Open MRI vs. Closed MRI for the Bipolar Patient

Posted by Barbara Steinberg on March 26, 2008 at 3:00am

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Magnetic Resonance Imaging has excellent soft-tissue contrast, so it is one of the best tools to help a doctor diagnose an injury in a limb.

Low-functioning bipolar patients usually have a number of other conditions and have accidents easily. My partner James deals with claustrophobia. When James hurt his arm carrying something too heavy, he had intense pain in his shoulder and needed an MRI.

First he tried a closed one. You can see what they look like here. They are tubes a patient must stay in for almost a half an hour. James had a panic attack of claustrophobia, and he could not do the test.

So we found another option: an Open MRI. Here is what they look like. Here he did beautifully, although there was pain for the last 10 minutes of the test. I held his hand. But the open MRI allowed us to get the pictures needed for the doctor to diagnose tendonitis of the bicep.

Another complication was that James cannot take an ibuprofen because a side effect is lithium toxicity. Also, too much of the pain killer hydrocodone gave him the side effect of breathing problems, which made us have to go to the emergency room because he got very frightened. Those side effects dissipated in time. However, today, he got his shoulder treated with a shot of hydrocortisone, and his pain is much better.

Although all patients are different and must consult their doctor, for us, an open MRI and a shot of hydrocortisone worked. And just as an act of human kindness, I would never put a serious mentally ill patient prone to delusions (bipolar or schizophrenic) in a closed tube for a half an hour.

Tags: opem-mri, tendonitis, claustrophobia, hydrocodone, bipolar-disorder, closed-mri, hydrocortisone

Comment by Debbie on March 26, 2008 at 7:38am: Delete Comment Barbara,

I don't suffer claustrophobia, but with the brain tumor the only way to correctly diagnose it was with MRI. I have got to tell you I didn't like it one bit, the space wasn't the issue for me, it was all the banging of the magnets and shaking of the big enclosed machine that had me scared to death I was going to be crushed or killed in it. I wish all hospitals would go to the open MRI units as they don't look so intimidating. Now I will confess, I am supposed to go regularly for MRI's due to the tumor being so large and having tentacles that had to be left so I had some normalcy of life but I haven't been back in years. The way I see it I will know as the headaches will start again, I lived with them for 11 years non stop. When that happens I will go, but not until. I also have this huge fear of the needles that are used with contrast. I am not sure why such a small thing scares me so badly but to have blood drawn is a huge feat! I used to take one of my kids to show them it was ok and didn't hurt...now they are grown and Ezra just isn't like they were to be able to stand there and watch this so taking him scares me more than the needle.

Comment by Barbara Steinberg on March 26, 2008 at 11:21am: Delete Comment Oh my God, there is banging in the closed-in tube? Can you imagine someone with schizophrenic delusions hearing banging in a closed tube for 1/2 hour? My friend Anne, whom I'm desperately trying to get to join, nursed her husband Howie through his brain tumor. I told her you commented.

I understand you not wanting to go through the torture of these tests, and I know a lot of people, including me, who are devastatingly fearful of needles. It actually has a name! Needlephobia! It is also called Belonephobia. I found some good information on it. Maybe it will help.

http://www.needlephobia.co.uk/
http://www.medscape.com/viewarticle/555513

The sites say the fear can start in childhood, and distractions might help. But I know many people who don't get the right tests and the right time because of this phobia. There are some cases, where patients won't accept pain medication via needle after surgery, so you're describing a very real problem.

Comment by Paula on March 26, 2008 at 11:54am: Delete Comment I have had a closed MRI and I must say it seemed to go on for an eternity. I was getting a MRI of my knee but still had to go all the way in. My biggest problem was I couldn't sit completely still. You can't even tap your fingers or it causes issues. I was constantly being told to stop moving and couldn't figure out what I was doing that was such an issue. Come to find out it was just a simple tapping of my fingers that was causing the problems.

As far as the banging.. when I got my MRI I had headphones and they played very loud music into them so a lot of that noise was muffled. However, when my son got an MRI at 8 months because of seizures I was there beside him outside the tube and I have never heard such noise in my life. My husband and I couldn't even talk to each other because it was so loud. He was completely sedated thankfully or I don't see how he could have went through the test just from a noise standpoint.

My mother had severe claustrophobia and anxiety issues. When she was diagnosed with cancer she had to get an MRI. Unfortunately her hospital did not have an open unit. She had to be heavily sedated to even go through the test. They tried it once without her being sedated enough and she completely freaked out and they couldn't complete the test. If you asked my mother what was the hardest part about her cancer you would think she would have said chemo but she would tell you time and time again it was all the tests, especially the MRI.

Debbie, I have a pretty bad needle phobia as well. I feel for you as this is a very real fear for me. I'm talking major anxiety to the point that I usually pass out.

Comment by Debbie on March 27, 2008 at 9:45am: Delete Comment Barbara,

Tell your friend to come on over! I love talking with other people who have been the tumor route, as you know with anything people can empathize but no one knows for sure what you go through until they go through it themselves! Family come closest to knowing how the patient feels.

The needle thing is a real fear, I won't take any medication after any surgery including the brain surgery unless it was in pill form, I even was hurting so badly I was nasty to the nurses saying what part of pill and water are you not understanding, I am the one who had brain surgery and I understand just fine! LOL I have no clue how they lived with me.

Paula,

Talking of passing out, my husband still doesn't let me live this down, when we got married they still did blood tests in our area, I turned as white as the walls behind me and my ears were ringing along with room spinning. I keep telling him it was God's way of telling me he wasn't for me...LOL But honestly that is how I get. Last Thursday I had to have blood drawn and I did ok, not as I would have liked though.

Now to both of you, our MRI machine is portable on a truck as it goes to several hospitals in the area, so when I talk of moving I am being literal, the whole truck moves and I honestly felt like I was going to be seasick! That is a very scary thing, at Morgantown they are inside the hospital so I didn't feel like I was moving but the noise was still horrendous. I wish they would have given me earphones! I can remember I was laying there praying as that is how I get through scary things and being Catholic there are standard prayers, it was so loud I couldn't remember where I was in the prayer and had to start over many times.