How To Get Your Doctor To Order An Mri

Although I'm in good health, I'm surprisingly injury-prone. I pull or strain at least one body part every year, and I'm on a first-name basis with everyone at the local physical therapy practice. I've also had three MRIs done so far—one on my left shoulder, one on my left hamstring, and one on my left thumb. (Maybe I should just do less with my left side?)

Getting scanned isn't my favorite thing to do, as I happen to be claustrophobic and the MRI machine is not known for its roominess. But I know that this test helps my doctor assess the extent of my injuries, as it uses magnetic fields to create high-definition pictures of my organs and tissues. (MRI stands for magnetic resonance imaging.) MRIs are also used to help diagnose infections, tumors, strokes, and more.

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I was pretty anxious before my first scan, but it wasn't as bad as I expected. Yes, you're pushed into a tube not much bigger than your body, and you're stuck in there for up to an hour. But I managed to survive (three times) relatively unscathed. (Still worried after reading this? Here are 4 scary health tests made easy.) If you're facing an MRI in the near future or you're just curious, here's what you should know.

You'll have to de-jewel yourself.
Got earrings or a gold watch? Leave those at home or in the dressing room. You'll also have to take off any clothing that contains zippers, hooks, or buttons (you'll get a gown). Techs even discourage makeup and other cosmetics because they may contain metallic particles. That's because the MRI machine creates a powerful magnetic field that can dislodge and move metal. If you have a pacemaker or implant that may contain metal, be sure to alert your doctor ahead of time and remind the MRI tech.

You might get an injection or have to drink a solution.
Sometimes a "dye" is used to help certain organs, vessels, or tissues show up more clearly on an MRI. If your doctor says this is necessary, you'll be given an IV injection, enema, or oral solution before the scan gets started.

You can listen to tunes.

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For at least one of my MRIs, I wore a pair of headphones and listened to music that was piped in by my MRI technician. I got to choose the genre; in some facilities, you can choose your favorite radio station. This gave me something to concentrate on aside from what was actually happening (which helps with staying calm). In some cases, you may be able to use goggles to watch something other than the inside of the MRI tube.

You may not have to go all the way into the tube.
For two of my MRIs, I was inserted into the MRI tube feet-first. So while my body was in the machine, my head was out in the open, which I much preferred. Ask the tech which way you'll be configured.

You'll be posed.
The MRI techs need a clear view of the body part they're scanning, and they may use straps and bolsters to prop you so they can get a clear view. This may feel a little awkward, but it's generally not super-uncomfortable (a good thing since you'll have to hold the position for quite a while).

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There are open-tube options.
If you're uber-claustrophobic, you might consider seeking out an "open" MRI. This machine is U-shaped instead of a closed tube, but it might be similarly narrow and the image quality might be poor. "A lot of the open MRIs don't have the same degree of imaging capacity," so your doc might not get the clinical information that he needs, says James Rawson, MD, chair of the American College of Radiology Patient and Family Centered Care Commission.

You can take drugs.

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If the idea of an MRI is stressing you out significantly, ask your doctor if you can get a prescription to take the edge off. "We often give patients Valium so they can be awake and able to cooperate during the exam but relaxed enough so the tight space doesn't bother them," Rawson says. Just keep in mind that if you take Valium or one of its cousins, you'll need someone to drive you home after the test. (Here are more health test secrets doctors don't tell you.)

It's not quiet in there.
Being inside an MRI machine can feel like being in a clothes dryer full of tennis balls. Don't worry, all the knocking noises are totally normal. You can wear ear plugs if the sound bugs you, and you can communicate with the MRI tech via intercom during the scan.

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You can keep your eyes closed.
Some people (including me) just close their eyes before they're inserted into the tube and keep them closed throughout the test. If you don't see the tube, the rationale goes, you aren't really in the tube. Just pretend you're on the beach. A noisy beach with a lot of knocking sounds.

But you must stay awake.

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This is trickier than it sounds, since you're supposed to hold absolutely still and you may have closed your eyes. But if you doze off, your body may twitch or move, which can make the images blurry and necessitate a do-over. You also need to be alert enough to comply with any breathing instructions. (You might have to hold your breath for 15-25 seconds at a time during a chest or stomach scan.)

You get breaks.
An MRI generally lasts 30 to 60 minutes, but the images are taken in a series of sets. Most sets last a few minutes, and during that time you'll have to stay perfectly still or risk blurring all the images from that round. Your technician will probably tell you when one set of images has been taken and another is about to begin, so you'll have a moment to scratch your nose or wiggle a foot that has fallen asleep.

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There's a panic button.
If you really do need to get out of the machine in a hurry, don't just wriggle yourself out like a worm. The MRI folks often give you a button you can punch if you start to lose it. Says Rawson: "For some patients, having that degree of control makes the exam much less intimidating."

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