Tips for surviving MRIs as an anxious person

July 15, 2015 10:10 AM

I am having two MRIs with contrast this week and I'm absolutely dreading it. Do you have any tips on how I can make it more bearable?

I have MS and I am having a brain MRI with/without contrast tomorrow and a c-spine/t-spine MRI with/without contrast later in the week. I had a brain MRI without contrast in May and it was horrible, so I am dreading this and can't imagine how I'm going to survive tomorrow since it's going to be twice as long as last time because of the contrast.

I have Ativan that I've been prescribed for anxiety. I usually only take 0.5 mg in emergencies and I took 0.5 mg last time and I still almost had to ask to be taken out of the machine. I didn't actually feel anxious in my mind, but my body was shaking and my eyes wouldn't stop twitching the whole time. It's not because of feeling closed in (although that doesn't help), it's because of the noise. The noise is so unbearably loud, and last time I had earphones on and music playing. I'm definitely going to use earplugs this time, so hopefully that will make a substantial difference.

I know that 0.5 mg is a tiny dose of Ativan. I'm planning on taking 1 mg this time. I'm not afraid of the IV or the results of the test or anything like that, I'm really just dreading the noise. Does anyone have any tips on how to combat this? What do you do to make MRIs bearable? Are there any kind of silly games or stupid things I can think about during the test to take my mind off of what is going on? I appreciate any advice!

posted by dangerbird to Health & Fitness (35 answers total)

Check with whoever prescribed you the Ativan if they can give you a prescription for a few pills of somethings stronger just for the MRI.
posted by griphus at 10:15 AM on July 15, 2015

i know someone recently who said they got to listen to music over headphones. i have no idea how that works, but maybe it's an option? it certainly can't be through your own headphones (since they will be metallic/magnetic), but apparently there's some non-magnetic way of listening to music during MRIs these days (unless my friend was mistaken i guess).

does it help to understand what the noises are? i'm happy to describe what those noises are, if you think understanding them will help any (i am not an expert, but i understand the basics of how they work, and have them all the damn time for "medical reasons").

(i guess this isn't any help, but they're actually really cool machines, and we're so lucky they exist, because they do amazing imaging with no real risk... sorry!)
posted by andrewcooke at 10:19 AM on July 15, 2015

Yes, ask your doctor to give you something stronger for the anxiety. This is totally a thing - my doctor prescribed me 3 pills of Valium when I had to have a series of 3 MRIs. For the sound, get the best earplugs you can, then put the headphones on over them. I have very sensitive hearing and I'm claustrophobic, so I totally get how you are feeling, and I'm sorry you have to do this.
posted by bedhead at 10:21 AM on July 15, 2015

Best answer: It's in their best interests to have you as relaxed as possible so I agree with griphus: more meds. And if it's helpful to you, consider taking some the night before as well just so you're not missing sleep and feeling jangley. I find that earplugs make a big difference and also setting up a scenario where the noise is ... something good? Like "I am on a spaceship and this is the noise of them building me a new double-decker cabin with a great view of the Earth and blabityblabla" I know it's goofy but it's useful to remind yourself that the noise is unpleasant but it actually can't hurt you, sort of like how (most) spicy food isn't really dangerous to you, it just gives the illusion of burning/pain but you have to train yourself out of the flight reaction you can sometimes get.

Also tell the technician you are nervous and they can be as gentle as possible in terms of the whole process. Have you had contrast before? I only ask because it can be ... unusual. I don't mind MRIs but I was a bit surprised when they put the needle in my arm while I was still in the headcage (I don't know what I thought was going to happen) and then I felt ... weird in my crotch? This is apparently normal but I would have appreciated a heads up about that.

But really, it's very good that you are taking care of yourself. I'd work on not letting the MRI colonize your head as much as possible in the next few weeks. Talk you yourself honestly and frankly about what you are really afraid of and maybe make up some lyrics to a song that is called THE NOISE CAN'T HURT ME so you can sing it to yourself when you are feeling jumpy. Good luck, I know it's hard.
posted by jessamyn at 10:22 AM on July 15, 2015 [4 favorites]

Close your eyes BEFORE you get sent into the machine, and do not open them until you are taken out of it. (I'm claustrophobic, and this plus the fresh air they gently blew through the machine to make it seem like I was in open air actually worked for me.)
posted by blue suede stockings at 10:28 AM on July 15, 2015 [3 favorites]

Some places now have open MRI machines even for brain imaging. It makes a big difference. You might ask your neurologist if they know of a different imaging venue that offers an open MRI machine upon request. I drove a little farther to use one of these because it was worth it to me.
posted by flourpot at 10:31 AM on July 15, 2015

Do you have an option to go somewhere with an open MRI machine? I agree about the sound and the time and the sound and the sound ... I had an option for open MRI on my knee and it was quiet enough that I could relax a bit better (I actually fell asleep).
posted by tilde at 10:32 AM on July 15, 2015

