I will never forget getting to my MRI appointment, looking at the tube, realizing I would never fit, and them saying, just try it you will definitely fit... Cut to a few minutes later, they are moving the table into the tube and I can feel the tube physically pressing in on my from all sides, squeezing me…. I was screaming for them to let me out… it was really horrifying!
Only then did they agree to let me reschedule in the open MRI machine, but not until after putting me through a horrifying, embarrassing painful experience.
I am a fat person and an MRI technologist (Radiographer) in the UK. While I agree completely that there should be access to MRI for everyone and I passionately believe that fat people should not be shamed or blamed when MRI is unavailable to them, there seems to be a lot of misunderstanding about the design and process of the scan so I would like to clarify a few things.
1. The design of the machine boils down to the physics of creating an MRI image. This is a very complex process and the width of the bore is key for the process to work. Wide bore scanners are now pretty standard (here at least) when new scanners go in, but many facilities can’t afford to spend another million+ on a new scanner, so the ones in place are likely to remain for some time. In my experience a scanner can stay in place for up to 20 years. I disagree with the comments that the original design is fatphobic - it’s just the only way an image could be obtained at that time. All imaging modalities have advantages and disadvantages. There are people who cannot have an MRI because it’s unsafe for them to do so, for example because they have a pacemaker - it’s not discriminatory, it’s just not compatible because of the way the scanner works.
2. The “fixtures” are not a thing to keep people still. They are coils, which allow signal to be collected and turned into an image via a lot of complex maths. You can’t get the image without the coil. Again, yes there are limitations, and a good MRI tech will know how to get a diagnostic image using a different piece of equipment if the one that should be used does not fit over the patient’s body part, but it will be very difficult to get an image that is as good as it should be in the same time. Often it will take longer and some of the image quality will be lost.
3. There is more to acquiring a diagnostic image than just fitting the patient in the scanner/coil. Signal (that creates the image) is affected by proximity to the coil, so for example a patient’s spine can be nearer or further away from the spine coil (which they are lying on top of) depending on the depth of tissue between their spine and their skin. So for people carrying a lot of fat on their back, the spine image will not be as clear, unless the tech takes steps to improve this, which usually adds time to the examination. That’s just an example, there are other issues.
4. I have worked in MRI for 12 years and I put people into our wide bore scanner every day, and I still can’t tell from their weight/height/measurements whether they will fit in or not, or whether they will tolerate the scan. I have scanned patients up to 190kg (over 400lbs) in a wide bore scanner (table limit 250kg) and if a patient were willing to try, I would not exclude them based on their measurements. That is why techs will usually ask patients to try. It is always the patient’s choice and consent can be taken away at any time. It is undoubtedly much more difficult for a bigger person than it is for a smaller one in lots of ways and your clinician should understand that.
5. There are other imaging modalities where the size of a patient impacts on the quality of the image, for example X-rays and CT scans. Sometimes it’s not possible to obtain a diagnostic image even though it seems that it has been no different to the process any patient would go through. You need a higher dose of radiation and the resultant X-ray may not be as good. Again it’s the limitations of the modality which is down to physics. It’s not the patient’s fault, but it’s not the technologist’s fault either.
I hope this is helpful in understanding a bit more about the MRI examination. It is a very complex process. I am sorry to hear of the bad experiences people have talked about in the comments. I can’t comment on open scanners as I’ve never worked on one, so I’m just speaking from my own experience. I think the main issue is that all healthcare professionals should be treating higher-weight patients with respect and compassion and that is what I will strive to do and help others to do in my work.
In the early 2000s I was hospitalized & needed an MRI. The hospital did not have a table that would handle my weight and the Dr claimed there were none available "in the hospital system." They did CTs and X-Rays and many dopplers and insisted that I try to get an MRI after I got out.
And, yes, the doctor did pull that "Ha, ha, we're gonna see if we can send you to the zoo" BS.
When I got home, I started digging. The web as we know it was still pretty new so information was still sparse and companies in general were new to email accounts for customer service, but they did list 800 numbers. I found the names of the biggest manufacturers of MRIs and started calling them. They were all very happy to give me the names & locations of MRI machines that would "handle over 300 lbs" within a 20 mile radius. I got a list of about 20 (there may have been more but that's where I stopped). 5 of them were within the hospital system I'd been in, and one was a mile away from the hospital where I'd been for 3 weeks.
