a pain in the neck

If you’re following along at home, you’ll remember I visited a neurologist recently to find out why my body seems to be breaking down like a car with a just-expired warranty. Like any older car, it’s a little sluggish to respond (especially in winter), and I’ve definitely got some alignment issues. Begrudgingly, I agreed to take their fancy tests, because, well, I’ve always been good at taking tests.

Of course, these weren’t like the exams I used to ace in school. My English teachers never hit me with a hard rubber hammer or poked me with needles or shot electric current into my arms and legs, although that might have given me more incentive to actually read “Paradise Lost.”

I was hoping the tests would be both definitive and reassuring. They were, I suppose, a little of both. But I’m getting ahead of myself. Buried a few paragraphs down, in amongst these 1,689 words, you’ll find what the diagnosis is, but first I should talk about the tests. Whatever’s wrong with me, I still have an understanding of dramatic structure. (If you don’t mind spoilers, the answer is in the twenty-first paragraph.)

The Neuro-Conductivity Studies were done by a very quiet man named Dr. Sharazz, which I kept thinking sounded like the name of a Bond villain (“We meet again, Doctor Sharazz…”). The name of the test had me imagining being strapped into something some gigantic, shiny apparatus like you might find in ‘Star Trek,’ but in fact the device looked like some precocious kid’s Science Fair experiment, very low-tech and definitely not shiny.

After an hour or so of this particular doc putting electrodes on various parts of my body and cranking the voltage to 11 (I’m guessing here), causing my arms and legs to twitch on his command (“You won’t break me, Sharazz!”), he began the EMG, which is like the previous test, except the electric jolts are sent through needles deep into your muscles.

I got an ‘incomplete’ on this one, because frankly, I wimped out. The pamphlet said, “The pain is less than a typical hypodermic injection” and “You may feel a tingling in your muscles,” which was accurate if by ‘tingling’ they meant ‘really disturbing radiating discomfort that will make you believe your leg is on fire.’

So after twenty minutes of this vaguely medieval process I said “No mas” and eventually he stopped. He seemed empathetic, and said he “got a lot of information.” Mostly, I’m sure, about what a wuss I am.

Next up was the MRI. Since I was pretty stressed, I wanted to have a cigarette, but at this clinic, there didn’t seem to be a place where I could have a cigarette in the MRI machine.

The room and the machine were all cool and sterile looking, like the second hour of “2001: A Space Odyssey.” Now I was getting the high-tech wonders of modern medicine. Unfortunately, this was another ‘incomplete.’

They were hoping to do four MRIs, two after being injected with contrast dye. I thought it would be just like a flu shot (damned lying pamphlets!), but as they started describing it, I just remember hearing terms like “put you on an IV” and ‘side effects’ and “nausea’ and…you can guess where this is going. I’ll take just the two MRIs for now, thanks.

Almost everyone I dealt with at the clinic had at least pretended they understood my irrational fears. Not the MRI lady. She was thoroughly professional, but let’s just say she didn’t have the warmest bedside (‘tubeside?) manner. I would try to lighten the mood (at least my mood—I suppose she was fine) with a joke, which just seemed to make her more annoyed.

At one point I had an itch and I moved a little, and she seemed genuinely put out when she said “You know, every time we pull you out of there we have to start over, and I’m not going submit crappy test results.” Now, I suppose she could have had a full slate of people she still had to shove into the pod that day, but c’mon—I might be a little easier to work with if I didn’t feel like I was being scolded.

me, looking all cross-sectional...

I had a week to wait for my ‘consult’ with the neurologist, and spent much of that week trying to distract myself from the test results. I even went out to a ball game for the first time in years.

In my somewhat reclusive writerly life, I can go days without real reminders of my ‘condition.’ But at the game, around forty-three thousand other people, I felt a bit more ‘disabled.’ There were two moments in particular that strengthened my resolve to see this medical stuff through.

First, since I can’t lift my right arm above my head, I’m incapable of giving a proper ‘high-five,’ and there’s not much point to watching sports if you can’t do that. I tried left-handed, but that felt really awkward and I knocked over a guy’s beer.Second, when ‘the wave’ came around to our section, I could only sort of half-stand stand and could only raise one arm, making it look like I was mocking the wave, or worse, trying to stop it. This was the compelling evidence I needed to get me back to the doctor.

I suppose sitting in a room with a guy is one of the better ways you could find out scary news. Although it might be cool to have those Publisher’s Clearinghouse people come by with an oversized envelope announcing “You may already have won an invasive procedure!”

But this was just my-far-too-young-looking-to-seem-like-he-knows-enough neurologist. My neurologist is young enough to actually have used Facebook in medical school—I’m just hoping his status updates were along the lines of “Can’t go out tonight—studying again” rather than “Can’t believe how hungover I am again.”

Suddenly I wanted to be in 1972, so that my doctor could be Marcus Welby, M.D., all gentleness and aphorisms, with everything wrapped up in about an hour. I wanted a kindly old doctor who would take my hand and start his talk with “Now, son, I know this has been hard…” I don’t think they even teach ‘kindly’ in medical school anymore.

