Claustrophobia and the MRI Machine
MRI Procedures are a Big Problem for Claustrophobic People
For anyone who's anxious or claustrophobic, the idea of feeling trapped in the small, loud space of the Magnetic Resonance Imaging (MRI) machine is daunting, to say the least. For some, the anxiety may even be a deterrent to having the procedure done and fears might seem to outweigh the benefits.
Don't let your fears control you. During the past 20 years, a severely claustrophobic friend of mine has undergone approximately 25 MRI procedures. He's had plenty of time and opportunity to develop a bag of tricks to help him cope, tips he shared with me and I share with you here. In this article, I will discuss those tools for how to manage your claustrophobia, tips that will be useful to anyone who has to undergo an MRI procedure, especially for the first time.
Tunnel vs Open MRI Machine
The following are pictures of a typical tunnel MRI machine and an open MRI machine.
Tunnel MRI MachineClick thumbnail to view full-size
Open MRI Machine
What Happens During an MRI?
Rest assured that the MRI is a simple, painless diagnostic tool that uses magnetic fields and radio waves to “see” what's happening inside, without the use of x-rays. MRI procedures have been performed for decades now. The process is safe, painless, and has no known side effects.
Knowing what will happen ahead of time will also help you prepare yourself. Although no one can predict the future, most MRI scans follow the same protocol.
The MRI Procedure
Because the "m" in MRI stands for "magnetic" and the machine employs a strong magnetic field, no conducive or reactive materials should enter the machine so first, you'll be asked to remove all metal items from your person. The radiology technician will also inquire about metal in your body—this may include dentures, pacemakers, cochlear implants, permanent tattoos, shrapnel, etc. Some items may disqualify you from having an MRI, so discuss this with your doctor beforehand.
Next, you will be asked to lie down on the MRI table. You may be injected with a contrast dye to make the arteries in the examined part of your body appear more clearly. If you are getting the contrast dye, you will be asked to not eat or drink for a specified number of hours before the procedure. If you're getting a brain MRI, a "catcher's mask" will be placed over your face. This "mask" has built-in antennas to detect the signals coming from your brain and retransmit them to the machine to construct an image.
After these preparations, you will be rolled into the machine. This can be particularly alarming for anyone who suffers from claustrophobia. Upon request, some facilities will give patients a "panic button"—a switch you hold during the duration of the procedure with a button you can press if you panic and wish to be rolled out of the machine. Some tunnel MRI machines have a small mirror which allows you to see down the length of your body and out the opening of the machine. At some facilities, you can choose to wear the headphones provided to listen to music during the procedure.
Having answers to these questions—what preparations will be needed, will there be a panic button, a mask, a mirror, or headphones—will help you feel more in control.
Watch and Hear an MRI Scan
Loud MRI Machine Noises
Although newer machines make less noise, an MRI scan can be extremely noisy. Even if you're not anxious or claustrophobic, you'll likely be surprised by the loud clanging, bumping, and knocking noises that the machine makes when you're inside. If you are claustrophobic, you'll need to know about this noise ahead of time so you won't panic.
My friend suffers from acute claustrophobia. Here are some of the coping mechanisms he uses, things that may help anyone manage their anxiety:
- Go to the MRI facility at least a week before the procedure and have the technician roll you into, and then back out of, the machine. Then you'll at least know what you're in for. (Be prepared to wait until the radiology technicians have a break between scheduled patients.)
- Most MRI facilities will give you a sedative upon request, or even anesthesia which would make you completely unconscious during the procedure. You should schedule an MRI at least a few weeks in advance if you are going to receive a sedative or anesthesia, since the former requires the presence of a registered nurse and the latter an anesthesiologist. My friend has used the sedative once, with positive results. This may be offered in pill or intravenous form. My friend recommends having an intravenous sedative since the sedative begins acting immediately, whereas there is an unpredictable delay with pills which varies from person to person.
- Have the technician agree to roll you out for, say, 30 seconds between images. This gives you an encouraging break from being in the machine. The technician will probably point out that it's important to not move any part of your body while you are out of the machine.
- You might be able to bring a friend. My friend has his girlfriend hold his hand during the procedure when using an open MRI. (Anyone in the MRI room also cannot have metal objects on / in them.) Or, for a tunnel MRI, she lays her hand on his lower leg. This gives him reassuring contact with the "outside."
- He also has her give a "countdown" by tapping his hand (or leg) with the number of minutes left in an image; e.g., three taps means three minutes left for the image and three minutes until he can be rolled out. (This will involve some coordination with the technician.)
- Some people find it useful to “preview” the noises they will hear in the MRI machine. Kent Williams (aka "chaircrusher") of Iowa City, Iowa uploaded some MRI sounds on February 12, 2010 for you to "preview." These sounds can be downloaded to your computer and transferred to an MP3 player.
- Some people shut their eyes for the entire procedure—this doesn’t work very well for my friend.
- My friend went so far as to simulate the MRI experience at home by lying in a small space while listening to MRI noises. Whatever it takes to desensitize you to the actual MRI experience is worth it.