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Magnetic Resonance Imaging

And Scattered Thoughts Thereof

8 min read May 01, 2024 Ruminations

Magnetic Resonance Imaging

And Scattered Thoughts Thereof

A week and a half ago, I had the misfortune of experiencing a knee injury while playing soccer. Not much drama to it. Just jumped up in the air, stretched out my right leg to stop a ball with my foot, got off balance, landed on the same leg, knee buckled strangely, heard a pop, and had immediate dreams and nightmares of ponies and pain.

Here for the Code

This article may not be for you. Feel free to move along.

The Pop

It's hard to describe in prose an experience that happens within a split second. What I do recall is a distinct, muffled sound, kind of like a muted knock on the door when you're in another room.

The immediate 10-15 seconds afterward were a tornado of thoughts and feelings, as my head tried to catch up with the "what happened" and anticipates the "what's next." It's also darkly comic remembering that I was also worried that the game would continue and our team might get scored on as a result, all while writhing in pain.

The Aftermath

Surviving those first 15 seconds was the hardest part. Well, maybe not. Harder than that is anticipating the frustrating exercise ahead, and I don't mean PT (physical therapy).

I mean having to navigate the myriad of bureaucratic entanglements brought on by insurance and medical providers (thanks United States healthcare system).

The league I play soccer in is an over-30 league near a major medical center, so thankfully, I got a lot of good advice from my teammates about what to expect next, as some of them are in the medical field.

Also, a few of them have had ACL/MCL or meniscus injuries in the past, and it was pretty clear that I was in the same boat based on the nature of the injury.

The game resumed. We ended up losing.

In the end, I decided to skip the emergency room/urgent care visit and try to fast track the process toward obtaining an MRI as quickly as possible.

The Fun?

The next day, I must have called over a dozen places to see what would be my fastest route to an MRI. Thankfully, my current health insurance allows me to make appointments with a specialist without a referral from a primary care physician.

Funny thing is, most orthopedic offices (that I called) don't have much availability (in my area), and the only way to fast track an appointment is to have an MRI. But when I called an MRI lab directly, they required a doctor's order.

I even called emergency rooms and advanced urgent care centers to see if they'd be either willing to do the MRI or provide a doctor's order. Nope. I'd need to go see a primary care doctor for anything outside of an x-ray.

Eventually, I got lucky and landed an ortho appointment with a physician's assistant. Waiting for an actual doctor would set me back another two weeks.

So no, this was not at all the fun part.

The Work

My employer recently had a great idea, which is to bring back a lot of their workforce to "in office" work after, oh, about 4 years of meeting and/or exceeding expectations for the small team I'm a part of.

It's a really great idea, because even though half of our team is already working remote from other parts of the state, half of us get to go in to a nice office so we can pull up Teams in a conference room instead of in our own messy homes.

It's a brilliant idea with no downsides...

Except for the many that I brought up to management seeking an exemption and was still asked to return anyway. But wait, what was I talking about?

Oh yeah! My busted knee...

So even though I can do my work just fine while in bed with my leg extended, or occasionally sitting as my knee regains strength, I also have the benefit of calling our Leave of Absence department to find out what I need to get a medical accommodation that allows me to work from home.

More paperwork from a doctor.

You know, because it's important that upper management gets the sense that we are collaborating as a team or something...

The Pain

The pain after those first initial 15 seconds wasn't so bad. Even the first two to three days, which were definitely the most "uncomfortable", it was mostly the lack of mobility that sucked.

At rest, my knee felt mostly numb, or maybe a low, dull pain which was more or less easy to ignore.

Fully extending or retracting my leg felt impossible, but more in the sense of instability than actual, sharp pain. Of course, a wrong movement or twist might hurt, but that can be mitigated by slow movements.

A pain I had not expected was in my hands from using crutches. Thankfully, my wife has a friend who guided me toward proper usage, and after adjusting handle height and technique, it's much better now.

Lastly, sleeping has been kind of a pain. No, not that kind. What I mean is, I only found three comfortable sleeping positions, and I am in a somewhat waking state each time I shift, so I generally feel tired.

The Melancholy

By nature, I tend to be as self-reflective as two mirrors facing each other. This does lead me down some infinite corridors and spooky dreams at times, if I must say so.

Ultimately, my knee and the recuperation ahead are the least of my worries. I have the great fortune of being relatively healthy. I know with patience, time, and proper treatment, I'll recuperate.

