For more information, contact

Mary Pat Elsen

Community Relations Director

St. Clare Hospital

707 14^th Street

Baraboo, WI 53913

608-356-1551

608-356-1367 (fax)

Mary_Pat_Elsen@ssmhc.com

A certain singing nanny suggests “a spoonful of sugar to help the medicine go down,” but that sweet solution would do little to calm the nerves of people who suffer from claustrophobia and other anxious reactions to diagnostic exams.

 For example, undergoing a magnetic resonance imaging (MRI) or computed tomography (CT) exam can evoke anxiety in some people to the point that they cannot remain still, as the procedure requires. The Medical Imaging Department at St. Clare Hospital and Health Services offers a variety of options to help those patients relax so they can complete the diagnostic tests they need.

People who have undergone an MRI previously may be relieved to find that St. Clare’s equipment is less confining and has a shorter “bore” than a mobile unit, explains Larry Skwor, Director of Medical Imaging. The bore is the tunnel-like area where patients lay.

Many patients find they have fewer anxieties with the larger unit, but some are still too anxious to lie still in close confinement for several minutes. In that case, the medical imaging staff can offer several options, including a headset playing music to distract them and give them something else on which to focus. In some cases, the technologist may also offer soft pliable eye pillows.

Some patients schedule a “practice run” of the exam to assess how well they can tolerate the test, Skwor says. St. Clare employee Barb Krueger, who works in the medical library, was able to get through the MRI procedure after a test run.

“I have some real apprehensions about being in a confined space, but I didn’t want to take medication if I didn’t have to,” Krueger explains. So, three days before her exam was scheduled, she reported to the Medical Imaging Department for a practice run.

“They gave me a headset so I could listen to music and a pad to place over my eyes, which was soothing,” she says. “And I could feel air circulating through the enclosure, which made it seem a lot less confining.”

In addition, Krueger was given a handheld device to alert the technologist if she had questions or concerns. “That sudden feeling that you need to get out, that you can’t breathe, can be overwhelming,” Krueger says. “But with that button in my hand, I had the feeling I was in control and that brought my anxiety level down.”

Baraboo resident Mary Farrell-Stieve experienced a similar benefit from a handheld control when she underwent an MRI exam several years ago. But more recently, at St. Clare to undergo an MRI to help diagnose the cause of seizures she had been suffering, Farrell-Stieve suffered another seizure that prevented her from completing the exam.

Her physician determined that Farrell-Stieve would be a good candidate for light sedation during the MRI, so she returned to St. Clare a couple days later and this time made it through the exam successfully.

“I was conscious and aware throughout the procedure,” she says. “Everything proceeded normally and without complications.”

Several options involving the use of medication are available for anxious patients or those with potential complications, like Farrell-Stieve, explains Al Garven, St. Clare’s Director of Anesthesia and Cardiopulmonary Services.

Various levels of medication or anesthesia may be administered to make patients comfortable during exams that range from endoscopies and colonoscopies to medical imaging tests such as MRI and CT scans. Even x-rays can be uncomfortable for patients in certain conditions, Garven notes.

The physician may prescribe an antianxiety medication for the patient to take orally before arriving for an exam. If further help is needed to keep the patient calm, specially trained nurses administer low doses of medication intravenously in a procedure known as “moderate sedation.” For patients who are extremely anxious, an anesthetist administers other medications to induce “deep sedation.”

“Our goal is to make the patient comfortable, calm and able to get through the procedure and return as quickly as possible to a normal state with as little medication as possible,” Garven explains.

For some diagnostic tests, the patient needs to be conscious to respond to the physician’s or technologist’s questions. Medications used in these procedures permit patients to be “comfortable but responsive,” Garven says. Depending on the type of procedure and sedation administered, patients may not remember what happened during the exam when the effects of the medication wear off.

Skwor urges people who know they are claustrophobic or who have had anxious reactions in confined spaces in the past to talk to their physicians about options.  “We are very concerned about the comfort of our patients,” he says.  “They should not be anxious or afraid.”

The need for tests to identify a potential medical problem can be a cause for concern, and emotional and physical reactions to the diagnostic tests themselves can make people even more anxious. In Farrell-Stieve’s case, the sedation option allowed her to undergo a necessary diagnostic exam she might not have been able to complete otherwise.

“I was very comfortable, very calm, very relaxed,” she says. “There’s a definite benefit to that.”