Sunday, 6 January 2013

Rog T's Cancer Blog - Surviving an MRI scan

For those of you who are regular readers and have read the previous posts on Cancer, you can skip this first paragraph.This is the latest installment in my occasional series about how I'm adjusting to living with a big C in my life.  For those of you who aren't, here's a quick summary. I'm 50 years old and I last year had a prostate biopsy following two "slightly high" PSA tests - 2.8 & 4.1. The biopsy took ten tissue samples and one of these showed a "low grade cancer" which gives me a 3+3 on the Gleason scale. I'm now on a program of active monitoring.  In early February, I got the results of the latest PSA test - down to 3.5 and an MRI scan which found absolutely nothing. My latest PSA test in August was not quite so promising, back up to 3.9, in other words the downward trend has stopped. I've no symptoms and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture?

So first off a little bit of an explanation. I write this series of cancer blogs to try and share what I've learned from the experience. Some of the stuff I write is practical and some is personal. I've noticed that there are quite a few hits on this series of blogs. I sincerely hope someone out there has derived something positive from what I've written. If you disagree or feel I've got something wrong, please share it with me. If you think I've misrepresented something please tell me. If you want to write a guest blog about your own experiences, please email it to me. I believe knowledge is power and the more we share the better our chances of survival become.

Which brings us to todays blog. The title is somewhat misleading, isn't it? I am not aware of anyone dying during an MRI scan, and certainly not through the effects of it (although I am sure there has been the odd freak accident). I am not referring to improving your physical chances of emerging alive from an MRI scan. Please don't think this blog casts doubt on the medical safety of the process. I am talking about dealing with the issue of remaining still and calm during an extremely unpleasant process.

If you have not had an MRI scan before, this is what happens. You are stuck into a metal tube which you will just about fit into and told to stay completely still for 30 minutes whilst you are subjected to an aray of extremely loud bangs, whirrs and crashes, whilst being jolted back and forth on a mechanical bed. It is a rather claustrophobic experience and I know of several people who found it too much. It is the fourth time I've had one. I had two on my head many years ago and today I had the second one for the prostate cancer. The last one was in February. If you fidget, this blurs the image and the process takes even longer.

What happens in Barnet for a prostate scan is as follows. You are made to remove your pants (and all metal items) and put on a gown. You then lie on a part of the machine and a plate is placed over your hips. The radiologist gives you some headphones to wear and tells you to stay completely still for 30 minutes. (If you move they have to do that sequence of shots again.)

Once you are safely set up, the machine pulls you in. For want of a better explanation, I felt like a torpedo must when it is loaded into a torpedo tube. Apart from the claustrophobia, the worst problem is you start to itch. I found the urge to have a scratch was overpowering in February. I also have a cold, so the urge to cough also was an ever present problem today, a fact I anticipated.

The issue of how to overcome these urges was my main problem when I had an MRI in February, I moved a couple of times and so the whole process took much longer than I'd hoped. This time I managed to make it through without a single telling off, even though I have had a cold and been coughing all day. The secret is to find a way of distracting your thought process. As you can't take a book in, it has to be something completely within your mind. I was given some helpful advice on dealing with this in August. As I'm sure most of my readers are not of a religious persuasion, consider the process rather than the method I used, as I am sure it can be adapted using a poem, song or great speech.  The idea came from an old Catholic priest who advised me to "say the rosary in your head and try and get to the end before the MRI finishes". He advised that as it is repititious and a form of meditation, it is ideally suited to an environment where you have to sit still for 30 minutes and not move a muscle. For those of you who are not familiar with the custom, Roman Catholics have a set of beads with five sets of ten beads punctuated by a single bead. Each of the ten represents one recitation of a "Hail Mary" and the single bead represents an "Our Father".

When I was a child at Catholic school, we were forced to say the Rosary. I haven't done it since and it has held certain negative connotations for me as a result of these memories. I did consider trying to see how many times I could sing "Living in the USA" by the Steve Miller Band to myself in my head, before the end. the song lasts 4.15 so maybe 9 times?  Maybe I would start bopping? I also considered trying to do a yoga meditation, but I had tried this last time and fell asleep, waking with a jar, requiring a rescan. In the end, I decided to try the saying the rosary mentally as advised. What I found was that I was able to stay awake and focused enough to avert the need to fidget. As I hadn't taken any beads in, the act of keeping count was rather difficult (especially for a dyslexic).

Whilst my main concern was to get through the MRI without moving, I actually found the experience remarkably calming and relaxing, even with the bumps and bangs. I must of course advise that under no circumstances should you take metal rosary beads into the machine. Over the years I've done quite a bit of yoga and repetetive chanting is a big feature of the relaxation exercises. I found that the effects were exactly the same. When I had the last MRI, I found it stressful and tiring, this time I was fine and energised when I emerged.

I think the elements of the exercise have to be

A) Something we know extremely well and we can recite without getting confused or losing our place.
B) A degree of counting
C) Something we associate with calmness and safety
D) Something we can focus on

I have found something that works very well for me. As I drove back, I pondered on the effect. For those of us from religious backgrounds, many of us will fall back on prayer in times of extreme stress. I believe we have programmed ourselves to be calmed by such things. The point as far as I'm concerned is not whether these things are rational or logical, it is whether they help us get through.  

What disturbs me about the health service is just how little help we are given with the psychological side of dealing with life threatening illnesses and the procedures we are subjected to. Given that in this country most patients have to hang around for a while before they actually get the procedure, surely some sort of advice sheet on how to cope with the claustrophobia and the effects of the noise would be a good idea? If it saved 10% of the time spent on rescanning, that would make a huge difference across the whole NHS. 

The problem I had writing this blog is that I wanted to try and give a few pointers as to how to cope with the experience, which anyone could use, yet I suspected the mechanism I used would not work for many people for a whole host of reasons. That is why I'm asking anyone who has developed their own technique for how to suppress fidgets and coughs and how to avoid getting too stressed to leave a comment.

When it comes to my health (and with yours as well), I'd advise anyone to put their primary faith in modern medical science. I must stress that I wasn't praying for a miracle cure (that isn't the point at all), I was using the tools I have to deal with a problem I had. I sincerely hope that if you are having an MRI any time soon and you read this blog, you take something useful from it. Make sure you are mentally prepared.


Lindsay said...

Been there - done that! (Not on prostate though!) Also had nuclear scans one after another adding up to over 75 minutes! Thinking is certainly the way to get through. What you think about is up to you, but positive thoughts do the job: happy thoughts of lying on a warm beach by a blue sea, or perhaps visualising those pesky cancer cells shrivelling up and going away, or maybe a mixture of both? I was surprised how quickly the time went actually! Next time,(for me that's in May) I'll try and plan a new novel!

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