Tests and Choices

In my last entry I defended the idea that those that suffer from depression and anxiety are actually much stronger than they feel, and are certainly stronger than the general public gives them credit for. Last week I was challenged to believe all that about myself. It was a long bad week that left little time to do anything but get through it let alone do any writing.

Back in November I took a spill on the walk outside my house landing hard on my right elbow. It hurt like hell at the time and has continued to be painful as the weeks have passed. I finally saw a Doctor about it who thought I should see an orthopedic surgeon. When that appointment came around it was determined that I should have an MRI of the elbow. I wasn’t all that worried about it until I was asked during the registration if I was claustrophobic. I have had a couple encounters with actually being trapped in relatively small spaces that have stuck with me, but I have never considered myself claustrophobic. I am actually quite sure that anybody would have been scared in those previous circumstances. Of course if you ask a guy with an anxiety problem if he is claustrophobic you are going to get their brain moving and that is never a good thing.

I have had a creeping feeling that last couple weeks that I am slipping. I don’t want to face it head on because I have come to believe in self fulfilling prophecies. In my experience if I get worried about how I am going to deal with something the worst case scenario of those worries often ends up being the case. It is probably stupid and maybe even reckless, but I feel that if I admit I am slipping I will fall, and if I ignore it and try to keep on trudging it will go away. To be clear I am talking about anxiety here not depression.  

Back to the MRI story… In the days leading up to the appointment I was feeling generally uneasy about it but I kept telling myself it that it cant be that bad. I figured I would tell the technician about my background and play it by ear. I was sitting in the waiting room when the tech came to get me, and I pulled a typical guy stunt. The tech was young, female, and attractive. Why should this matter? It shouldn’t. I am happily married and well off the market, but I am a guy and pride or ego or whatever stepped in and I suddenly wasn’t so sure about confessing my insecurities. Stupid. Very stupid. She did eventually ask the claustrophobia question, and I muttered something about generalized anxiety.

When we got in the room with the machine I was stunned at the size of it. Turns out upper extremities are about the most

The opening in a GE Signa MRI machine

Image via Wikipedia

difficult part of the body to scan. She lays me on my stomach with my arm out in front of me, and gets me all propped up on pillows. I am laying on the little gurney thing look at the hole thinking that the whole center of the machine is going to slide out as the gurney slides in. I mean it has too right? There is no fucking way my fat ass is going to fit in that little god damned hole. Imagine my surprise when  I was wrong. She tried three times to stuff me in there and it just wasn’t going to work. Now I am overweight, but were not talking obscene. I am 5’11” and weigh in at 250 pounds. I have wide shoulders probably from ten years of competitive swimming. I am big, but I am not out of control. There are plenty of folks fatter, and plenty of guys with bigger shoulders than me, but I was not going to fit head first. Her next attempt was to put me on my back. Of course that puts the bad arm at my waist meaning my waist is going to be in the center of the machine and I will be ALL THE WAY in. I get situated and she says I have to roll up on my side a little and raise my left are over my head.  When I asked why she said it was the only way she could get my shoulders in the machine. At this point I am still playing along, but the anxiety is at a very high level and the associated stomach upset is building. I get my arm over my head and she places a grid over my bad arm and ties it to me, which effectively ties me to the gurney. When it comes to me and small spaces I am fine if I feel like I can get out. It is not so much the tiny space as the feeling of being trapped that bothers me, but here I am getting ready to be wedged back in that tiny hole with one armed up over my head, and the other tied down. She begins to run me in slowly getting my up on my side a little more to squeeze me in. My shoulders are folding up and my head is sliding down the side of the tube. My nose is an inch from the top of the tube, and as I go in it is getting darker as my body mass closes the hole.  I have a sudden image of myself puking in the tube unable to move and I am done. Get me out of this thing!!

I was embarrassed and felt like shit. Many of my troubles mirror those of my mother. She cant even get in an elevator. She has had a couple MRIs but they always involved valium. When I was on my way home and told my wife what had happened her response was “you are your mother’s son” which wasn’t exactly the hug I was looking for. The remainder of the week I suffered through the anxiety hangover. When something like that happens it is not over when it is over. Once those chemicals get flowing in my brain they don’t just stop. I was low, easily angered, my stomach was a mess, and I was always on edge. Other events transpired over the week to reinforce all those feelings. I have been dealing with gradually decreasing levels of anxiety for the last seven or eight days. They are not decreasing fast enough.

The new plan is for me to go check out one of the larger bore MRI machines and see if I can hack being in that one before I make an appointment. Having just been through, and maybe still going through, the Klonopin withdrawal the last thing I want is to be drugged up for this test. It will probably be the end of this week before I can make that happen. I am trying not to schedule it and just do it when time allows to prevent any build up of anxiety.

I am not sure what I am going to do with this increased state of anxiety. I have written before that I feel like I am flying with no net, and that sensation is still strong. The Klonopin was my filter, and to a large extent my safety blanket, but it is gone. With my Coast Guard documents still in limbo I am in a tough spot. I see a few choices but they all blow. The first and most likely course is to hold steady and see what happens. I could always try a little talk therapy to see if it takes the edge of. Another option is to go back to the shrink and say I cant hack it, which will make me feel like a failure, and will likely lead to the loss of my documents. An alternative to this would be to get the medication from a different doctor and keep my mouth shut. The last option would be to go back to the SSRIs and all their associated side effects. The effects of this on my sex life and marriage make it the least likely course even if it is the one that would probably make me feel the best. I have written before about a life filled with unpleasant choices, and if that list doesn’t prove my point I don’t know what does.

