PET scan and MRI; what to expect.

I’ve just had an MRI and a PET scan on successive days in the ongoing diagnostics for the cancer. The two scans are strangely familiar, yet there are a couple of differences that you should be aware of. Let me just step you through my experience.

MRI: Grey Nuns Hospital, Edmonton. I was asked to strip to my knickers and socks, and was provided with the obligatory hospital pajama bottoms and wrap-around-but-tie-at-the-back smock. All my jewellery was removed. I was queried about dental work, tattoos, stents, shunts, piercings and anything metal that may have been introduced into my body. I was very surprised when I was told that there would be a contrast dye introduced intravenously during the scan. I was even more surprised when the intravenous was placed (or poked!) by an inept MRI technician, which isn’t to say that he was inept as a technician but he sure left a lot to be desired as an IV tech.

I lay on the moving bed of the MRI, head towards the machine. They attached a collar to hold my neck, put headphones on me to minimize the noise of the machine, which actually slotted into the bed thereby positioning my head. They then added a head piece that had adjustable screws which further restricted the motion of my head. I had them back off the tension at one point. I was given the option of radio through the headsets, but they couldn’t get the volume right, so, after some frustration from the young woman who was trying to get it to work, we went without it.

Oh, by the way, the MRI had a prism in the headpiece that allowed me to see the techs in the control room, and I was given an emergency call button to hold, and use as necessary. I did use it at one point to tell them to turn down the damned radio.

The scan itself is not one continuous scan… it is a series of two and three minute bursts. The tech that was controlling my scans kept forgetting to warn me when one was starting, and therefore I got caught needing to swallow part way through a scan, and they had to re shoot a couple. Don’t MOVE when they are scanning. Ensure that they give you time to get comfortable at the very beginning. Be forceful about it. You are not going to be given an opportunity to adjust once they get started.
The machine bangs, and whirs, and thumps and hums. This thing is NOISY! You’d think that for the cost of one of these things they could develop a bloody muffler for it. Geez! Each position that they took the shots from had a slightly different sound. If I’d have realized that, I could have made a bit of a game out of trying to identify the number of different sounds it used.

The contract dye that was injected really poses no significant problems; it was just a bit of a surprise that they needed it.

PET Scan: University Hospital, Edmonton, AB. This experience started with a biggee sized glass of water with a very small amount of contrast something-or-other to coat my intestines; first confirmation that this was going to be a full body scan. The water was tepid, and had no real ‘taste’, but a kind of aftertaste. Not unpleasant.

After having read seven pages of disclaimer about the contrast material, which is a radioactive glucose, I was then invited to strip down to my knickers and socks. Hospital pajama bottoms, hospital smock and (bonus!) a hospital dressing gown. The only jewellery that had to go was my silver necklace and medallion.

Also for this test was the IV, handled much better by this team than the one at the Grey Nuns. The tech, Greg, then injected the radioactive material. He used a special device that shielded him from the radioactivity, regardless of how small, ’cause he is exposed to this stuff all the time; his rads exposure would be off the charts and he would be working as an orderly somewhere without this funny little, but very heavy, device.

And then I was told to relax for one hour, had the recliner I was seated in tipped back, was covered by a warm blanket, curtain pulled, lights dimmed AND THEY TOOK AWAY THE BOOK THAT I WAS READING! That one surprised me. Greg told me that the reason they don’t want you reading is that the optic muscles, when they work to read, can suck up more of the radioactive glucose and therefore give a false scan.

I must admit that I fell asleep, briefly.

I must also admit that the contrast material in the drink works as a ‘trigger’ on my digestive system. Within 40 minutes of finishing the water, I absolutely had to use the toilet. Very liquid stool; one time only and then my system was purged of the effects.

I was walked to the PET machine. Now, I mention that because I was told that some individuals will be tranq’ed to make it easier for them to lie motionless. Ativan seems to be the drug of choice. I suspect that this team avoids the use… there was no mention of it, and none of the other patients that were in the pipeline seemed to be getting any additional consideration.

Now, where the MRI seems to be done in burst of two and three minutes, with a brief break to inject the contrast media, PET appears to be a couple of extended scans.

The first block involved lying on my back, arms above my head. Make sure you are comfortable! Its surprising how the shoulders can cramp in this position. The second block (focusing on neck and head, I assume) allowed for me to cross my arms on my stomach.

Watch your legs; some folks can’t keep them still and straight, which affects the back and abdomen. I asked specifically if I could cross mine at the ankles, ’cause I know that I can relax in that position for long periods of time. It was ‘approved’ and I had absolutely no problem. In fact I was complimented on how still I managed to stay for the entire process…

Its all in the breathing. Focus on your breath… count ’em. One in, two out, three in, four out and so on until ten, and then start at one again. It seems to keep me relaxed, calm and, with the exception of the rising/falling chest, immobile.

The machine is virtually silent, with the exception of the brief sound of a jet engine warming up. I think that I only heard this sound twice in the entire time I was in the room, and never while I was inside the machine. For more information try http://www.radiologyinfo.org/en/info.cfm?pg=PET&bhcp=1

No emergency call button provided, but then again, the team was actively monitoring me as a person, speaking to me, checking to see if I was alright. Much better, reassuring environment than the MRI.

Now, one thing that the techs for both scans will ask you to do when they first line up the machine is to close your eyes. This is only necessary for a few moments as they pass your face under a laser alignment system. For both of my scans, I was able to keep my eyes open. I didn’t, but, hey, I could have.

Questions? Leave me a comment and I’ll see what I can come up…

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