Actually, by this point, I had gone from dreading the results to hoping I had something they had never seen before—maybe an article in a respected medical journal about my strange pathology, or some grant money. Then I realized the grant money would go to the doctors, not to me.

So, ready for the worst, I walk in with The Girlfriend, and the doc says “Well, you don’t have MS or ALS.” Okay…so we’re going to have me guess, by process of elimination? “Uh…Is what I have…longer than eleven letters?”

Then he says, “I think I’ve figured out what’s wrong.” Keywords: ‘think’ and ‘figured out.’ It’s at this point that I remembered the old saying that medicine is an art, because he sounded exactly like a chef stating, “I think I know what the sauce needed—more tarragon.” Great—now I’m worried I have a tarragon deficiency!

I tried to make a joke about not taking all the tests, and he just sighed and said “Well, I have limited data to work with” with the same resigned but mildly disapproving tone as your freshman biology professor saying “Well, the midterm is forty percent of your grade…”

For some odd reason, he did the Hitting Me With A Metal Hammer test again, and either my HMWAMH responses were ok, or he got bored hitting me, because out of nowhere he said “Your brain is fine.” Not ‘you’re fine,’ just my brain.

"Why, that's a FINE brain you have there, young man. Just fine."

The it was time for the slide show. I saw pictures of my ‘fine’ brain, and he pointed out how the pictures showed I didn’t have MS. “The problem is in your neck. You have severe spinal stenosis.” More pictures, this time clearly showing my spinal column narrowing until, at one point, it looked like my spinal cord was being pushed through a straw. This, it turns out, is not good.

Severe. Spinal. Stenosis. I liked the alliteration, but a long-held theory of mine says that if your diagnosis starts with the words ‘severe’ and and ‘spinal,’ it doesn’t matter what the third word is. I wasn’t gonna be able to just get a prescription for this.

As for how it happened, it was one of those Zen moments in which I got the impression that didn’t matter either. The doc muttered something about “wear and tear,” and since I had been clumsy all my life, he thought I could have injured my neck in a fall, but what he knew for sure was that I would need surgery to fix it.

He went on to say “The concern is, if you get in a car wreck and get whiplash, you’ll be a quad.” I guess he figured it didn’t need any sugar-coating, but…YIKES! Get me Doctor Welby, stat! Look, I’m not sure when I might sign up for spinal surgery, but I know damn sure I’m gonna try to avoid getting into whiplash-inducing car wrecks.

When I left they gave me a CD with all my pictures, though I’m not sure why. I’m probably not gonna look at them again, but maybe I’ll put one of the brain scans on a t-shirt or a hat with a catchy phrase (This is MY brain on drugs.”) Anyway, the next step is a consultation with a neurosurgeon.

After not seeing a doctor for decades, I see a GP, then a neurologist, then a neurosurgeon…you know what, I’m gonna keep going up in the medical hierarchy—see if I can get seen by someone who teaches neurosurgery, or maybe a dean of neurosurgery somewhere. Just to be sure.

Eventually I may even become comfortable enough to have the operation I need. If I do, I know the first thing I’m gonna do when it’s over…I’m gonna high-five the hell out of someone.

seeing a guy about a thing…

I saw a neurologist today, and by that, I don’t mean I spotted one from a distance (“Look, there’s one now!”)—I had an appointment. If you know me, you know that I’m dealing with some health issues, and I’m irrationally afraid of going to doctors. But, thanks to the State of Minnesota, I have insurance now, and my friends would kick my hypochondriacal ass if I didn’t at least start the process. So, I saw a neurologist today.

Actually, I told myself I was just ‘seeing a guy about a thing.’ That’s not scary—and it sounds a helluva lot better than SEEING THE NEUROLOGIST. People don’t see THE NEUROLOGIST unless something is seriously wrong. But this is just some guy—just gonna talk to him about some stuff. And besides, I’ve realized something that makes this ‘process’ a little less daunting—whatever I ‘have,’ I’ve already beaten it so far.

Now I don’t want you to think you’re gonna have to suffer through regular updates on my condition and progress—I don’t intend to become the inspiration for a Lifetime original movie, “Tingling and Numbness—the Michael Dane Story.” I will let you know if my case gets written up in any medical journals, but if I’m still writing, assume they haven’t found any BSD (Big Scary Disease).

I figured I had an advantage going in, because I know a little something about medicine, having been pre-med for two years as an undergraduate. Still, I think everyone fondly remembers their first ‘specialist.’ I’d seen the occasional general practitioner, but this time I was gonna see a guy who took extra years of school specifically to figure out my shit.

The neurologist’s lobby looked like a cross between an airport Starbucks and a bank, all curved lines and earth tones and a water dispenser that looked like an espresso machine. And the people couldn’t have been nicer. I was glad The Girlfriend was with me, because otherwise I would have been pestering the other patients with my wry observations about the health care industry.

