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Mayo Clinic Time-- also endo-rectal MRI query

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Posted 10/24/2014 4:22 PM (GMT -5)
Well, I am frazzled. It took a few days of back-and-forth and time-on-hold, but I eventually got scheduled for Mayo Clinic to do the C-11 Choline Scan and meet with Dr. Kwon. I also thought quite a bit about doing a clinical trial at NIH. Time suddenly became urgent due to an unexpectantly large PSA increase. I had to do it in November, if at all. One alternative was to just get back on HT in a couple of months and then do it during the next HT vacation (hopefully there will be one).

Also, Mayo is in-network with my insurance. They do require pre-authorization. I got the sense that it won't be a problem, but one never knows. The C-11 scan is about $7650. So, not cheap. Regardless, I'm going ahead with it.

I still have to book a hotel and flight (not cheap, either!).

I am scheduled for 11/5-11/7 at Mayo. On the 5th, they will do a heap of blood tests, and then an endo-rectal MRI. I have never had that and I thought without a prostate it would not be done. But I am scheduled for that. The materials indicate that I could request a sedative if I think it will be an issue. Well, I don't know if it is an issue? I have heard many comments indicating that it is no fun. So, how bad is it? How long does it last? Should I request sedation (I did with the biopsy and I'm glad I did).

Mel
Posted 10/24/2014 4:54 PM (GMT -5)
Hey Mel, I am pulling for ya!

I did the endo-rectal coil MRI the day after a colonoscopy! This was pre-op and all I took was a xanax about 15 minutes prior. Not fun, but not all that bad either. I swear that clock slows down during! Good luck.
Posted 10/24/2014 5:07 PM (GMT -5)
Yes, the sedative will wear off and if it is expected to be uncomfortable - take it - request it. No question unless you respond badly to sedatives. Good luck with it all. I don't think medical procedures should be 'endured' when some assistance is possible. I wouldn't let my hubby have one without it (now I sound like a control freak).
Posted 10/24/2014 7:49 PM (GMT -5)
An endo rectal MRI doesn't make any sense for one who has a prostate removed and salvage radiation. The chance of a local reoccurrence is extremely rare. Did you ask why?
A Valium or a Vicodine sure helps as you will be in a MRI with a plug up your butt for an hour.
Posted 10/24/2014 8:07 PM (GMT -5)
Mel – sorry you’re frazzled & and that you’re having to go through all this. Check to make sure the MRI machine is a 3 Tesla machine. Much better imaging with the more powerful magnets.

I did not enjoy the endo-rectal coil – at all – hated it – found it painful – extremely uncomfortable. Even with the Xanax.

Take the sedative. If they’re offering it – take it. Unless you’re made of stronger stuff (and that is quite possibly true). They didn’t offer it to me. Reeeeaaalllllyyyy wish they had. I liken it to pushing a .30 caliber rod up a .22 caliber bore!!! Oh, but wait -- they’re not done yet … once it’s up there … they Expand It :-(

Btw, for my biopsy – all I was offered was a Xanax. If I had to have another one I would have insisted on sedation, or found a different uro who offered sedation.

Best of luck – Tigerfan

PS I honestly don’t consider myself to have low threshold for pain.
Posted 10/24/2014 9:05 PM (GMT -5)
Mel, I had the 1.5 T MRI w endorectal coil on August 26 without the sedative since I had rented a car at LAX.

Though different with respect to where it hurts, a lot like a biopsy except most uncomfortale part is when the doctor first inserts it, you come to equilibrium glad the enema worked and you did not crap on them, and then more discomfort when it is removed an hour later.

Take a cab and have the sedative.

It did help to have the PSA test later in the day to get whatever PSA increase was needed to get my first of two PSA increases at least 14 days apart to qualify for Provenge and leverage the abscopal effect with my SBRT high dose radiation that took place this month.

LupronJim
Posted 10/24/2014 11:09 PM (GMT -5)
Best of luck to you Mel. I hope you get some answers.

Sonny
Posted 10/25/2014 2:15 AM (GMT -5)
Mel
I think they can offer you an Ativan when you check in for the MRI. Ask your GP or Urologist to prescribe something stronger, like Valium for the procedure. For me, the Valium and the Ativan are not effective to relieve the discomfort so I usually load up with Vicodin before the procedure. Of course, I inform the nurses and staff of the meds that I have taken.
As mentioned above, the coil is not comfortable. They will numb you up with lidocaine and insert some of the gel before they start the coil. I always ask for more gel because it never seems like enough. After the coil is in as far as it needs to be they blow up a ballon on the end. This balloon helps to keep it in place since your body will most likely naturally reject it and want to push it out.
The procedure takes 45 minutes to an hour. It is easier if you can relax your muscles and your entire body, which takes some concentration.
Another tip - ask them to give you time updates. I found it easier to get through segments of the MRI knowing I was 1/4 done, 1/2 done, 15 minutes left, etc...
The machine is loud so they will give you earplugs. It would be nice if they could play some music but I don't think that it's available.
Hopefully, you'll find this procedure to be much easier than we have described for you. I think the key is just being relaxed.
I will send you some hotel info via email.
I have had this procedure before and after my surgery and I think it was used again for analysis prior to radiation. It has been brought up that I will have to do it again. I assume the reason for this is to just have additional images of the Prostate bed. The C-11 Pet Scan images the choline uptake but doesn't give all the detail that the MRI can give (I was told this but I can't remember why - will have to ask again).
Good luck,
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