Radiologists: There’s More Than One Way to be Stabby!

Never again, Radiologists. Never Again.

Never again, Radiologist friends. Never again.

I woke up at two PM today after a very long day yesterday. Long, but also more pleasant than I’d anticipated, all things considered. I did, after all, have a date with a humongous needle.

The following post is a public-service announcement for radiologists, as well as anyone and everyone who needs to have an MRI Arthrogram on their hip in the near future, be you athletic, arthritic, or accident prone. My radiologist took a very different approach to the procedure. Instead of entering vertically, he went in horizontally. While I was initially skeptical (read: ready to bolt out of the room), his technique was much less painful than the standard method. I never want to have a “normal” hip MRA again.

I am NOT a radiologist, and I'm sure I have the angle wrong, but I also pay VERY close attention during these procedures. This is my best approximation of the approach that my Radiologist took.

I am NOT a radiologist, and I’m sure I have the angle wrong, but I also pay VERY close attention during these procedures. The blue line is my best approximation of the approach that my Radiologist took.

As I mentioned in my last post, the standard operating procedure for performing an MRA on the hip involves sticking a really big needle into the patient’s groin. This sucks for several reasons.

Even though your radiologist has magical x-ray vision to guide you, because she or he is entering vertically, their margin for error goes up. I once had a radiologist wiggle a needle that was a good six inches inside of me because he realized he hadn’t quite hit the spot he needed to.

By entering horizontally, the radiologist was able to do that guess work ahead of time. He had me lay on a “pointer.” Instead on manipulating a needle, he manipulated that pointer, until the x-ray showed that he’d found the right angle to get where he needed to go. After that, all he had to do was match the angle of entry laid out for him.

Standard hip MRAs also suck because…. you’re sticking a needle in a human being’s groin. If you had to stick yourself with a needle, would you rather stick it in your stomach or your arm? Answer’s pretty simple right?

I was worried at first that going in from the side of my hip would mean travelling through more muscle, and—since the tear they’re looking for is on the groin side of the hip—reduce the likelihood  of the dye actually illuminating the part of the acetabulum that needed seeing. The latter concern won’t be fully assuaged until I get my results, but the former… that was pretty instantaneous. A giant needle in the side of your hip is less painful than a giant needle in your groin, period.

Now that I’ve had this procedure done both ways, I can say with certainty that it takes longer to recover from the MRA if you enter through the groin. While this new approach caused a different kind of pain (a pain with which I was unfamiliar, and therefore unprepared for) it was easier to walk immediately following the procedure. Today, instead of feeling like I have a water balloon in my groin, I feel a soreness that, if unpleasant, is certainly more bearable. It just feels like my side is a little tender, a little swollen. It’s pain, sure, but it’s not exactly going to ruin my day.

I was terrified when I first realized I was going to be worked on by a “rogue radiologist,” so I asked him why he opted for this non-traditional approach. His response was very heartening. To paraphrase, when he began practicing, he realized that he’d only ever been taught by radiologists, and that there may just be other doctors out there who knew things he didn’t. So he sought out orthopedic surgeons and asked them at what point of entry patients feel the least pain, and changed his approach accordingly.

THIS. SHOULD. NOT. BE. AN. EXTRAORDINARY. STORY.

And yet it is.

No radiologist in their right mind is going to change the way they perform a hip MRA because their patient walks in holding a copy of my blog post, but I want to encourage people to circulate this post to their doctor friends, and especially their radiologist friends. If even one doctor finds themselves moved to have a conversation based on this story, than this post was 100% worth my time.

 

“The Six Million Dollar Scholar” is the personal blog of Andrea Milne, a Ph.D. candidate in modern U.S. History at the University of California, Irvine. To get the story behind the blog’s name, click here.

Bringing Hauntology Home

I wrote a blog post almost a month ago in which I broke down the various life hacks that have helped me go from exerphobic to exerphilic (those probably aren’t words, but humor me). Near the end of that post, though, I revealed that I was currently sedentary, for reasons beyond my control:

[My fitness hacks] worked for a while. I even logged a hundred miles on my new bike! But then I started feeling some pain. I took a week off and it went away, so I got back to working out. Maybe I got too excited—I always feel good while I’m working out—or maybe I should have taken more days off. Point is, the pain returned… and it hasn’t gone away.

… I haven’t worked out at all in almost two weeks, and it still hurts to walk. I’d actually built up some visible muscle over the past month or so, but it’s now melting away before my eyes. And I can’t really do anything about it.

Travel plans being what they are, it’s going to be a while before I get to a doctor. The worst case scenario isn’t really that bad, all things considered, just inconvenient. Minimize your physical activity, they’ll tell me. Rest. Take pain medicine.

The whole thing kind of pisses me off. I guess the one thing you really can’t hack is your own body.

Well, a month has passed, and things have changed, but not for the better. Yesterday morning I finally accepted reality and broke out one of my old crutches. Despite a month and a half sans-exercise, my condition is worsening, and my mobility is increasingly compromised. I can walk unassisted, but it’s not a pleasant experience. Needless to say, I wasn’t expecting this turn of events.

I remain optimistic that I’ll be running around causing trouble in the very near future, but the fact remains that I have a series of hurdles ahead of me in the coming weeks. Some of these hurdles are physical, some logistical, and some professional, but the biggest hurdles—and the ones over which I have the most control—are emotional. I get depressed when I feel limited. The pain is uncomfortable, yes, but its true power (at least in my case) comes from its ability to activate bad memories.

I’m hoping to have a diagnosis and treatment plan in place within a week or two, and even before that process begins I’m truly convinced that the worst of my mobility and health issues are in my past. So I’m not mustering the courage to go on another medical odyssey, not really. No, I’m a seasoned traveler. I’m steeling myself for a confrontation with my past. I’m coming face to face with ghosts. I’m being haunted not just by my own medical history, but by those of so many people I love who’s physical challenges I’ve been witness to, many of whom have passed away.

I won’t be posting medical updates on this blog, but—given my interest in increasing accessibility in both the academy and the world beyond—I suspect there will be many posts in the coming weeks inspired by the issues I’m currently facing.So, get excited for that, I guess?

There’s good reason for me to be optimistic in spite of the pain I’m currently in. I’m an historian of patient advocacy because of the time I spent as a patient. As hard as those years were—and they were very hard—I don’t regret them. Whether the journey I’m in for this time around is long or short, easy or hard, I know that I’ll be the better for it, as long as I stay positive, and continue living an intentional life.

“The Six Million Dollar Scholar” is the personal blog of Andrea Milne, a Ph.D. candidate in modern U.S. History at the University of California, Irvine. To get the story behind the blog’s name, click here.