Peeing in a cup - other options?

[lilly.hewlett]

At my MRI today, I was told that I would need contrast, but before that I would have to take a pregnancy test (I told the tech that there was no way, but they dont take people's word for it - no problem - I get it) The thing is, I used the toilet before I left the house, so being able to fill the little cup was not happening.
No one offered me any other options whatsoever. Actually they behaved more like I was just being difficult, and didnt want to cooperate with them rather than having an illness that would cause difficulty with urination.
After the third hour and trying several times (futile), I finally said - cant you give me a blood test? They told me it would be another 2 hours if they got in contact with my dr who would need to order it.
Is this how it is everywhere or is this hospital just a special case? Are there just no options for you if you are physically unable to do a test? Any suggestions on what I could do if this happens again or is it just a hazard of being a young female with MS?

[sexygatubela]

Originally Posted by lilly.hewlett

At my MRI today, I was told that I would need contrast, but before that I would have to take a pregnancy test

Hi Lilly:

I certainly do not know why they made you take a pregnancy test because it is well known that the compound used for contrast during the MRI does not affect an unborn child. I looked into this last year before a MRI (I was breastfeeding at the time) and it is not necessary to pump and dump for a couple of days to get rid of the compound. It does not affect breastfeeding babies or babies in the womb.

MRI technicians gave me the same grieve when they did my first MRI while I was pregnant. They did it, but without contrast, even after my OB-GYN called and gave them the green light

Anyhow, I would probably call some place else and ask about their policy with female patients.

Be well.

[cranberrysauce]

I've had 4 series of MRI's now with contrast and I've never been given a pregnancy test! I'm 29 so I'm prime age to be given a pregnancy test too I'd assume.

How frustrating! I know when I have an MRI they call me before and remind me not to wear metal and other things. I would hope if they require a pregnancy test they'd let you know ahead of time so you can make sure you need to pee

[kingrex]

Originally Posted by sexygatubela

Hi Lilly:

I certainly do not know why they made you take a pregnancy test because it is well known that the compound used for contrast during the MRI does not affect an unborn child. I looked into this last year before a MRI (I was breastfeeding at the time) and it is not necessary to pump and dump for a couple of days to get rid of the compound. It does not affect breastfeeding babies or babies in the womb.

This is absolutely incorrect.

Gadolinium most definitely crosses the placenta and enters the body of the fetus, and studies of its effect upon the unborn fetus have been extremely limited. Therefore, no determination of the effects of gadolinium on the fetus has been made. If you doubt what I'm saying, Google this topic and you will see that medical centers in general do not inject pregnant women unless it is felt that the benefit outweighs the risk. My guess is that nobody regards the hunt for an active MS plaque as more important than the life of an unborn child. A brain tumor, OTOH, might be different.

That said, I've never known anyone to require a pregnancy test before injecting. If a woman says she's not pregnant and signs the consent, that's always been sufficient. In 27 years of imaging I've never known of anyone requiring a woman to pee in a cup. OMG.


rex

[lilly.hewlett]

Originally Posted by kingrex;1350695That said, I've never known anyone to require a pregnancy test before injecting. [B

If a woman says she's not pregnant and signs the consent,[/B] that's always been sufficient. In 27 years of imaging I've never known of anyone requiring a woman to pee in a cup. OMG.

rex

I asked to sign the consent - more than once. The person who would give the contrast got frustrated and said I would have to wait 2 hours for the doctor to come down and give me the consent form (seeing as what happened with the dr, I understand that frustration now). I said ok, and waited because I'd hoped to be able to coax my bladder into working with me within that two hours. When they did finally call the dr - he did not come down, he told the tech to tell me to drink lots of water. Im still not sure what made him think that among all of the people present - we couldnt think of that on our own in 2 hours. That's when I just finally asked for the blood test and that dr said that my neurologist would have to be the one to order it...

I couldnt understand that whole exchange. If I said that I was willing to sign the consent, why wasnt anyone willing to let me sign it? No one was offering me any other options, and the doctor couldnt seem to be bothered at all. Im still unsure of what they do for a completely disabled young woman who comes in.

I guess I came to understand yesterday that everyone just wants to get the job done. It's your misfortune if you cant keep up.

Thanks to everyone who answered. I appreciate your thoughts.

[techie]

If you had known ahead of time you could have brought in a urine sample.
A blood test determines pregnancy earlier than a urine test does.
So someone with a negative urine test could still be pregnant.
techie

[kingrex]

Originally Posted by lilly.hewlett

Thanks to everyone who answered. I appreciate your thoughts.

