Ask the Experts: MRI Scans; Surgery for Arthritis; Aromatherapy
Q. I need to have a full-body MRI scan, and have heard these can be rather unpleasant. Can you offer any coping strategies?
A. Many people do find magnetic resonance imaging (MRI) tests unpleasant, particularly if they need to have a full-body scan that involves lying inside a narrow metal tube for some time, while staying as still as possible so that the resulting images are clear. MRI machines also emit a banging noise due to the magnets inside the device switching on and off.
The radiographer will likely offer you headphones with a choice of music to distract you during the test—a good alternative is an audiobook on a CD that you bring from home. I recommend you close your eyes once your head enters the machine, and keep them shut to avoid a sense of claustrophobia. A simple meditation routine may help you relax—breathe deeply and steadily, slowly letting your body go completely limp. Incorporating visualization into your meditation also can be useful—imagine you are on the beach watching the waves lap the shore, or mentally drive somewhere you enjoy visiting, visualizing the route and any landmarks along the way.
Rosanne M. Leipzig, MD, PhD
Geriatric Medicine
Q. I found your January article on hand arthritis informative, but I’m wondering what you think of surgical treatment? I’ve been considering wrist replacement.
A. Surgery for hand arthritis is a last resort for people whose arthritis is severe and unresponsive to medications, and you should kep in mind that it does come with a risk for infection.
Surgical options include ligament and tendon repair to tighten loose joints and restore motion, and synovectomy, which removes swollen, inflamed tissue within the joint. More complicated procedures include a partial or complete wrist fusion, in which the bones are joined together using wires, screws, and/or metal plates. Fusion alleviates the pain of arthritis because it ensures that the bones don’t rub against each other. Another procedure is proximal row carpectomy, in which the row of arthritic wrist bones closest to the forearm is removed. This generally reduces pain, and preserves partial motion.
The wrist replacement surgery you are consider preserves even more motion. As with hip and knee replacement, the procedure replaces the damaged parts of bones with metal and plastic components. Wrist replacement can improve range of motion to about 50 percent of normal. It’s reserved for people who don’t need their wrists for heavy daily use, and the artificial joint typically lasts 10 to 15 years.
Other surgical developments include knuckle replacement, but its success depends on patients having healthy bone and soft tissue to stabilize the replacement part, and avoidance of heavy daily use.
Mark E. Pruzansky, MD
Orthopaedics
Q. Can aromatherapy reduce stress and relieve other health conditions?
A. Essential oils extracted from plants, flowers, and herbs have been used for centuries to promote healing. Today, people use aromatherapy for everything from relaxation to pain relief, and the oils can be inhaled, or diluted in a carrier oil and applied topically.
A few essential oils do appear to help with certain health conditions—for example, lavender and chamomile may relieve stress and improve sleep, and peppermint may ease indigestion and other digestive woes. However, there hasn’t been a lot of good-quality research done on how effective (or safe) aromatherapy is, and although it involves natural substances, it isn’t necessarily appropriate for everyone. People with high blood pressure, for example, should avoid stimulating oils such as rosemary and hyssop. Also, in some people who are allergic to essential oils, aromatherapy can cause potentially dangerous reactions. If you want to try it, I suggest you consult a qualified aromatherapist—the Aromatherapy Registration Council (www.aromatherapycouncil.org) maintains a searchable database.
Patricia Bloom, MD
Geriatric Medicine
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