THUNK THUNK THUNK THUNK
BRRZZT BRRZZT BRRZZT BRRZZT BRRZZT
The sounds are deafening, but more than that, you feel them vibrate every inch of your body. Invisible signals are being sent through you by the coils of incredibly powerful magnets trying to make a picture of your brain and spinal cord, trying to see if your body is fighting against you. You lie motionless on the table, your head is “cushioned” in place with a cage over your face. A tiny mirror is meant to comfort you as it shows you the room beyond your feet.
DZZZZZ DZZZZZ DZZZZZ DZZZZZ
If you reach out to touch the tube you’ve been shuttled into you’ll feel the cold plastic and realise that you can’t straighten your arms, the tube is too small. It feels like you’re in a torpedo chute. You’ll notice the alarm button they gave you to hold in your hand, you can press it if you aren’t coping with the claustrophobic space you’re stuck in and they’ll get you out. But you’ll just have to go back in. They need those pictures.
TCK TCK TCK TCK TCK BRZT BRZT BRZT
Despite the headphones with Queens “bohemian rhapsody” playing today, and the ear plugs they kindly squashed into your ears, the noise is inescapable. Your whole body shakes with every noise, if the soul could be rattled about this would do it. There was a time headphones weren’t an option.
Our bodies are mostly water and those molecules contain hydrogen nuclei (protons). These hydrogen protons are slightly magnetic, meaning we are slightly magnetic. An MRI machine uses this feature of ours. Filled with coils of powerful magnets, the MRI produces a strong magnetic field (a thousand times the strength of a fridge magnet, or 30-60 thousand times stronger than the magnetic field of the earth!) that forces these hydrogen protons in our body to align with that field. A radio-frequency current is then pulsed which varies that magnetic field. The protons absorb the energy from the magnetic field and change how they move, changing their magnetic alignment. In very simplistic terms, the MRI sensors detect these changes in the way the protons move and create images of our bodies. The way the protons move is also dictated by the nature of the molecules, that is, the nature of our tissues – different organs, bone versus cartilage, undamaged and damaged areas will look differently to the surrounding tissues and will have differing magnetic properties. It’s these differences in the behaviour of the magnetic hydrogen protons in our body tissues is what allows doctors to detect significant changes, like the development of lesions from dymelination events in multiple sclerosis, or a brain tumour, or damaged ligaments. Those big powerful coils vibrating, pulsing inside the MRI, the variations in the radio-frequencies they use to help image different parts of the body better, make the loud banging noises that are unmistakable. Technicians can change the frequencies that permeate your body to see slightly different things, for instance one sequence called “FLAIR” removes the effects of your cerebrospinal fluid from the scans which makes multiple sclerosis lesions easier to see. Each pulse sequence will create it’s own waveform, it’s own sound, which is why you may hear a variety when in the machine. For those who have never experienced it they can reach over 120 decibels, the equivalent of a balloon being popped next to your ear.
I remember during my first MRI I struggled. I closed my eyes and tried to count my breaths. The thought of the damage they could be finding, the future I could be headed to, the weight of this disease that I might have was crushing me, more than the tight space of this tiny tube. I closed my eyes harder but it only squeezed out tears. It felt so cold, so impersonal, so routine. But this was new for me and terrifying. All those negative “what if’s” swirled around my mind like a vicious whirlpool; I felt like I was drowning.
Part way through they come to inject you with a contrast agent. This dye, usually a metal called Gadolinium, improves the visibility of our tissues by changing the rate at which the protons move. About an hour later they pull you out. You haven’t been launched into space, but you’re shuttled back to the change room in your revealingly thin gown to redress and wait for the images. Not that you can read or understand the images, you’ll have to wait for the neurologist to explain those results to you. But you have to wait.
The first few times in the MRI machine can be scary. The noises, the coldness, the gravity of your disease bearing down on you. But, as with my infusions I’ve redirected my approach and thinking. This is an incredible machine that without which my MS would have gone on undiagnosed. This process is essential to monitor the progress of my disease, without it I wouldn’t know for sure if my medications or lifestyle changes were having a positive impact. This hour of the day, once every 6 months, is complete “me” time. This is another moment where there are no demands upon me from anyone else. This is a designated period of time where I must do nothing, so why not take advantage of it?
Now, I look forward to my MRI’s, as I do to my infusions. I can recite the spiel back to the technician as he preps me for the process. I lay back, he asks if I want to hear the radio through the headphones, and covers me in a nice warm blanket. I slide into my machine, close my eyes and begin to meditate. I count my breathes, I practice mindfulness, I hear my mantra even over the banging of the MRI. I feel the pulses move through me and I’m relaxed. It is such an all encompassing sensation that I can’t help but feel that my very soul is being massaged by this misunderstood brute. At the end of my hour they pull me from machine, but I don’t want to go. This is a moment of solitude, a moment to myself. I am relaxed, warm, comfortable. But, I must go. I must go and wait for the results, which is another journey of it’s own.