Kids Were Terrified of Getting MRIs. Then One Man Figured Out a Better Way
slate.com
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As for the noise (that other people were flippantly dismissing), it really can be jarring. Cover your ears with your hands, with your fingers pointed towards the back of your head at about at 45 degree upward angle. Then, repeatedly bang your head with your middle fingers while your ears are still covered. That's roughly the a quieter version of one of the more unsettling sounds.
I'm quite used to it -- to the point that I always ask the tech to tape my head in case I fall asleep and move -- but still. That sound is not just the rhythm backing a techno song; it's the sound of parts swirling around you with massive energy.
It maybe safe, but so are roller coasters. Yet, while you go on a roller coaster looking for a thrill, you enter an MRI machine with the very real fear that something could be very wrong with you. That's not going to make for a pleasant experience. And, it's not surprising that that underlying fear might be projected elsewhere.
you're in a fight. you want to win. you don't hate the guy that's giving you the good data.
sorry if that doesn't help. i'm not trying to bash you. i'm just trying to show there's an alternative. i'm as scared as anyone when i open the envelope. but those machines have helped me a lot....
[also, as physics machines, they're pretty awesome. if you're an engineer or scientist and don't know how they work, read up on them. they have huge supercooled magnets that flip the nuclei of atoms. it's amazing stuff. despite the noise there's nothing moving - that's just the coils shifting as the fields / current change (and maybe the chug chug chug of a cooler / vacuum pump). you're basically lying inside a human sized speaker coil!]
I am not someone who generally suffers from claustrophobia, but as a tall person (6ft 5in) who is by no means fat, I can honestly say it was one of the worst things I've had to do. My shoulders are broad enough that it felt as if I was uncomfortably wedged within the machine, and that I was far enough inside the machine that should something go wrong it would be impossible for me to get out unassisted.
Perhaps it wasn't so much claustrophobia in my case, more my total dependence on someone else to get out. I am definitely not looking to go through that experience again any time soon.
I think there are definitely things that can be done to improve the experience.
Also worth noting: I do realise that these machines come in different sizes, but they are also expensive to purchase (replace), so I am not holding my breath for regular updates at every hospital when they can add another inch to the diameter of the chamber.
Medical-tech-in-a-past-life here. I think it's more that the sicker people are, that both they have more experience with getting tests, and they're more interested in fixing the problem than feeding on the attention. Really sick people are tired of being sick - a test at a hospital is not a highlight of the day, but a drudge. It was rare, though not unknown, to see either a very sick person or a long-term sufferer make a fuss in my experience.
Someone who does make a fuss could very well be genuinely sick, but usually they hadn't really mentally accepted that fact yet.
1) Open Standards: Images need to be shared from any hospital or lab to any doctor via internet! I had to go through the scan praying that there wasn't a new tumor or that the tumor was small etc... Wait 15 minutes for the CDs to be printed and my son was in pain and just wanted to go home. OR I forget and have to go through an hour or two days to get a copy BEFORE I can see the doctor. Also doctors should feel comfortable using whatever program they want to view MRI or CT scans!
2) Video: My son loved going to one hospital because they had a video player that went over his eyes! Awesome lets raise the money to get one at our local hospital. it cost over $40,000 :(. Really????
3) Open MRI systems are great. http://www.mrispecialists.net/Equipment.shtml
Open standards would be awesome. I thankfully went through treatment at an integrated system so everything was just "in the system" for all of my doctors, but if I were hopping around between systems that would be extremely useful.
As far as the video thing, the only reason I can imagine is because MRIs are basically huge magnets so they have to build the whole thing out of non-ferrous materials. Plus the customary medical equipment mark up, but still that can't actually be $40k.
There is another solution, which is to use a reflective surface at 45 degrees to your eyes and a video projector the other end of the room focused down the scanner. A few years ago I volunteered for a functional MRI brain scan which required me to watch various video clips, that's how they did it for me. I guess it might be slightly cheaper, but knowing medical equipment maybe not.
Lay in this tunnel. You're immobilized and can't move. Oh and no one can hear you call for help because of the loud jack-hammer like sounds. Wear these head-phones and we'll blast music into them so you'll feel better. Squeeze this little thing if you panic and we may come and help you.
