Saturday, May 26, 2012

Into the Tube

MRI.  One of my least favorite acronym when it comes to MS.  Besides, of course, the acronym MS itself.

It would be more accurate to say I have mixed feelings about MRIs.  Since I'm claustrophobic, the idea of getting into a loud, confining tube is not the way I'd choose to spend my time.  On the other hand, the MRI is such an effective tool for neurologists in monitoring MS activity that I've just had to suck it up and deal with my fears.

MRIs can provide useful information both about your current situation and your progression with the disease.  The MRI can show hot spots of activity that explain current or recent exacerbations.  For example, when I had a bout with double vision, my neurologist was able to see the lesion that had caused it.

For those of us on Tysabri, an MRI can provide even more valuable information.  My neurologist explained that sometimes MRIs can show early signs of PML.  The sooner PML can be detected, the better the chance of being able to treat it.

Comparing MRIs over time provides a lot of valuable information to your neurologist.  By comparing the most recent MRI to previous MRIs, neurologists can see whether there's been any changes.  If there are no changes, then that tells the neurologist that your current course of treatment is effective.  If there are changes on the MRI, then the neurologist can adjust treatment options accordingly.

So, how do you get through an MRI?

This is NOT the time to be brave.  If you have the slightest suspicion you are claustrophobic, tell your neurologist.  You could be prescribed a relaxant, or you could even be given a valium IV during the MRI.  If you get the meds you need to get through the MRI, it's better for everyone - you'll get through it faster, and the technician has a much better chance of getting good images.  Trust yourself and don't listen to others.  Before my first MRI, a family member told me I was being a diva, so I tried a medicine-free MRI.  I had to be pulled out of the tube sobbing.  Instead of getting the images, I had to reschedule for another date, which meant I wasted everyone's time.  On the plus side, I did enjoy saying "I told you so" to the family member who had questioned me.  Small benefit, I know.  Ever since, I've had my neurologist prescribe IV valium, and the MRI goes smoothly for everyone.

If you do get IV valium, you need to have a driver, and you're not supposed to drive or make any important decisions that day.  The receptionist told my husband he could take advantage of me that day.  When she realized how that sounded, she reminded him that she meant that for legal matters only.  He grinned.

You'll also be given a questionnaire to determine whether there's anything that could interfere with giving you an MRI (ex. if you've been shot).  Some MRI facilites have music (and in some cases videos) to help distract you during the procedure.  You'll change into scrubs and head into the room where the MRI machine is located.  At this point, I introduce myself to the machine by sticking out my tongue at it, but that's not required.  Then the technicians will get you set up for going into the tube.  If your doctor has prescribed valium, a doctor will come in and adminster that as well.  Before you go into the tube, they'll hand you a panic button that you can push if you need to come out of the machine before the procedure is complete.  Trust me, the button works - you don't have to test it for yourself.

You may hear the doctor and technician refer to contrast or dye.  In those situations, the technician will get a series of images, then inject some dye into your IV before taking the images again.  This dye will provide contrast, which could make it easier for anyone reading the MRI to detect lesions.

After your MRI, you may be given a CD with a copy of the MRI images.  Store this CD in a secure place.  If you go to another doctor or a different MRI facility, you'll be able to provide those treating you with some valuable history to help them treat you better.

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