Tuesday, May 1, 2012

I'm with the M...R....I

I've never been a big fan of horror movies. I guess there are enough things in day to day life that scare me, I don't need the extra horror. Today's big challenge is to get through the first MRI without a panic attack. I'll deal with the next two MRIs as they come- which no one really knows because of the way "the system" is set up.

Up today is the breast MRI. It has not been easy to get here. Months ago, during my annual exam- my doc put in the order for breast mri to avoid irradiating my already radiosensitive tatas. It was promptly denied. I guess that they are only performing these for active duty women on site and Tricare doesn't want to pay for me to go off site. The denial actually said they wouldn't pay for it unless I could show that I am high risk breast cancer. That I can do- with the genetic test for a cancer predisposition syndrome that they paid to have done. A syndrome that makes one sensitive to radiation.

Tricare- Oh, Ok, let me look in my file- Oh it says here it's already been approved.
So why did I just get a letter of denial?
 It must have been sent out before .
Before what? Before anyone read the request? Or my file? That seems inefficient.

So I call to schedule the mri.
We can't do that here.
Oh here we go again.

I call my genetic counselor.
We are working on that. We don't want to send you to town because things, well, you know.
Get lost? Aren't done in house? Don't transfer? Cost more? Yeah I know.

I don't know why patients are non compliant- this seems like a perfectly reasonable way to spend my time.

Fast forward 2 months. Still no Mris ordered/approved.
I am sitting with the surgical oncologist who would like to see what else is brewing in my arm, and lungs- since that's where these little buggers like to go. He orders 2 more Mris. He throws another breast Mri in there for good measure. Wait 24 hours and call- they receive the order, it has to be approved by the radiologist then you can schedule. I know the drill- we do this every 3 months with Lily monkey. They are actually much more efficient with the kids- of which I am glad for. The Genetic counselor and oncology nurse go to physically speak with the radiologist to let him know about Li Fraumeni syndrome and why these tests are being ordered.

I wait a day and call. The order says arm mri, the lung mri was cancelled as was the breast. Seriously?

I call the Genetic Counselor.
Well that was not very nice. She says.
I was thinking- GDMFCSSOB.

It's hard enough because I don't want to do these scans. I am grateful to be able to be proactive with my care and try to "catch" cancer at the earliest and most treatable stages. But at some point you are just beating your head against the wall. This is not in line with my quality of life goals. Spending time fighting over scans I don't want to do because the mere thought of causes waves of nauseous anxiety.

Days pass. While I am in the waiting room, waiting to be seen by my PCM- who needs to look at my 2nd-indelicate incision which has decided to come undone and after 8 calls to 3 different numbers- surgery clinic has no one available to tend to it's inconvenient dehiscience on a Friday afternoon. I learned new words that week. Dehiscience usually is a concern for abdominal wounds because of the risk for evisceration. Not pretty. Although I wouldn't mind part of my arse falling out- it would then be lopsided and that's just no good. But I digress- I get a call from radiology. They want to schedule my breast and arm mris and chest CT.

I am not doing a chest CT.
It says here that a lung mri was ordered, but the radiologist wants a chest CT.
I am sensitive to radiation is why the lung Mri was ordered. I am not doing the chest CT.
Well another guy will have to schedule that, I can only schedule the mris. How about Tuesday and Friday?
I can't do Friday- It's my kids' May Day Program. Why 2 days?
That's how they ordered it? How about Thursday?
Who?
The radiologist.
It seems to make more sense to do it all at once- especially since I am clausterphobic and have to take meds for the procedure.
Oh you are clausterphobic? That's why they ordered it for two days. Make sure you have someone drive you- the meds they give you make you pretty woozy.
It would be less daunting for me just to get them over with.
That would be a long time to be in the machine, especially if you are clausterphobic. 
Thursdays Fine just schedule them. My husband is out of town and I have 4 kids- I'm sure finding a driver won't be an issue- for 2 days.
 Oh you need to do an xray too on your arm.
Really.
Yeah- if you could do that as soon as possible, that would be great.
How about if I do it after my MRI on Tuesday.
Oh that makes sense.
That's why I get paid the big bucks.
What do you do?
I schedule mris- it's a full time job.
silence.

So I get a call yesterday. The lung MRI has finally be approved. Same scheduler.
SO I would like to schedule your lung mri.
Ok, what days you got?
I can do Tuesday.
(The irony not lost on me...) OK let's do tuesday.
Oh wait you have an MRI on Tuesday. You can't do Friday because of your kids' May Day program Right?
Right(creepy- you remember I have May Day, but not an MRI that day.)
How about Wednesday?
So I would need a driver, for 3 days- of which I would be taking an addictive sedative- for 3 days and that is more convenient that just doing it all at once?
Let me ask. Pause. I can't get a hold of anyone I'll have to call you back.

Oh I'll be waiting.  My plan is just to be surprised this morning when I go in- the magical multiplying MRI game- maybe we can turn 1 into many.


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Lily Kay Monkey

Lily Kay Monkey
November 2008 Photographed by Shelley Detton (7 Layer Studio)