Wednesday, August 05, 2009

Welcome to the (MRI) Machine

[for those of you who are terminally lazy, here's the most interesting piece of information in this post: nerve impulses in our body travel at fifty meters per second. Go about your business.]

Here's the medical tally for the last ten days: one annual physical (sterling, for once), two MRIs, and a nerve function test today.

I've had MRIs before, but I was really struck by their surreal nature this time. You walk into a room and see a pure white piece of equipment that looks straight out of 2001: A Space Odyssey. After you lie down (lay? lie? Who can ever tell?) and are properly restrained, the table whirrs and you're slowly moved into a small tube (again, pure white), with the ceiling only inches away from your face.

Then you're treated to a twenty-five minute rendition of the introduction to Welcome to the Machine by Pink Floyd (don't take my word for it--listen to the first forty-five seconds of the song).

MRIs are an easy freakout situation, and while that doesn't happen to me, I don't like them, either. I was having one done to my shoulder and my neck (both would take about twenty-five minutes), so it was going to be fifty minutes in total with a small break in-between.

I decided as the first one began that I was going to concentrate on my breathing and breathe as slowly as possible. I estimated that I could take six breaths a minute, so if the test was going to last twenty-five minutes, the tech should come get me after 150 breaths.

It took 158. Bummer.

When he pulled me out, though, he said "Sorry--I had to redo two slices and it took thirty minutes instead of twenty-five."

When you walk outside after having an MRI done, it's very difficult to adjust to the world for a few minutes. There's just so much going on, so many divergent streams, and it's radically different from the kind of unified environment (even though it's loud as hell and slightly nerve wracking) that exists inside the tube.

There's a band name: Inside The Tube.

I've noticed while I've slept with a little elbow brace on (so that I can't bend my elbow at night, to relieve any pressure on the ulnar nerve), my left arm has definitely improved. No question. It's wrecked my sleep, somewhat, but my sleep was already wrecked, so big deal.

The goal here is not to sleep, it's to play Rock Band.

Because of my improvement, I guessed that the orthopedist's diagnosis of ulner neuropathy was correct, but he wanted me to go to a neurologist and have a nerve function test done.

Fine. So I went on Tuesday morning.

The first part of the test consisted of the doctor putting electrodes on my arm and administering low-level shocks to measure the response time for various nerves. He said that nerve impulses traveled at 50m/second (110+ MPH, incredibly), and that by measuring response times, he could detect if I had any nerve damage.

I asked him how they would have done this twenty years ago, and surprisingly, he said it would have been done much the same way, except that instead of using a computer that immediately registered the response times, he would have used an oscilloscope and manually recorded the data.

Cutting to the chase (do I ever even have a chase, really?), he found a very small degree of impairment in the response time of my left ulnar nerve (only 46m/sec). That was it, though--everything else was fine--and that's a very small issue.

Everything else checked out--no carpal tunnel syndrome, no other problems--and he said that ulnar neuropathy was definitely the correct diagnosis.

Then he said, "Part two of the test is where I stick a needle into your muscle tissue at various points to measure your muscular response."

"Really?" I asked. "I don't think that you are."

"I'm not?" he asked.

"Not unless you can catch me," I said.

All right, I didn't say that, but I was none too pleased about the visual picture in my mind. I went from little shocks to something like the last scene in Brazil in less than a minute.

So he stuck needles into my arm at various points (some at very awkward points), and then I had to move my arm to test my muscle function. It was all very weird and very strange, and occasionally it hurt like hell (he put one needle into my shoulder that was so deep it felt like it came out the other side).

I was very, very glad when it was over. Everything checked out, though.

I'm hopeful that wearing elbow braces at night is going to make a big difference in how my forearms feel, and I've also been working (as much as I can) on relearning my drumming technique. I'm focusing on the fingers instead of the wrist, and I can (much to my surprise) play a beat without even moving my wrist now.

If I could just swim a few miles a week, ride the unicycle three days (2-3 miles each time), and play Rock Band for thirty minutes a night, I would be a happy, happy guy.

Well, I'd fine something else to complain about, obviously, but I'd be very happy about those specific things.

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