I have a 5 mg Valium prescription and found I need 10 mg to feel okay in the machine. Talk to your doctor about more meds.
posted by purpleclover at 10:33 AM on July 15, 2015

sorry, another thought. something that helps me not with MRIs, but with other unpleasant medical stuff is meditation. i am not very good at it, but there's this thing called mindful meditation where you basically lie there trying not to think, which sounds pointless (and probably is, in all honesty), but does help take your mind off things (note, it says "a quite peaceful place" is optional there which may make you think it's completely unsuitable for inside one of those machines, but really it's not - whether it's horrible noise or your nose itching, you're going to be trying not to think about something...)

(and also, of course, what everyone else is saying about meds).
posted by andrewcooke at 10:33 AM on July 15, 2015 [1 favorite]

You really need disposable foam earplugs. Headphones do not usually do very much at all.
posted by Maxwell_Smart at 10:35 AM on July 15, 2015 [1 favorite]

Yes to more meds!

But also: I got an MRI a few months ago and my husband, a synthesizer/electronic musician guy, was in the room with me, and there was a little mirror at eye level so I could see him but he couldn't see me, and he was totally rocking out to all those weird sounds, like making them into parts of songs and stuff. It was really amusing to witness. Maybe you could not try to block out the sounds as much as really listen to them as the weird, interesting things they are? I imagine a bunch of anti anxiety meds could help make this sort of thing easier, too.

I also try to focus on how great an MRI is compared with other scans that use radiation. At least it's not sending potentially cancerous rays into your body!
posted by something something at 10:40 AM on July 15, 2015 [3 favorites]

Earplugs! Without them the pump noise is jarring. With them I find the steady rhythm to be soothing (I've almost fallen asleep in a couple of the machines). Up your meds as recommended above, use earplugs, and try to think of the pump sound as the heartbeat of modern medicine, enfolding you and helping you become healthier and better-feeling. Good luck!
posted by Johnny Wallflower at 10:47 AM on July 15, 2015

Best answer: I feel ya. I really do. I had my first MRI this year, for a tumour in my skull. I am not at all a claustrophobic person but when I realized just how small that space really is I had something like a micropanic attack. It took an incredible (for me) effort of will not to lose control of my emotions.

For my scan, the noise was more than bearable because the tech put earplugs in me, then crammed these foamie jobbers beside my head, then locked them in place with slider things that clamped the whole works down tight. The sound was omnipresent but not at all bothersome. Earbuds are really no substitute for earplugs so I am glad you are going that way this time.

As far as the lorazepam goes, hell yes take 1mg and let them know you did. Don't mention that it's more than your usual dose or anything, just tell them you took lorazepam just in case something goes wrong somewhere.
posted by Sternmeyer at 10:55 AM on July 15, 2015

Definitely take extra Ativan. I'm not sure how much this would help, but my noise-cancelling earbuds (Bose) works well for other things. It might be worth a try...personally, I do find they're a lot more effective than earplugs.
posted by three_red_balloons at 10:57 AM on July 15, 2015

I kinda agree with something something's stragegy. I've listened to a lot of electronic music in the past, so I tried to just imagine that the sounds from the MRI machine were something like that. It really helped in my case.
posted by dcjd at 11:10 AM on July 15, 2015

Did you ask if they offer sedation? My last mri they asked if I needed sedation when I scheduled my test. You may need someone to drive you then. Definitely do the earplugs. Focus on breathing. Let them know you have anxiety and that you had problems with your last test.
posted by Crystalinne at 11:12 AM on July 15, 2015

If you're considering disposable earbuds: these wax earplugs I personally find much better at reducing sound than the regular foam ones and more comfortable for longer use. Take off the cotton that surrounds them and warm them up in your hand. You can use them multiple times, they actually get better then (so if you choose these you might want to kneed them a bit beforehand). After warming up, they melt a little and you can push a thinner part very far in your ear and then the rest to close it off. They don't hurt even when you jam them far inside (for a better effect).
Good luck tomorrow!
posted by Dutchmeisje at 11:15 AM on July 15, 2015 [1 favorite]

When I ran MRIs we always always had people wear earplugs under the MRI headphones (with music optionally depending on what we were doing). Earplugs or headphones alone were not sufficient. When I was in the scanner I usually tried to get zen with the "pulse" of the machine and use it as a beat to sing to myself or something if I didn't have other music playing. If you have games you play in your head (I think there are some askme questions about that) it's good to have something to keep your mind occupied.

Good luck!
posted by brainmouse at 11:18 AM on July 15, 2015

I just did this last month. Had Brain and cervical at same time. Was in that tube for 90 minutes. My doctor only gave me 1mg of lorazepam and I added 1 mg of Xanax. It removed my ability to complete a thought which is what I need. I also use the headphones they provide and this time the tech put a washcloth over my eyes right before he put me in. It all helped.

