The Cultural Politics of the CAT Scan Experience

I had to get a renal/pelvic CAT scan yesterday. Just ruling out some options for a trace of blood in my urine (kidney stone, polyps in the bladder—who knows). I’m not convinced I truly needed the procedure, but I decided to play Good Little Patient and let the young, overconfident urologist order it. He’s been reassuring that we’ll figure out the problem with the blood and some urethral burning (yes, I know, that's more info than you want or need), and the antibiotics he gave me first did cure the burning symptoms. But the blood hasn’t (yet) gone and no kidney stone has been forthcoming, so he wants to rule out any kidney problems (after thumping me in them a few times to no effect in the office) before we head for the office-visit cystoscopy (a.k.a. scope up the urethra, which makes me turn into Kevin Meaney and think “that’s not riiiiight!”).

Anyhow, the point of this unpleasant blog is how unpleasant the damn CAT scan was! The real rant, though (given the general aims of this blog), is less to bitch about the procedure than to bitch about the way the procedure is and is not represented to the patient. Here is a list of my complaints:

1. The doctor made it seem entirely simple and without complication or discomfort. He did give the usual caveat, glibly babbled off, about people dying from the procedure in very rare cases, to which I replied, “How can you say I have nothing to worry about AND that I might die from it?” “Don’t worry, we’ll take good care of you,” he smiled into my face. And off I went to schedule it.

2. The nurse in the X-ray area gave me two bottles of yuck to drink without ever once mentioning—verbally or on the instruction sheet—that this barium stuff causes bloating, cramping, serious gas, and even diarrhea. She did say it has a metallic taste and to put it in the fridge before drinking it. (The flavor was mildly coconut, but the texture was something between school glue and male ejaculate—ok, that’s DEFINITELY more than you wanted to read, but it gets across the point of how difficult it was to guzzle down in quantity.) She did not, however, say “Watch out for the runs!” (The CAT scan technician put it this way when I complained of the cramping during the procedure: “Oh, some people don’t even get diarrhea.”) In that waiting room after swigging the shit down, I made several potty trips in half and hour and passed so much gas I could’ve filled a hot-air balloon.

3. The “contrast dye” they use for your organs is, as the doctor said, “an injection,” but he didn’t say it was through an IV! Those things HURT and the dye can cause hives, shortness of breath, or more severe allergic reaction, including death. No one told me this until I was already in the CAT scan room with the Donut of Doom looming before me. The technician did tell me that the dye would give me a burning sensation in my throat and bladder, and it did, but it passed quickly.

4. Oh yeah, they make you injest ANOTHER large cup of barium yuck (this time it wasn’t coconut glue but metallic orange fizz) just before you lie down, to “top you off” as the technician said.

5. The actual renal/pelvic CAT scan requires that you hold your breath about 10 times during the procedure, between 10 and 30 seconds each. This isn’t tough unless you’re already hyperventilating, of course, which I’m happy to say I wasn’t. However, it is not easy to hold your breath over and over again when you’re having increasingly sharp gas pains from being overfull of barium yuck and having to lie prone with it gurgling through your guts.

In the end, I lived to tell the tale. I withstood the horrid IV experience, held my breath as required between stabbing gas pains, passed the barium yuck over the course of the day from every orifice, and then went shopping (found a remarkable pink tank top with Tank Girl on it, saying “Oh, the preposterous bollocks of the situation!” at Marshalls—an unexpected treasure).

What I want is for doctors and nurses to let people know this stuff awaits them with this “simple procedure.” Just a little sheet saying that some of this may happen to them. But truly informed consent seems something the medical community is just simply uninterested in.


Kate said...

My friend, I do so soundly commiserate with you. I've had that procedure, more than once. Didn't react quite as instensly as you, but I know the pain. I've also gone through several other embarrassing, uncomfortable and discomfitting tests. But I am a doctor's worst nightmare, not to mention, nurse, technition, receptionist, volunteer and any hospital worker anywhere(except for the housekeeping and food service staff), because I am not a good patient.
Comes from having a mother that was a nurse. I demand answers and will not cooperate until I get them.
No pats on the head and 'good girl for me.
I discovered this trait in me at nine when a doctor kept me waiting too long.
You are quite correct in the idea of lack of respect the medical profession has for those of us placed in their hands. The only thing to do is to remind them that they are not God. Not even close. Feel better soon.

Anonymous said...

Oh my -- it sounds like the "procedures" themselves were more disconcerting then the REASON for having the procedures.

Deborah said...

I had the same procedure. I was warned about the IV, not by the doctor, but by the tech. The doctors tend to be enormously ignorant about the experience. I doubt they've ever done it themselves, or walked through it with a patient.

I was FURIOUS about the 3rd cup of yuck. I was told I was going to have to drink two cups. Then I arrive in the room and they hand me the third. What's up with that? Am I five years old, that they have to tell me little white lies? Did they think I'd back out if I knew there was a third cup? Totally violates informed consent, if you ask me.

Anonymous said...

Elyce, This is a certain guru you might remember. I've seen and had to experience however vicariously, your situation. My second wife and my youngest daughter both had to undergo those things.
I sympathize as always. But just wanted you to know that informed consent is a personal right that should be exercised and it isn't. I would recommend suing but cannot truly advocate yet another litigation for anyone.
Be glad that it is happening at this time in your life. My youngest had to go through this over cervical cancer diagnosis. Not only that, they wouldn't give her a clear idea even on the % chance she would have to be able to have children. Her mother just had to have a complete hysterectomy because of related complications.
BTW, HI!!! and you know I wish I could help more
The Green Dragon thingie.

Grace said...

Sorry you went through that and hope you are well.
I learned at a young age not to trust another human with my health. I can ask their opinions and utilize their skills and knowledge, but, in the end I find being a self informed patient is the best for whatever ails.
I was surprised by the rigid, controlling, cold manner of female professionals (doctors, receptionist AND doctor) at a Womens Heath Clinic in Culver City, Ca. After shocking them with my mirror at the first exam that included a Pap smear (apparently I am the first ever to want to see what they are doing) I simply asked for a second Pap smear before a Colposcopy (not the simple procedure they claim it is)...after 20 min. talking to one then another then another staff member, they finally scheduled a second Pap. I decided against the appt. with them & i let them know why they wont be getting my business. Healthcare in the U.S. is big business after all. They can at least respect their customer/patients.