My Arthrogram

Copyright © 2001 Daniel V. Klein

March 28, 2001

Well, I got to experience one more of the wonders of modern medicine today. I've had this on-and-off numbness/tingling in the fingers of my right hand (the hand on the end of the arm on which I broke the elbow and wrist and radius on at least three separate injuries). This not being a good thing (and my having good health insurance), we decided to check it out early, and not wait for anything to get worse. I have an excellent diability insurance policy that I'd really rather not use :-) Last week, it was an EMG (where they shock you repeatedly and then stick needles in your arm and wiggle them around). Today it was an arthrogram. It was a sufficient ordeal/interesting experience that I figured I'd share the... uh... well, share the experience.

To start with, I wait 45 minutes to be interviewed, and then another 45 minutes for the technician to come claim me, and then another 10 minutes for the doctor. Then the fun starts. I have already divested myself of anything even vaguely susceptible to magnetics (they even ask about tattoos, more on that later). I then get a liberal Betadyne wash (and I wore a white shirt), a lovely little shot of lidocaine in my elbow (thank God for drugs), and the doctor spends the next 20 minutes or so attempting to find my elbow joint with a sharp instrument. A large gauge hypodermic needle, in fact (did I thank God for anaesthetic yet? Oh, yeah, there it is, the previous sentence :-).

This is easy, you say. The elbow joint, wait, don't help me... I know! It's right there between your shoulder and your wrist! That bendy part! Well, not exactly. See, he wants to inject some Gadolynium salts (diluted in some kind of weak Iodine solution into the very innards of the elbow joint - where the radial head glides over the humeral fossa). Now, I haven't even heard the word Gadolynium in about 20 years, let alone ever seen any. Sure, it's "Gd" on the periodic chart, and if I recall correctly (okay, I just now looked it up so that I did recall correctly :-), it's one of the Lanthanides. And that is all I ever knew, but somehow, they're using it as a contrast solution for my MRI (using contrast solution means that the MRI gets better contrast on the images).

So there I am, dripping with Betadnye, numb in the elbow, and he's poking me with a needle. Needle in, turn on the flouroscope, nope not quite, move the needle, move your arm, nope, still not there, turn off the flouroscope, needle out, needle in, turn on the flouroscope... lather, rinse, repeat, you get the idea. I count at least a dozen holes in my elbow, no doubt he made more than one attempt on some of them. Did I mention how nice it is that we have lidocaine? Finally (after using up his initial 5 minutes of flouroscopy time, which translates to about 20 minutes of real time), he gets it (he's not a bad technician, but the elbow joint is small, and since I broke the elbow 15 years ago, I have these osteophytes that make it harder). He then injects me with about 20cc of contrast solution. My elbow now not only looks like a pincushion that is purplish brown from the Betadyne, but there is what looks like a small balloon under the skin. Oh joy.

They now wheel me to the MRI. I can walk, but they're not allowed to let me! So I ride about 30 exciting yards in a wheelchair. Heck, when I had my knee rebuilt, they made me walk out of the hospital the next day, but when I have my elbow worked on, I get to ride. Go figure :-)

I arrive at the MRI, and once more iterate all the metal that is in my body Did you know that some tattoos are paramagnetic? I didn't! But apparently, some of the old red ink can mess with an MRI (and get hot, which is even less fun). I don't have any tattoos, so other than the steel plate in my head from that freak fishing accident back in '42, I'm okay. Into the MRI.

If you've never had an MRI, the first thing you should know is that it used to be called NMR - nuclear magnetic resonance - but people freaked out at the word "nookyoolar", and so they renamed it. You'd think that people would be more worried about liquid Helium 8" from their skin, or mega-Gauss magnets, but nooooo.... The second thing is that it's loud. No, LOUD. No, really, they give you earplugs, and it is STILL LOUD. And the third thing is that they put you in a machine that is barely wider than your body, so you better not be claustrophobic (I'm not). I'm on my stomach, one arm (the one with all the holes and the contrast solution) straight over my head, the other under my body between my legs (there's no room for it anywhere else), and my head in a "you thought the flouroscopy was uncomfortable!" position.

The next 35 minutes was basically a cramped nap, in a don't move at all, bang-BANG-bang, rattatatattata, buzz, glurgle (that's the cryogenic pump), tube rather reminiscent of being born (if I could remember that far back). Actually I slept rather well after the first 10 minutes. I had dreams and everything! Of course, the dreams were pretty noisy...

After they woke me up (kinda hard to hear with the earplugs), I washed off the Betadyne (the white shirt wasn't a problem after all), and got on my scooter and drove home. It's now about 2.5 hours after the injection of the contrast solution, and it's already gone - no unsightly lumps. We already know that I don't have carpal tunnel syndrome (that's what the EMG ruled out last week), so now we get to see what's in the elbow capsule.

The bottom line is that they think I'll live, so if any of you are fighting over the artwork on my walls, you'll have to wait a lot longer :-)

So, how was your day?