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.