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Saturday, November 26, 2011

The MRI


Not long ago Tobias asked to join The Walking Gallery.  You might know him from twitter as @tobiasgilk or from his blog: MRI Metal Detector Blog.  Tobias is Tobias Gilk, President & MRI Safety Director, Mednovus, Inc.  He wanted a jacket focused on MRI safety.  And I read quite a bit about the topic before deciding on the image for this jacket.  I saw picture after horrific picture of metallic items propelled into an MRI chambers.  I read about the very sad story of a six year-old child named Michael Colombini who died in 2001 due to an oxygen canister that flew out of the hands of an anesthesiologist into the MRI chamber.  The tank hit Michael’s face and head creating fatal wounds.

I thought of painting these things but the horror of the situation seemed too much.  I was concerned that viewers would focus on the flying object rather than the systems failure that led to the event.   So I decided to focus on our own MRI story for Tobias’s jacket.
This is his jacket: “The MRI.”

The MRI: Tobias Gilk's Jacket
A tale of two MRI experiences:

The Olney MRI
In the spring of 2009, Fred went week after week to the doctor because of pain.  He was prescribed multiple pain medications.  In mid March of 2009, Fred, I and the children went to a local ER to find out exactly why he was suffering unbelievable pain for the past eight weeks.  After waiting three hours in chairs a staff person told us that the MRI and CAT scans were overbooked and they would not be able to anything other than X-rays that night.  They sent us home with more pain medication and told us to see Fred’s regular doctor during the week.

We went to the doctor and she asked if Fred was depressed.  I told him of course he was depressed due to extreme pain.  Then I demanded an MRI.  Fred had been seeing her for eight weeks and she had no clear idea of what was causing his pain.  I also asked for a referral to a MRI facility that would see him that week and that the MRI machine should be an open design due to Fred’s extreme claustrophobia.  In the small town of Olney Maryland they had such a facility.  Fred drove there and had the test done. He said the facility and staff were very nice and helped keep him calm during the experience. They gave him the results on a CD and he gave the CD to his doctor.

She called four days later and referred us to an oncologist.  Fred never heard from his primary doctor again.

The MRI after hospitalization: one of the worst days of our life.
On the morning of this day, I dressed nicely in one of my Church outfits and went to the hospital early.  I was supposed to see Fred’s oncologist.  A few days before the doctor had called me little Miss A-type personality because of my questions about Fred’s care, diagnosis and treatment.  He told Fred if I had questions to see him in his office hours.  I did.  The oncologist never closed the door, he never stopped taking phone calls, and he never spun the computer screen around so I could read the record.  It was a horrible moment and I painted about it in the artwork called “Office Hours.”
 
Office Hours
I left the consultation went back to Fred’s room and he was missing.  The nurses said he had just been wheeled down for an MRI.  I found the MRI suite and the tech said I could wait with him until it was time for the test.  Fred was very worried.  He did not like tight closed spaces and this would be a long MRI experience.  I drew my hand across his furrowed brow to soothe his troubled mind.  He was hot to the touch.  I asked the tech for a thermometer.  The MRI tech said they did not have such tools in here.  I left Fred’s side and went to the oncology ward and asked if someone could take his temperature, and failing that, could I borrow a thermometer and take his temp myself. The nurses said they were too busy and there were no thermometers to spare.

I went back to Fred.  He was hot and distraught.  I managed to get him some ice water to drink.  At this point the MRI tech grew concerned that Fred would not provide a good image if he did not calm down.  I offered to go in with him to soothe him with my voice and presence.  The tech said we do not allow visitors in during the test.  She called a nurse down from oncology to administer a second dose of ativan.  The nurse did not bring a thermometer though she did remark he was warm.  She shot him with another dose of the anti-anxiety medication (my aunt Minnie, a retired ICU nurse later told me she would only give such a high level of ativan to a patient who actively violent prior to applying restraints.)    

The tech wheeled Fred in and I told her I would be waiting right outside when she needed me.  I waited for 15 minutes before the tech came out.  She said she would not be able to do the test if Fred did not calm down.  I followed her into the room.  She told me to take off my ring and watch.  I went over to hold Fred’s feet.  I began to shout soothing words over the railroad train roar of the MRI.  Within moments my Visitor ID tag tore off my blouse and shot across the room toward the MRI chamber.  There it was lost.  I had no idea how powerful the magnet was and could not grab the tag before it soared out of reach. 
 
Visitors Pass
I worried about it for a moment and then went back to the more pressing task of calming Fred.  I yelled my love and endearments to Fred for over an hour.  By the end I could barely speak and it was hard to hear as I was not offered ear plugs for the noise.  But Fred got through the MRI and I had helped to calm him.
After the test, the tech paged a nurse again.  Fred was very hot and his temperature was over 101 degrees.  The nurse quickly tried to get approval for Tylenol while Fred was wheeled upstairs.  Between the fever and the double dose of ativan Fred was altered in his behavior for the next 48 hours.  He would not remember that any events or the visits from friends that happened for the next two days.  
 
After diagnosis Fred only lived for 84 days.

48 hours lost may not seem like a big deal, but it is if you only have weeks left to live. 
The MRI

So I painted our experience on a jacket Tobias.  A flying visitors pass my not have the visual horror of a crushed bed or a wheel chair imbedded in an MRI chamber, but it represents our personal horror.  It represents the horror of being relegated to the role of visitor in your own life.  Fred did not need two doses of ativan, he needed his wife at his side.  And I cannot help but wonder if things would have turned out differently if Michael had his parents with him when he needed more oxygen.

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