Wednesday, October 26, 2016

Torn (Not Torn)

“Strip down to your underwear,” the technician said, “and put these on over them.” She handed me a pair of baggy blue paper boxers. I changed as directed, pulled on a hospital gown, and locked my stuff in a locker.

Just a week earlier my insurance company declined to pay for the MRI I now prepared for. Insurance companies are sometimes called providers, but in my mind, I see old white guys who say no; who understand the bottom line and little else.

My doctor wanted me scanned so she could see what was probably a torn left shoulder rotator cuff. After the insurance company said no, she referred me to an orthopedic surgeon. He too wanted that MRI. This time, the old white guy said yes.

“It will take about half an hour,” the MRI tech told me, once I came into the exam room. “Some people try taking a nap in there.” A nap, in that forbidding MRI tunnel?

I gave her the locker key and she hung it on a hook. At her bidding I lay back on a kind of runway that would deliver me into the apparatus (3.0 Testa Magnetic Technology). She girded my left shoulder in something not unlike a football player’s shoulder pad, and tucked a thick cushion under my knees.

“If you need something, squeeze this,” the tech said, handing me a bulbous object about the size of a chicken egg. She did not instruct me to lay still, but the message was clear.

At last she slid me into that big magnetic thing, like a cake into an Easy Bake Oven. And with alarming rattles and clangs and beeps, the enormous machine came to life. It buzzed noisily, like the deep buzzing of an airport luggage carousel, but in short staccato blasts. Superior imaging resolution. State of the Art technology. Thirty minutes of it.

I closed my eyes. Some patients experience claustrophobia. Not me – but I didnt nap, either. No; more like sensory deprivation, almost an out of body experience. Images: a woman in silhouette at the top of the stairs. Children taking cannonball plunges in deep clear water. Dancers, flocks of birds, masses of humanity. Shoulders. Soft tissue damage.

And suddenly ... it ended. Done so soon? I asked. Half an hour, the tech said. It seemed like less. She burned the MRI images onto a CD. Take this with you to the doctor. Virtually one hundred precent detection of rotator cuff tears.

Two days later I huddled with the orthopedic surgeon, who told me that I did not, in fact, have a rotator cuff tear. Subscapularis and teres minor are intact,” he said. “Evidence of tendinosis and peritendinosis through the rotator interval…there is a linear tear of the superior labrum extending from the biceps anchor anteriorly to the 2 o’clock position...” and so on and so forth.

So there is a tear – a fray, the doctor also called it. Very minor. Go get yourself some physical therapy, he said. No need to cut you open. But he understood there still was pain.

In my previous blog post, I expressed doubts about Western medicine. But a drowning person grabs the blade of a sword – or in this case, a steroid injection. “Yes, please,” I said, when the doctor offered, and I sat willingly as he shot me up. Within minutes the pain was cut in half, maybe even a bit more than that. There was an accompanying giddiness, an elation, which the doctor said was common. And I realized how beautiful everything is.

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