I once worked for a large organisation that used a lot of acronyms. It took me ages to find a summary of these on their intranet, as they were under the heading TLAs (Three Letter Acronyms – an autological abbreviation).
A Patient’s Guide to Scans and Medical Acronyms
CT Scan with Contrast: A large polo or doughnut masquerading as a Time Machine, wishing it could transport you to another dimension where you are well. Like Escher’s Journey into Infinity dissected into layers, peeled off to reveal what you don’t want to hear. A snapshot of a cross-section, a slice to analyse with what you dice, a penetrating wave of intrusion. Contrast dye is injected, a weird glow flows through the body then a sensation of wetting yourself. You don’t remember this from childhood, only the shame of an adult. Hands over your head, a disembodied voice tells you to breath in and hold your breath, reminding you when you can breathe again. You concede control fantasising how far you would obey that voice.
MRI Scan with Contrast: It sounds like you’ve been dumped, arms tied in the middle of a building site or locked in the boot in a car crushing junkyard in a thriller. Ella Fitzgerald can be your distraction, if you perversely enjoy the irony of ‘I’m Feeling Good’, but many ‘suites’ do not have a CD player now and you’re given yellow squishy earplugs and oversized headphones instead. No metal, no pacemakers, or bits in your eye from welding, no jewellery (all piercings emptied), no braces, no glasses, and an obsession with bras, safe with a sport’s one, even if you can no longer play. And no glitter make up to further suppress your sparkle. A claustrophobic’s nightmare, powerful magnets and radio waves. Leave your phone, watch, and bank card outside of the room, exposed, anonymous. All for very detailed pictures of the bumps in your brain, granuloma (Gremlin) lumps of inflammation from a self-attacking immune system. Your head is in a foam and Perspex box like an exhibit in a museum. Concentrate, Don’t Panic, Don’t Move, Don’t Open Your Eyes. It’s a love/hate relationship as you’re consumed, enveloped in its embrace.
PET Scan: Not checking to see if you prefer cats or dogs, in the Department for Nuclear Medicine. A strange stillness and calm as also where people receive chemotherapy. Six hours NBM (Nil By Mouth) beforehand and avoid pregnant women afterwards as you’re still glowing like someone from the old Ready Brek adverts. These images detect the radiation given off by the ‘slightly radioactive’ substance injected in your arm, showing not just how you look but how parts of you are working, or not. Another long tube to be squeezed into reverse sausage-like, just keep still as you feel snakes sequester every vein.
X-Ray: You think you know about this one and picture a child’s broken bones, but the ‘X’ stands for the unknown as in maths. Discovered by accident, winning a Nobel Prize, crystals giving a fluorescent radiance producing silhouette pictures on photographic plates, internal shadow puppets. People died from over exposure in the early days for a catalogue of strange items swallowed or stuck in the skull. Although used in airport security, diamonds don’t show up on X-Rays. Can I take the photos home?
Ultrasound Scan: Cold lubricating gel sensuously rubbed over the offending area and a probe giving off high frequency sound waves. The baby scan, most known for finding unborn heart beats. External is obvious, internal, probes are inserted in the body vaginally, and endoscopic passed further still where a sedative may be required to relax, a local anaesthetic if down the throat. The echoes create the image which you can watch surreally in real time.
FibroScan: A specialised ultrasound for your liver, uses vibration to look for fibrosis scarring and steatosis fatty changes, measuring inflammation. You’re graded with a CAP (Controlled Attenuation Parameter) score, a measurement of fatty change in your liver measured in decibels per metre (how loud is your problem?), and an IQR (interquartile range) calculates liver stiffness. The scan is quick and painless, the consequences of the results, cirrhosis, may be less so, especially having to explain it’s not just the remit of drunks, especially if you can’t drink as on MTX (Methotrexate).
EBUS Bronchoscopy: To diagnose different types of lung disorder. A video camera with an ultrasound probe and scalpel would not go down well in the world of wildlife photography but goes down your throat. Tough luck if you have a high gag reflex, not ideal for this process giving a small taste of what waterboarding torture feels like. You’ll betray anyone to make the pulmonologist stop probing your windpipe and lungs whilst trying to drown you. The IV intravenous anaesthetic makes for a pleasant monitored one hour come down before a day of coughing up blood.
DEXA Scan: A Bone Density Scan to assess your risk of osteoporosis due to all the medication reducing the absorption of calcium, added bonus if you’re post-menopausal. A low dose X-Ray (called Dual Energy X-Ray absorptiometry – part of which sounds like a gaming power boost, the other part sounds like a made-up word) to see how dense or strong your bones are. The technician can stay in the room for this one as it’s the equivalent of less than 2 days’ exposure to NBR (natural background radiation). A traditional X-Ray is 3 days’ worth, and a flight to the US is approximately a week’s exposure. Part of NBR is Cosmic Radiation from space. Smokers’ lungs are radioactive, and you would die from radiation poisoning if you ate 10 million bananas at once.
It’s business as usual for ECGs, Cervical Screening, Lumbar Punctures and Mammograms.
Surely only a man could design a contraption for scanning breasts with two square metal plates. You dream of designing something more like a pin screen impression, the device moulding to the woman, a perfect pinpression, not being squashed by The Machine.
And now you are a new acronym, CEV (Clinically Extremely Vulnerable). Medication to suppress the immune system not so timely in the middle of a pandemic.
About the Author
Work by Kath Gifford (she/her) has been anthologised in Between the Lines (2021, 2022), by the Ripon Poetry Festival (2021, 2022), and in Hot Poets – Sparks (2022). Her work has been published online by the Urban Tree Festival and The RSL Write Across London Poetry Map. Kath was a winner of the London Lit Lab Queer Competition; she was also shortlisted for The Bridport Prize (2022).