I've had a total of 4 MRIs since that hospital stay. None were awful, but one was very memorable for the fact that when I went to get off of the table, the technician handed me my METAL cane. The thing whipped past my head so closely that it brushed my ear and wedged itself into the machine. The technician managed to pull it out but, obviously, that broke the machine. And turned my cane into a pretzel.
I’ve had several MRIs in various regions of the US and in varying levels of fatness (small fat to super fat) and they’ve always been awful. The one time I fit in the old standard bore tube, I got cuts on my hand from scraping a couple loose screws on the insides of the tube. I sucked it up because they told me I had no other options if I didn’t fit. (I assume the large bore and open mri existed back then but who knows.)
I’ve tried the open MRI and it didn’t feel any roomier except my arms weren’t squished into my sides. I had to drive an extra 30 min to get there, in a major metro area (Phoenix).
It’s amazing that such a modern diagnostic tool is so elusive to fat people. These are fairly new and I’d be very curious to compare the average size human with the year MRIs were invented because I feel like this instrument was designed to be anti-fat right from day one, and it’s completely ridiculous. I get that it was more expensive when they were new but that was not a valid excuse to exclude half the population from accessing this new technology.
Out of curiosity, how did you respond to the residents discussing the person who died in the ER and that zoo quackery?
"You can try it," is a lie. The technologist will tell yes, we want you to do that. They do!
Reception and the nurse manager will not let you. They will look at your clothed body and tell you whether they think you fit or not. In a loud, public conversation.
It's AWESOME!
Also: do not recommend breast MRIs when you have gall bladder pain. The coil prop digs hard in just the wrong spots. But hey, remember, if your gall bladder revolted because you lost weight (for any reason or means), the medical establishment considers you a winner-- to a point.
I tried the upright MRI and it was awful. Imagine an airplane seat with solid 5-foot diameter discs in place of the armrests. My shoulder (the reason for the MRI) was hurting as soon as I contorted myself into it and I was in tears by the end of it.
Yah. I had an m.r.i. before my hysterectomy last December and I cried the entire time. I was squished in there so hard. Plus it was so loud! And, there were not kind about it or very compassionate. The p.e.t. scan I just barely fit in the machine, too. Nothing is created for us. We are an after thought for sure. However, we make up the majority of the population.
I will never forget getting to my MRI appointment, looking at the tube, realizing I would never fit, and them saying, just try it you will definitely fit... Cut to a few minutes later, they are moving the table into the tube and I can feel the tube physically pressing in on my from all sides, squeezing me…. I was screaming for them to let me out… it was really horrifying!
Only then did they agree to let me reschedule in the open MRI machine, but not until after putting me through a horrifying, embarrassing painful experience.
I am a fat person and an MRI technologist (Radiographer) in the UK. While I agree completely that there should be access to MRI for everyone and I passionately believe that fat people should not be shamed or blamed when MRI is unavailable to them, there seems to be a lot of misunderstanding about the design and process of the scan so I would like to clarify a few things.
1. The design of the machine boils down to the physics of creating an MRI image. This is a very complex process and the width of the bore is key for the process to work. Wide bore scanners are now pretty standard (here at least) when new scanners go in, but many facilities can’t afford to spend another million+ on a new scanner, so the ones in place are likely to remain for some time. In my experience a scanner can stay in place for up to 20 years. I disagree with the comments that the original design is fatphobic - it’s just the only way an image could be obtained at that time. All imaging modalities have advantages and disadvantages. There are people who cannot have an MRI because it’s unsafe for them to do so, for example because they have a pacemaker - it’s not discriminatory, it’s just not compatible because of the way the scanner works.
2. The “fixtures” are not a thing to keep people still. They are coils, which allow signal to be collected and turned into an image via a lot of complex maths. You can’t get the image without the coil. Again, yes there are limitations, and a good MRI tech will know how to get a diagnostic image using a different piece of equipment if the one that should be used does not fit over the patient’s body part, but it will be very difficult to get an image that is as good as it should be in the same time. Often it will take longer and some of the image quality will be lost.
3. There is more to acquiring a diagnostic image than just fitting the patient in the scanner/coil. Signal (that creates the image) is affected by proximity to the coil, so for example a patient’s spine can be nearer or further away from the spine coil (which they are lying on top of) depending on the depth of tissue between their spine and their skin. So for people carrying a lot of fat on their back, the spine image will not be as clear, unless the tech takes steps to improve this, which usually adds time to the examination. That’s just an example, there are other issues.
