MRI and ICDs?

[Dolly (Andrew's mom)]

Andrew had an accident at school two weeks ago. He blew out his knee and was taken by ambulance to the ER. The only thing they could tell for sure last week was that the knee cap was dislocated. He had way too much fluid and pain in the knee for them to do any type of manipulating tests. (X-rays showed no broken bones) Today was his 2 week follow up. The swelling was down enough to do some flexability tests, which were not good. (his knee was way too loose) that along with the amount of pain and fluid still in his knee, has the doc worried about a complete tear of the MCL and possibly ACL both.

He wants to do an MRI on Andrew's knee however he said he wasn't sure Andrew could have an MRI with the ICD implanted. He was going to talk to the MRI poeple tomorrow and let me know.

Any of you ICD patients have any knowledge about doing an MRI on a ICD patient?

Thanks

[Pam Alexson]

Re: MRI and ICDs?

Hi Dolly,
I am actually a little surprised to hear that a doctor would even consider an MRI. I know that technology is advancing but I was not aware that it had to the point where MRI's and AICD's are a compatible mix. I heard through my cardiologist that it may be a possibility in the future but at present he would not consider it if he had an AICD.

Certainly I would make a call to your son's EP and also look online at the info put out by the manufacturer. I have even E-mailed the manufacturers and always recieved a timely response.

Personally I never entirely leave these matters of question to the doctors I see . I call it my micro management of my health care.

Good luck and keep us posted.
Pam

[Dolly (Andrew's mom)]

Re: MRI and ICDs?

Thanks for the reply Pam.

I should have specified that what he was unsure about was if they could do the MRI on his knee without him completely going inside the tube, keeping the machine far enough away from his ICD.

He knew it was not possible to do an MRI near the ICD..............so I guess my question is if anyone who has an ICD has been able to have an MRI at all, on any part of their body.

[Cynaburst]

Re: MRI and ICDs?

Basically, it's impossible at this time. There is testing going on now to determine the feasibility, but I can promise you that noone in the U.S. at this time would attempt it for anything short of an emergency, and maybe not even then. I looked into this issue with great depth before my implantation as I had a brain tumor which is followed by MRI and I didn't want to give it up. I also closely follow the literature. The bottom line is that maybe sometime in the future, but definitely not now.

[Boz]

Re: MRI and ICDs?

I had a cardiac MRI two weeks ago, which incidentally was the tool which confirmed my diagnosis for Dr. Maron, and did some studying before going in. Check this picture of a pallet jack which was sucked into an MRI machine.

I might have done too much research as I was imagining all kinds of things when I was inside the tube. I did not remove my wedding band – it’s gold which is not magnetic. I swear I could feel that machine tugging on it anyway.[/url]

[Pam Alexson]

Re: MRI and ICDs?

Dolly,
Sorry I pretty much realized what you were asking and should have said so. I was thinking of a tragic story I had heard of in the past where a child was in the room and a MRI was about to be performed , someone had left an oxygen tank in the room by accident, I believe if I am remembering the details correctly that the tank killed the child as the tank went sailing towards the machine.

These are very powerfull magnets as seen by the picture Boz provided us with. I have a plate and screws in my wrist and I was never able to have an MRI of my head, even though my head was all that was needed.

You have done right to investigate this.
Pam

[mtlieb]

Re: MRI and ICDs?

Dolly,

Just to re-affirm what everybody has said, i definitely don't think an MRI is possible for Andrew. I've had a few MRI's now, and those are some powerful magnets believe me. It's not just a matter of metal being inside the tube... there can't even be any metal in the same room as the machine. We've all heard horror stories i guess, but the one that springs to my mind is of the fire extinguisher coming off the wall, flying across the room, and killing the man inside the machine. Regardless of what your doctor decides, i would definitely say no to the procedure.

Jim

[shirleymahoney]

Re: MRI and ICDs?

Guys that was one of the first things i was told when i got my ICD NO MRI's

Shirley

[Burton Borrok]

Re: MRI and ICDs?

Maybe I should sell my MRI stock - - but I was drawn to it so.

Actually when I had my MRI’s I felt nothing, but even with ear protection the noise was something else. And the questionnaire I had to fill out covered everything metal imaginable – and then they questioned me on the answers before I even got into the room with the monster. They even asked if I had metal fillings in my teeth.

To tell you the truth, if I had an AICD I wouldn’t even go down the hall where the monster lived. I don’t know how true it is, but the tech said when it was first installed it even pulled some metal nails out of the walls.

How did they check on soft tissue damage before the MRI? There has to be another way.
Burt

[Dolly (Andrew's mom)]

Re: MRI and ICDs?

Oh my, I sure got an education on MRIs in a hurry!

After researching (including the Medtronic site) and what everyone told me here, an MRI is definetly OUT!!! I too am surprised his doctor (GP) even considered it! I had no idea at all what exactly MRIs are all about, but I know now.

