Getting an MRI

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Six-year old and anesthesia for MRI

Aug 2009

My son who is six-years old may or may not have a spinal cord problem. Kaiser recommends an MRI but he would need to have full anesthesia. Has any parent experienced pediatric anesthesia through Kaiser? The MRI department was uninformative. They just told us to book the appointment and consult with our pediatrician. Naturally, we wanted to speak to the pediatric anesthesiologist first and make sure the correct dosage was given before the MRI? Has any parent had an MRI for their young child at Kaiser? Advice? Problems? Good, bad? Thank you very much.

We have had a number of experiences with the Oakland Kaiser pediatric anesthesia department, all of them excellent. One of the first was when my son (four years old at the time) needed an MRI. Here's what I can tell you: A pediatric anesthesiologist (Dr. Ken Zuckerman in this case) was there to answer our questions ahead of time and to monitor my son throughout the procedure. I got to go in to he MRI room with my son and stay with him while they got everything ready. I also got to be with him when he went under, thanks to some bubble-gum scented gas. The anesthesiologist explained everything as it was happening (it's a little scary to watch them go under), and became my liaison and the person I knew was watching over my child. It was a nerve-wracking experience, but one made much easier by a great anesthesiologist.

Our son also had 2 surgeries at Kaiser Oakland, as well as a bronchoscopy and a CT scan which required anesthesia. For both of the surgeries we had the same, very good nurse-anesthesiologist who seems to work with the pediatric surgeons. For the CT scan we had another pediatric anesthesiologist who was outstanding. They really have a special way with the kids. The dr. that was there for the CT was warm and kind, and he told my son stories while they were getting ready and as he went under. He stayed with him after, walking us up to and staying with my son in the recovery area.

I guess what I want to say is that the pediatric anesthesia team at Oakland made me feel comfortable and confident. They are good with kids, good with parents, and (the bottom line) got my son safely through a number of procedures. However, I would be very surprised if you got to meet your pediatric anesthesiologist ahead of time. What was important to me in evaluating the care my child was to receive was that the doc specialized in **pediatric** anesthesia (not adult or general) and were board certified. I came to the MRI with all my other questions in hand, which they were happy to answer. Frankly, if I really didn't like someone at that point I would have just left. There is also a Bay Area Pediatric Anesthesia Consortium (BAYPAC) that some of the docs belong to, they are very well established. Satisfied Parent

You want to second guess their dose of medication based on what knowledge or training? I'm a practicing pediatrician and would not feel qualified to do that. My son had an MRI at Kaiser Oakland when he was a newborn. I was quite comfortable knowing that they have pediatric anesthesiologists doing the sedation or anesthesia for the test. They have several years training in pediatric anesthesia after their training in anesthesia as a whole. No two people are exactly the same so there will always be some variability in how much medication is necessary to keep the child still, how long it takes the kid to wake up, etc. But this is their job -- they know how to dose anesthesia. Kate

MRI for 4-year-old for eye condition

March 2005

We are considering a brain MRI for our 4 1/2 yr old daughter, at Children's Hospital Oakland. It is being strongly reccommended by our neurologist, for an unexplained/ undiagnosed eye condition. She will need total sedation. Has anyone been through this? I haven't been able to find any info about possible adverse affects of the MRI, though there have been plenty of injuries due to unsafe metal objects accidently brought into the MR environment. I don't know if there have been any such accidents at Childrens. Any info, thoughts or experiences would be greatly appreciated. sheri

Our infant daughter had an MRI at Children's last month and it was absolutely fine. I was more concerned about the general anesthesia than I was about the MRI itself, but the doctors and nurses were very reassuring. Our pediatrician reminded me that the anesthesiologists at Children's do nothing but kids and babies and you couldn't ask for better trained and experienced people. Since then our daughter has had general anesthesia for another procedure that went off without a hitch and will have it yet again this next week. Unfortunately, our baby is quite sick, but we are happy to have Children's Hospital in our community!

As for the MRI itself, well, I didn't do any research about it. We just had to get in there quickly and get it done. So we did.

Hope this eases your mind a bit... Another concerned mom

Hi, I have had an MRI recently (I had meningitis). My first thought is: why does your daughter need total sedation? I would think that is much more dangerous than the MRI itself. If she is a good communicator (and from your email it sounds as if she may well be), I think you might be able to comfort her enough, by staying with her during the procedure, for her to handle the MRI in her normal conscious state without going under.

I was absolutely terrified before my MRI, which was of the brain, and involves putting your head in a sort of open helmet within a large donut of magnets. For me, it wasn't exactly a tunnel (the modern MRI machines are much less claustophobia- inducing than the ones you tend to see in movies!). In fact I was fine - a friend told me to visualise how the Dalai Lama would feel having an MRI, appreciating the wonders of modern science, and feeling very safe. So I spent the whole time day- dreaming about the mountains of the Himalayas, and found it quite meditative.

