Coping with MRIs
Posted 3/23/2009
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My group for women with Stage IV breast cancer met today, and we had a lively discussion re coping with MRIs. Most women with metastatic cancer have periodic scans to assess the state of the cancer and the benefit of the current treatment. Some women regularly have CT scans, some have MRIs, and some mostly have blood tests. The important thing seems to be having the same test as regular intervals. Trying to compare a CT scan with an X-ray with an MRI is trying to compare the proverbial apples and oranges. Most women find MRIs more difficult, not painful, just difficult, than other tests, and it was helpful to share tips.
MRIs have been in use since the 1980s. They use magnetic and radio waves to scan the body--not any kind of radiation. Here is a description and explanation from WebMD: Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. In many cases, MRI gives different information about structures in the body than can be seen with an X-ray, ultrasound, or computed tomography (CT) scan. MRI also may show problems that cannot be seen with other imaging methods.
For an MRI test, the area of the body being studied is placed inside a special machine that contains a strong magnet. Pictures from an MRI scan are digital images that can be saved and stored on a computer for more study. The images also can be reviewed remotely, such as in a clinic or an operating room. In some cases, contrast material may be used during the MRI scan to show certain structures more clearly.
It is lying inside the "special machine" or tube that is often difficult. Machines used for breast MRIs are usually a bit different. In them, the woman lies on her stomach and odd/nifty little holes are in the right spots for her breasts. The scanning machine is below her body, and she is face down, less aware of the tube overhead. MRIs for other body areas generally require lying on your back--so that there is real awareness of the closeness of the tube and the ceiling.
In all cases, the loud noises are distressing, and there isn't much to be done about them. Sometimes you are offered earphones and music of your choice--but the loud machine noises overwhelm James Taylor or Elvis or Bach or whatever you have chosen.
Here is a summary of my group's recommendations for slightly easier times during an MRI:
1. Ask the technician to talk to you frequently. You will be able to hear her, even when the loud machine is going. If you want, ask her to give you a regular accounting of how much longer the scan will last: e.g. "Five more minutes, four more minutes.."
2. Consider wearing an eye mask as some people do for sleep. If you can't open your eyes, it might be easier than opening them and seeing the narrow tube that you are in.
3. Confirm that you have a "Help" button. Hold it tightly in one hand and be reassured that, if you punch it, you will be taken out of the machine. Remember, however, that stopping the test means that you likely will have to re-do the whole thing.
4. One woman, a musician, said that she composes music that matches the rhythm of the clanging machine.
5. Consider reciting something to yourself--songs, poems, the Gettsyburg Address, anything that will distract you.
6. If you are claustrophobic, ask if there is an "open" MRI machine in your community. These do exist and look much more like a large donut, so you are not encased in the tube.
7. Drugs, drugs, drugs. This was by far the most common suggestion. As long as you are not driving, it probably is fine to take ativan or Xanax or something to relax you. Ask your doctor.
8. Since there is no radiation associated with MRIs, it ought to be acceptable to take someone into the room with you. S/he will also have to remove anything metal (jewelry, belts, etc) and probably wear ear phones, but s/he can stand or sit at one end of the tube and keep a loving hand on you. That reassuring touch goes a long way to help you stay calm.
9. A woman in Portland, OR wrote to share this excellent suggestion: I am very claustrophobic and had to be really zonked out on drugs to tolerate the machine. Then I was told about "prism" glasses which allow you to see out of the machine while on your back. Wearing these, you don't feel claustrophobic as long as you look forward because you can see the room and people. My husband would always stand and rub my feet and put up fingers to tell me how many more minutes to any given cycle. Being able to see him as well as feel his hands on my feet was also very comforting. I have advised claustrophobic friends to ask if their MRI facility has them. Much better than gorking out on drugs!
10. Try to remind yourself that this is something you are doing to help yourself. One woman said that she most feels like an active member of her treatment team during these tests. Being scanned is something that she can do to help herself.
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