They will have to come up with another plan. I am not sure what the other choices are. It is obvious he needs a lot more done with his knee. It failed the flexing tests, it is still full of fluid, and it is still VERY painful for him. It is so unstable that if he tried walking without the immobilizer brace on right now his knee would probably crumble beneath him..........

The doctor said if he couldn't have an MRI we would be sent to an orthopedic surgeon for further evaluation. And after what I learned in the last 12 hours I think being sent to a specialist is the best thing right now.

And as long as I am on that subject.............any concerns a person with HCM/ICD should have about possibly having surgery to fix his knee if that is suggested by the orthopedic surgeon? (His GP already mentioned it)

Thanks a bunch for the eye opener everyone!

[Lisa Salberg]

Re: MRI and ICDs?

No, you can not have an MRI if you have an ICD. The magnets in the MRI are very strong and can alter the settings of the ICD and may even destroy the device. Research is underway for ways to allow MRI for those with devices and it is expected to be possible in the next 5 or so years.

They may want to try a cat scan of the knee.

Lisa

[Pam Alexson]

Re: MRI and ICDs?

Hi Dolly,
Happy we were all able to help you. It sure is nice to say the least that we have such great informational sharing and nothing can be left to second guessing or in the hands of some who may not truly know what is best for us.

I think it is wise for you to take the step to a specialist for your son. This will get the best picture and summation of your son's knee problem. Arthroscopic surgery may possibly be in his future and you will learn this best from an expert.

As far as actual surgery should it be neccessary, there should be no problem as long as they are comfortable with caring for individuals with AICD's. Of course it will have to be turned off for surgery, if he has surgery.

Try to get a feel for the orthopedic surgeons in your area first hand so that you know what kind of a track record they have for these type of things. You can call the local hospital where you take your son , you can ask around your neighbors, friends, collegues, and you can look them up once you have their names. You can go to your state Board of Registration for Physcians and look them up . Heck you can even look me up in the Mass. Nursing registration. ( I am currently listed as expired past one renewal; just means I am inactive and saving the cost of renewal since I am not working.) My patients actually put me on to this as many looked up their medical care givers.

I have learned the hard way; after having a mis- alignment of the distal radius ( short for setting the bone in my wrist wrong ), then having the arm rebuilt by another orthopedic surgeon, to having labor for 36 hours and almost dying when the obstetricians had over estimated my capacity to deliver a 11lb baby when they believed it was a 9 lber, to having facial cancer removed by someone who I recently learned was a physicians assisstant and whom tried to fry me and my AICD with a hyphercator, being prepped for an EMG ready to go to learn that they did not want to attempt it as I did not have my EP doctor in that facility and they felt uncomfortable. This last was probably the most insightfull as she did not try to do something she was not comfortable with. So my advise : check , check and check some more.

Take care. Pam

[Burton Borrok]

Re: MRI and ICDs?

Hi Dolly,
My son had arthroscopic surgery on his knee when he was about your son’s age. He carries a scar (If you can call it that) which is maybe a quarter of an inch long and is the same color as his skin. You have to look to find it, and when you do find it you would swear it was the result of a scrape and not surgery.

He wanted to go out for football, but his knees would give out and spill him on the up hill down hill runs. After the surgery that knee is much tighter then the other one, but that one was not so bad that we would consider surgery on it also.

I don’t think they would consider surgery while his knee is inflamed, but they probably would treat it to take away the pain, swelling and fluid – with surgery to repair it when the time is right.

Yet another page in the wonderful world of parenting. I swear, the kids can take it a lot better then we can.
Burt

[Dolly (Andrew's mom)]

Re: MRI and ICDs?

Andrew's doctor called back after talking to the MRI techs and said they couldn't do one. Glad I didn't have to educate them!!!!

Andrew is going to see an orthopedic on Thursday. Hopefully we will find out more then!

Burt, when you said this Yet another page in the wonderful world of parenting. I swear, the kids can take it a lot better then we can. I couldn't help but laugh! This "page" in Andrew's book is just one of many lately! I swear if it can be broke, bruised, torn, lacerated, ect. he will find a way to do it! Within the last year he has been to the ER more times then I have in my life! (severly lacerated foot from a run away gas powerd remote control airplane propellar, broken collarbone from a skateboarding fall, severe reaction to sulfar from fireworks, broken hand from wrestling around with a friend, broken pointer finger from a basketball.............) and now this! All since August of 2003!!!!!!!! I certainly hope his days of "no fear" are almost over!

[Heartmans Wife]

Re: MRI and ICDs?

Hi Dolly-

I am so glad that you are going to an orthopedic surgeon. Believe me, he will be able to tell alot more than the GP just by the x-rays and touching Andrew's knee.

I had major surgery on beth knees as a teenager and have been following up with an orthopedic surgeon ever since. I have never had an MRI, (not that I cannot as I do not have a device) and these specialists were always able to tell what was going on.

Good luck and keep us updated!!

Ange