My daughter also had an MRI of her foot last year - this was done in an 'open' MRI unit, at no extra insurance cost. I sat beside her, and talked to her when she needed throughout. Her only complaint was that it was boring, staying still for 20 minutes. But the assistant put on her favorite 'Eagles' CD, and she was fine. She was 9, not 4, admittedly. But I think I could have got a 4 year old through the experience.

As to the dangers of metal flying around the room - I went in with my daughter, and had a good look at all the equipment in the room, and told the radiologist my concern. All metal objects are bolted to the floor. One metal canister was not bolted down, and I asked about this - and was told it was aluminium, and not magnetic, so there wasn't a problem.

As to the other dangers - to some extent there is an unknown here. The medical profession say that an MRI is much safer than X-rays. (This was why I chose an MRI rather than CT scan for my meningitis scan). It also gives a better picture of the brain for many situations. The 'donut' type, a very wide but short tunnel, open at both ends, apparently gives a better image than the 'open' MRIs, which are like great circular slabs above and below, but open all around. So I chose the donut type for myself. My doctor sent my daughter for the 'open' type.

Before any medical tests for my children I have to convince myself, using all the available information from my doctor, and all I can find, that the test is necessary. Then it's a matter of weighing up the risks.

One small point - about the helmet necessary for a brain MRI (I think they focus the magnetism in some way) - children have done well after being told they need a helmet 'like Luke in StarWars' - I don't know if that would help with a 4 year old though.

For me that was the most alarming part (putting on the helmet - you sort of slide in) - but I'm really quite claustrophobic, and it was OK, really, with an open donut type MRI. A friend stayed with me, and was able to hold my hand, and I arranged that if I panicked they would stop the procedure and wait until I felt able to continue. I didn't need to do this though.

Good luck with this; I hope that your daughter is well (that's the main thing), and that the test will be reassuring. J

Our 2.5 year old daughter had an MRI at Children's in December to rule out a brain tumor or cerebellar swelling. Ours was an emergency situation. She is perfectly fine now and the MRI conclusively ruled out the problems they were looking for.

The most difficult part was keeping her from eating or drinking for 8 hours prior to the procedure. We were admitted to the hospital and they drew blood and put a hep lock on her arm for the sedation during the MRI. That was not fun for her but the nurses were excellent and it was done quickly and efficiently. We were brought to our room and our neurologist, Dr. Davis explained the procedure to us. She was wonderful with our daughter and my very nervous husband.

We all went up to the MRI room and the anesthesiologist explained the process and again was great at addressing my husband's fears and concerns. They brought us to the room where they administer the anesthesia and I was there to hold my daughter's hand. The anesthesia takes effect in seconds and she was out. They had us leave immediately so they could begin the MRI. Parents are not allowed to wait in the MRI area so we went to the cafeteria. The whole procedure took maybe a half hour and when we went back to check on her she was already in recovery. We were both allowed in the recovery room and she woke up quickly and with no problems.

We stayed the night at the hospital and went home the next day. I have to say that all of the nurses, doctors and other staff at the hospital were wonderful. They have Child Life Specialists who are there to help make the experience bearable for the parents and the children. Suzanne is a Child Life Specialist there and she was fantastic. She checked in on us frequently, brought toys and books for my daughter to play with and even read to my daughter so I could take a bathroom break.

They also have a playroom upstairs where the children can play with toys or make artwork. It's staffed by an enthusiastic group of college volunteers and hospital staff and it made a huge difference for us even in the short time we had to stay there.

We were very grateful to all of the caring doctors, nurses and staff at Children's. I am glad we had the procedure done because it ruled out all of the scary possibilites. I don't know much about the problems surrounding sedation and did not research it prior to her MRI because we had to make a decision quickly.

I hope this helps and good luck to you and your daughter. Julie

It wasn't at Children's Hopsital, but maybe our recent experience will help. Our then six-month-old daughter had to have both an MRI and a CT-Scan this past December, with total sedation for both. They were scheduled about ten days apart at Kaiser Oakland, with the MRI first. We were quite nervous, especially about putting such a small child to sleep not once but twice, but she sailed through both experiences without any problems or side effects.

The pediatric anesthesiologist and his nurse met with us before the procedure and explained what was going to happen, which was reassuring. Then they let both of us stay in the room while they administered the anesthesia -- it was *very* hard to watch our duaghter struggle against the mask and then fall asleep, but we were glad to be there so she could see us. The MRI took about 45 minutes and then we met the nurse and our daughter in recovery. She was already starting to wake up as we walked in and she was pretty much herself within 10-15 minutes. (Children are just amazing at recovery.)

