Anesthesiology/MRI PANIC and anesthesia
Dear Dr. Levy,
I read an interesting Q&A here that you answered about being able to get anesth such as Versed (or, the same type meds you would use for an endoscopy or colonoscopy). About a year ago I was unable to complete a needed MRI on my C spine (tube type), and I have had many of these things in the past with no problem, but it had been about 25 years since I'd been in a tube type MRI. I failed due to panic. I have never reacted like this before, and I do believe that it began after waking during CABG surgery in 2006, but had no idea I'd react that way about imaging until the first CAT scan a couple of years later. And then last week I tried the neck MRI again, in an open MRI, as well as going to Houston the next day for nuclear stress testing and failed for the first time ever, with the gamma camera scan. I have Prinzmetal's Angina (variant angina due to arterial spasm9+), and likely will need many of these over my life-time to come. I also need an abdominal CT scan because I have had stones in my kidneys for over a year waiting to get the OK from my cardio Dr. to be off my Effient post stent (June 2012) for a week each time I get shockwave lythotripsy and stents two weeks apart per side, but have had to put it off, yet again, due to the chest pain cycle for the moment. I can reschedule the neck MRI again and abdominal CT for the same day at the imaging place with the open MRI near me, but it won't work without anesth and I doubt they do it there, but will ask.
Can you please tell me of someplace that does MRI and stress with Versed type meds where I would be totally asleep like when I've had endoscopies and colonoscopies? I am not afraid of anything medical, was an EMT in the past, am very knowledgeable, but this problem is one I cannot take! I have no problems with anesth, am not in the least afraid, and will joke around with them right up to the time I start to count backward :) PA attacks can be brought on by stress and high emotions, which I am told to avoid, yet when I failed my stress imaging the other day my Dr. (who was somewhere nearby waiting for me to get to the chemical stress part) wouldn't order anything for sedation. All I could do was leave. Same thing last year when he ordered the MRI of my neck; I failed, then a few days later he Rx'd a couple of Xanax, which I took before the next MRI attempt, and it was no help.
Please advise, and know that I very much appreciate your time!
Sally In Livingston
Most academic teaching hospitals will do MRI with sedation although I cannot speak specifically about any particular hospital since I don't work there. I know that my hospital does them but if you want it done in Houston, I would suggest calling up the various facilities and asking if they do MRIs with sedation.
Ronald Levy, MD
Professor of Anesthesiology