Fighting MRI Fatigue
Throughout my life I have always been affectionately labeled as “accident prone”. Maybe it was because of the time I broke my leg skiing and needed a couple of surgeries to put it back together. Or from the time I crashed a moped in Bermuda with my best friend on the back, landed us both in the ER, and left with a plaster souvenir on my arm. Who knows! But thanks to my many colorful adventures, I had already had several MRIs of various different body parts when I was diagnosed with MS. I used to not care about them at all, heck sometimes I even fell asleep! Now I know the glory of the brain/triple spine MRI with and without, and along the way I have stopped appreciating being shoved into a tube. My legs now insist on spasming, my bladder refuses to give it a rest for a couple of hours, and the pressure points on my back and head get so painful that I have actually cried. A couple of years ago the accident prone, no pain no gain version of myself may have rolled her eyes at someone insisting an MRI could be that awful. Now I know better!
Did you know that MS actually stands for Multiple Scans? No, I’m totally kidding but it sure does feel that way at times. As clinicians we live and breath MRI results. They are the best tool that we have for measuring how our patients are doing, if the medications are working, and to monitor for serious conditions like PML. Dr. Vollmer of the Rocky Mountain MS Center even argues that we should treat patients more aggressively according to their MRI results, not just based on symptoms. This could potentially change how many of us treat MS and the way we respond to what is called “silent damage”. Silent damage is when an MRI shows some new lesions, but the patient has no new symptoms. In response the doctor may hold off on changing medications since it seems like a fairly benign change, and because the patient outwardly is no different then they were at the last visit. Dr. Vollmer argues that the goal of therapy would be to aggressively try to stop this silent damage from occurring in the first place because once the patient develops a big enough lesion that does cause symptoms then you have let the proverbial horse out of the barn. That of course is only one view of how to manage medications, but the point I’m trying to make is that MRIs are extremely important when it comes to letting us track our patients progress.
So I, as a patient, have concluded that MRIs are a necessary evil. Important, but not fun. However, I have come up with a few strategies that have actually really helped me fight the MRI fatigue, and I hope you will share anything that has helped you:
#1. Music! I found out that my radiology location can plug in my iPod and play a custom playlist. I now have a great MRI playlist which both distracts and calms me.
#2. Find my “zen”. I’ve never been very good at meditation or yoga or any other relaxing activity really (I need to work on that), but boy do I love a good massage. When I can I get one the day before my MRI, then when it’s time for my scan my muscles are a little bit more relaxed and less inclined to jump around. Also, when I’m in the MRI machine I try to relive the massage head to toe, and try to relax each muscle as I go…much like you do in meditation.
#3. Speak Up! Now that I know I get those painful pressure points on my back and on the back of my head I let the radiologist know and they have been able to pad those areas a little better. Tell them if there is anything that they can do to position you more comfortably and push that button if you get too hot or too cold.
So in summary being a musical, zen, loudmouth has helped me fight my MRI fatigue. I haven’t tried taking sedating medication because I usually drive myself to and from my appointments but many of my patients have, so communicate with your doctor if you do experience anxiety during MRIs.
Most importantly, if you ever do experience MRI fatigue try talking to your doctor or your nurse. Some patients choose to refuse MRIs altogether and that is a personal decision, but maybe we can help you find something that makes it better, or maybe you and your physician could come to a compromise before you get to that point.
Best of luck!