She took a long nap that afternoon, which was unusual at the time, but otherwise she was crawling and babbling and generally behaving like her very happy self. As I said, we saw no side effects from the sedation, either then or later.
Nervous but it turned out okay

Hi, I work in an MRI lab at UC Berkeley, working only with adults. The reason your child needs general sedation to have an MRI is that they need to remain still for a long time, which is something that even adults have trouble with. In our lab, for example, our clients are outfitted with a bitebar fitted to their teeth that holds their heads still while inside the scanner. This simply won't work with kids, who are frightened of the noise of the scanner and who are too wiggly to get a clear image.

I am assuming that your child has a condition that warrants capturing an image on film, and you will want it to be of the highest quality possible. This is the reason for the sedation, and keeping that in mind should help your whole family through the ordeal, especially because your child has some symptoms that require you to be strong and steadfast while your doctors reach their diagnosis and design treatment. The doctors at children's are wonderful, the anesthesiologists are skilled and very experienced. Your child will be okay.

Another respondent posted that MRI is safer and better than CT scans, and I want to clarify that while MRI machines do not use radiation, CT and MRI scans have completely different ways of functioning and both are good at seeing some things (MRIs, for example, cannot see acute bleeding in the brain if it is less than 24 hours old, so CT is always used in trauma situations).

Also, keep in mind that you may not be allowed to be in the scanner room with your child (I don't know their specific protocols). This may be because having another person in the room can alter the magnetic fields through which these amazing machines work their magic. Try to understand that if there were an easier, better way, they would do it that way. This is just what seems to work best and ensure that your child gets a good image taken the first time around.

Stay strong, and best wishes

Spinal MRI for Toddler

Jan 2003

Our 15-month old daughter has a suspicious birthmark on the base of her spine and we are going to be taking her for an MRI, most likely at Children's Hospital in Oakland. Does anyone have any advice for us about this procedure, how to prepare her for it, what to expect during and in the following days? Any and all advice would be very, very welcome. Thanks. a concerned mother

We were in a similar situation a year ago. Our 20 month old needed an MRI to try to determine the cause of her cerebral palsy.

We went to through Alta Imaging and worked with a pediatric sedation nurse named Mari (name ?). She was wonderful and walked us through everything. My advise to you is to follow the instructions exactly, and plan to have a stay-at-home quiet day after the MRI.

Good luck with everything. We were very nervous and scared about the proceedure and prospective results. (The MRI helped us with information about somethings, but it ultimately never told us why/how she had a brain injury. We concluded it must have been while I was pregnant.) Julie

MRI for 6-year-old with headaches, dizziness

Jan 1999

My child will turn 6 in April. For a while during last year, she has been complaining about headaches. Recently, she complains about dizziness in her forehead. Most of the time, she feels nausea, too. According to her, she is always dizzy, from the moment she opens her eyes in the morning... I have taken her to a neurologist at the Children's Hospital. He thinks it is probably not a big deal since she is playful and functions normally. However, it could be something serious. ( I did not dare to ask him what he meant by serious, specially in the presense of my child.) He suggests an MRI which requires general anesthesia.

My questions for parents:(1) Is there any recommendations for overcoming dizziness? and nausea? any similar experiences? (2) Is general anesthesia a must, or a 6 year-old could hold still during the MRI procedure?

One thing that can cause dizziness is anemia, although your physician may have already ruled that out. Also inner ear infections.

My then 8 year old daughter complained of dizziness, headaches and nausea. She's very bright (no bias here!), playful, alert and attentive. I was sure that it was just a result of quick growth. The doctors first ran an electro-encephalogram (EEG) to check out her brain waves, and, as a result, went the MRI route. No anasthetic was used. Both my wife and I went with her and since she was very interested in science, got a brief explanation of how it worked. She stayed still just fine, and the MRI showed no abnormalities. The Doctors analyzed the MRI and told us that it was the result of fast brain development.

My daughter had a MRI a couple of weeks after her 7th birthday, and another 3 months later. She did not require sedation of any kind. She was able to hold still, and in fact after her initial apprehension over the strangeness of the experience, she actually found it kind of relaxing, & almost fell asleep. I was able to be with her during the procedure, & although she was lying in the tube & couldn't see me very well, I kept my hand on her foot the whole time, which probably reassured her. I strongly urge you to get this test done. Dizzyness is not normal, it is a symptom of some condition which must be identified and treated.

