to do it for 35 or 45 minutes? The tech offered me a narrow pad to cover the cross piece but I barely felt it. She said too much padding and I’d be too far out of the boob slot to get good pictures. So we stuffed a pillow up under my stomach and I laid down and I suffered.

See the area where you put your face, like a massage table? Yeah, they cover that with one of those caps you wear into surgery. So you’re face down into a blue plastic-papery non-breathable cap. And when you breathe? You get a face full of your own hot air. There’s no place for your air to go. And because you’ve got your full head weight all resting up there, it all gets put on your face, cuz your head be heavy like a fucking bowling ball. All on your face and cheeks.

Then they readjust your gown out of the way, shove gi-normous earplugs into your ears because the MRI machine is SO LOUD I could hear it out in the hallway with the doors closed. They shove a rubber ball thing in your hand and shout into your ear (because you’re wearing earplugs) “Squeeze the ball if you have an emergency.” And then they leave you.

I’ve had MRIs before, and normally they tell you when the test is going to start and how long that section will take. I heard the tech do it for the patient before me. But I got none of that. The only time she said anything to me during the test was, “You have four minutes left. Stay still.”

I had my arms extended over my head the whole time, I didn’t move, and I breathed so shallowly that I thought I would hyperventilate. If I breathed any deeper, the pain in my sternum multiplied by a thousand. I do not exaggerate. I know pain. I live with lots of it. This was so horrendous, it was worse than post-surgery for my hysterectomy.

At no point did I look like this:

p-mrimachine

But rather more like this:

breastmri

See that hyper-extension of the arms and shoulders? Yeah. For 40 minutes. Ouch. The MRI tube was wider than ones I’d been in previously, but it was hotter than I remembered. The MRI waves affect me. Not everyone feels it, but I feel the heat and I feel the magnets. They move across my body, making it feel like the flesh is rippling…which some people describe as “vibrations”. At some point I felt the cold slither of the contrast go through the tube she’d wound around my thumb so the tubing didn’t fall off the table, but no other warning for that. At least at that point I knew I was close to done.

When they finished, the tech came in and started sliding the table out. “Don’t move yet!” she said. GREAT. Then she unhooked me from the contrast machine and tried to warn me about sitting up slowly, but I still had earplugs in. When I pulled away from the torture device, onto my knees again, my entire sternum and chest area SCREAMED. The tech yelled at me not to stand up, to roll to a sitting position and wait. Then she approached me and yanked the earplugs out of my ears. I’m sitting there, dizzy, half blind because the room is so bright after being enclosed for so long with my eyes squeezed shut…and my chest is just so painful that when I breathe, I want to throw up.

The tech stands there while I try to get my bearings, then I push to my feet. The tech gives me the key to my locker, says, “you’re cube six” and then disappears. Doesn’t tell me where the cube is or how to get out of the maze of rooms and hallways back to the waiting room. I basically hobbled around the corner to find my cube, got dressed really slowly, then went back into the hall. I had to stop someone to ask how to get out to the waiting room. When I got out there, I hobbled to the exit and waited for Hub to meet me there. Then he helped me out the doors and as soon as I got outside, not even onto the parking lot, I started sobbing. Which hurt my sternum like a motherfucker. Hub helped me into the car and asked if I needed to go to the urgent care or ER and I said I just wanted to go home. I cried all the way home.

When I got home, Hub helped me upstairs and brought me ice packs for my chest, and I just laid in bed for three hours, trying not to cry. I had trouble sleeping last night–no surprise. This morning–one day later–every single muscle in my body hurts. My back and shoulders and arms… OMG so painful. My sternum still hurts. I can’t bend over without sucking in air from the pain.

I have no idea when I’ll hear from the doctor. I have no idea when any of this pain will subside. I’m so tired and so weary. I don’t know that I could do another MRI like that again. I wish I had been able to really tell the tech how I felt about the whole experience, including her attitude, but I didn’t have the energy or the strength at the time. I wanted to get a CD copy of my test, but I couldn’t stay in that building one second longer. I’ll have to call and order it, then pick it up. Hopefully just for record-keeping sake. Hopefully this will be nothing and I’ll have a good base-line for any potential future issues.

I’ve mostly been sitting around today. It’s taken me most of the day to write this email because my shoulders hurt so much. I don’t even know psychologically how much this trauma is going to affect me. Ugh.