But the nature of the immobility has me thinking about a lot of other things. Relationships, both current and lapsed. Values. Accomplishments. Wants. Needs. Noises. Missed opportunities. The mess. My guitar picking up dust.

Oh shit, PyCon US is in a few weeks. I'm supposed to go to that, right?

The MRI

WARNING: If you are claustrophobic, you may want to skip this part.

Thankfully, my initial blitzkrieg of calls trying to find the path to an early MRI mostly paid off. Within a week and a half (as in, yesterday), I was staring at this overly large contraption that really belongs exclusively in retro-futuristic sci-fi movies.

"It's pretty loud," said the Technician.

In addition to being highly introspective, I generally am not easily rattled.

"You'll hear lots of loud noises," he emphasized.

I had anticipated that the MRI experience would be new and surreal. But my only experience with them comes from television and film, often accompanied by a moody or sad soundtrack.

"You can listen to some music, because it can get pretty loud."

But I must admit, the whole experience was unnerving and frightening.

And it's not that I'm claustrophobic or generally uneasy in unknown situations. But as I lay down and propped up my knee, I had to straighten it as much as I could. This was not comfortable at all.

"You have to be still the entire time."

I was also handed some sort of "panic" thing to squeeze in case the pain was too strong or I needed assistance. I was asked what music I would like to hear. I planned for this. Sufjan Stevens, I said.

"How do you spell that?"

My knee was not in severe pain. Yet. I was instructed one more time that I would need to lay still.

"Okay, I'm going back now. It will be loud. Squeeze your left hand if you're in too much pain."

The bed rolled into the cavernous machine. This whole time, it sounded as if it was breathing with a machine lung.

Sufjan started singing, but was I listening to Mystery of Love? The headphones only emitted a cacophony of treble, very shrill and disconcerting. And suddenly, something like a slow-motion machine gun, loud and menacing.

Did I mention that it was loud?

It was loud.

Not in a way that hurts the ears. But more in the sense of sheer contrast. My mind was not prepared. As much as the tech tried to warn me about the sound, I just wasn't ready.

There are these sounds... the machine-breathing (in my imagination); the swirl of too much treble in the headphones; sudden and extreme slow-motion machine gun sounds, as if I'm lost in some ancient movie, but in slow motion; higher pitched "horn" sounds that belong is some alien construction yard; and back to that eerie breathing.

The discomfort of the pain from my knew suddenly felt urgent and distressed. My leg twitched. Oh no! I closed my eyes and felt myself wandering from the pain, to the sound, to distraction, to the accident, back to the sound, to senselessness.

Think about something else. Wait, but I'm thinking about thinking, and that is distracting. That's good, right? No? That sound is awful!

Rationally, I didn't feel fear. But my body was stressed, extreme fight or flight.

The temptation was right there in my left hand. I could squeeze and make it stop. But did that mean it would have to start all over again?

Oh, hell no!

And after 20 minutes or so, it was over. Twenty minutes? It seemed like one. It seemed like a hundred...

The Road Ahead

I haven't really shared my status with very many people. My hope is to take it... wait for it...

One step at a time.

But the experience in the MRI kind of jolted me. Since the accident (probably even before), I haven't really felt very motivated. Blame the introspection, the melancholic malaise, general discomfort, among other things...

I don't actually think I'll be doing an about face, per se. Yet, I sense the weight of heavy introspection. I don't think it's bad. It's just that I recognize the need for a release.

And part of that was writing about this whole experience, even if just for myself. Even if just to exorcise some of the tension I've been holding on to since... yeah... since much before the accident.

As mentioned above, I had originally planned to attend PyCon US in Pittsburgh this year. I still would love to go, but at this point, it's hard to say.

I'm back at the doctor's office this Friday to review the results. My initial impression (and uninformed opinion) is that I have a tear, either the meniscus and/or ACL, but the extent of it is unknown (to me) at this time.

I do believe I should be walking by the time mid-May rolls around, but I'll wait to hear from my doctor.

The Bonus

While relaying this experience to my friend shortly before writing this post, he reminded me of an album by Charlotte Gainsbourg released in 2009 titled IRM. (French acronym for an MRI scanner.) Songs were written and produced by Beck.

I've been listening to the title track on repeat while writing this. Beck introduces some of the droning sounds the MRI machine makes while layering hypnotic drums and synth sounds. Gainsbourg adds her vocals to float on top of it all.

Maybe I should have chosen this song on repeat before I got my own scan? Next time.

Wait... No. I hope there's decidedly NOT a next time.