On the other hand, the stance I had to adopt (even though lying down) meant I had to support the weight of my arms from shoulder to wrist, and after a while this became uncomfortable and caused them to shake a bit, at which point the MRI team thought I was freaking out - which I wasn't. Maybe this was just down to bad packing and could have been avoided.
The aircon in the room had also failed so I had a combined MRI and sauna; which meant the sensor pads kept coming unstuck and so I kept 'flatlining' and had to be removed from the scanner a couple of times for more bits of surgical tape.
Do you also avoid sleeping?
I had an MRI done and it took about 5 minutes to just gather in all the details of the situation. After that it was okay.
To be honest, the only time I had to go through this, I was not scared about anything else than the possible result of the scan, but the noise was disturbing at best.
It's a science machine to see inside your body without cutting you up. If a theme park offered MRI rides I'd be in there all day.
I've had two MRIs. One with Xanex, one without. I actually enjoy the sound of the machine, it can be rhythmic and pleasing.
The only time I had an MRI without Xanex, was a religious experience. Things were going well for 20 minutes (they had me in for just under an hour total) and then the thoughts of how people die in MRI machines came on strong. I'd seen a few videos of how strong they are [0] and the thought of being crushed or otherwise mutilated by a million dollar magnet, along with the confined space, was too much. I felt panic coming from a mile away, and it engulfed me. My brain was telling me to 'get the fuck outta here!'. I knew it was irrational fear. I took labored breaths. The fear moved from my feet to the top of my head and exploded. The pulse oximeter must have been going crazy because the tech asked how I was doing. "I'm fine." The lie worked, the fear immediately dissipated and a wave of euphoria rushed over me. I'm not going to die. I'm going to live! What should I do with my life? The best I can. I fell asleep a few minutes later. I woke up feeling fantastic.
The cute pictures, etc. definitely help, at least with kids. But the real improvement would be a 5-min intro to the patient, perhaps a simple video clip, explaining the technology to put them at ease. Just reading his description of the response of the technician to the child's fear, you can see that it could have been handled much better.
Well, at least not without leaving out the "1 ton magnet spinning around you at crazy speeds" part.
In any case, everybody goint into one of these things should at least be told that the machine works without ionizing radiation, i.e.: "Unlike a CT scanner, you are not at risk of getting cancer from this."
Maybe that puts at least some people at ease.
I don't know from this story when Doug had his epiphany. But by 2005 it was becoming increasingly common to skin the MRI and even whole rooms. It became clear that you could get better results with a friendlier room and machine. But the bigger difference was an explicit training session. Kids are seldom told to lay absolutely still and for no apparent reason. The challenge was understanding that as the problem to be overcome. The design helped wrap the experience and the memory.
To reduce the noise, I wonder why they haven't investigated active noise cancelling like the engine mounts used by some auto makers. The computer introduces waveforms that are the inverse of the frequencies they want to reduce. Or at least added mass to panels that conduct noise, using material like Dynamat eXtreme (common in car audio).
I do think that active noise cancellation is a brilliant tool for solving many repetitive noise issues ( I explored its use in a server room, dual purpose was, if anything was 'wrong', I could hear the room get louder as the fans lost sync with the inverse waveform. )
However given the sensitive nature of the machines, I wonder if there would be any issues caused by projecting loud inverse waves into the room the machines operate, since it would be very strange if these equipment manufacturers didn't explore the active noise cancellation technology as a way to mitigate the ear splittingly loud noise they produce.
The other one is in the engine mounts, where they have a liquid inside the rubber mount that can stiffen up on command (maybe magnetorheological[1], maybe some other kind), and this is used to counteract the vibrations the engine would transmit to the body/chassis. This is controlled by the ECU because it knows when the engine is on a power stroke and can thus apply correction on a timing basis.
I would think the latter would be what the MRI makers would want to investigate -- they've got a huge spinning mass[2] with components that vibrate. Much like an engine. :)
[1] http://en.wikipedia.org/wiki/Magnetorheological_damper
[2] At work, so can't post a video link, but if you look for "cover off mri" it's really scary/impressive how they work.
I've had two MRIs when I was a child. For some reason the "thunks" are relaxing to me and I fell asleep during both procedures. I even pressed the "panic button" by mistake when I had a sleep spasm! MRIs are nap time for me :)
Add to that feeling very ill and weak and having a headache. The thunks are equally likely to be experienced as a pleasant rhythmic music or cause your head to spin and make you throwup.
