When Deborah, 48, went in for
an MRI scan of her knee, she expected it to be a painless
and easy procedure. To her horror, it was a panic-inducing
experience that left the Vancouver-based former nurse
rattled.
"Halfway through I opened my eyes
and I saw that the table I was lying on had gradually
moved underneath the 'tunnel,' so my head was almost
inside it," she recalls. "I freaked out, and I just
said 'I don't think I can do this'".
With the help of her technician,
Deborah managed to calm down and, with her eyes closed,
she visualized that her head was free of that giant
magnet.
Deborah had, at most, experienced
only mild discomfort in enclosed spaces in the past.
What occurred at the hospital came as a complete surprise
to her — but perhaps not to the staff overseeing
her scan.
NOT
TRIVIAL
According to Dr David Li, professor of radiology at
the University of British Columbia Brain Research Centre,
"2% of people who undergo an MRI have the sensation
that they're enclosed and uncomfortable, and unable
to undergo an examination."
The numbers may be even higher
than that. A study by University of Alberta Hospital
radiation technologist Jason Wiebe, published in the
Summer 2004 edition of the Canadian Journal of Medical
Radiation Technology, found that 12.4% of 1,790
patients undergoing MRI scans experienced some claustrophobia.
Of those 1,790, 0.8% were found to suffer from severe
claustrophobia.
A year later, Mr Wiebe notes: "We
still find that about 12% of our patients are claustrophobic.
We usually have at least one patient every day that
refuses to complete the scan — or even go into
the room for that matter." He adds, "We scan 40-50 patients
per day, so at least 4-6 patients are claustrophobic
to one degree or another."
But are they normally claustrophobic,
or is the fear induced by the special conditions of
the machine? Dave Hodgins, a patient who underwent an
MRI, feels the doctor running the test got him all wrong.
"When I went to pick up my results, the doctor's notes
said I was claustrophobic, but I'm not. It's the machine,
not me," he says.
AN
IMPERFECT SOLUTION
Unless a relatively new spacious 'open MRI' is used
(which has the disadvantage of producing lower resolution
images), the machine can't be helped, though technicians
and physicians can act to alleviate anxiety. Shelley
James, general manager of Canada Diagnostic Centres
in Vancouver, explains how.
"We describe the machine, tell
them how long it will take, and how noisy it will be,"
she says. "If someone is very claustrophobic, we might
tell them to talk to their doctor about getting Ativan
(lorazepam)."
COPING
MECHANISM
Technicians can allow patients to have a friend or relative
with them during the procedure. They can also offer
patients a cloth to cover their eyes, or even a mirror
so they can see the rest of the room.
Dr Neil Rector, head of the Anxiety
Disorders Clinic at the University of Toronto, does
not recommend the use of drugs, but feels that therapy
can help.
"We can probably treat this within
four to six sessions of talk therapy, and the probability
of it reoccurring is exceedingly low," he says.
As far as Deborah is concerned,
she'll be making sure to be more informed in the future.
"If I had to do it again, I would make sure I knew exactly
how far my body was going to go under there," she says.
"It's silly, isn't it? But it's a horrible feeling."
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