About seven years ago, my eleven year old daughter began experiencing morning nausea, and then headaches. She seemed otherwise healthy, and continued to function normally at school and at home. It turned out that she had a malignant brain tumor. This experience wreaked havoc with my basic sense of trust that It's probably no big deal. The time that followed was difficult, challenging, life-changing. My daughter went through neurosurgery, radiation, and chemotherapy. I am happy to say that she is now a healthy 19 year old college student. I urge you to have the MRI done without delay. My story represents the something serious about which you did not dare ask. I sincerely hope that your daughter is OK, and that it turns out to be not a big deal.

My daughter, who is now 3, has had an MRI and 2 CT scans of her head. The CT scans were relatively short procedures and she went through both of them without any anesthesia (although the doctors and nurses were fairly amazed that she held still for them). The MRI required general anesthesia, via IV. The MRI is done in a large, noisy, dark tube and takes about 30 min. I doubt that a 6-year old would be able to hold still for the procedure. The recovery from the anesthesia took several hours, but wasn't a big deal (she was sleepy and a little wobbly when she tried to walk). You may want to ask your doctor if a CT scan would be an acceptable alternative to the MRI. Depending on what they are looking for, it may not be. I would definitely recommend going ahead with whatever your doctor suggests. It is a relatively non-invasive procedure and it is better to know what, if anything, is wrong. Good luck.

You are probably the best judge of whether or not your child can remain motionless during the procedure. The MRI machine is big, loud, and pretty scary and my inclination would be to use the anesthesia. There are some new ones which wear off almost instantly without the grogginess associated with the old kinds. I don't know if these are approved for children. My experiences with outpatient services at hospitals elsewhere is that the youngest kids are treated first--perhaps so they don't wait as long on an empty stomach.

I wanted to offer a suggestion to the parent who asked about their dizzy child: Since you're in/near Berkeley, and it's all available, you might want to consider taking your child to a chiropractor, homeopath, and/or Chinese medicine practitioner. Or maybe try Yoga. Or a nutritionist. Or a hypnotherapist. But also talk with the neurologist, maybe on the phone when your daughter isn't around, and find out just what he did mean--it's nothing and get an MRI sound to me like conflicting messages: what did he really mean? What would be the likely consequence of putting off the MRI while trying less drastic measures? How likely is it that the MRI will give a definitive answer? I will share from my own experience that it is very uncomfortable and anxious-making to go around dizzy all day. Even though you tell yourself, no, I'm not really falling your body keeps sending the frightened I'm falling signal again and again. I even started to get real anxiety attacks about it, which was very scary. So even if the MRI shows it's nothing serious, I would still suggest exploring avenues to heal it. I was afraid to address my own dizziness for a long time because I didn't want to have any privileges taken away from me and I felt certain that I was not really a danger to anyone. After months of silent, anxious suffering, it luckily sort of cleared up when I got pregnant and hasn't come back since.

Several years ago I suffered from the same symptons as your child. I was also seen by a neurologist and took an MRI. I also was seen by an Ear, Nose & Throat Specialist. It turned out to be an inner ear infection. Since I had not had a cold or any other illness prior to the symptoms, I was surprised by the whole experience. The dizziness was pretty frightening and I too had nausea. As it turned out, there was nothing that could be prescribed for it. It eventually went away.

Although I didn't find the MRI uncomfortable, many people do, including adults with claustrophobia. It feels like being in a garbage can with someone clanging on it! And, it is of the utmost importance that the person remain very still. Has menigitis been ruled out? Here is an article I found on the internet

Meningitis explained

This response submitted by David Margolin, M.D. on 2/19/96.

Meningitis is any inflammation of the meninges, a membrane which surrounds the brain and spinal cord, enclosing the cerebrospinal fluid which bathes the central nervous system. Spinal meningitis is a common presentation of meningitis, where the spinal cord rather than the brain is mostly affected. The usual symptoms are severe headache, fever, rigidly stiff neck (can't touch chin to chest), and possibly alterations of the level of consciousness.

The most serious meningitis is bacterial meningitis, which requires treatment with antibiotics. Untreated, it can cause seizures, coma, and lasting disability (blindness, deafness, brain damage) or even death. Bacterial meningitis can indeed be infectious, even epidemic, in schools. Someone infected, and perhaps their close contacts, may need quarantine until treated.

Other meningitis can be caused by viruses (which are mostly self-limited conditions, improving without antibiotics), fungal meningitis (commonly affecting AIDS patients), tuberculosis, and even Lyme disease and syphilis. Rarely, meningitis is non-infectious.

In general, everyone is susceptible. In the USA, all infants are receiving a vaccine (HIB vaccine) which prevents a common pediatric bacterial meningitis.

Please check with your doctor to make sure this has been considered ruled out. I personally think that an on-going headache is more serious than not, but that is my personal, parental opinion.

Take good care.