Things that appear trivial and insignificant can cause a great deal of discomfort for people. I actually felt anguish because of a cracked ceiling for example (you're stuck looking at it for days).
I get why people might be scared, but I just don't, and can't see the scary in MRIs. I can fear the outcome, but not the procedure itself.
I'm just curious about what's scary about it. Perhaps fear of the unknown? I knew why that machine was making those noises (my dad was cool and he taught me the basics about MRI machines). Or is just a personality trait, just like fear of cockroaches?
Its why they are called feelings and not thinkies. :) You're ill, it makes it sucks more somehow.
This decal idea in the article takes the drama out of it I suppose is the best explanation I could offer.
I see opportunities for gamification quite often. If we took any tedious or daunting task and broke it down into a fun, easy, and simple problem for everyone, society in general would benefit from a harvesting a lot of wasted productivity.
Instead of seeing dozens of people on the subway playing Candy Crush, if they enjoyed answering questions on StackOverflow just as equally, how much faster could we advance our knowledge and solve unique problems?
One of the worst things about web-based businesses is that the people working on them are cut off from a vast amount of data about their users. It's a giant broken feedback loop, and I'm glad that user-centered approaches like this are getting developers to realize that great benefits come from reconnecting with their users.
Then when they came out they might really believe it and be thrilled. This would help for the next visit. Though it might be disappointing to figure out years later.
In medical school I worked with a pediatrician who had a patient brought by her mother, a foreign physician. She had told her daughter she was taking her to visit "a friend" to help reduce the time that she would worry about shots and other unpleasantries.
The physician, upon hearing her ruse, explained the ethical landscape in the United States and referred the family to a different doctor, feeling that he would never be able to restore the bond of trust that the mother had frayed.
I do agree with the example you give tho, that truly is a blatant deterioration or trust. I don't feel that this is on the same level of destructive misrepresentation.
I imagined it more like having the child trust the doctor because its a friend of his parents, as opposed to a 'stranger'.
http://futuramarama.tumblr.com/post/92077790/ooh-whats-this-...
On topic: His solution was pretty smart. One of those elegant solutions that seem obvious in retrospect. Hopefully it helps make the process a lot less stressful for some kids.
It's a tight space, and the device is noisy. Pretty much designed to trigger these emotions, even though I knew it wasn't dangerous.
Second time I almost fell asleep.
MRI machines are incredibly loud and "thunk" repeatedly.
Yeah, MRI's aren't exactly risk free "adventures".
Only Wolverine is at risk in that regard.
Unless you're planning on augmenting yourself like in Deus Ex I agree its not a big deal. But a big thing coming at you at high speed would ruin your day.
"It's a bit scary isn't it! Look, it's a big machine! It makes lots of loud noises, and you're in a little space. But it's an adventure!" changes expectations. You're allowed to have fear and express it. But you're allowed to enjoy it too.
> Just before the whirring and banging of the machine gets louder, the operator encourages young patients to listen closely for the moment that the craft “shifts into hyper-drive.” This reframing transforms a normally terrifying “BOOM-BOOM-BOOM” sound into just another part of the adventure.
It's like dressing up as a witch for Halloween, you know; there's a lot of horrifying history if you know about it, but if you don't, it's a black cape, a pointy hat, and lots of strained cackling, and little more.
Aye, aye Captain!
Medical equipment looks way too scary to children. It's all cold, white, sterile, and aluminum machinery. The smell of latex and alcohol don't help, and overall, the hospital seems like a very scary place. Heart monitors beeping every minute, weird blipped lines on EKG machines, and electrodes attached to your chest: is this a healing center or a torture prison?
Sedation is the problem with healthcare exemplified. Instead of creating a hospitable (no pun intended) pediatric environment that's comfortable for kids, knock 'em out and bombard them with EM radiation. That's sure to make the kid and the parents more comfortable.
Hospitals need to be designed with a human factor. The way they're designed right now makes them seem like robotics factories.
Huge props to Doug for trying to change the medical landscape to make it more comfortable for younger children. I was hospitalized several times as a young child, and I used to be terrified every single time. I know I would have appreciated this level of attention to design. I know many other children who need medical attention will too.