(Happy update. My breast surgeon called about twenty minutes ago to tell me that the area was just “normal glandular tissue” and there was nothing to be concerned about. No follow-up needed, but to keep up with annual mammograms as usual. Yay.)

 

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Um, ow.

Okay, so I made it through all the medications and such. And I got to the gyno office, where I waited. And waited. And got moved to another waiting room to wait. And went into an exam room to get vitals, then back to the waiting. Then FINALLY into the procedure room, where I got to wait some more.

But the nurse was nice, and after being told what would happen, I told HER what might happen. About my anxiety and my potential for panic attack and/or bursting into tears. AND that my leg muscles aren’t great, so as such…the candy cane stirrups. I didn’t realize the actual position it would put me in, and that hurt my hips A LOT.

Also, apparently warm speculums are not a happy thing for me. That actually hurt like a burn.

I’m really tired and sore and achy. I am going to shower and get into bed. I’m moderately hopeful I’ll be okay tomorrow, because my mother goes for a 2nd opinion and I want to go with her.

More in another post when I’m feeling better. But I wanted people to know that I made it through, no panic attack. Moderate pain during the procedure, but it could have been worse. Thanks to those were thinking of me.

 

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I haven’t posted

mostly because I wasn’t sure I was ready to really share. Sometimes I need time to process before I know what to say. Often when I’m in session with T, she’ll say things and I’ll just sit there for a minute before I say, “Oh-kay” even. And then I’ll need to take home what she’s said and really process it.

I’ve been processing the hell out of some stuff.

We went to see my mother’s new radiation oncologist, who was not upbeat about the situation. He, in fact, was very gloom and doom about my mother’s prognosis. She hadn’t had her PET scan yet, but he seemed to indicate that they weren’t likely to be able to “cure” my mother. We spoke with him for about 45 minutes, maybe an hour, and he tried to explain what was going on. The phrase that still eats at me is, “Chance of cure is not high.” It took me a while to think on the fact that just because she can’t be “cured” doesn’t mean she can’t live WITH the cancer. But at that point, we still had no results of the PET scan, so we had no decisions to make. She has since had her PET scan, but the radiation oncologist did not call her to talk to her about his suggested path as he was supposed to. She ended up calling his office three days after the test, talked to the receptionist and left a message (the receptionist said, “oh, it’s always good that the patient calls to remind the doctor he was supposed to call” and she was SERIOUS not snarky!) but didn’t get a call back. So she called her chemo oncologist and left a voice mail and HE called back right away. He said he was going to call the other doctor first thing this morning to talk to him. Then he sent her the written report. But reading those damn things is…hard. So we still have no set path, and at this point Mom has decided she wants a second opinion, no matter what.

The appointment was hard. The doctor put his hand on my shoulder as we were walking out of his office and said, “I’m sorry to give you such bad news.” It made my heart skip a beat. It’s like you aren’t sure what is exactly being said, but when a doctor says that to you point blank, you really get it. On the way home in the car, we were only mildly discussing the appointment, but also trying to talk about other things. I knew my mother was upset–this whole episode has been much worse than the original diagnosis, the hysterectomy, the chemo–so I was trying to do something to help her. I finally wrote on my notepad (I always take notes for her during appointments), “Today you are okay.” I ripped the page off and handed it to her, and I told her to just keep it in her pocket. Every time I see her she shows me that she has it with her. The truth is, today she IS okay. The recurring spots are small and localized (at least from the CAT scan that found them), and she’s not having symptoms. (The unfortunate part is that they are concerned it has made its way into her lymph system…and also that it recurred so quickly after chemo ended.) So my brother and my uncles (her brothers) are all researching and inundating her with information, but I’ve been staying out of it. I’ve been doing what I can do, which is talking about other things with her. Doing other things. Planning other things. When she brings something up about the cancer or the research, I talk with her. But otherwise, I don’t bring it up. She has enough of that from everyone else.

