Two years ago, my gastroenterologist (gastrointestinal specialist) ordered a CT scan after he did a colonoscopy on me. I was still drowsy from the anesthesia when I agreed to it so I didn’t remember much. This time, I was fully conscious.
A CT scan is basically multiple x-ray combined into one by computer so that the doctor can see cross-sectional. The doctor also inserts dye (called contrast) into the body so that the scan images are easier to see.
It is amazing because it was with CT scan that doctor determined the size and location of my cancerous tumor to decide on the surgical procedure. CT scan also helped determine if there’s anywhere else that they have to operate in case the cancer has spread.
One surgery, twelve cycles of chemotherapy and two years later, I was due for a routine CT scan. I’m guessing it’s called a “routine” scan because there’s nothing wrong and they just want to monitor and make sure.
Registration and Wait
I arrived at University Malaya Medical Center (UMMC, or better known as PPUM) minutes before 9am. I was late but thankfully they didn’t deny my appointment. Phew.
After registration and payment (RM780), I sat beside an uncle in the waiting area. Everyone there was very quiet and dull but this uncle decided to strike up a conversation with me. “Muda lagi dah kena scan?” Indeed, I was the only young one there. Everyone else was at least 50 years old. As usual.
It was my first time doing a CT scan at UMMC but Uncle was doing his fourth there. Apparently, the cost gets lower when you return for a scan even though this scan is typically done years apart. Uncle’s scans have dropped from RM800+ to RM300+. Not sure if there’s really a discount for repeat scan or it’s just that his scan got simpler.
Anyway, I waited for quite a bit before being called to change into hospital gown. I had to remove everything metal including necklace, bra, fitbit and earrings. Metal items interfere with the radiation beams.
I kept my items in the locker provided and joined the rest in staring blankly. LOL kidding. I grabbed a week-old newspaper and started reading.
Radiologist Consultation
Not sure how long I was reading before I was called to see the doctor, a radiologist. There were two radiologists in the consultation area. One radiologist to one patient at one time. However, there’s no partition so while patients could overhear everyone’s consultation, the radiologists could interfere each other’s consultation too. And that’s what happened to mine.
During the consultation, the radiologist asked preliminary questions to ensure I was fit for the CT scan. For whatever reason, I thought I remember my mom saying I had childhood asthma. The radiologist wanted to dismiss me from the scan that day because asthmatic patients would need to be administered steroid beforehand. I called my mom and was gladly told that I don’t have asthma when I was little. Yay! Super relieved. From now on, I shall correct my memory and remember that I do not have asthma so not to raise false alarm again.
After the asthma episode, the radiologist asked if I am allergic to any drug, etc. I told her I have no drug allergy but I got an allergic reaction to haze when I was 15. I could see her sigh silently. Not again?! We had another discussion on the severity of the allergy and the worse case scenarios that can happen.
Honestly, I didn’t think a CT scan would be so tedious. I knew CT scan was bad for the body because of the radiation. But hearing it from the radiologist when you’re feeling half naked in hospital gown felt worse.
“I need you to understand all the risks associated with CT scan. I’m gonna tick here that you don’t have asthma because your mom says so. A small percentage of asthmatic patients — even if they stop having it beyond childhood — may have an adverse reaction to the iodine-based contrast. Even though you only had skin allergy once, it means your body is allergic. You have to let us know if you spot red spots (like mosquito bites). It’s not common but you may have difficulty breathing, your blood pressure may drop, your heart may stop and you may die. Please sign here if you decide to proceed.”
Whoaaaa so stress. But I’ve done it before and it was totally fine even when my blood pressure was low after a full day colonoscopy prep and even vomited before the scan. So I told my doctor I am confident and signed on the dotted line. Phew.
Contrast Insertion
I walked out feeling less excited than when I first walked in. But before my mind could process much, they intrigued me with one thing after another to prepare for the procedure. I had 3 contrast insertions in total.
The first was by injection to scan my circulatory systems and some organs. I told the radiologist I have a PowerPort® on my chest. Both radiologists seemed excited but I had to buy a RM7 special needle from the pharmacy. I imagined myself walking out of the waiting area in my half naked hospital gown to buy a needle and decided, nope. I offered my arm to be poked for IV site instead. Let them do the hard work 😂.
I was definitely feeling tense inside when the doctor commented that I have tiny veins. Thankfully she got it in one go! And thankfully a bunch of medical practitioners walked in to observe a patient as the radiologist was doing her thing. The bunch of people distracted me enough for me to not notice when my radiologist injected water into my bloodstream. She had to do it again with me paying attention because I had to report if it’s painful; if it’s painful, it means there’s leakage. No pain. Phew.
Actually, there’s no contrast injection at this stage yet so moving on!
The second contrast insertion was by mouth to scan my upper digestive tract. I drank one big cup of lime-coloured liquid containing contrast material. It tasted fine at first; like weird lemon water. Then as I gulped through half of the cup, it tasted weirder just because it was a lot of water after fasting for more than 10 hours.
The third insertion was by enema to scan my intestines. In case you’re not sure what this means, it means they put stuff through my behind. I was brought into a room for the procedure that was over in 10 seconds after the nurse flipped my gown up. Wow, that was fast. Thankfully. After this procedure, I just wanted to sit down and block my outlet because it made me feel like going to the toilet 😐.
The Scan
Something fun happened before the scan! I was made to wait in the technician room with all the medical practitioners operating the place. There were computers and monitors inside a room with a huge window overlooking the CT scan machine.
Remember the patient who had observers? He came in for a procedure along with the bunch of observers. There were like thirteen people in blue gowns staring at the monitor as he went through the machine. Whoaaa. I gladly felt invisible, like I was behind the scene of some medical drama.
It was my turn next and I walked into the CT scan room shivering. It was so cold!
I lay on the table shivering and was covered with blanket, still shivering. After that, I was moved closer to the donut-shaped scanner and was asked to raise my arms, still shivering. Next, I did a rehearsal of the scan where I had to breathe following instruction: (1) breathe in, (2) hold, (3) breathe normally, still shivering.
A doctor walked next to me and injected contrast through the IV site on my arm. It was slightly painful when the contrast first went in. The pain grew as more was injected. I yelled, “pain pain pain” as he massaged my arm to ease the injection. The pain felt like bruising pain; manageable but I had to voice out in case my vein was leaking.
I could feel the contrast travel through my body as it heated my body. But I was still shivering.
The real deal happened. My CT TAP (thorax, abdomen, pelvis) started. I stared as something spun real quick inside the “donut”. (Well, they didn’t tell me I couldn’t stare even though everyone probably left the room as they spoke to me via a speaker above the machine.) I did the breathing routine again and someone walked next to me to check on my arm if there’s any swelling. Then I realized the scan was done when I was asked to breathe normally. Wow. The actual scan was like 10 seconds? I haven’t even run out of breath when I was asked to hold.
I commented that my arms were getting numb but I guess no one could tell if they were numb because of the reaction from the contrast (possible), my existing neuropathy or from feeling too cold. Oh well. I just left the room feeling just like myself and changed my clothes.
That’s all! What an experience. It felt way more tedious than my first but it was refreshing because I could remember everything this round. My injected arm is slightly aching now (two days after the scan) but everything else seems fine. No allergic reaction and whatsoever.
I should have drunk coconut water to hydrate and rinse out the contrast from my body instead of just increasing my water intake. Whatever. It’s done now. I have to wait close to a month to collect the report during my next quarterly consultation. I look forward to not hearing anything from UMMC till then because I believe no news is good news in this scenario.
p/s Counting down 3 days till two full years since my doctor said, “Girl, you’re in big trouble.“