Honestly, it is all about the drugs.
posted by cairnoflore at 11:23 AM on July 15, 2015

Best answer: Here's one of those questions about games to play in your head. This one is focused on pre-sleep which is very applicable to the MRI experience.
posted by brainmouse at 11:24 AM on July 15, 2015

During my MRI, after my initial freak-out, I asked for an eye mask, like the kind you wear when you're sleeping. That helped me keep my eyes closed. Plus definitely some meds.
posted by lyssabee at 11:32 AM on July 15, 2015

I'm claustrophobic and recently had about 7 MRIs, with and without contrast, in a 3-month period (due to what turned out to be a spontaneous CSF leak). Super fun. I highly recommend AT LEAST 1 mg of lorazepam/Ativan (.5 did nothing for me; 1 mg made it survivable); using earplugs/headphones if they have any (listening to music made me feel more claustrophobic and made my head hurt more, so I just had the headphones, no music); and asking for the mirror thingy. Having the mirror there in my face made me feel a bit like a parakeet in a cage, but it was very helpful in making it seem like I was not, actually, trapped in a very loud coffin.
posted by mothershock at 11:34 AM on July 15, 2015

I work scheduling these procedures for patients all the time. Earplugs will definitely help, and some places will play music for you as well. I'd suggest calling them to see if they're able to play music while you're in the machine and if so, if you can bring music with you.

Also, call your physician to see what dosage her recommends for before the scan and sometimes they will even call in an additional few higher dosage pills for you to take or something a little stronger. (For me, I had Valium, EEK!)
posted by Sara_NOT_Sarah at 11:43 AM on July 15, 2015

nthing something something's strategy, plus drugs. I always refuse the headphones when offered, because they are over the ear and end up creating a weird pressure/suction that I can't bear. I use foam earplugs and xanax, and I pretend I'm listening to a really long song by Daft Punk or J.U.S.T.I.C.E.
posted by ImproviseOrDie at 12:06 PM on July 15, 2015 [1 favorite]

Best answer: I'm a frequent flyer MRI patient for a variety of issues--last one was last week for lumbar spine. I always use earplugs, sometimes use medication to take the edge off, and always listen to the noises and try to detect some type of musical pattern to them. I'm a musician anyway, so that is my nature, but it helps take my mind off the situation.

I've also found that visualization is very helpful; it's like I'm looking at the slices as they are being made, to view my anatomy. I don't know, maybe that's too weird for you, but I try to imagine what my insides look like when I hear the different banging noises, and which noises correlate with which images. It just helps pass the time.

Best of luck to you and I hope you do well. Will they give you a copy of your images as a party favor? :)
posted by FergieBelle at 12:39 PM on July 15, 2015

Best answer: I also have MS (diagnosed 13 years ago) and have lost count of the number of brain/spine MRIs I've had. They get easier with time, because they become so routine. I was crazy nervous the first time, and now it's just another Annoying Yearly Thing I Have To Do.

Firstly--the good news is that the post-contrast part of the scan isn't as long as what came before, because they don't repeat the entire series of scans post-contrast. By the time you get to the contrast, you're actually more like 75% done!

Secondly--did they seriously not give you any earplugs for the first one?! I'm so sorry, that is just terrible. Earplugs will make a ton of difference! I mean, it's still loud, but it won't be physically-painful loud like it is without them.

I think you'll be pleasantly surprised at how much less anxiety-provoking your experience will be with a full milligram of Ativan and earplugs.
posted by jesourie at 1:41 PM on July 15, 2015 [2 favorites]

I have to have MRIs about once a year for a head/neck issue so I'm really stuck in the machine. I'm very claustrophobic and hate the noise too. I take xanax - it's really helpful. And I insist on having the mirror over my head so I can watch the technician and see the room. And I also insist that they tell me the exact length of time of each scan. 45 seconds? I count it out - it's like a game where I time myself to see if I am counting the seconds correctly. And it's a strange thing, when you are counting for a whole 3 minute scan, you begin to concentrate on not losing count and I hear the noise less. Worth a try...good luck!
posted by meerkatty at 2:10 PM on July 15, 2015

Is an Open MRI an option? Ask the place where your MRI(s) are scheduled. Let them know you are claustrophobic and had a tough time with a previous MRI.

I had a c-spine MRI (my first MRI ever) a few weeks ago, and I agree -- it would NOT be a pleasant experience for someone who is claustrophobic. I normally do not care about that sort of thing, and even I felt closed in. Plus it was very noisy, even with the disposable ear plugs the MRI center gave me.
posted by tckma at 3:02 PM on July 15, 2015

Best answer: An open MRI machine is much preferable to a closed one. If it's open and it's just a question of noise, I think earplugs should help a lot. (Is there a reason why you can't wear earplugs?)

