A quick CT scan for the frail and elderly

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First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The phlebotomist doesn’t notice, but your daughter does.

A couple of days later, your daughter drives you and your latest bruise up to the front door of the hospital. She parks while you walk in.

You have trouble deciding whether she’ll get parked so quickly that it’s not worth the effort of sitting down and the even bigger effort of getting up again. As you stand there indecisively, your daughter appears, and the two of you get on the elevator. She somehow already knows which floor to go to. Perhaps she asked someone as she walked by the front desk. That’s not something you could have done. It now takes all of your concentration just to walk.

When you get to the reception area, you get to sit and rest while your daughter checks you in. That was nice because this long walk has tired you out. Next, you go into the locker room and change into their gown. You can keep your underwear, but your bra has to come off. Getting that wretched thing on and off has become hard with your stiff shoulders. There’s not even a good place to sit down while you do this, but fortunately, your daughter helps you without your asking.

Now that you’ve got the gown on, you start noticing you’re feeling a little weird. You’ve missed your 9:30 meds. This morning you weren’t sure if you should take your diuretic and risk having to pee constantly or not take it and risk being short of breath. You took half. Now you’re feeling a bit short of breath, and you have to pee. You grab your walker and head off to the toilet.

When you get out of the toilet, you find that the staff is already waiting for you. You’re holding up the show. The nurse puts an IV into your other arm and leads you to the CT scanner. She has you sit down on a curved piece of plastic and gets your feet up so you can lie down on this cold, slightly padded thing. The technician says, “Yes, you have to be flat on your back, but it won’t be long at all,” and she slides you into the machine.

You lie there, worried about what will go wrong. The IV doesn’t fall out when they put the contrast through. You don’t have a pee accident. You were able to hold your breath when they asked, and your back didn’t hurt too much. The technician slides you out of the machine and helps you up. As she does, you feel a sharp pain shoot through your back. You know that kind of pain. It means your back will hurt for a week, but at least the scan is over with. The nurse removes the IV. You go back into the locker room. On your way there, you notice you’re feeling even weirder than you were before. You’re now due for your 10:30 meds. You start wondering how high is your blood pressure is now, and when you get home, should you take your 9:30 and 10:30 meds together or has it been so long now that you should skip your 9:30 meds, or is this the combination of meds where they just don’t work as well if you take them together or the one where it could mess up your heart rhythm if you take them together? You can’t figure it out and trust that your daughter will remember. You wish it wasn’t so complicated and that you could remember all the details about your meds that your heart doctor, your kidney doctor, and your primary care doctor went over with you.

While you were ruminating about your meds, you’ve managed to get half-dressed. Now you notice you have to pee again. You feel bad that you’re making your daughter wait, so you try to hurry. As you get up from the toilet, you reach for a bar to help you stand. The end of your shirt slips down into the yet-to-be-flushed toilet. This is what happens when you’re someplace different and not doing things the way you’re used to.

You get back to the locker room and tell your daughter about the shirt. You feel bad because she does so much laundry for you. She helps you get dressed and out to the car, the reverse of the steps coming in. You arrange yourself carefully so as not to get your damp, contaminated shirt on the front seat. Your back is really killing you now, and you feel a little dizzy from not taking your medications.

When you get home, you change your shirt and all the other clothes it got wet. Your daughter tells you to take your 9:30 and 10:30 meds and the rest of your diuretic dose altogether. Your back is killing you. You go straight to bed and turn on the TV.

A week later, about the time your latest bruise has started to fade, and your back is mostly recovered, the doctor’s office calls you. The nurse cheerfully says, “Your CT scan was fine. It turns out that your chest X-ray showed overlapping shadows, and there was nothing there after all.”

You know your daughter wants to know how the scan came out. You call her, feeling bad that she had to take half a day off of work for all of this.

Mary Braun is an internal medicine physician.

Image credit: Shutterstock.com

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