The Angiogram

Angiogram: Round Two – My Adventure with Mr. Johnson

After the first aborted attempt at an angiogram, I returned to University Hospital two weeks later, better prepared. This time I knew not to eat anything after dinner the night before and that I would be spending the entire morning and afternoon in a hospital bed. Call me naïve, and many have, but when I was first scheduled for an angiogram of my left leg, I assumed it would be as breezy as the ultrasound, x-rays, and MRI that had already been performed.

Let me back up a second. I have a problem with my left ankle. It's swollen. Has been consistently for the past 7 years. There's no pain or loss of flexibility associated with it. It's just a fat swollen ankle. You've seen them before, mostly attached to the feet of older women in muumuus – often diabetics. Every doctor I've visited has been puzzled by why my left ankle is fat, yet functional. No matter what the problem I'm seeking medical treatment, the conversation always shifts to my ankle. Have a chest cold? That's nice, but what is wrong with your ankle?! Got an ear infection? That's easily treated, but how did you hurt your ankle?! Want to be tested for chlamydia? Your confidentiality is assured, but where did you stick your ankle?!
One day this summer, about two weeks after arriving in New Jersey, I woke up with a profound pain in my ankle. It had been slowly building for a few days, but one Wednesday it was so bad I couldn't stand. So, off we went to the emergency room where I was poked and prodded and referred to a podiatrist. Who, over the course of a month, recommended a number of tests, and diagnosed that there was a cyst above my ankle. About the size of two peas.

One test would be taken, and then another would be considered before the doctor could be certain that it was ok to remove the cyst.

Interestingly enough, while I was waiting for a final diagnosis, the pain went away. Completely. Can a cyst pop? If so does the fluid just spill into the rest of my body slowly causing moral decay? Or did my body naturally fight it? Or at least move it into a less painful neighborhood? Are our bodies full of pus filled sacks that we don't even notice?

These and other philosophical/medical queries may never be answered. Or maybe they will. At any rate, I was scheduled for an angiogram. And, as I mentioned above, I had no idea how involved an angiogram is. I thought I'd swing by the hospital in the morning, have the test, and zip on into the city for a day of work. The admitting nurse on that fateful day wasn't in the mood for me and my inexperience. I was sent away and rescheduled for another day. Which is a bureaucratic adventure in itself. Long story short – only a doctor can schedule an angiogram. But I managed to do it myself anyway.

So, round two. I'm in the hospital, trying to figure out which side of the gown is the back. I tried it on both ways. It fastened at the shoulder and the hip, so I couldn't decide which way was preferable. Did I want a plunging neck line or the V in back? Since it'd been a while since my neck and shoulders were shaved, I opted for an open chested gown. If only I'd packed some disco medallions.

The nurse, resembling Margaret Cho's mother, instructed me to remove my underwear. Creepy, cuz I was under the bedsheet at the time. X-ray vision?

Finally an orderly and a gurney came to the room and wheeled me down to the basement where the procedure would be performed. My guess is because it's near the morgue. I was introduced to the student doctor who would be assisting on the test. He ran down the procedure and three main things I should fear.

An angiogram, as I understand it, involves putting a catheter into an artery and then some dye injected into my blood. This will allow my arteries and veins to appear on an x-ray. The minute he said "catheter" I panicked thinking 'that's why I had to take my underwear off!' But, this wasn't one of THOSE catheters.

The student doctor – side note: when did all the doctors become younger than me? – the student doctor informed me that I had three dangers to consider. First, that the catheter could burst an artery and send my blood spilling everywhere. This could lead to death. My death, specifically. Second, that I could have an allergic reaction to the dye and die. And third, that my kidneys could have an issue with the dye and stop functioning properly. Again, death.

So, I signed my No Law Suit agreement and was wheeled into the lab.
I was heeved onto the "operating table" – such drama queens really, at this point I could have very easily walked in and laid down – and lay there for a while staring at the huge mountain of equipment hanging above me. I was hooked up to a number of pulse and heart monitoring machines and an oxygen tube was run under my nose. The dye would be injected into my left hip artery, so my hip was shaved.

I think it's playwright Maria Irene Fornes who wrote that everyone has genitals, we just spend our lives pretending we don't. Like me, Mr. Johnson is a leftist. With him hanging out near the left hip and razor flashing around nearby, I spent a hard time pretending he wasn't there. The barber did a pretty good job also of pretending Mr. Johnson wasn't there either. He'd nudge him a little with his knuckles, concentrating on the work at hand.

When the shaving was done, the student doctor and the doctor in charge came back. Disinfectant was rubbed all over the shaved area and well into the hairy spots. Again, Mr. Johnson was nudged and bumped. And again, I pretended as hard as I could that he just wasn't there. Finally, blankets and towels and table cloths were spread all over me and Mr. Johnson was finally out of sight. Which made it easier to pretend he wasn't in the room.

After the catheter was inserted I felt a rush of warm fluid poor over me. And the student doctor, a little too nervously for my taste, said "don't look, don't look, don't look" thereby affirming my fear that it was blood, my blood, I felt oozing over my hip and past Mr. Johnson's luggage.

But, everything ran smoothly after that. Dye injected, x-rays taken, catheter removed, pressure applied, bandage in place and I was wheeled back upstairs. Where I had to wait for 4 hours without moving. My blood pressure was measured every 15 minutes and my heart rate checked constantly. Unfortunately, I have a slow heart rate. Any time it dipped below 40 that machine would beep until someone came in and reset it. Seeing as I was just laying there, staring at the TV that only picked up PBS – just how much children's programming is necessary? – my heart rate dipped below 40 quite often. One nurse asked me "Are you an athlete?" "No," I said, "just really bored."

Lunch was a chicken salad sandwich and carrots, I peed twice in a bottle, and then got dressed and was sent home.

It's three days later, and my artery hasn't popped open and my kidneys don't seem to be having any trouble with the dye. I meet with the podiatrist again later to discuss what it all means. And Mr. Johnson is back to being ignored successfully.

© 2005