4. I have worked in MRI for 12 years and I put people into our wide bore scanner every day, and I still can’t tell from their weight/height/measurements whether they will fit in or not, or whether they will tolerate the scan. I have scanned patients up to 190kg (over 400lbs) in a wide bore scanner (table limit 250kg) and if a patient were willing to try, I would not exclude them based on their measurements. That is why techs will usually ask patients to try. It is always the patient’s choice and consent can be taken away at any time. It is undoubtedly much more difficult for a bigger person than it is for a smaller one in lots of ways and your clinician should understand that.
5. There are other imaging modalities where the size of a patient impacts on the quality of the image, for example X-rays and CT scans. Sometimes it’s not possible to obtain a diagnostic image even though it seems that it has been no different to the process any patient would go through. You need a higher dose of radiation and the resultant X-ray may not be as good. Again it’s the limitations of the modality which is down to physics. It’s not the patient’s fault, but it’s not the technologist’s fault either.
I hope this is helpful in understanding a bit more about the MRI examination. It is a very complex process. I am sorry to hear of the bad experiences people have talked about in the comments. I can’t comment on open scanners as I’ve never worked on one, so I’m just speaking from my own experience. I think the main issue is that all healthcare professionals should be treating higher-weight patients with respect and compassion and that is what I will strive to do and help others to do in my work.
In the early 2000s I was hospitalized & needed an MRI. The hospital did not have a table that would handle my weight and the Dr claimed there were none available "in the hospital system." They did CTs and X-Rays and many dopplers and insisted that I try to get an MRI after I got out.
And, yes, the doctor did pull that "Ha, ha, we're gonna see if we can send you to the zoo" BS.
When I got home, I started digging. The web as we know it was still pretty new so information was still sparse and companies in general were new to email accounts for customer service, but they did list 800 numbers. I found the names of the biggest manufacturers of MRIs and started calling them. They were all very happy to give me the names & locations of MRI machines that would "handle over 300 lbs" within a 20 mile radius. I got a list of about 20 (there may have been more but that's where I stopped). 5 of them were within the hospital system I'd been in, and one was a mile away from the hospital where I'd been for 3 weeks.
I've had a total of 4 MRIs since that hospital stay. None were awful, but one was very memorable for the fact that when I went to get off of the table, the technician handed me my METAL cane. The thing whipped past my head so closely that it brushed my ear and wedged itself into the machine. The technician managed to pull it out but, obviously, that broke the machine. And turned my cane into a pretzel.
I’ve had several MRIs in various regions of the US and in varying levels of fatness (small fat to super fat) and they’ve always been awful. The one time I fit in the old standard bore tube, I got cuts on my hand from scraping a couple loose screws on the insides of the tube. I sucked it up because they told me I had no other options if I didn’t fit. (I assume the large bore and open mri existed back then but who knows.)
I’ve tried the open MRI and it didn’t feel any roomier except my arms weren’t squished into my sides. I had to drive an extra 30 min to get there, in a major metro area (Phoenix).
It’s amazing that such a modern diagnostic tool is so elusive to fat people. These are fairly new and I’d be very curious to compare the average size human with the year MRIs were invented because I feel like this instrument was designed to be anti-fat right from day one, and it’s completely ridiculous. I get that it was more expensive when they were new but that was not a valid excuse to exclude half the population from accessing this new technology.
Out of curiosity, how did you respond to the residents discussing the person who died in the ER and that zoo quackery?
Wow. Super surprised to find out the whole zoo thing is a myth … I was told that just last year!! Ended up getting a RBC scan instead
"You can try it," is a lie. The technologist will tell yes, we want you to do that. They do!
Reception and the nurse manager will not let you. They will look at your clothed body and tell you whether they think you fit or not. In a loud, public conversation.
It's AWESOME!
Also: do not recommend breast MRIs when you have gall bladder pain. The coil prop digs hard in just the wrong spots. But hey, remember, if your gall bladder revolted because you lost weight (for any reason or means), the medical establishment considers you a winner-- to a point.
I tried the upright MRI and it was awful. Imagine an airplane seat with solid 5-foot diameter discs in place of the armrests. My shoulder (the reason for the MRI) was hurting as soon as I contorted myself into it and I was in tears by the end of it.
Yah. I had an m.r.i. before my hysterectomy last December and I cried the entire time. I was squished in there so hard. Plus it was so loud! And, there were not kind about it or very compassionate. The p.e.t. scan I just barely fit in the machine, too. Nothing is created for us. We are an after thought for sure. However, we make up the majority of the population.