The same day my mom was getting her PET scan, I was in with the gyno CRNP talking about MY fantastic upcoming procedure. Apparently the next step for me is something called a hysteroscopy. Where they put you in stirrups and shove a camera and a tube past your cervix into your uterus–which they fill up like a water balloon with some liquid–and poke around. They also take “material” for biopsy to see what’s going on. This is done in their women’s procedure center, attached to their office, which fortunately is attached to a hospital. So I get to be awake, but I’ll be having all kinds of medication. Now I’ve had a biopsy before, but no camera. This is supposed to take a little longer and likely be more uncomfortable than just a biopsy because the camera is larger and there’s more that needs to be done. In preparation for this fantastic voyage, I get to start my week by taking 800mg ibuprofen today, 2x a day, for two days. That’s today, by the way, and I’m home alone. So I have no Hub to be my safety person as I take my pills. I know it sounds weird because we’re talking about ibuprofen, but I haven’t taken ibuprofen in 15 years. I take nothing, other than the occasional antibiotics and only recently that stupid progesterone. I don’t even take tylenol or aspirin. So I get to take that ibuprofen with lunch, then again with dinner. Then 2x tomorrow, as well. AND I get to take something weird tomorrow night to “soften” my cervix in preparation for the camera. And then morning of the procedure, I get more ibuprofen AND a beta-blocker (which the doctor says is FINE with my PVCs) in preparation for counter-acting the epinephrine I’ll be getting directly into my cervix during the procedure (which causes people to be “jittery” and anxious!). I’m so unhappy about all these medications, I can’t even explain. I’ve been blocking this whole thing out until this morning so I wouldn’t have to think about it. I asked if they were going to be monitoring me, and the CNRP said they’d do my blood pressure ahead of the procedure, but during they basically just visually monitor me…and depend on ME to tell them if something is wrong. I wanted to laugh and cry, because those of you who are anxiety sufferers KNOW that we don’t interpret things–like pain, breathing, heart rate–properly when we’re anxious. Now the doctor DID prescribe me a couple of ativan pills in case I needed (or wanted) to take it the night before or morning of the procedure. I’ve had ativan ONCE in the hospital ER when they were putting me into the MRI. I don’t remember much about it, but I’m worried if I take the ativan (0.5mg) the morning of, I won’t be alert enough to tell them if something is wrong. I’m open to opinions on that from those of you who have experience with ativan.

I’m also concerned about being in that kind of horrible position for an extended period of time, due to my muscle issues. The CRNP keeps telling me that recovery shouldn’t be bad–lots of women go back to work the next day, some even go “shopping” the same day she told me–but I have muscle pain after going to an annual exam because of having to keep my legs open without any kind of support. So the CRNP offered me “candy cane” stirrups, which I found out later will sort of hang my feet in the air rather than me putting them into stirrups and having to keep them balanced. No idea if the candy cane stirrups will be better.

On top of all of that, I am trying to ignore the potential result of the biopsies they might get. This part has been really really hard, because it scares me the most.

I’m feeling overwhelmed between what’s happening with me and what’s happening with my mom. The potential scheduling of my procedure caused me so much stress because I KNOW it’s going to take me a couple of days to recover, and I was worried that my mother was going to have an appointment during the time I was unable to get around to go with her. I tried to work things out, but we had no idea what timing was going to be with her scan and her results and etc. As it turns out, because she’s considering a second opinion, I should be okay by then to go with her. And if not, my uncle (her brother) has really stepped in to attend appointments…he has some medical background, so he understands things differently than we do.

So just the length alone of this post should indicate my mental state, eh? If you’ve read all of it, thank you. If not, no worries. I just needed to be able to vent AND put this all done for posterity.

(and for record’s sake, my PVCs have been milder and less often in the past two or three days. I have no idea why.)

 

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My ER experience

I went into the emergency room of a local and well-known hospital  because of the symptoms I had been dealing with for several weeks. On top of an onslaught of depression and grief, I had been suffering from extreme lethargy, lack of interest, paranoia (mostly over food), body pains, weakness, severe panic and anxiety, lack of concentration, heart palpitations, and more. I had no idea where all this was coming from, and I was unable to continue the way I was. I scheduled with my husband and parents to go to the ER on a Monday morning, so that we knew who would take care of our dog and how my in-laws (in from out of town) would be dealt with. I had packed my bags for a multi-day stay, just in case. Even though I knew I was doing the right thing by seeking help, I was scared shit-less. I was terrified the hospital would find me mentally unstable and would have me committed. I begged my husband to never let me out of his sight, to not let them take me away. I was so sure I would not be coming home that I left my husband a note telling him goodbye, telling him how much I loved him and how sorry I was that I had done this to him. There was more in the letter, very personal and private emotions that spilled out, because I knew in my heart that I was going to be taken away from my family.