The receptionist/teller asked if I wanted The Girlfriend to be able to access my medical records, and it felt right, so I signed a form. After all, anyone willing to deal with my anxiety and drive me to clinics and wait around calmly while I flip out should be able to find out the results of my paraneoplastic antibody panel.

Awkward moment: figuring how to discretely go outside for a smoke. Yes, I get it. Kinda defeats the whole “getting health care” purpose to burn a cig while you’re waiting. Regardless, I made my exit, and just past the “No Smoking” boundary I saw the charge nurse, enjoying a refreshing cigarette. And I gotta tell you, there’s a perverse fun to smoking in front of a hospital. And fitness centers with big picture windows.

The neuro guy was what you would get if you were casting “a dramedy centering around the life of a quietly witty neurologist” (how have I not made it as a writer with ideas like that?). Good-looking in a vaguely ethnic way, he was easy to talk to and seemed to listen.

After some questions about my history, and what seemed to be an unnecessary amount of time hitting me with a metal hammer, the doc and I agreed there’s something wrong with me. I was hoping he’d say something along the lines of “It’s just a bad cold,” but since only about half  of my limbs seem to work properly right now, he thought some tests might be in order.

I had hoped that the ‘tests’ would consist of asking me a bunch of questions, after which he would deduce what was wrong (“It’s murky, but I’m getting a vision of…it’s becoming clearer…peripheral nerve damage.” Apparently I had ‘doctor’ confused with ‘Gypsy fortune teller.’)

In fact I will be having eight tests: five blood tests, an EMG, and two MRI. And I think I have a punch card that gets me a free procedure of my choice after ten, so that’s nice. The blood tests are no big deal, but I didn’t really know what an EMG involved.

Turns out, an EMG involves someone poking me repeatedly with needles and electrodes. I guess it’s not as fun as that sounds, and I wasn’t thrilled to read in the little pamphlet (“Your First EMG”) that it is used to test for “blah blah blah,” “blah blah,” “some other random thing,” and ALS. That’s right, there’s like fifteen things listed, but all I remember is Lou Gehrig’s Disease.  And not because I’m a huge baseball fan. That’s just how my mind works.

I didn’t need the pamphlet to tell me to “avoid tobacco and caffeine a few hours prior to my test,” since I figured being jumpy and edgy and jacked up might affect their ability to stick needles and electrodes in the right places. And I’m sure there will be highly trained professionals doing the poking. But I bet they get burnt out on their jobs like anyone, and sometimes just screw with people by making their arms and legs do funny things –“Watch—I can make him hit himself in the face.”

I have free time, nervous energy and an internet connection, so I looked up ‘EMG machines’ online and found a catalog where they sell them. Reading through it I got an idea: right before the test starts, I’m gonna mess with their minds by asking ridiculously detailed questions about the machine, like “This one does have four channels of surface electromyography with analog and USB output, right?” Or, “Please tell me this thing does at least three paraspinal images and has the E-Stim trigger option.”

Speaking of selling things, any idea how much an MRI machine costs? They start at around A MILLION AND A HALF FREAKING DOLLARS! I’m not really familiar with how much big machines typically cost, but isn’t that about what a rocket costs? Am I being sent into space for this test? Because I don’t think Medica covers that.

I’m pretty sure I’m not supposed to smoke before the MRI, either (doctors are so militant about the smoking thing). The overly perky twenty-something who scheduled my procedure told me I’d get to see some ‘cool pictures’ of my brain, and I explained that those pictures might show signs of a debilitating terminal illness, which got her to ratchet back the perkiness a bit.

She also asked me whether I was claustrophobic, and I said, “No…,” but in retrospect, I should have said “I’m not sure, because up till now, I’ve managed to avoid getting trapped in big metal tubes, so I guess we’ll have to see–might want to figure out a way I can smoke in there.”

Apparently, you get to listen to music while you’re entubed, which seems great, depending on who has control over the playlist. What if they pipe in ‘80s arena rock (“Just relax…we’re gonna play Poison’s second album now in it’s entirety.”)? Or if, just as the anxiety of claustrophobia has passed and I’m very calm and still, the lab tech-slash-DJ decides to blast that part of ‘Dark Side of the Moon’ with all the bells and chimes?

I’ve always known that my mind doesn’t work the same as most folk, and the great thing is, now I’ll have the pictures to prove it. From now on, whenever someone questions why I’m doing something, I’ll just whip out a wallet-size copy of my brain scan. They won’t know what it means, but they’ll figure I must have a reason for having it with me and leave me alone. And since I don’t have kids, I’ll have something to show at parties!

In the end, this isn’t about needles, or electrodes, or being in a claustrophobic coffin-like metal tube while someone magnetizes the atoms in my brain. It’s just about me, seein’ a guy. Just checking out a few things. No. Big. Deal. After years of not dealing with my health, if whatever is causing my various infirmities hasn’t stopped me yet, I’m not gonna worry about it.