My diagnostic journey…so far

Last Tuesday, I saw my primary provider.  She ordered an X-ray of my right hip and referred me to Sports Medicine. The X-ray didn’t show any acute fracture or dislocation.  There was some mild degeneration of the SI joint, but that isn’t something that would be causing the symptoms I have been experiencing.  I wasn’t anticipating that the X-ray would show anything.

This Tuesday, I saw Dr. Rudolph in Sports Medicine.  She and her Athletic Trainer associate spent more than 30 minutes with me talking about my symptoms and evaluating me (and my running shoes).  She was particularly interested in the bump on my right butt cheek from the Tough Mudder I did in September.  It was her decision to order an MRI.

I was lucky enough to be able to schedule the MRI for that afternoon.  I went over to radiology to complete the safety survey.  Basically, they just ask me if I’ve ever done any grinding or metal work (to be sure I don’t have any metal shavings in my eyes) or if I have a seizure disorder or anything.  After that, I was about to leave and they called me back in to get a pelvic X-ray.  The one I had done the week before was only the right hip and they wanted to get a full picture.

Then I headed home to go teach a BLS course.  Just as I was pulling into the driveway, my phone rang.  It was someone from the billing office at the clinic.  She told me that she had called my insurance company to get the MRI preauthorized.  And, my insurance company couldn’t preauthorize it.  She couldn’t tell me why. She just said that my case was being presented to the medical director at the insurance company and that they had told her they might have an answer for her by the end of the day.  She asked if I wanted a self-pay fee estimate, or if I wanted to reschedule the MRI and wait to hear back from the insurance company. 

I tried not to cry while I was on the phone with her.  I told her to go ahead and get the fee estimate for me and to call me back.  Then I went in the house and I did cry.  I was so frustrated.  I’ve been dealing with this hip pain for so long and I felt like I was finally making some progress.  The doctor was fantastic working with me and talking with me to find out the different things that caused the pain.  She understood how important it was for me to get back to running as soon as possible.  She ordered the MRI because she felt that was the best diagnostic tool to be able to determine the cause of the problem.  And now there was some idiot medical director who has never talked to me who was going to determine if I was actually going to get the MRI.  I was an emotional wreck.  Then I had to go teach my class.

The clinic called me back with a self pay fee estimate of $5,570.  Right.  I’ve got that lying around.

I decided that when I finished teaching my class, I was going to call the insurance company and find out what the problem was.  When I called, they transferred me to one of the nurse case managers.  She was really not helpful.  She never directly answered any of my questions.  She tried to throw me off my game with her insurance double-speak.  I was frustrated and annoyed and I wasn’t going to let her intimidate me.  I wanted to know why the test wasn’t approved.  She couldn’t tell me that.  I wanted to know what in my medical information caused it to have to go to the medical director.  I wanted to know when I could expect an answer.  I told her that my MRI was scheduled for three hours from then.  She then did the only helpful thing.  She flagged my claim as urgent and sent an email to the medical director.  She told me that she would call the clinic back when she got an answer.

I stressed out. 

About 90 minutes later I got a call from the same lady at the clinic saying that my MRI had been preauthorized!  Whew!

So, I headed down to the clinic.  I checked in at 5:30 for a 6:00 appt time.  I changed into a gown and a robe and met with the technician who asked me all the same safety questions I had answered that morning.  He also told me that the doctor wanted to put an opaque marker on the spot on my butt where that bump was from the Tough Mudder.  That way she could identify that spot.  So, I had to put a strange sticker on my butt.  Then he explained that they would take 11 pictures and that each one would take about 4 minutes.  I was looking at spending about 45 minutes inside the machine.  But he would pause after the first 8 to inject a contrast for the last three pictures.

I tried to get as comfortable as possible on the table.  He put a coil of some sort over my pelvis to help get clearer pictures.  He gave me an emergency squeezy ball thing in case I felt that I needed to urgently stop the machine and get out.  He put some headphones on to help block some of the noise and turned on Hits of the 70s on Pandora.  It is really hard to lie perfectly still when listening to Stayin’ Alive by the Bee Gees!

The first picture took about three minutes.  The second one took just over four.  After each picture, he would talk to me to check and see how I was doing.  I would take a minute to scratch my nose or stretch my arms.  I couldn’t really move my legs.  After the first two, he told me I was a professional MRI patient and that he was going to do the next three pictures in a row and he would talk to me in about 10 minutes.  After that batch of pictures I was starting to get uncomfortable.  I reminded myself that this was a relatively short procedure and that it was part of the process of getting me running again.  We did the next three pictures and then took a break to inject the contrast. 

The tech was a really good IV start.  I have one good vein and it doesn’t always cooperate, but he did a great job.  It took a minute or so to inject the contrast.  It isn’t like the contrast they use for a CT scan (where it feels like you pee your pants).  This felt like nothing. Then, back into the machine for three more pictures.

Once I was done, the tech came to let me out of the machine.  He took the coil off my pelvis and helped me sit up.  Then came the searing pain from my lower back.  I realized that I had just been lying flat on this super hard table for a little more than 45 minutes without moving anything below my chest.  There was almost no padding on the table and I wasn’t able to bend my knees or put anything under my lower back to lessen the stress on my lower back.  Once I sat up, I just had to sit there for a few minutes.  I felt like my lower back was on fire.  Every move hurt so badly.  I slowly limped back to the changing room. I got my clothes out of the locker and went to change.  I had to just stand there for a couple minutes.  I was in so much pain that I couldn’t even sit down.  It took a long time for me to be able to get dressed.  All in all, I was at the clinic for about an hour and a half. 

I rewarded myself with a Shamrock Shake from McDonalds.  (Hey-the ‘season’ is almost over!)

Now I have to be patient and wait for the results.  The doctor told me that I should hear something in a few days.  If I don’t hear anything by Friday morning, I think I’ll call.  I’m anticipating that the treatment will involve some sort of injection.  I really don’t care what it is as long as I can get rid of the pain and start running again.

I’ll do a post when I get the results/treatment options.  Oh, by the way…I’m totally not claustrophobic inside the MRI machine, but I’m still not a huge fan of elevators.  Weird, huh?

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2 thoughts on “My diagnostic journey…so far

  1. Pingback: Another MRI | (G)O'Donnell

  2. Pingback: Further diagnosis | (G)O'Donnell

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