Jonathan Crowe

My Correct Views on Everything

Adventures in Tomography

I had an MRI on Wednesday. I can safely say that they have no recreational value whatsoever.

The MRI was done to confirm the diagnosis of ankylosing spondylitis. Those of you who have known me for a while may ask: But wait? Weren’t you diagnosed a long time ago? Yes I was: on January 13, 1998, in fact. But I was diagnosed based on criteria — family history, symptoms, bone scan results — that, while sufficient for a diagnosis per se, aren’t sufficient for the purposes of the Quebec government insofar as access to certain treatments is concerned.

Or, to put it more bluntly: if I want the Quebec health care system to give me Remicade, I need to jump through certain hoops. I need to have tried several different NSAIDs for at least several months (no problem there). And I need radiological evidence of AS — i.e., proof in the X-rays. But X-rays taken last year didn’t show any clear evidence of AS, even on the ground-zero sacroiliac joint, even after 14 years of symptoms.

(It’s had me wondering whether what I actually have is non-radiographic axial spondyloarthritis, but I’m not qualified to assess that, and I haven’t discussed that hypothesis with my rheumatologist.)

So the MRI was ordered up for a closer look, and six months later, I actually get one. (No fulminations about the delay in getting one, please. I understand the system’s limitations. My situation is chronic, not acute. I’ve had it for nearly 15 years; another six months won’t kill me. Cancer patients? Go on ahead of me.)

Entering the MRI is like being fed into a torpedo tube while at the same time being put into traction. I expected to be launched at any moment. It’s extremely loud and cramped and the air isn’t very good. My head and neck were restrained even though it was my spine and hip they were imaging. They really want you not to move, which as someone who’s done long-exposure photography I can appreciate, but still. You get really conscious of how deeply you breathe (the bad air doesn’t help). And then the technician said: “Try not to swallow.” Well, I hadn’t had to swallow before, but now that he mentioned it the urge became overwhelming. Completely Pavlovian.

The whole thing took about forty minutes. It’s a good thing I’m not claustrophobic.