We went into the ER and as expected, had to wait. Because of some of my symptoms, they did take me in briefly for an EKG to check my heart, but I guess it must have been normal because they then sent me back to the waiting room for quite some time. While I was out there, I struggled with my panic and anxiety. I struggled to sit still, but failed. I shifted in the wheelchair I’d come in on (I had no strength to walk in from the car, let alone walk through the ER), constantly moving my body around. My heart raced continuously and my fear over what was going to happen in the ER escalated minute by minute.

When they finally brought me back to a tiny room, they re-checked vitals and took a urine sample. Pretty quickly they realized I was dehydrated, so they set me up with an IV before I even saw a doctor. I don’t remember everything about the experience, but I know at some point they moved us from this one room that had a private attached bathroom, to another room that was just as small but did not have an attached bathroom. It was here I was seen by doctors, including a neurologist. They were concerned that I was neurologically impaired due to something called Guillain Barre syndrome, but the best way to test was by spinal tap. Since the neurology resident wasn’t feeling confident about the diagnosis, we requested she speak with her supervisor before we went for such a painful and (terrifying!) invasive test. Instead I went for a CT Scan of my head and neck. My husband, G-d bless him, insisted he go with me to the CT scan, even though he had to wait in the hall outside. It was a quick trip, and the neurologist came back in shortly thereafter to do her physical exam. I’ve been through these before, stand, sit, walk, scrape the foot, test the eyes, strength, balance… the majority of these results were normal for me, a few slightly abnormal, but nothing alarming. She felt my hearing was compromised in one ear from one area, but it wasn’t something I’d ever noticed.

Then the CT scan came back with an abnormality in the hearing and balance area of my brain, so they immediately scheduled me for an MRI. I’ve had an MRI before…once. I hated it. And even then I’d been concerned about the dye used because people can have anaphylatic reactions to it. But I was told this was a different kind of dye, and that if I was nervous I could have an Ativan before the MRI. I told the nurses that yes, I have anxiety, and yes, I am severely anxious about the MRI and how enclosed it is, and how I can’t keep my head still when asked to do so. But that I was too scared to even take the Ativan. They assured me the Ativan would be short-lived, and that it was unlikely that I would have a reaction. I was actually surprised at how compassionate the nurse was with me, and the resident doctor as well. And considering I was in the emergency room and could be seen right away if I had a reaction, I finally relented. They gave me a small pill and I took it. And I sat and counted the clock, waiting to feel something…good or bad. Instead I started feeling mildly sleepy…and numb. When they came to prep me an hour after the pill for the MRI, they gave me more Ativan intravenously, then took me away. They wouldn’t let my husband come this time, as they said it would be a long wait and no place for him to sit.

Although I remember going to the MRI, and how nice the techs there were, I had no real sense of time. I knew I was in there a while, no question, and I was bored out of my gourd, I was mostly just…bored. The noises were annoying, and staring up at the stupid mirror showing me my feet was … boring and aggravating and kind of confusing. It was like, what the hell were my feet doing over my head? After some time, the tech came out and gave me the dye in my IV, then rolled me back into the MRI, telling me it would only be another hour! And no, even though my ass hurt like a mother-fucker, I could not adjust on the table because I had to be in the exact same position. I think there was music playing, which they’d asked about initially (top 40 or pop, please), but I don’t remember much of it.

When I came back, my husband was waiting in the hall for me, like a caged animal. He told me I’d been gone for 3 hours. I had no idea…again I knew it had taken a while, but not that long! Ativan, interesting creature.

The neurologist came back saying I had something called a schwannoma in my brain. Benign, she told us, and smaller than they had originally thought. Centered on the balance and hearing part of my brain on one side (I think it was the right, which would affect the left side). She scared the hell out of me and my family. Schwannoma is a collection of extra cells that grows extremely slowly. They apparently don’t do anything unless it is causing problems. I’ve had balance problems for 13 years, attributed to migraine associated vertigo. Now we were left wondering if it was the schwannoma instead.

The neurologist talked to her supervisor about the guillain barre syndrome, and they decided it didn’t really match what was happening, and so the lumbar puncture was canceled. And I was told I was dehydrated and undernourished, and that my inactivity had led me to the pains I was having, as well as the lethargy and stiffness. I was told to go home, stay hydrated, eat more, and move.

(and not so incidentally, after weeks of no update from the neurologist, I made an appointment with their out-patient clinic, went out with my supportive family, only to be told by the resident and senior neurologist that there was nothing showing up on my MRI at all — well, except my brain…so the whole scare was a false reading! ARG!)

After the ER visit, the next day, I had that horrible panic attack and eventual realization about Prilosec.

 

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