Wednesday, January 07, 2009

I'm not making this up to bug you, doc.

I gave birth to my first child at Massachusetts General Hospital. At the time, it was rated as the second best overall hospital in the country, second only to Johns Hopkins.

Before I had my first ultrasound, I had to empty my bladder. There were signs all over the place, demanding that I do this, and the tech even asked me if my bladder was empty before we started. This was my very first ultrasound ever, so I thought it was normal.

At 20 weeks, I flew from Boston to Utah to celebrate my mother's 60th birthday. My sister and I were driving somewhere, and we got into a car accident. It wasn't her fault or anything, but I was in enough pain and was having enough contractions that I opted to go the ER to get checked out. In retrospect, I probably overreacted, but pregnant woman aren't known for rational behavior.

They decided to do an ultrasound, and I told them, "Go ahead, my bladder is empty". The nurse looked at me and said, "We need to FILL your bladder. I'll put in a fluid IV to get it going quickly."

I was confused. My last ultrasound, I needed an empty bladder. So again, I said to the nurse, "Well, last time I had an ultrasound, they said they need an empty bladder."

She said, "It's impossible to do an ultrasound without a full bladder. Where was this?"

"In Boston. At the MGH. Maybe they have a different kind of ultrasound machine than you do?"

She got REALLY huffy then, and said, "This is the standard ultrasound machine. It's a good machine, and this is a good hospital. You just don't do ultrasounds without a full bladder. Seriously, somebody must have made a mistake when they did your last ultrasound. Or you're remembering wrong."

Not being very familiar with ultrasound, I figured she was right. My bladder filled up nicely (the nurse even complimented me on that, and I remember thinking, 'Like I have any control over my bladder filling--whatever') and we did the ultrasound which showed my happy son, kicking and squirming in his very healthy manner.

I went back to Boston, went back for yet another ultrasound, and kept my bladder full. Then the tech asked me to empty it.

"Don't you need a full bladder to do an ultrasound?:

"No, we can't do an ultrasound with a full bladder. You'll need to empty it."

At this point, I was fully confused, and a little frustrated. Full or empty--which one was it?

I talked to the tech about it, and she was surprisingly understanding. She said that most ultrasound machines do indeed need a full bladder. At MGH, however, they had state of the art technology, stuff that most hospitals don't have, or can't afford. They were the only ones doing it like this now, because it was better. It's the future, she said. And I was mollified, and excited to be where people were on the cutting edge of technology. And I thought dark thoughts about that other nurse, because I'm kind of evil like that.

(I feel I need to point out, however, that I've had several ultrasounds since then, dozens even, and I've always needed to have a full bladder. So I guess the future isn't here yet, or I'm just getting really crappy healthcare.)

Fast forward to yesterday. Yesterday, I had an MRI at the Beth Israel Hospital, a hospital located only a few miles from MGH. I walked in to the room, and said, "Oh, this is one of the open MRI machines." I was also inserted feet first, which was a new thing for me. I told the techs how my previous MRIs had all been in closed machines, with me going in head first.

"Well, all MRI machines are open. Some of them are longer than others, but they are all open."

I said, "Well, mine weren't. And I've always gone in head first."

They looked at me and said, "And where was this?", as if to imply that surely such a travesty could only take place in a backwater.

"Um, Washington D.C."

To their credit, they shrugged, and didn't press it, but I saw the look pass between them that means, "Yeah, this patient is out to lunch. Let's just humor her."

Let me say, THIS DRIVES ME NUTS. I wish that more medical professionals would take their patients seriously. One of the best SLPs I ever met told me that she thinks most patients are almost always right when it comes to describing their symptoms, and that you can figure out a lot just by trusting patients and asking them enough questions to get the info you need. After all, she pointed out, most people are not keen on having invasive, expensive, and uncomfortable testing done on them just for kicks. People don't seek out these things unless something is vastly amiss or bothering them. And most people don't have MRIs or barium swallow studies done on a weekly basis. These are major events that get seared into people's brains. Why wouldn't we remember what happened during them?

I did appreciate that these techs were very open with me, and told me everything that was going to happen. This always makes things better, when I know what is going to happen beforehand. And, I got to see my scans, which made it all worth it. If the patient can see the result the doctor is going for, I think it makes her much more willing to endure the test. Holding your breath for 22 seconds in an MRI machine is not an easy thing to do, and it's not an easy thing to do over and over, which was the case yesterday. There were many times when I thought, "I'm not sure I can take much more of this." But when I saw how awesome the pictures were, how much information it gave the doctors, I was ready to hop back in the machine and hold my breath for however long if it meant getting more of those beautiful images.

What can I say, I'm kind of a dork.

I've been on the other side of the stethoscope, so to speak, working in hospitals with patients in various stages of illness, listening to their chief complaints and trying to come up with a solution for it. In graduate school, my supervisors always emphasized that these were people, sick people who didn't feel well, and we had to be aware of there emotional needs as well as their rehab needs. I'm always glad when, as a patient, I meet a practitioner who has learned this lesson too.

Because, seriously folks, nobody gets an MRI for kicks. And when you suffer from claustophobia, you remember which way you got put into an MRI machine. Trust me.

1 comment:

Di Hickman said...

can't remember on my ultrasound it was a long time ago, but MRI I definitely remember being head first. Weird hospitals and their rules and staff that look at you like you grew another head or something! lol!