If you are presently undergoing testing to find out if you have Multiple Sclerosis you undoubtedly will be told that you need an MRI scan. If you have never had one before, you might be wondering what it is like. Not to fear as I will tell you all about it! Although I have only been diagnosed with MS for over a year now, I have had four MRI's already. I feel like an old pro. Yet each time I have one, I learn a little bit more about the process. I better get used to it as MRI's are a definite part of my medical future.
MRI's are not just for Multiple Sclerosis patients. This handy dandy bit of technology which was developed in the late seventies, is used for all sorts of reasons including investigating sports related injuries, reproductive issues, and even heart problems. Basically an MRI is capable of giving some fairly detailed information about most parts of the body. Chances are great that in your lifetime, you will be getting an MRI for one reason or another.
How does it work? There is this big magnet see...and uh hmmm...how does it work? Good question!
MRI stands for Magnetic Resonance Imaging. It used to be called Nuclear Magnetic Resonance Imaging about fifteen years ago but people got a little freaked out about the word "nuclear." People thought that meant something dangerous and radioactive was going happen to them which isn't the case at all. Actually MRI's are a pretty darn safe procedure. It is also non-invasive with the exception of the injection of dye into you, but I will save that tidbit for later. I was correct in telling you that a large magnet is used. Basically you lie inside a tube which is really a large and powerful magnet. A radio wave antenna is used to send signals to the body and then get signals back. These signals are then converted into pictures by the computer which is connected to the scanner. This is how you get those nifty large scale photos of your brain or whatever body part you had scanned that day.
Now what happens when you have Multiple Sclerosis is that the images you get back will have some white spots to indicate brain lesions. I had looked at my scans and had great difficulty knowing what in the heck I was looking at. Gee...do ya think it is because I am not a doctor? Nonetheless it is good to have some clue about what is going on in your diagnosis and treatment and have the doc explain things to you so you are not needlessly freaking out over things you don't know how to interpret.
*SPECIAL TIP* When you do get an MRI, the scans are yours. They belong to you, so it would behoove you to go and get your scans when they are ready. That way you always have a copy to bring with you to the different docs you might see. It has been known to happen that the MRI scans mysteriously do not show up at the doctor's office on the day of your appointment. (Yep...this happened to me) So get those scans as they are yours. You and your insurance paid for them, you might as well hold onto them. At first I got the big huge scan pictures that I could barely carry. But now they have them saved to computer disc. These discs are a lot easier to manage. Before you have your scan just ask the technician for a copy.
Now where was I?
Ah yes...I was going to talk about what the experience is like. I have to warn you that if you are claustrophobic, then it is well...a little tight in there. I really didn't know how claustrophobic I would be for my first MRI, ten years ago so I opted to be given some valium to take before I went for my scan. At that time I was told I might have a brain tumor so the valium really didn't do a whole lot for my fright. (By the way I did not have a brain tumor but ten years later I have MS.) The valium did help with the claustrophobic feelings though. For my recent scans I was never asked if I needed anything. So if you know you will need a little something, make sure to be vocal to your doc when they are ordering the scan as they don't automatically ask you.
Recently I have had both a brain MRI and a C-spine MRI. Note that if you are being looked at for MS then it is possible to have all sorts of different MRI's but generally they will look at your brain and possibly your spine. Here is a little anatomy refresher about the spine. The spinal column is made up of three sections of vertebrae: the cervical, thoracic, and lumbar. The cervical spine is what most people call their neck. There are seven vertebrae here. The thoracic spine is located in the middle of the back, and is made up of 12 vertebrae. Just below is the lumbar spine with its 5 vertebrae.
So it is conceivable that if MS is being investigated, that you may have to do not only a brain MRI but also have ones done of the different parts of the spine. While my brain MRI showed multiple lesions, there was nothing on my C-spine MRI (my neck).
But you still haven't answered the question of what it is like to have an MRI! Okay I hear you, I am getting to it!
Well let me tell you first what is fashionable to wear for an MRI. The minimal look is in as in NO jewelry or metal of any kind. You don't want to pull a Homer Simpson do ya? For my brain MRI I got to wear scrubs. Cool! I got to see what I might look like on the set of Grey's Anatomy. Oh mister McDreamy where are you? For my C-Spine MRI they were very casual about the whole thing and I got to wear my regular clothes sans bra. Look Mister McDreamy I am braless! But I digress. Serious stuff here these MRIs.
