Thursday, March 01, 2007

Complications CT Scan With Injected Iodine

Complications CT Scan With Injected Iodine

2007 March 01 Thursday

Having iodine injected into your body can cause complications, with one of the potential side effects being death. In the case of today's medical adventure, however, there was only one unexpected problem, and that was the difficulty I encountered in getting two and from the hospital.

I had been to Meijin Hospital a number of times before, so did not anticipate having any difficulty getting there. However, on arrival at the railway station which serves the hospital, I found that the whole place was under construction, and that my familiar route had vanished, replaced by a circuitous detour which was complicated and poorly signposted.

I looked for a sign saying, either in English or Japanese, "This is the path that leads to the place you were going to when you came this way last," but there was no such sign.

There were, however, signs pointing the way to the entrance of the subway station near the train station, and I had the feeling that I had a hazy idea of where the subway exit was in relation to where I wanted to go.

So I headed for the subway exit and, in the course of doing that, debouched into a passage which looked as if it might be heading in the direction I wanted, so abandoned the subway goal and took that passage instead.

On previously exiting the railway station, I had followed a route which was flat, but this one had small flights of steps, four or five steps per set. Not seeing one of these properly in the haze of my visual field, I stumbled as I encountered it, and almost fell.

Once I was finally on the streets, familiar roads and buildings oriented me, and getting to the hospital was straightforward.

I knew there would be a blood test before the CT scan, so figured there might be a urine test as well, so was careful not to relieve myself before reporting for the CT scan. Yes, there was going to be a urine test along with the blood test.

Because I had left home much earlier than I really had to, there was plenty of time to get both tests done before returning to the CT area.

At the CT area a drip was inserted into my right arm and then, after a short delay, I was led to the CT room and was told to lie down on the bed, keeping my shoes on. At that stage, I was wearing jeans with a metal buckle, a T-shirt and a jersey, and was told to slide the jeans down as far as the mid point of my thighs, which I did.

The CT scan got underway and I heard a voice say, in Japanese, "Hold your breath." So I did so. Then the voice spoke again, and I knew that this was the signal to start breathing again.

After that, the iodine was injected via the plastic cannula which had been used for the drip.

The first time I ever had injected iodine, I had no special sensation whatsoever, and was disappointed that the promised flush of heat did not occur. The second time, in New Zealand, I did experience a little heat. This time, immediately after the iodine had been injected, it felt as if warm bath water was coursing through my veins, and my entire body had a kind of mulled wine feeling.

After the CT scan I went and paid in the cashier's department, and was charged a little over 13,000 yen for the day's entertainment, about $US 108, if we take an American dollar as being worth about 120 yen. Not unreasonable, I thought, though of course I was only picking up thirty percent of the cost, with the Japanese taxpayer picking up the other seventy percent through the Japanese National Health system.

Since I had been told to fast before the CT scan, I had skipped breakfast, and it was now about eleven in the morning. The entire procedure had taken about half an hour, including waiting time, and I had arrived in advance of the scheduled 1045 start.

Being hungry, I went to the hospital's restaurant, which is overpriced for what you get, but is not exorbitant.

I then headed for the station, and, approaching it, found the route well signposted, with signs clearing saying how to get to the tracks. However, I did note that absolutely all the signage was in Japanese script, with not a single word of English anywhere, so if you'd been an English-speaking tourist with a guidebook then you'd have been lost.

My parents, visiting Kyoto a few years back, remarked on how poorly signposted the station was, at least from the perspective of anyone who only spoke English. And Kyoto is, in terms of incoming foreign tourists, probably Japan's busies city.

By this time I had quite forgotten stumbling up some steps while finding my way out of the station. On the return trip, I encountered not just one set of unexpected steps but three. I stumbled badly on both the first two, each time almost falling, and almost failed to notice the third set of steps, even though by that time I was on the lookout for any.

By the time I got back to our home station, I was distrustful of the ground underfoot.

I had a couple of minor chores to do, buying bread at the supermarket and then picking up a reserved book at the library, then it was time to head home and crash out on the sofa, which I did, as I had endured something of a wakeful night.

Tomorrow, Friday, I have an MRI scan scheduled. Today's CT scan was a scan of the whole body but tomorrow's MRI scan will be just of the brain. While iodine was injected today for contrast, tomorrow it will be the rare earth gadolinium, which does cause the occasional person to throw up, but which does not come with a "side effects may include death" warning. Because I never throw up when I have this stuff, I will be having breakfast as usual. In New Zealand they don't tell you skip breakfast, as there's no medical reason to empty your stomach before having a scan of your brain, but in Japan, mindful of the inconvenience of being vomited upon, they do tell you to fast. And, if asked tomorrow if I did fast, then will lie blandly and say, yes, I did. (Part of learning how to manage the patient role, in my opinion, is figuring out when and how to lie to the medical staff.)

I had volunteered to have both the CT scan and the MRI on the same day, but my hematologist, Dr Gunma, advised against doing any such thing, and, in retrospect, I'm glad that he took that line.

Tomorrow's MRI scan will be in the early afternoon, with a consultation with Dr Gunma to follow, at which I will learn the outcome of both tests.

It's still not clear to me what the utility of these tests is, since any return of brain cancer would, in all probability, turn out to be (a) incurable and (b) lethal. But, even so, I confess to being at least a little curious about the outcome.

The payoff from my last set of blood tests was that I got told that my cholesterol levels were perfect, which was nice to know even though I have never been fussed about cholesterol, and have never taken the initiative to ask anyone to have my cholesterol tested.

I believe that my wife, who went to work as usual today, plans to be on hand for tomorrow's consultation with Dr Gunma when I meet him tomorrow.

As I was entering Meijin Hospital today, someone in a medical coat said good morning to me in Japanese, so I answered likewise. I thought perhaps it might be Dr Gunma, but, as I'd come in from the brightness of a windy spring day to the dimness of the hospital, I couldn't make out who exactly it was that had said good day to me as he strode on by.

Spring is warming up and the cherry blossom is getting underway exceptionally early, as I noted when we visited the southern town of Ito back in January. The neighbor's tortoise (ie, land-dwelling turtle) is already awake, having cut short its winter hibernation. And I believe I saw in the paper saying that the Dutch did not get to do any ice skating this winter, as the expected freeze of the canals and waterways never took place.

George W. Bush may not believe in the reality of global warming, but I think that I do. And I believe that the neighboring kid's tortoise shares my opinion.

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