Just a thought - did you at any point (prior to them asking for a pregnancy test) write or tell anyone that you could be pregnant, or that you didn't know if you were pregnant or not?


rex

[kingrex]

Originally Posted by kingrex

Just a thought - did you at any point (prior to them asking for a pregnancy test) write or tell anyone that you could be pregnant, or that you didn't know if you were pregnant or not?


rex

I re-read your original post, and you say you told them there was no way you could be pregnant? If that's so, I would find another facility. I cannot conceive (no pun intended) of a facility refusing to believe a woman who says there is no way she could be pregnant - that's not their business.

When you go for surgery, you're supposed to eat nothing after midnight. The morning of the surgery, they ask if you ate, and if you say no they simply believe you and proceed.

There is no reason to refuse a woman's MRI scan, with or without contrast, if she states that she is not pregnant. As long as it's in writing (we ask the question on the patient information sheet, which is signed by the patient) there is no legal liability if she turns out later to have been pregnant at the time of the exam. Your facility must have some over-zealous attorneys!

Anyway, I'd avoid that place if there are other options where you live.


rex

[sexygatubela]

Originally Posted by kingrex

This is absolutely incorrect.

Gadolinium most definitely crosses the placenta and enters the body of the fetus, and studies of its effect upon the unborn fetus have been extremely limited. Therefore, no determination of the effects of gadolinium on the fetus has been made. If you doubt what I'm saying, Google this topic and you will see that medical centers in general do not inject pregnant women unless it is felt that the benefit outweighs the risk. My guess is that nobody regards the hunt for an active MS plaque as more important than the life of an unborn child. A brain tumor, OTOH, might be different.

No offense, but I certainly would believe my doctors more, my OB-GYN and neuro-opth on this subject, since they did their research and found no risk in doing an MRI with contrast at the time. I was right between my second and third trimester, so that might have been the trick. However, I do understand that all doctors pretty much will avoid anything unnecessary during the first trimester.

But, again, in most centers, a sign consent is sufficient and not a pregnancy test.

[kingrex]

Originally Posted by sexygatubela

No offense, but I certainly would believe my doctors more, my OB-GYN and neuro-opth on this subject, since they did their research and found no risk in doing an MRI with contrast at the time.

When I say that there have been no studies done to adequately assess the impact of gadolinium compounds on an unborn child, don't feel as though you have to take my word for it - the manufacturers themselves will tell you the same thing. In fact, their own package inserts carry the same warning, like this one from the Prohance enclosure:

There are no adequate and well-controlled studies in pregnant women. ProHance (Gadoteridol) Injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

The trouble is, without knowing what the potential risk is, it's difficult to measure the risk vs. the benefit.

Here's what the doctors at UCSF think:

Intravenous gadolinium is contra-indicated in pregnancy, and should only be used if absolutely essential, and only after discussion of risks and benefits with the patient and referring clinician.


Again, without a body of knowledge with which to assess the risk, it's impossible to accurately measure the risk vs. the benefit. So, it's up to you and your doctor to determine what you're willing to do - but don't confuse your doctor's opinion with any scientific evidence that gadolinium has no effect on the fetus. Of course, this is a sort of Catch-22 - without the go-ahead, nobody wants to put their baby in jeopardy, thus there can't be any science done which might ultimately demonstrate the safety of gadolinium for unborn babies.

So, your doctors are making a presumption, one which may in fact be true. But it's a reach to say that they've done the research and there's no risk. Late-trimester is generally felt to be safer for everything, as a rule of thumb, because more structures are fully formed, but it's not a guarantee of safety.


rex

[kingrex]

Originally Posted by lilly.hewlett

Actually they behaved more like I was just being difficult, and didnt want to cooperate with them rather than having an illness that would cause difficulty with urination.

Nah...if anything, they're just unhappy about the schedule getting backed up. That pee-policy is weird and wrong-headed, but it's not their policy, and I'm sure it's as frustrating for them as it is for their patients.

FWIW, everyone (including MRI techs) knows that peeing isn't something we can turn on or off.


rex

[jazzgirl]

Here are two thoughts: drink a beer (not really acceptable if you ARE pregnant, which you've already said you are NOT), or something way less desirable, cath the urine out. I'm sure that option wouldn't go over big with any of the parties involved (I know it wouldn't with me!)

Sounds like they're definitely making this harder than it has to be! Totally sounds like medicine in the USA!! Guess that's what we get for being so litigious....

I hope you get this worked out!