Monday, July 23, 2012

Spa Treatment

In the past few years I have grown less and less interested in massages - at least the ones you have to pay for, and spend 30 to 60 minutes receiving.  Like a gourmet dessert, it's the first bite that is really all you need.  Spontaneous neck or foot massages from a loving spouse or child, however, these are of course still priceless.  But last week I had an experience that seemed just about as rejuvenating.  Maybe more.  Any guesses?  Nope, wrong.

Wednesday morning I went in for an MRI.  After signing in, I was met at the door by a cheery Nigerian man, 'Utibe', with a mustache thin enough to have been painted on in vaudeville style, just not shiny like Groucho's.  Seeing me amble forward with my cane, he asked whether I needed a wheelchair.  "Not unless you're in a hurry," I said, hobbling along.  He chuckled and led me to the men's dressing area, showed me the locker to put my clothes in, and handed me the smocks.  As I got into the toga-like garments, and slippers, it felt somehow new and different - refined even - though I had done this at least a dozen times before.

Apparently in a hurry now, he met me at the dressing room door with a wheelchair.  I took a seat - no, I'm not proud - and remarked that it was quite comfortable.  And I have known a few wheelchairs in my time, I've sat in some real pieces of work.  Upon entering the room with the massive tubular machine, I mentioned that it looked new, and he confirmed it was less than a year old.  I climbed aboard, handed him my cane, and lay back.  "Just one more centimetre," he indicated with his fingers holding an imaginary pencil.  I wiggled northward, as I noticed that it was not just new, but also actually comfortable.

For those of you who have never had the pleasure of such an experience, you have to lie with your head in a narrow compartment, and then earplug/spacer thingies (I doubt there is a better word for these) are placed either side of your head between the ears and the side of the opening.  Then like a cavalier's helmet, a rigid plastic cover is placed over your head, with a small tilted mirror positioned so that if you wish, you can observe Utibe where he sits monitoring the control board to make sure the scan is proceeding as it should.  And I am a model patient, with much experience, both in MRI's and stillness, not moving my wedged-in head - which still could be moved if I needed it to - not even a hair's breadth for the entire forty or so minutes.  Unless it moved during one of the two times I fell asleep - but I'm getting ahead of this compelling narrative.

He asks whether I would like to hear music.  The aforementioned and auspiciously named earplug/spacer thingies also seem to have audio speakers in them, further complicating the naming issue.  I answered that today I'd just like to hear, "hammer music."  Another chuckle - this fellow was generous.

In addition to MRI machines getting gradually more comfortable over the past many years, the loud hammering noises they emit - right there next to your head - have gotten more subdued.  Sometimes even sounding like a loud hum, or 'white noise.'  Not that I have needed such white noise to catch up on my z's.  Even back in the day (ten long years ago) I would often fall asleep in the midst of the Hammerklingen Konzert.

Next, as if at a musical bridge, I was awakened by a voice emanating from the twice-aforementioned ear-thingies, as Utibe said it's time for 'the contrast.'  This means that gadolinium, a silver-white rare earth element, in an emulsified form, must be injected into the bloodstream.  The pre-contrast, and post-contrast images show more clearly the areas of active lesions, where the immune system is busily doing its enigmatic chore of eating away at my nerve casing, or myelin.  These active lesions are not what are called 'black holes.'  I'm not kidding, that's actually what some doctors call spots that are 'finished,' or inactive scar tissue.  But unlike black holes in space, nerve impulses don't fall careening at the speed of light into the ones in your brain - they either have to find a way around, or just take the day off, sittin' by the dock of the bay...  Which not coincidentally means that an MS patient will often prefer to just sit by that very same dock...way-ay stin' time.  My doctor, a tall, heavy set, and very sweet natured Columbian, does not use this term, he finds it misleading.  I'd first heard it used eight years ago by a doctor scanning my images, and the hole which subsequently pierced my self-image did indeed feel as dark and scary as the celestial kind.  Some doctors, sheesh...  I suppose, without the chaff, it would be harder to appreciate the wheat.

Anyway, back to the 'bridge,' gadolinium.  Placing my arm on a platform slid out for just such a purpose, Utibe started to prep the area inside my right elbow.  Gloves, alcohol pad, he told me to make a fist.  A prick, some mild pain, but no go.  He tried again on the back of my hand - a bit more pain, but again no luck.  So he went to fetch the guy who would get it first try, definitely, no problem.  I assured him it's no big deal, "my personal 'record' is five tries."  And I have a friend suffering from metastasized ovarian cancer for over ten years.  She's had more than 70 chemotherapy infusions, and her record of failed attempts to hook up the IV - in one sitting, mind you - is eleven!  I've got work to do... at this rate I may never catch up.  (Gallows humor, in part, but perhaps also a way to make it seem less unseemly... which I guess is the whole point of gallows humor?)  So the expert arrived and struck oil first try, as promised, but it was probably the most painful attempt.  A pain that sometimes happens, and sometimes doesn't.  Back in the day when I was giving myself daily injections - not my time on skid row, no, much later than that, injecting boring old MS medicine - I learned that every place on the skin does not necessarily have a nerve ending.  And that by placing the tip of the needle softly on the skin, I could tell whether there was:  if I felt nothing, then it was fair game to penetrate.  Which worked most of the time.  Occasionally there would be a nearby nerve ending that would register only after the pressure of the needle going in affected it.  This is the reason that some nurses seem to be 'good' and some 'bad' at giving shots.  It's a matter of luck, whether they miss the nerve ending.  In my next life, as a nurse, I will ask the patient 'can you feel this?' until they answer no, then I will give the pain-free shot.

But this tangent has drawn out a bit too far by now, time to return to topic, no?  Which was...wait, let me guess, the spa?  Right, remember that?  I'll leave to your own imaginations the process of getting back out of the MRI machine, toga, hospital, etc., though I can imagine you are likely feeling short-changed by this omission.  I used to really dislike having to go to the doctor, clinic, or hospital.  But more and more, I feel the love and care of these medical professionals, and perhaps with a mindful aspect, am able to take it in as if it were all set up for my very own benefit, which of course it is, just like a spa.

One might call my growing disdain for massage 'anhedonia.'  And I don't know what this other stuff about the MRI might be called.  But perhaps it's a sign that slowly I'm opening to the miracle of life in all its splendor - whether a mani/pedi/jacuzzi/massage, or an MRI.  It inspires me to coin a new word: panhedonia...

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