Sometimes I wonder about the job descriptions for the nurses and medical technicians in pelvic medicine: Training and certification? Attention to detail? A sadistic streak?
My friend Jaime was having a medical crisis and she put out a “story problem” on Facebook that went straight to my heart.
“If Jaime needs to drink 6 glasses of water stopping at 3:30pm and arrive at her destination at 4:30pm with a full bladder at what time should she either start drinking water or stop urinating?”
Ah, pelvic diagnostics.
They can send a man to the moon, but they can’t get a picture of the inside of your lady-pelvis unless the sound waves can bounce off of a bladder the size of a watermelon.
I tried to ease Jaime’s worries, explaining that if she just made sure to have something in the tank when she arrived for her appointment, it’d all be fine.
But uro-gynecological practitioners and ultrasound technicians are barbarians.
They made a special phone call to remind Jaime: six glasses – be sure now!
And so Jaime dutifully drank the water, and, not having a car, got on a train. And then took a long bus ride in the suburbs to her doctor’s office.
“Story of my goddamn life,” she thought.
I’m not that person who forwards you e-mails about cinnamon curing rheumatoid arthritis. But I felt well-qualified to advise Jaime, having been diagnosed with a little-known bladder disease ten years ago.
My first urologist was a small, crisp, curly-haired woman who gave me a questionnaire for some funny condition called “interstitial cystitis.”
At my next appointment, the torture chamber was ready.
Jaime understands. When she finally got off the bus, she rushed to the front desk and said, “Is it really necessary for me to hold all this urine?” She explained that the nice dry floors were in imminent danger.
The technicians consulted and ruled that she could go to the ladies’ room and empty just a bit.
Perhaps these professionals are so blasé about our desperation because every fifteen minutes brings another wincing victim to the exam table. Yawn.
But doesn’t it ever occur to them that many of the people who must undergo pelvic diagnostics are doing so because they have faulty, painful plumbing? The physical calculus of how much water to drink and when to start holding it, figuring in travel, and then wait time while the technicians bustle indifferently, is sheer agony.
Back in the torture chamber, a brisk physician’s assistant with exactly half of her eyebrows ruthlessly plucked away catheterized me for the first time.
It hurt worse than the burning punch of a bee sting, if you can imagine a bee sting down there.
“Oh, it’s not pain, it’s just discomfort,” she said.
She hooked my catheter up to a big bag of saline, which began to pump into my panicky, pain-wracked pelvis, chilly water filling my bladder in reverse.
I had to bear as much saline as I possibly could, naked from the waist down, while a stranger with denuded eyebrows who did not believe in pain made notes on a clipboard.
In the years that followed, I learned that every urologist worth his or her salt can come up with a reason for you to have a bursting bladder on your way to the office.
I’ve peed into specially-engineered metal devices that report the velocity of the flow. No-nonsense nurses peer at my bladder with their sonic wands before and after I go. And of course, every time the pain worsens, someone prescribes another ultrasound, to make sure it’s not a tumor.
I dread the tests so much I want to take my chances with a catastrophic illness.
And barring all that, everybody still needs a nice cupful to rule out a good old-fashioned UTI – but, in direct violation of the Hippocratic Oath, they make you wait in the exam room, naked from the waist down under a flimsy paper sheath. Then they take your medical history until that sterile plastic cup in the ladies’ room is the Promised Land.
My worst urologist was a skeptic who wouldn’t believe another doctor’s diagnosis until he got me into the hospital.
He kept me conscious for the catheterization and preliminary tests – it turns out that excruciating catheterizations are a hallmark of interstitial cystitis – and I have never been so grateful for darkness as when the anesthesia kicked in.
The doctor’s camera took a tour of the inside of my bladder.
As my eyes opened in the recovery ward, I saw him standing by the bed.
“You won’t remember anything I say to you right now,” he said. “I could see your bladder bleeding. You have interstitial cystitis.” He walked away.
Interstitial Cystitis is a strange little condition – a genetic autoimmune disorder, some doctors theorize. Basically, I have bleeding ulcers in my bladder and no-one in a white coat knows why or really cares that it hurts like a forest fire in my torso.
I hope Jaime can get some answers.
When the technician exclaimed over her bladder, Jaime asked if that meant something was wrong.
“No, it just means you’re good at following directions,” the tech replied. Then she told Jaime that practitioners don’t actually expect people to drink the amount of water their doctors tell them to in advance of the test – and they don’t bother to take into account the size or age of the patient or the reason for the exam when they say six glasses.
See what I mean? Sadists.