There are usually two people present on either side of you. You get to see the big machine. Remember in Monty Python the machine that went ping? Well this machine goes "PING" very loudly! For this reason they give you earplugs. I have heard that sometimes music is played but that was not my experience. Sometimes the folk there tell you exactly what is going to happen and sometimes they are rather abrupt and just send you in the tube with very little explanation. If you don't understand something do ask before they put you inside the machine.
All of my MRI experiences were with the conventional closed MRI machines but I hear there are ones which are open, meaning you don't go into the tube. I have read that the scans are of better quality with the closed MRI's so you probably want to opt for that kind if they are investigating MS.
So you lie down and they have a place to rest your head and a rest for your feet to elevate them some. There is a squeezee bulb placed next to your hand in case you need to contact the nurse. You squeeze it and they will stop the scan and attend to you. I can proudly say that I never had to use it but I wanted to! If you are cold they may offer a blanket. Hospitals are notoriously chilly places. They will sometimes tell you how long the procedure will take. My brain MRI took about 45 minutes and my c-spine MRI took slightly less time.
Get ready! They are about to push you into the tube! But first they put this mask thing on you which reminded me of the Silence of the Lambs mask. It doesn't touch you but it is definitely covering your face. Then comes the moment they push you in there. The ear plugs do help as it gets loud in there. You hear a lot of science fiction-y sounds including hums, pings, pongs, and jackhammer rat-a-tat rapid fire sounds. You do begin to feel as though you are in a bad sci-fi movie where aliens are probing your brain. It feels very surreal. To add to the weirdness you are supposed to remain still and not move! Of course I always imagine something is itchy during such times. So be sure to scratch and itch anything you need to before going into the tube.
Some people go to sleep in there. I sure can't. And I am not sure that is such a good idea to sleep anyway. You might start dreaming and begin to move during the scan which would cause them to have to repeat things. So just try to be calm and still while awake.
*SPECIAL NOTE* It seems common sense to tell you this but close your eyes when you go into the tube. That way you are less fearful of what you see as in this tube like tomb encasing you!
Now with my C-spine MRI, I read something beforehand which talked about that not only should you not move but you should also not swallow. This was very psychologically disturbing to me. No swallowing? No can do. I asked the nurse and she said that it probably is not a good idea to swallow too much and to definitely not take "big gulps." I didn't get to ask more details as my mind wondered, "Exactly what is too much swallowing? Do I get three swallows in a half an hour? And "What constitutes a big gulp?" I had much time to dwell on these matters as I tried to remain both still and not swallow too much.
For some MRI's you get to have a special dye injected into your veins. This dye lights up any areas of enhancement, showing the docs any areas of active lesions. Don't worry, the dye won't hurt you. (Special note here: In rare cases some people do have an allergic reaction to the dye. If you experience any sort of reaction tell the nurse right away!) While the dye usually won't hurt you, an inexperienced nurse doing the injection can!
During one of my MRI's I listened to the small talk of techs and nurses and I took in every detail. Two nurses were talking about the fact that the injection can sometimes be painful if the needle does not get into the vein properly and also if they do not wipe the alcohol dry before injecting you. This is exactly what happened to me for my second MRI. The girl doing it looked...well...inexperienced. She had difficulty finding my vein and then asked if it hurt. This was a warning as things did not hurt at all...yet. Once I was in the tube my arm started to hurt tremendously. My arm felt like it was on fire and burning. I didn't want to be a wuss though so I didn't say anything. In about ten minutes the burning stopped but I was mad! Soon as I got out of that tube I was going to ask what she did to me! Of course when I finally did come out that bad jabber was nowhere to be found.
That was a difficult day for me, lots of different tests and the C-spine MRI was just the last of it. And then to not be able to move, swallow, and having my arm set afire was no fun. But seriously, it is usually not a big deal at all to have an MRI. I am the biggest chicken in the world and if I can do it, and multiple times, you can do it too.
The information the MRI provides is of great value. This will probably be the best information for you to get a diagnosis and subsequent treatment. The MRI can also tell you if the treatments you use have been effective or not. I wonder what we did without this technology. Imagine that several decades ago diagnosing MS (along with a lot of other diseases and disorders) was a guessing game at best.
So this concludes my very long post about MRI's. I hope it was useful to someone out there. I will be back to talk about other medical adventures very soon including what it is like to have an EEG and Evoked Potentials. Here is a hope and a wish for good health for everyone!