More than 80 million people from all over the world go through a MRI test and 2.3%, some two million of them, are patients who suffer from claustrophobia. Many of these people fear going through the test before doing so, for others claustrophobia can kick in at that moment and stay with them forever.
The data in Spain, in this hospital in Córdoba, indicate that in 2014 around 19,000 tests of this type were carried out and between 1.5% and 2% of the patients, a total of 333 showed signs of claustrophobia before carrying out the test. Between 2012 and 2015, some 900 patients have passed through the Cordovan hospital program.
According to Carmen Ramírez, the nurse responsible for the “Care Program for Claustrophobic Patients for Resonance” from the Reina Sofía University Hospital in Córdoba, those who go through these situations are not always claustrophobic and may have had their first crisis in an MRI test with powerful physical signs generated by the emotional problem,
Claustrophobia itself constitutes an emotional disorder defined as “fear of closed and small spaces” that causes physical symptoms such as tachycardia, heat, tremors, shortness of breath, tightness in the chest and the urgent need to run out of the place where they are. .
The first patient that Ramírez attended went to the emergency room after an experience of this type while undergoing an MRI test that caused a hypertensive crisis. “After entering the program, in the same week, two resonance tests were carried out in good conditions,” says the nurse.
These types of claustrophobic situations are very varied, from people who do not expect to have a claustrophobic crisis to those who refuse to go through the test even though they know they must do it and still feel incapable. “The reactions, upon achieving it, are of all kinds, some people have cried and have hugged me after being able to pass the test,” says Ramírez.
The professional remembers that although there are people who have requested that an open resonance equipment be used They have not been able to do it under these conditions either. “It must be taken into account that an open resonance may not offer the same guarantees in image quality since the magnet included in the equipment is usually more powerful in the closed one,” says the nurse.
Great misinformation that scares
The program coordinator indicates that there is great misinformation among the general population about what an MRI machine consists of.
A Magnetic Resonance Imaging is an examination for diagnostic imaging that uses a combination of powerful magnetic fields and radiofrequency, digitizing the images and in which a computer system is used. Its structure is striking.
“Patients come scared because someone has told them that it is like a box, it would be good to spread what a resonance is, what types of resonances exist, the duration and the sound that the test produces. A significant number of these people report that being in a resonance is like putting them in a niche,” explains Ramírez.
The nurse clarifies that, although it depends on the type of machine, the area of the body to be studied is also essential and that only this area of the body can enter the magnet and not the entire body. This may or may not be possible depending on what MRI equipment is used.
Tranquilizers or anxiolytics are used and there are even patients who have requested sedation, however, Ramírez points out that with the training included in the program, the use of any type of drug or medical procedure that may have, although few, side effects and associated risks is not required. Premedication requires a waiting time until it takes effect or prior preparation for hospital admission in the case of sedation.
“With prior training in these techniques you are able to take control of the situation but the drug, being an external agent where the will does not intervene, if your head tells you no, the test is not performed. Despite the premedication, without prior preparation and training, there are patients who have not been able to overcome it,” continues Ramírez.
Although prior preparation is carried out, in those patients who have suffered an MRI crisis, the nurse points out that a few days must elapse before approaching the test again in order to forget the claustrophobic situation experienced, since The brain powerfully memorizes traumatic experiences.
Recommendations to face the test
Ramírez points out that the Córdoba hospital’s program against claustrophobia in these patients is based on very simple questions but for which intentional training is also necessary and whose results are very effective. They are also practices that anyone who is going to undergo an MRI test and is afraid of it can put into practice:
1) Demystify resonance: Knowing the technology, the types of machines and how they work improves the patient’s perception.
2) Work at home: You have to do visualization training on pleasant mental images several days before the day of the appointment, remember pleasant moments to relive them during the duration of the test, lived situations that provide comfort. “This helps to disassociate yourself from the real situation and put emotional distance”, clarifies the nurse.
3) Breathing relaxation techniques: They are necessary to have a relaxed attitude to which you have to surrender, says Ramírez. Both the visualizations and the relaxation should be practiced, at home, in a comfortable place and at a quiet time of day a couple of times a day (after dinner and before going to sleep, for example). With his eyes covered by a scarf. Five or ten minutes at a time is enough “We don’t know how to relax and we also have to learn to remember the good things, we are all more prone to remember the bad”
4) Eyes closed: “It is not convenient to open your eyes, since by doing so you become aware of the situation in which you find yourself. With your eyes closed you hear the noise but nothing else,” says Ramírez. The nurse suggests that patients use a handkerchief over their eyes without holding it, as this is more annoying and gives a greater feeling of oppression, so masks can also fail. She recommends bringing this same tissue on the day of the test to use during the MRI.
At the Cordoba hospital, Ramírez accompanies and supervises throughout the entire process those patients who are referred to the program after indicating their claustrophobia or having suffered a crisis during a previous test. The nurse provides her mobile number for permanent contact with the patient, shows him the resonance equipment used, He tells them how to work at home and accompanies them during the resonance. Of every 100 patients treated in this program, 98 perform the test without problems.