Tuesday, April 19, 2011

Patient Refused Contrast

In November, I went to the GYN and she referred me to get an ultrasound because she suspected I had cysts on my ovaries. Thanksgiving was right around the corner then Christmas and finishing up my classes for the semester, so I decided to wait until the new year to get my ultrasound. I made an appointment in January and had my first ultrasound done. I actually remained very calm during the whole process. About two weeks later, I received a call from my doctor telling me that I lots of cysts or masses on one ovary and two large ones on the other, so she wanted me to get another ultrasound. After the second ultrasound, the smaller cysts had disappeared but the two large ones were still there. She told me I could go straight to surgery and have them removed because they were quite large or I could get an MRI; I went with the latter.

I was anxious about the MRI, but I knew it would be better than surgery. When I received the form in the mail from my doctor, I noticed that she had checked with and without contrast. I didn't know what that meant, so I googled it. I started reading all these terrible stories about things that the contrast did to people like vomiting and having to go to the hospital and arms being numb for extended periods of time, etc. All of this freaked me out. Besides not being able to drive far distances, another anxiety point for me is taking any kind of medicine or putting any substance into my body. I drank a little bit of Children's Motrin when I had one of my wisdom teeth removed, but that's the only medicine I've taken in about six years. A doctor prescribed me Lexapro when I was 22 and I had one of the worst panic attacks of my life, so I've avoided taking medicine since. I knew if I let someone inject dye into my veins, I would feel like I had no control of what it would do to my body and I wouldn't be able to get it it. But, I also knew that I should get the dye just in case the masses were tumors because it would help highlight them.

On the day of my appointment, I was anxious. I couldn't drink the calming tea I usually drank on anxious days because I was only supposed to have clear liquids. I made myself a cup with two teabags and took it in the car with me for after my appointment. My mom met me there. I know I'm 28 and shouldn't need my mom for something like an MRI, but I did and I do. It was pouring down rain, which made the 7 minute drive more like 12. I was a few minutes late. When I got there, my mom was sitting on a bench with all of her work stuff out prepared to be waiting for a while. I signed in and filled out all the forms except for the one that gave them permission to inject the contrast with all the possible risks, such as death. I hid that one under the others and didn't let my mom see that I didn't sign it.

A pretty girl with dark hair who was probably a year or two younger than me came out to get me. She asked me about 15 questions in less than a minute: Do I have anything metal in my body; do I have diabetes; is there any chance I am pregnant, etc...I can't remember most of them. I answered no to every single one. I handed her my paperwork and told her I hadn't signed the contrast form. She told me someone would come out to answer my questions. A man a few years older than me came out and asked me if I had any questions. I told him I wasn't comfortable with the contrast and he said I had the right to refuse it but it would not be a full study without it. I told him that I didn't think I could handle that today. He wrote really big on my file: "Patient Refused Contrast."

The girl came back to lead me into the room. The door had a caution sign on it because of the radiation; it was bigger than a normal door and it reminded me of the freezer and refrigerator doors at restaurants. It was wide and heavy. I always feared I would get trapped in the freezer at my old serving job, so I would put something in front of it to hold it open. The MRI door closed behind me.

My arms and legs were shaking a little bit as I got closer to the machine. The machine itself was also a lot bigger than I imagined. I felt like I was in an episode of "Little People Big World" because everything in the room seemed so much bigger than me. The girl asked me if I was going to be okay. I asked her if I could come out if I freaked out inside of the tube. She said all I had to do was squeeze the panic ball she gave me. I got up in the table and she positioned me right in the center. She pushed me into the tube gradually and gave me headphones to distract me from the noise. Finally, I was all the way inside the narrow tube listening to faint music through the headphones. My entire body was inside except for my feet dangling on the edge of the table. I wiggled my toes every few minutes just to reassure myself that I could still move; I tried to keep the rest of my body still so my dr. could see as much as possible without the contrast. I wished my head could have been out of the tube. The machine started making really loud noises and then would stop and the lady taking the pictures would say something to me like "You're doing great" or "it's about to get loud again."

I counted the songs I had listened to, counted backwards from 100 in my head,  counted the small screws inside the tube and anything else I could make out to be an object. Counting has always decreased my anxiety because it takes my mind off of what's going on. There were a couple times in the tube when I thought I may have to squeeze the panic ball and get out, but I told myself to just hold on for one more song. And I did just that. I made it to the end and didn't have to come out. I was happy with myself that I made it through that but disappointed that I didn't have a full study and may still have to wonder what's really wrong. And my file will always say, "Patient Refused Constrast."

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