When an MRE is a medical test, not a meal

 

 

After my cat saved my life I suffered misery, wonder, and an MRE. Not “Meal, Ready-to-Eat.” Not food rations at all. But a test.

My doctor – who diagnosed me with diverticulitis based on a CT scan that showed I had a Meckel’s Diverticulum – recommended surgery and referred me to a surgeon.

I sounded the alarm – via my blog post, for which I then had to apologize to my children, whom I had failed to tell personally.

“I should not be finding out about this through a forum,” my second oldest son said as he scolded me. (I did not correct him by calling it a blog, but I was rather excited to think he actually read it.)

I had planned to tell them after the appointment with the surgeon when I would have more information, and I should have waited to blog about it until then, too.

Because the surgeon thought the CT scan was “inconclusive” and, even if it were conclusive, was not convinced that surgery was necessary. Instead, he requested I have an MRE, which he called “the granddaddy of CT scans,” meaning BEST of the best of CT scans providing a view of my insides that would be “the next best thing to opening you up and seeing for myself.” (I clarify “granddaddy” because one of my colleagues thought I meant grandfather of the CT scan, as in two generations prior to the CT, as in old technology.)

I left the office with a hop in my step and the thought, “maybe I won’t have to have surgery!” which felt a lot like “I don’t have to have surgery!”

But I did have to have an MRE.

“Meals ready to eat?”

“Did you mean MRI?”

Those were the questions.

In addition to Meal, Ready-to-Eat, MRE stands for Magnetic Resonance Enterography, more commonly called MR Enterography. It is exactly the opposite of meals ready to eat; it is a starve-and-dehydrate-yourself prep followed by a barium fluid chaser (four quarts to fill ‘er up) and an IV of glucose followed by ice-in-your-veins contrast dye. Oh, and a tunnel so noisy and narrow I understood my youngest son’s take on the MRI he had taken of his knee: “I don’t want to go to Hell, Mommy; I think it would be just like that.”

Of course, I didn’t know all this then.

When my appointment was scheduled, I was relieved that my prep was simply not eating or drinking after 10 a.m. I knew I’d have had my coffee and two breakfasts by then. All I had to do was show up at the lab 2.5 hours early.

Being a nervous Nellie and disciple of my high school band director’s edict “to be on time is to be early,” I arrived nearly three hours early and took my seat in the waiting room, where I watched episode after episode of Home Town while I waited, too nervous to read the book or write on the pad of paper I’d brought to be productive.

When nearly an hour had passed, I returned to the front desk to make sure I hadn’t been forgotten, and I was rewarded with a “they know you’re here.” A few minutes later, I was further rewarded by a brief meeting with the radiologist behind closed doors. He gave me a quick summary of what lay ahead for me in MRE land and handed me the first of four bottles of barium-laced liquid.

Yummy.

I finished the bottle fairly quickly and anticipated the next one a half hour later. It didn’t arrive. Slightly later, a different radiologist came for me and took me to insert the IV. Apparently, my veins have muscles and decided to use them. Though the man was able to find the vein with the needle, my veins clamped down and wouldn’t allow the tubing to enter.

“Wow, that doesn’t happen often,” he said. Keeping the needle inserted, he moved the needle this way and that in an attempt to start the IV, but it failed.

I held gauze on the open wound while he reached for new supplies to try a different place. It too failed, and I watched the second wound drip while he attempted a third time, this one on the back of my hand.

“You’re not going to like this,” he said.

Was I supposed to have enjoyed the others?

The third one was the charm. And he was right, I didn’t like it. To make it all better, he stabilized the IV with pretty pink tape, handed me a plastic bin filled with three more bottles of barium-laced water, and told me to drink each 20 minutes apart. My stubborn veins had wasted too much time, and now I had to rush drink the barium beverages.

He pointed out the bathroom as he walked me back to the waiting room and told me I could use it whenever I needed.

“When you feel as if you’re going to pee out of your butt, you’re probably ready for the test. Just let the front desk know,” he told me as he left me in the waiting room.

I drank another bottle, went to use the bathroom, and returned to the waiting room. At the 20 minute mark, I consumed another bottle of the liquid and finished just as the tech came to get me. I had one remaining bottle.

“Do you want me to drink this last one really quick?” I asked.

“No, we’ll put you on the table and see if you’re full enough.”

He had me change into a gown and follow him into the room with the MRI machine. By this time I was shaking with cold (and probably fear), and he strapped me onto the table, placed a rack over my rib cage, and tried to still my shivers with an extra sheet. The tiny tunnel was warmer but quite close.

My arms were above my head, and in my hand was a rubber bulb, though I never knew why. I imagined I could squeeze it should I panic and need to get out of the tunnel, but I mostly consoled myself with the thought that I could squirm my way out of the tunnel (and likely fall on my head) if I must. What I feared most was a power outage; I suppose I should have feared a power surge, but it never occurred to me.

“Your body is like a radio” (or maybe “radio-conductor”?), the radiologist said as he explained the process. Somehow he made it clear that the giant magnet scanning my abdomen and pelvic region would succeed only if I didn’t move a muscle.

Meanwhile, my intestines were working furiously to move that barium-laced water through my system though the only viable end of such an untimely journey was the MRI table and its white sheets. Um. My bowels were moving, gurgling, clearly in turmoil. Wouldn’t that mess up the scan?

As if in answer, the enormous doughnut-shaped machine began its banging and whirring, and the foam ear plugs I’d been provided did little to nothing to dampen the noise, but it did distract me from my bulging bowels.

“Breathe in,” the woman’s voice emanating from the machine said to me. I obediently breathed in air.

“Hold your breath,” she said. I held it, counting the seconds: 1, 2, 3 … 10 … 20 … 30 … 45.

“Relax.”

Wheeeewwwww. I breathed out generously, glad that was over.

“Breathe in,” the woman in the machine said again. “Hold your breath.”

Again? And again, again, again, and again…

I lost count, but at long last, the machine quieted, the computerized voice stopped bossing me, and I heard the door open. I had never been so happy to see a perfect stranger in all my life.

Except that this someone was carrying a syringe of glucose.

He moved me out of the tunnel and slowly released the glucose into my IV.

“This will stop your bowels for a few minutes so we can get some still shots. After that, we’ll add the contrast dye, which will feel cold as it moves up your vein. Don’t move!”

With that, he moved me back into the tunnel and let me know I had about two-thirds of the scan left to complete.

The sugar made me feel a bit nauseated and the dye felt like ice running through my veins, and the whirring and banging and inconsistencies in the noise along with the repeated commands to breathe in, hold your breath, and relax in sometimes excruciating sections of time made me want to pray, want to mull Scripture through my brain, anything to think of God rather than the closeness of the tunnel, the banging and whirring, and the wonder of what the scan would reveal. But all I could do was count – to the beat of the machine, which sped or slowed and served as a metronome to the parading numbers in my head.

At long last, the scan was completed, and the only thing I wanted more than getting out of the tunnel was getting into a bathroom. Again and again and again. And then I wanted answers.

But for those, I would have to wait.

(And so will you.)