A Test She Couldn’t Fail

glowheartWhen I was pregnant with my younger daughter, Sammi, I worked in an aging office suite with a highly-coveted tiny kitchenette. Other departments of the same non-profit had to go to the basement to retrieve and reheat their lunches, but our little corner of the building had a full-size refrigerator and a microwave.

That microwave must have been older than I was. In the years before having children, I often warmed my cold fingers in front of it as heat leaked out the seams in the door. Once I was pregnant, I wouldn’t even pass by the cubby where it rested if I knew someone was using it; I was afraid the radiation was seeping out with the heat, and I didn’t want to put my unborn child at risk of cancer before she was even born.

Then she was diagnosed with a rare congenital heart condition at the age of 13 months, and in addition to the chest x-ray she’d already had, she had to be put under general anesthesia so that her surgeon could get a clear picture of her vascular anatomy via computed tomography — also known as a CT scan. An IV allowed the flow of a contrast solution into her veins and arteries so that they would all light up in the scans. I sent her in — all sixteen pounds of her — and tried not to think about how much radiation she was absorbing. They needed those pictures. It was the only way to get them.

Seven years later, after false diagnoses and many unnecessary procedures, we learned that her cardiac condition required another surgery, and that surgery required another CT scan. Because she was older, and because the issues with her aorta were affecting her esophagus most of all, this time she would need to be awake AND be an active participant in the test. On a freezing cold December day, we headed to the hospital for her second CT scan.

In the children’s hospital where she’d undergone all of her surgeries and procedures, they try not to do anything invasive to a child who is awake if there is another option. For that reason, even though she had been under general anesthesia sixteen times by then, she had never been awake to feel an IV inserted — they always gave her gas to help her fall asleep. This time, she needed to be awake, and so the IV went in, for the first time, with her watching.

ctdayIt did not go well. The needle was bigger than usual, as it needs to be for a CT scan, and the operating rooms were all busy that day. She spent nearly an hour waiting for the test to begin, and for the first time, she was hard to distract.

“It hurts! It stings!” she told us, holding her right arm rigidly away from her body.

We pulled out our phones and watched funny videos on YouTube. I climbed into the bed with her to stabilize her body against mine, keeping her from jiggling the needle and making it hurt again. We read. We told stories. We did everything we could to distract her.

When it was time for the test, the radiologist pulled us aside in a huge CT room designed to look like a carnival. The walls were decorated with cotton candy, clowns, circus tents, and other cheerful things that made it all the more maudlin. She handed us heavy head coats and asked me more than once if there was any chance at all that I was pregnant.

No, I thought. My baby is right there in the machine.

I shivered when I looked at her. She was dressed in a thin hospital gown, laid flat in the machine. She looked utterly vulnerable. In contrast, the radiologists were in a booth, talking to her through a speaker in the machine, and my husband and I were protected against the radiation so well that it was hard to move freely. More than once, I stepped out of Sammi’s sight lines to take a deep breath and try not to cry.

To get an accurate picture of both the arteries in her chest and her esophagus, the radiologist decided it would be best to have Sammi also drink a contrast solution and capture images of her chest as the solution made its way down. This way, the images would be able to show the surgeon both the contrast solution coursing through her arteries from the IV and the contrast solution chugging its way down her kinked esophagus.

Timing the swallows to her pulse was crucial, and so the radiologists were watching and giving her a countdown to take sips of the liquid — mixed with apple juice — and then hold it in her mouth until it was time to swallow. Because she had to maintain a specific position inside the machine, my husband leaned in and held the cup out to her when it was time.

All the while, I was thinking: she trusts us, and we’re filling her up with radiation. 

The entire process was, in a word, traumatic, from the painful IV and long wait for her to the high emotions it brought up in me. The end couldn’t come soon enough. As my husband leaned into the machine to pick her up, I asked the radiologist what the next step was.

“Oh, don’t worry,” she said. “I am meeting with your surgeon in twenty minutes. He’ll be in touch very soon.”

Once again, we dressed our little girl, put her in the car, and took her home. After dozens of visits to the hospital, she didn’t even ask why we had been there, what that test was for, or what would happen next. She asked for Tylenol for her sore arm, French fries for her empty belly, and a movie to watch at home.

It was easy to comply, and much harder to wait for word from her surgeon. That would take nearly two weeks. In the meantime, we covered her room in glow-in-the-dark stars at her request, and I watched them each night at bedtime to see if she would be reflected there, a contrast solution brought to life.

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