If it's closed, I'd definitely try the suggestion to close your eyes before you go in. I had a PET scan recently and I freaked out. Part of the problem was the enclosed space, and part of it was that I had to hold my arms up above my head for a really long time and not move. If I'd known the tip about closing your eyes, I think it would have helped a lot.

My girlfriend had an MRI and she got through it by pretending she was in a pod on a spaceship, heading to another planet. She was visualizing the whole trip clearly enough to distract herself. I've gotten through terrible dental procedures by visualizing vivid scenes. (Like if the dentist is scraping and hammering and SCRAAAAPING on my tooth, I'll imagine it's a block of marble and I'm sculpting it. It gives me some feeling of control, and takes the focus off my mouth and puts it into this marble block I'm imagining in front of me.)

Any kind of visualizing like that can help. You imagine a scene as vividly as you can, turning everything that happens into part of that scene. (Keeping your eyes closed will also help this, as you'd imagine.)

Alternately, you can do mental games. Try to think of an animal, or a girl's name, for each letter of the alphabet. Try to recite the alphabet backwards. Try to think of everybody you ever dated, and rank them in terms of your personal preference!
posted by Ursula Hitler at 3:22 PM on July 15, 2015

Best answer: Please be cautious before slamming yourself with more meds. If you have no tolerance built up to benzodiazepines like Ativan and Valium (which you shouldn't if you only use it sporadically) then suddenly taking a large dose is probably not advisable. 1mg of Ativan if you're used to 0.5mg and have no problems with it is fine, but something like "3 pills of Valium" (which could be anything from 7.5mg for a 2.5mg pill to 30mg for a 10mg pill) could be a HUGE dose for you and be totally inappropriate.

You probably already realize this but I don't like the cavalier way in which people are advising that you need to use 'something stronger' and 'much more meds' here. These are dangerous medications if used unwisely. Ativan is plenty strong, it's all about how much you take of it. A 2mg dose would probably knock you out for 8-12 hours (probably not unconscious but difficult to rouse). Valium's effects are significantly longer lasting than Ativan's (on the order of hours, longer than you need for this MRI), so Valium is probably not a better choice for this purpose- obviously talk to your doctor to decide what's right for you. If you cannot achieve reasonable 'anxiolysis' to use the medical term with a reasonable dose of these medications, then procedural sedation could be an option for you, but it is higher risk and requires the presence of someone like an anesthesiologist to monitor you for the entire procedure.

And of course, regardless of what you decide to use medication wise, if you are using medications that cause drowsiness, do not drive yourself either to or from the test.
posted by treehorn+bunny at 5:41 PM on July 15, 2015 [3 favorites]

Can you bring someone with you? I freak out in MRIs, too -- never realized I was claustrophobic until the first time I had to have an MRI, fun!! The last one I had, I brought a friend (MeFi's own clone boulevard, in fact!!) to hang out in the room while they did the MRI, and it helped a LOT with the "something terrible is going to happen and this huge noisy machine is going to eat me" feeling.
posted by sarcasticah at 7:45 PM on July 15, 2015

Ask the person who ordered the MRI to arrange for sedation, if possible. If it is that important to you you may even ask for a referral to a place that will do sedation if the place you are going to does not. We do various varieties of sedation up to and including general anesthesia on children of all ages for MRIs; especially important in some of the longer scans that can take 2 or 3 hours; asking a young child to be still that long is not realistic even when they are not trapped in a loud, noisy tube. The adult hospital we are affiliated with also does anesthesia and sedation for adults that can't go in the scanner otherwise; it is not an unusual request. A couple of other thoughts: open MRI is not an unreasonable option, but many feel that they give worse image quality; our technicians give everyone in the scanner both in the ear and over the ear foam ear plugs, even when they are anesthetized. I am surprised they didn't offer them to you previously.
posted by TedW at 7:16 AM on July 16, 2015

My mom is close to ten years past a brain tumor. She used sedation for every one of her MRIs, both pre-op and in all her checkups since. Wishing you the best.
posted by rubster at 10:54 AM on July 16, 2015

I don't know if it will help you or make it worse, you'll have to use your own judgement, but you can practice listening to the sounds so that you are more used to them. Here is an example of a "Getting Ready for MRI" plan from Stanford.
posted by freezer cake at 12:37 PM on July 16, 2015

More votes for:
* earplugs instead of headphones
* closing your eyes before you're in the machine
* focus on thinking about something else

I had my first MRI recently. Head only, 60 minutes w/ and w/out contrast. The first 30 minutes were stressful. I thought my heart was beating too fast and tried to slow it down by regulating my breathing which felt like it made it worse. I realized after a while that it was the machine pulsing and not me :) which helped me calm down.
posted by Constant Reader at 8:38 AM on July 17, 2015