"Those twenty minutes in the tube feel like an eternity."

It’s not incapacitating, but I do feel a little claustrophobia. It wasn’t too long ago that I was on holiday with some friends and we visited a cathedral with a narrow stairway to the top. Once I started seeing people come down I felt like I lost my breath and I had to leave. A few days ago I had to get a scan on my pelvis and, even though I managed it, those twenty minutes in such a tight tube weren’t easy.” Lara Rozas, a 41-year-old salesperson from Madrid, is one of many people who have a bad time when undergoing this medical test, which is a common occurence. “I let them know that I was a little bit claustrophobic and they said to me that when I started to feel anxiety I should throw my head back to see that the tube is open. I did it three times and it relieved me a lot. I also thought about my daughter when I was inside.”

Cases like Lara’s are seen on a daily basis by Inma Camarasa, a radiodiagnosis technician at La Ribera de Valencia hospital. “Coming to the hospital is always scary because of the fear of the unknown. We point out to patients that the tube is open at both ends, so no one is going to get stuck. Sometimes we touch their hair so they can see how close they are to the edge of the tube and we tell them to turn their heads to see the opening. In the case of head MRIs, which as well as them being in the tube [patients] have a special frame placed on them, and in that ‘helmet’ there is a mirror so that the patient can see the tube’s exit by their feet; that gives them a lot of tranquility.”

“Nowadays all resonance scans are done in open-ended machines that are 1.7 metres in length and 50 to 60 centimetres in diameter (there are shorter tubes and one with side openings),” the specialist explained. The protocol, she said, is that the patient enters the tube feet first. “Aside from head, neck and cervical tests, where you must go head first, the rest of the time it’s done the other way around so that the person doesn’t have to go through the entire tube.”

Even though the feeling is of total isolation, the patient is in constant contact with the professionals and they are given a buzzer that they can use if they feel unwell or overwhelmed. “Approximately one in every five [patients] uses the buzzer, but very few can’t finish the test.”

It lasts around half an hour, though there are exceptions (15 minutes for a standard head scan to investigate the origin of an intense headache and up to 45 minutes if a complete spinal column study is required).

“There are cases of people falling asleep. It happened recently with a woman we were doing a shoulder scan on; we called her and she didn’t respond, so we went in to see what was going on and she was happily asleep. But it’s unusual. That half hour is quite long for most people, which is why we suggest counting in their heads. It’s a way of getting the patient to pass the time and, at the same time, keep them distracted. Some sing songs in their heads, others think of happy thoughts... and a lot of people pray,” Inma Camarasa explained.

Cristina Wood is a health psychologist and a European doctor in Psychology. She also works with patients who suffer from claustrophobia and with those who find going into a lift, an airplane or an MRI tube to be a bitter pill to swallow.

“Attentional bias is the tendency to pay attention to the information that for me is threatening, like space, in this case: ‘The air won’t get to me’, ‘I’m going to faint’, ‘I won’t be able to get out of there’... Attention is anxiety’s fuel, so the key is to teach the patient to change the focal point.” But when you try and suppress a thought, it appears stronger than before.

“They say to themselves: ‘Don’t think about how small the MRI tube is’ and they only pay it more attention. The only way of not paying attention to something is distraction. Counting backwards, singing, remembering scenes from the series you watched last night, thinking about changes in decor to your home... It requires concentration and it steals the attention away from what worries you,” Wood explained.

Outside of cognitive behavioural therapy, psychology recommends that patients practise mindfulness and physical exercise. “Exercising the day of or the night before a scan helps because it has benefits on a chemical level, because the endorphins we secrete produce well-being.”

And what happens after the scan? “Lead a normal life, the same as before the test. Though when contrast MRI is done or when the patient has a certain pathology, some precautions must be taken,” Inma Camarasa said.