I am at least back to believing that if I can go about my day to day life with all the above shit going on that I am actually stronger than people think.

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6 thoughts on “Tests and Choices

  1. That sounds like a very rough time. I want to let you know that even the calmest of the calm can freak during an MRI. I am not a claustrophobic person. Never have been. I can stand in elevators and small rooms, etc. It has never bothered me. But, I have had to endure too many MRIs to count due to migraine diagnoses and epilepsy. In my case, they put my entire body in that machine, and clamp my head down inside a cage. I can’t even move. It’s nightmarish. I had an MRI that lasted over an hour two years ago, and, I’ll tell you, it felt like a lifetime. Everyone has a threshold, and, for too many people, the MRI is the line in the sand. It’s effing loud, it traps you, and it almost feels like you’re in a coffin…being buried alive. So…you are not one of the rare people who hated the MRI experience and put a stop to it. Your experience was common, AND you actually did what most people don’t do–you put a stop to it. I just lie in there and cry with my head in a cage, strapped down, unable to move. You’ve got great personal boundaries, and you used your voice–“Nope! Stop. I don’t like this. There’s a better way. Let’s find it.” There are open MRI machines that are so much better, and there are even standing MRI machines, too. So, all in all, I would say–“Good job!” You aren’t your mother’s son. You are you, and millions of people the world over have the exact same response that you did WITHOUT suffering from anxiety or depression. I’d say, in a way, it was a victory. You are going to find a better way to treat your elbow that is more respectful of the person you are right now. If I had made that choice, I’d feel very proud of myself, my elbow be damned.

    PS Ever try biofeedback? It’s very useful.

    • My wife had a head MRI and described the cage thing. The hell with that. Hopefully the end of the week I will have some time to check out this open bore machine. I looked it up and that one only has a 27” opening, which is about the same width as my shoulders. I’ll take a look and see how it goes. Monday night I was pretty much ready to live the rest of my life with a sore arm. With personal boundaries there is a fine line between looking out for yourself and not allowing your comfort zone to be stretched. I hate irrationality, and the truth is being fearful of the MRI isn’t entirely rational. Nothing bad is really going to happen in there, but the confined space and the restriction triggers something very basic in your brain. I wonder what would have happened had I still be taking Klonopin? I am not sure I ever felt fear the way I did last week when I was taking that stuff.

      • You make a good point. If I may, the next question I would ask were I in your spot (and I’ve been there many, many times), have you ever felt that way before? That sort of fear? It’s irrational, but to your brain, it is not. These connections seem funny, but they are real. As I’ve explained before, financial troubles have caused me no end of deep panic because the feeling of financial “tightness” feels exactly the same to me as being trapped. That same feeling of being trapped and without escape that I felt when I was in captivity. It’s not logical, but my brain links it. Since that was a time when I was being threatened with death (I really did think I was going to be killed), my brain draws the conclusion, financial tightness=death. Hence, I have had incredible panic attacks. I share that to illustrate that our brains can make the strangest of connections, and those connections can fuel our fears and anxieties. What seems completely irrational to us now was very legit in that moment. There actually is a part of ourselves that is stepping forward to defend. That’s why I ask if there was ever a time that you ever felt that way. Even if you weren’t really trapped physically…then again….gosh….I could be full of it. Our journeys are different, of course. I respect your desire to push beyond where you are at. I’m the same in that. Best…

      • One of the great ironies of my life is that I am drawn to things that are dangerous. I wanted nothing more than to be a fighter pilot when I was young, and pursued that goal to the fullest extent possible. I have sailed small boats across oceans, worked on tug boats, flown light airplanes (not as dangerous as it sounds), love to SCUBA dive, and on, and on. My entire life as been taking and managing risk. I was better at it before this all started, but I have done some of it since. Have I honestly thought there was a chance I might die in all reality in the past? Yes. But I had a measure of control over the circumstances, which is quite unlike what happened to you. I have felt before what I felt in that machine, but having basically gone to college to learn to manage risk I get upset with myself when irrational fears become unmanageable. I have had enough experience wth anxiety to know very well that rational thought has little to do with my reactions to specific stimuli. Anxiety scares me way more than to depression. I don’t trust myself when anxiety takes over.

      • “I don’t trust myself when anxiety takes over.” I think that is a revelatory statement. What would happen if you could learn to trust yourself when you were anxious? What might that process look like? I’m not analyzing you. These are just questions because, boy, what a statement. If we can’t trust ourselves, then, ultimately, who can we trust? Our entire sense of self is undermined to the core, our experience of ourselves is cracked, if we are not trustworthy even in the midst of panic and anxiety. I speak of myself, too. It’s just an observation. Something I might apply to my own experience, too. In general, it’s a worthy question to pose: Is the self trustworthy even in the midst of panic? I imagine a case could be made for a ‘yes’ and a ‘no’, but what an interesting discussion it would be.

  2. Is it okay to tell you that I laughed at your description of the MRI sequence? The whole thing seems comical the way you made it sound like the hole was tiny and there was no way you would fit in there. It certainly seems like it wasn’t the right machine for you if the tech had such difficulty figuring out how to get a good picture of your elbow.

    Not many people I know like MRI’s so you are not alone. My son had quite a few for sinusitis and when he was 8 years old we called the MRI machine the big donut! Eventually he had surgery at Mass Eye and Ear in Boston where they do endoscopic stealth surgery which is an MRI during surgery.
    MRI’s can tell the doctors a lot, not that your fear and anxiety cares about that.

    I hope the larger bore machine works out for you.

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