Nurse Kim Asks...
A magnetic resonance imaging (MRI) scan uses powerful magnets and radio waves to create pictures of the inside of your body.1 An MRI of the brain and spinal cord is one of a few tools that can be used to diagnose multiple sclerosis.2 If you’ve been diagnosed with MS, you’ll get regular MRIs to monitor for any disease progression.2 Your healthcare provider also might request you get an MRI with contrast, which is a dye, administered through an IV, that improves the quality of the picture.2,3 Like any medical test, an MRI takes some preparation. How do you get ready for your MRIs? Do you have any tips or information to share?
Preparing for an MRI
January 14, 2019
MRIs can be intimidating if you don’t know what to expect. Being prepared can help. Share your concerns with your healthcare providers, or even the radiology unit, prior to your appointment. They can tell you more about the MRI machine that they use, as this differs from facility to facility, in addition to some tips regarding your test.3
You should talk with your healthcare provider ahead of time if you have anxiety when you’re in a confined space. MRI machines tend to be a bit confining (think of a tunnel), and you are in the machine for a good period of time (anywhere from 20 minutes up to 1½ hours), depending on the images that your doctor requests.3-5 Your healthcare provider can offer tips on how to best deal with any nervousness, including medications that may help mitigate it.4,6 If you will be taking a medication to help with this, you might need a driver to bring you home after your MRI.
Your MRI experience may be different, but during the test I am typically positioned in the MRI machine on my back with my arms at my sides. There is a block under my knees to help with comfort.
A mask goes over my head and face and cushions are placed between my head and the mask to help keep it in place.
The technician then goes into a control room. The table moves and I’m placed in the correct position in the MRI tube.4,6
Before we begin, the technician tells me how long each test will last. The test is done in a sequence of images. I like to count down the time for the shorter tests or count the number of songs that I hear (each song is about 4 minutes long) for the longer sessions.
After a sequence of images, the tech stops the testing to come back in the room to place the IV and administer the contrast. This is a great time to request to get up for a minute to stretch or use the restroom before the next sequence. When the contrast is administered, I sometimes feel a warm or cool sensation in my arm. But it passes quickly. The IV is removed as soon as the contrast has been administered. The remaining images are then taken.
After the test, I’m usually free to get dressed and leave. Then I receive the results of the test from my healthcare provider. I’m always sure to drink lots of fluids after the test,
to help flush the contrast out of my body.
Preparing for an MRI
January 14, 2019
I don’t think anyone really enjoys going for an MRI. They’re noisy, cramped, and generally uncomfortable, but I view them as a necessary evil.1 My perception of my condition is entirely subjective, but the MRI results provide a quantifiable measure of multiple sclerosis progression.2 MRIs never really bothered me, but I tend to get bored just lying motionless, so there are a few things I learned to do in order to make the experience a little better.
Like many, one of my MS symptoms is periodic leg spasms.8 Having uncontrolled jerks in the legs doesn’t really mesh well with the whole “motionless” challenge.6 I’ve found that stretching my calf muscles and massaging them sometimes helps. On the topic of staying motionless, I try to make myself as comfortable as I can before the MRI starts. Minor discomfort at the beginning can become quite annoying by the end of the exam!
Ideally, I try to nap during the MRI, so I want to be really tired before I get there. I try to schedule the MRI for late at night, like 11:00 PM or later, if I can. If it is scheduled during the day, I just try to go to bed a little later the night before, and get up much earlier. I also try to eliminate caffeine for several hours before I get to the hospital.
If I can’t fall asleep, I try to keep my mind occupied. Sometimes I will “listen” to an album I am very familiar with, playing the music in my head. I might spend the time brainstorming a project, or planning out things I need to do for the next few days. In a pinch, I might even try playing mental games, such as thinking of a person’s name, a place, or a food that begins with each letter of the alphabet. One facility had a very small mirror that let me look down past my feet and out of the machine. I spent a lot of time reading the countdown on the MRI machine backward as it was reflected on the window to the operator’s station. Anything to pass the time helps!
I don’t remember how many MRIs I have had, but during the last two, I had a reaction to the contrast.9,10 The reaction was not severe, and the symptoms passed quickly.9,10 My healthcare provider recommended that I take an antihistamine about an hour prior to my next MRI. I’m looking forward to trying that at my next MRI in a few months.
Nurse Kim Sums It Up
Getting regular MRIs is a necessary part of managing MS.2 As Connie and Stewart said, it’s a good idea to plan ahead and make sure you’re as comfortable as possible during the test. I encourage you to talk to your healthcare provider about what to expect.
You can also ask the lab tech any questions on the day of your MRI. Be sure to communicate with them about how you’re feeling. They’re there to help and want you to be comfortable.
References: 1. National Institutes of Health. U.S. National Library of Medicine. MRI Scans. https://medlineplus.gov/mriscans.html. Accessed May 18, 2018. 2. Kaunzner UW, Gauthier SA. MRI in the assessment and monitoring of multiple sclerosis: an update on best practice. Ther Adv Neurol Disord. 2017;10(6):247-261. doi:10.1177/1756285617708911. 3. National Institutes of Health. National Institute of Biomedical Imaging and Bioengineering. Magnetic Resonance Imaging (MRI). https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri. Accessed May 18, 2018. 4. Mayo Clinic. MRI. https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768?p=1. Accessed May 18, 2018. 5. National Health Service. MRI scan. https://www.nhs.uk/conditions/mri-scan/what-happens/. Accessed May 18, 2018. 6. U.S. Food & Drug Administration. MRI (Magnetic Resonance Imaging): Benefits and risks. https://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/MedicalImaging/MRI/ucm482765.htm. Accessed April 18, 2018. 7. Lenhardt R, Seybold T, Kimberger O, Stoiser B, Sessler DI. Local warming and insertion of peripheral venous cannulas: single blinded prospective randomised controlled trial and single blinded randomised crossover trial. BMJ. 2002;325(409):1-4. 8. Multiple Sclerosis: Current Status and Strategies for the Future, Janet E. Joy and Richard B. Johnston, Jr., eds. Washington, DC: National Academy Press, 2011:1-457. 9. Behzadi AH, Zhao Y, Farooq Z, Prince MR. Immediate allergic reactions to gadolinium-based contrast agents: A systematic review and meta-analysis. Radiology. 2018;286(2):471-482. 10. Bottinor W, Polkampally P, Jovin I. Adverse reactions to iodinated contrast media. Int J Angiol. 2013;22:149-154. doi: 10.1055/s-0033-1348885.