Tuesday, November 10, 2009

Pins and Tuners

Today I headed over to UCSF for my annual visit to the Multiple Sclerosis Research facility. Since this is only my second time, it's kind of an exaggeration to call it "annual" - but indeed, I went last year and I went this year again at the same time.

I am participating in a study about MS and genetics. Tis true that there are some family trees that produce more neurologically deficient apples than others. I am one of those bad apples. But, it also turns out that medical science likes to do research on said fruit and I am game for whatever I can do to try and figure out 1) what causes this bad johnny and, 2) what to do about it if you should happen to have to take a bite out of this rotten apple. I'm a joiner that way.

Today consisted of several hours of allowing myself to be prodded and poked and perplexed. Sounds like a sexual encounter, except in this case, the whole "feel good" part of it consists mainly of knowing you are doing good for science. Not exactly enough to want to make you call out God's name like you actually believe.

I gave 11 large vials of blood. I played a version of the triangle golf-tee game that used to be found on the counter tops of your road-side Stuckey's with both my right and left hands, and I was forced to do the ultra-frustrating "cognitive-math" test - which is enough to make you want to hunt down and garrote the guy whose voice is on the tape recorder spewing out numbers every 3 seconds.

The "test" goes like this. Bored sounding guy says random numbers every 3 seconds. You listen to the first two - say 3 and 7. You add them up and say 10. Then bored sounding guy says 2. You answer 9, which is the sum of the last two numbers that you heard. In other words, you have to add two numbers, forget what you just said and remember the last number that the guy said and add it to the next number that he said. Try it some time. This little gem of a test goes on for 5 excruciatingly long minutes. I'm not sure whether they are really trying to measure your cognitive ability or if they are surreptitiously attempting to find out at what point of frustration the average person with MS will reach over and whack the test administrator with the very tape recorder that is belching out digits.

After that, I headed down to China Basin to spend the better part of two hours inside the ultra-clinique-soap-dish called the MRI machine. After enrobing myself in the exquisite combo patterned scrub pants, back-tie gown and mismatched robe designed as one-size-fits-all (including, as far as I could tell, participants on the "World's Biggest Loser"), and before being inserted in to the tube of despair, I met with the test coordinator: Sweet-little-miss-I'm-26-and-just-graduated-from-liberal-arts-school-with-no-experience-in-neurology. Her job is to give me a little basic neuro test before I am strapped down on the slidey-thingy with another needle inserted in to my arm so that they can easily inject contrast dye in to my already sore arm, where someone earlier has already been siphoning off 11 tubes of blood, when the time is right. Thanks for that. But, I digress.

For the uninformed that have never been subjected to the standard neuro tests, they can easily be described as the modern day equivalent of determining whether you are a witch by dunking you in water. Yes, they are HIGHLY complex. You get to tap your fingers together as fast as you can, smile, stick your tongue out, blink rapidly, squeeze your eyes shut, walk heel to toe for several feet (note: when you are encased in hospital scrubs comprised of enough fabric to encircle the globe and the majority of that is pooling on the ground around your feet - this test can be even more challenging - or funnier to watch, depending on your vantage point), try to keep your balance with your feet together and your eyes shut (I fail that one every time), follow the doctors finger as it moves through space with only your eyes, then try to touch his finger and then your nose as he randomly moves his finger to different spacial positions, you have your reflexes checked, your strength measured by trying to resist having various limbs pushed and pulled in several directions and finally it's time to pull out the tuning fork and the pins.

Tuning forks and pins are used to determine whether you have feeling in various parts of your body. The coordinators whacks the fork on her hand and asked "can you hears this?" Yup. She whacks it again on her hand, places it on some part of your body (face, hands, feet) and then asks you to tell her when you can't feel the vibrations any more. Face = OK. Hands = Less, but still OK. Feet = Not OK. I can't feel it at all. So she whacks it harder. Still can't feel it. She whacks it even harder. Still can't feel it. She is starting to get pissed. It seemed that in her opinion, I was failing the test. She whacks it so hard that the thing makes a twanging barking sound (I think she broke it!) I finally gently explain that it doesn't matter how had she whacks it. I can't feel it. She seemed perplexed but moved on the the final test....the Pins.

Eyes closed you are supposed to tell her when she pokes you whether the stick is sharp (pointy side of pin) or dull (non-pointy side of pin). Talk about some fun party games! Face = OK (pointy) Hands = OK (mostly pointy). Feet = "I don't know. I can't tell". She pokes my feet some more. Harder this time. "I don't know, I can't tell". She then pokes even HARDER at which I point I interject with, "Could you stop ramming the pin in to my feet? I can't tell if it's dull or sharp. But, if you are going to continue to poke the sharp part in to my feet, there's going to be blood. I won't feel that dripping on to the floor either, but it's kind of annoying." I was reminded of the people who are trying to speak English to a non-English speaker and feel that if they just yelled louder they would be clear. I might have suggested that a hammer and nail would work if she wanted to take it to that level. A nail through my foot? Well, I would definitely tell that sharp end of that.

Suffice to say, that the exam was over and I had a couple of hours to nap in the MRI machine with my head securely strapped down. And, on a final note - what the heck is it with the need to scratch your nose or your eye brow or whatever when there's no way on earth that you can get it done? I have no feeling in my feet, but apparently, I have enough hyper-feeling in my nose so that I can create phantom itches without the ability to address them. Sheesh. Maybe next year, I will join a scientific research project that focuses on that. Perhaps they don't use pins for that one. Maybe you just get to put on the super-sized scrubs and they throw you in the hospital pool to see if you float?

1 comment:

chaoticgrace said...

Wendy - I work in neurology for Medtronic Neuromodulation. Recently, I have been working with MS patients implanting pumps that have baclofen/lioresal to reduce spasticity. It is delivered into the subdural space and very effective! I have seen children with CP(cerebral palsy) start walking and feeding themselves after receiving this drug. It's amazing! So glad your doing well and love to read your blog.
Take care,