Saturday, December 2

How to relieve the burden of having to do an MRI


People who are not claustrophobic also have a hard time getting into the ‘tube’

Yolanda Veiga

It’s not disabling, but I do feel a bit claustrophobic. Recently I was on vacation with some friends and we went to visit a cathedral that had very narrow stairs to climb. As soon as I started to come across people coming down I felt short of breath and had to get out of there. A few days ago I underwent a pelvic MRI and, although I was able to do it, those twenty minutes inside that narrow tube were not easy. Lara Rozas, a 41-year-old commercial from Madrid, is one of many people who has a hard time in this medical test, which is, on the other hand, so common. “I told them that I was feeling a little claustrophobic and they told me that when I started to feel anxious, I should tilt my head back to check that the tube is open. I did it three times and it relieved me a lot. Also think about my daughter while she was inside ».

Cases like Lara’s are seen daily by Inma Camarasa, a radiodiagnosis technician at the Hospital de la Ribera in Valencia. “Coming to the hospital is always scary because of the fear of the unknown. With patients we emphasize that the tube is open at the front and at the back, so no one is going to get locked up. Sometimes we touch their hair so they can see how close they are to the edge of the tube and tell them to turn their heads so we can see the opening. In the case of head MRIs, in which, in addition to putting them in the tube, a kind of casing is placed on them, a mirror is incorporated into that ‘helmet’ so that the person can see the exit of the tube through the area of ​​the feet, that gives them peace of mind.

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1% is the prevalence of agoraphobia. And claustrophobia is a type of agoraphobia that affects around 0.5%

“Today all resonances are made in machines open on both sides with dimensions of 1.70 meters long and 50 or 60 centimeters in diameter (there are also shorter tubes and others with lateral opening)”, explains the specialist.

And the protocol, he says, is that the patient enters the tube by the feet. “Except in the head, neck and cervical tests, where the head must be inserted first, in the rest of the cases it is done the other way around so that the person does not have to go through the entire route.”

Despite the sensation of total isolation, the patient is in permanent contact with the doctors and is given a button that can be used if he feels unwell or feels overwhelmed. “Approximately one in five use the bell, but there are very few who cannot finish the test.”

It lasts about half an hour, although there are exceptions (15 minutes for a standard head MRI to investigate the origin of a severe headache and up to 45 minutes if a full spine study is required).

“There are cases of people who have fallen asleep. It happened to me recently with a lady on whom we were doing a shoulder MRI; We called her and she didn’t answer, so we went in to see what was going on and she was peacefully asleep. But it is not usual. Almost everyone finds that half hour long, so we tell them to mentally count the seconds. It is a way for the person to realize the passage of time and, incidentally, distract themselves. There are those who sing songs mentally, others think of beautiful memories… and many people pray».

Cristina Wood is a health psychologist and European doctor in Psychology. She also works with patients who suffer from claustrophobia and for whom getting into an elevator, a plane, or an MRI tube is a real treat. «Attentional bias is the tendency to pay attention to information that is threatening to me, such as space, in this case: ‘I’m not going to get air’, ‘I’m going to faint’, ‘I’m not going to be able to get out hence never’… Attention is the fuel of anxiety, so the key is to teach the patient to change the focus of attention». But it happens that when you try to suppress a thought, it appears with more force. “They say to themselves: ‘Don’t think about how small the MRI tube is’ and only manage to pay more attention to it. The only way to not pay attention to something is distraction. Counting backwards, singing mentally, remembering scenes from the series I watched last night, thinking about the decoration changes I want to make at home… It requires concentration and steals attention from what worries me, “explains the expert.

Apart from cognitive behavioral therapy, the psychologist recommends the practice of mindfulness and physical exercise to her patients. “Playing sports the same morning as the MRI or the day before helps because it has benefits at a chemical level, since the endorphins that we secrete produce well-being.”

And after the MRI? “Normal life, just like before the test. Although when it is necessary to use contrast or the patient has certain pathologies, some precautions must be taken, ”explains the radiologist.

“What can happen to lie there for 20 minutes?”

Am I exaggerating? Am I overestimating the negative consequences? “These are the two questions that the patient has to ask himself. Because, really, what can happen to you for twenty minutes lying in a tube or trapped in an elevator? Nothing really, but they don’t stop to think about it, they stay in the ‘oh, oh, oh’. They tend to exaggerate, they underestimate their abilities, their common sense. And they also underestimate the help they can receive from others. If you stay in an elevator you have to think that the firemen are going to help you or if you have to undergo an MRI you have to think that the doctors are talking to you, listening to you if you feel bad. You will not be alone despite being in there, “explains psychologist Cristina Wood.

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