Health Editor’s Note: Here is another humorous item, but not so funny for those who cannot have a MRI due to feelings of claustrophobia.
First of all, a couple of definitions to lay some ground work. The ICD-10 Diagnosis codes are those assigned to diseases, signs, symptoms, complaints, abnormal findings, external causes of injury or disease, or social circumstances. These began in 1983 and we are looking at the 10th revision of such codes, thus the number 10. Your health insurance company must see the correct codes or they will not pay.
A MRI (magnetic resonance imaging) is a big machine (a magnet) that is used to look at computerized images of body tissues. A MRI makes lots and lots of noise, humming at new levels of low, loud knocking sounds as the magnets are turned on and off, loud clicking and is a generalized ear disaster. That is why ear plugs or ear phones are often offered and a choice of music to experience. Good luck with listening to the music because you will barely be able to hear it when the machine is performing its nuclear magnetic resonance (a strong magnetic field) of atoms inside the body.
A MRI is really a great diagnostic tool since it offers pictures inside the body, without being invasive or delivering radiation. Now a large blip in a MRI procedure is the way the MRI is designed. It is really a long tube, open at both ends, but can seem quite restrictive depending on your size and the part of the body that is being looked at. A MRI can be used to look at one specific area of the body. A scan is performed inside a large magnet. You must remain completely still from 30 to 60 minutes. That in itself will make a person uncomfortable and feel very restricted and create a perfect storm for a panic attack. If your head is being analyzed, your face will be looking directly at a surface, just inches from your nose. Another claustrophobia reaction waiting to happen.
The tongue in cheek article for today reflects that it will be (wished that it would) be recognized as a medical issue, when someone cannot be placed into a MRI machine due to inability to outlast a panic attack from feeling oppressed, compressed, held down…..what closed spaces will do for someone who has claustrophobia or just does not feel comfortable in small spaces. Basically in reality, someone who cannot stand to be in a MRI machine will either have to be completely sedated (out like a light) during the procedure or just not have the diagnostic imaging done. Sad case, when an accurate diagnosis (MRI results are good at this) cannot be made due to the inability of the patient to live (well to actually have) through the testing procedure. For those who opt to be knocked out with some form of anesthesia so she or he can have the procedure will now have, medical reimbursement for any anesthesia used.
Sometimes people are offered an “open” MRI which offers more space. While you are not in a tube, and your sides are exposed to room around you, you will still have the machine above and below you and if you are laying on your back, you will still be staring at a fixture not that far from your face. An open MRI machine still does not take away the necessity to not move for umpteen minutes. So……since we have gone to the moon perhaps we can develop a better MRI that is quieter, open to the sky, and will work if you have to scratch your nose……:) Carol
Practice Advisory: MRI Dysphoria Received ICD-10 Diagnosis Approval
Proponents of continuous inpatient sedation won a victory today when CMS approved MRI Dysphoria as a legitimate thing that an otherwise well-adjusted adult can claim as an affliction.
When asked to define the pathophysiology of MRI Dysphoria, non-clinician non-researchers at the Joint Commission Institutes of Health explained that completely losing your sh** when about to undergo any sort of imaging test was not in fact due to claustrophobia, but instead part of a ghastly health crisis known as Panxiety in which patients feel that they do not have a body and any reminder that they do have a body causes them deep distress—as well as literally every other interaction that they have with the physical world.
CMS also delivered another blow to the selection pressures that brought our species from amoeboid organisms to super-intelligent primates when they confirmed to patient advocacy groups that reimbursements would start to decline for hospitals unable to keep Panxious patients under so-called “twilight” anesthesia for at least 80% of their stays.
With the new diagnosis of MRI Dysphoria added to the previously approved Panxiety-related indications of IV Placement Phobia and Unrealistic Expectation Panic, practitioners of door to door anesthesia will see job growth as acceptance rates of any minimal discomfort continue to decline nationally.
Under newly proposed guidelines that expand on the assumption that no reasonable physician would ask a patient to endure a few minutes in a smallish but totally safe MRI machine, new Anesthesiology residency programs are being formed to meet the coming demand for uninterrupted unconsciousness during inpatient hospitalization.
Some cutting edge academic institutions have further shown their commitment to any patients unable-to-even before even exiting their car in the hospital parking lot. These forward-thinking facilities have deployed board certified sedation valets who will perform a mask induction from the passenger seat on any patient who has exhausted their last reserves of even-being-able-to-deal since it is generally understood that patients with advanced cases of inverse resiliency will experience subtotal decompensation if required to have an IV placed prior to their preadmission induction.
With the approval of the MRI dysphoria diagnosis, now patients unable to be convinced that the benefits of noninvasively obtaining detailed pictures of their afflicted internal organ outweighs the minor inconvenience of lying still for, like, maybe not even twenty minutes will receive the same goal
BIS score as patients mildly annoyed by being awoken perhaps once per night to take their vital signs. Everyone from owners of international end tidal CO2 monitoring conglomerates to nurses who don’t like being called when the TV won’t change channels will see benefits of the widespread adoption of aggressive inpatient anxiolysis, analgesia and amnesia standards.
When told of the changes, one patient eloquently summed up the feelings of so many suffering from intractable Panxiety:
“Seriously, they told me I would be in twilight by now. Where is that patient satisfaction survey card? Somebody is getting a bad Yelp review over this! I am going to blog about this after my ketamine induced nystagmus resolves! What was I supposed to do? Someone asked me if I have any allergies after someone else had already asked the same question earlier–it just sent me into this omnidirectional existential crisis for which the only answer was horse tranquilizer. Who refills the Xanax around here?”