MRI and Claustrophobia: Dispelling the myths and managing anxiety
According to the NHS, claustrophobia (an irrational fear of confined spaces), affects between 10% and 30% of the population. Whilst the signs of claustrophobia are easy to identify, pinning down the exact cause is not so simple. As the definition suggests, the fear is usually irrational and can often take an individual by surprise. In fact, it is a common misconception that the fear pertains only to the fear of being physically confined in an enclosed space. Claustrophobia sufferers may find themselves feeling equally anxious in a traffic jam or a crowded shopping centre, as in an MRI scanner. Unfortunately, for the majority of sufferers, claustrophobia will dictate many aspects of their day to day lives.
MRI and Claustrophobia
For most claustrophobes, the idea of having an MRI scan will not be a pleasant one. If you ask the general public to describe an MRI scan, responses will often include at least one descriptive from the following list – ‘tunnel’, ‘dark’, ‘enclosed’ and ‘claustrophobic’. However, it is worth remembering that the way people speak about MRI is often not based upon what they have experienced themselves, but have more commonly heard from others. Everyone has a story about a ‘friend of a friend’ and subsequently, MRI scans do have a certain reputation. Indeed, if there were a PR agency for medical procedures, then MRI would surely be its best customer!
The fact is that many people’s perception of MRI is based upon the very early days of the technique. Surprisingly, this was not that long ago. In its infancy, MRI scans were the realm of scientists, where patients did have to cope with less than comfortable surroundings to get the best possible pictures. Technology was such that the desire for high diagnostic quality superseded patient comfort and speed. However, as MRI has developed over time, comfort has increased. Modern MRI scanners are faster and fully kitted out with things which are designed to make the experience more comfortable.
Now…….not wanting to contradict what I have said above, MRI is still a ‘unique’ experience. MRI is not something that most people undergo very often. Therefore, feelings of apprehension and perhaps even nerves should be expected. Even the hardiest submariner (or even MRI radiographer) would lay down on an MRI scanner and find it unusual. (Believe me, I can talk from experience having been a guinea pig for countless new scans over the years.) This is not because MRI scans are dangerous, or even particularly scary. It is just an unusual experience when our natural reaction is to be cautious of what is happening around us. Feelings of claustrophobia before and during an MRI scan is normal, but most people adapt quickly.
So what can I expect from an MRI scan?
As I mentioned previously, MRI scanners such as the ones we use in our imaging units in Queen Square and Chenies Mews, are now more comfortable and designed specifically to make getting through an MRI scan more manageable. Modern scanners are now much wider (Queen Square has the widest available on the market). They are also fully lit, ventilated and open at both ends. We have all heard from a next door neighbour who went into a ‘tunnel’ which was closed at one end. However, scanners have always been open at both ends! It is just that older scanners were deeper and the end of the bore was not so visible.
For many MRI scans (depending on the area being scanned), a patient can now be positioned in a ‘feet first’ position. This means the patient’s head doesn’t have to enter the scanner. This can often make a big difference to patients and it is always worth asking the radiographer if this might be possible for your scan. If it is technically possible, then the radiographer can do this easily.
MRI scans and noise
MRI scanners do also have the reputation for being noisy machines. This is something which unfortunately hasn’t changed a great deal. Whilst manufacturers have developed ‘silent’ imaging sequences, these are a way off from being commonplace and there are some drawbacks. However, it is worth remembering that the clicking and buzzing produced during an MRI is perfectly normal and nothing to worry about. In fact, the noise means that the scanner is working perfectly and doing exactly what it should be doing.
To put the noise into perspective, the noise for a routine MRI scan is a similar to what you would expect standing beside a busy road. The noise can also produce some subtle (and not entirely unpleasant) vibrations in the bed. This is again, perfectly normal. To protect your ears and to make it more comfortable, you will always be given ear protection. It is very important that this is worn. We use foam earplugs in our departments, which reduce the noise to a limit well within safe and comfortable margins.
In many cases, patients can also use special headphones to listen to music during their scan. This can help pass the time and reduce feelings of claustrophobia. It is always worth asking the radiographer for it if you feel it might help. The radiographer will talk to you during the scan via a two way intercom and keep you fully informed of the scan’s progress, from start to finish. You may even find that you want to have a snooze! An emergency buzzer is also there should you want to stop the scan at any time. The patient is always in control of their scan!
Most importantly, our staff understand exactly what we are asking of our patients. We treat each individual with respect and use an unhurried approach. Every patient, including those who identify as having claustrophobia, can be at ease and comfortable enough to successfully complete their MRI scan.
What if that is not enough?
Some patients will still find that their claustrophobia and anxiety levels are too high to cope with an MRI scan. If this is you, then you are not alone. The radiographers will have seen many patients before you who have had similar problems. However, all is not lost and there are things which can help further:
Familiarise yourself with the department and the MRI process
Whether you have claustrophobia or not, we would always recommend that you familiarise yourself with the scanning process. You can read our ‘Patient Journey’ guide here. You may also want to take a look at our patient video:
You are also welcome to visit the department before your scan. We can show you the scanner and answer any questions you may have in person. If you would like to arrange a pre-scan visit, give us a call at any time that suits you. The more familiar you are with the environment and the team, the more relaxed and less claustrophobic you will feel.
Bring a friend or relative
Sometimes, it can also help to have some company in the scanner room and it is perfectly OK for you to bring a trusted adult with you to hold your hand during your MRI scan. It is important that this person is safe to enter the scan room and the radiographer will need to go through a strict safety checklist with both of you before taking you into the scanning room. You may not be able to talk to each other during the scan, but often just knowing someone else is there is all that is needed to help you relax.
It is reasonably common for some people to require a light sedative to help them relax during their MRI scan. This medicine will not put you to sleep. Instead, it will just relax you enough to control your nerves and be comfortable enough to tolerate the scan. This medicine is often very effective and we find that the majority of patients who do this will be successful. If you feel that this would help you, then you must obtain a prescription for the sedative from your doctor and bring the tablet with you on the day of the scan to take here in the department. We cannot give you sedation as this is something your doctor must be aware of and help you organise. We will give you more instructions when you book your appointment.
Remember, you are not alone
In essence, if you have been referred for an MRI scan by your specialist, there is likely to be good clinical justification for it. It is important that we work with you to do all we can to make you sufficiently relaxed and comfortable that you are able to tolerate the scan and keep sufficiently still, enabling us to obtain the best imaging possible. Trust me when I say that we have encountered every possible scenario and are able to adapt what we do to suit your needs. However, by taking into account the simple actions outlined above and trying to keep an open mind, chances are that the experience will not be nearly as bad that ‘friend of a friend’ had said!
How to get in touch
If you would like to discuss an MRI appointment, or have any questions in relation to MRI and claustrophobia, please don’t hesitate to get in touch with our friendly team at the Queen Square Imaging Centre on 020 783 32513. You can also email us at firstname.lastname@example.org.
Mr Peter Sutton
Operations Manager, QS Enterprises Ltd.