The long-awaited MRI (magnetic resonance imaging) will soon be providing a service in Bermuda that previously residents had to travel abroad for.

It is anticipated that the machine, recently installed on the ground floor at King Edward VII Hospital, will be fully operational by early December. In fact, scans have already been performed on people - hospital staff and others - invited to have one and and will soon be open to the public. Last week 25 scans were performed on volunteers.

"Most exams are from 30 to 60 minutes long and patients, for most exams, lie on their back and enter either head first or feet first," explained Rona Donawa, the senior imaging technologist.

"The magnet uses the water molecules in the body to produce its images, along with radio frequency pulses. The exam is very loud so hearing protection is mandatory. We provide them with either the music through headphones or disposable earplugs. Patients can bring their own CDs or cassettes. Once the pulses have been detected the computer generates and reads the signal - transmit signals and receive signals - and turns that into images."

The scan is different from a CAT scan in that the MRI is for soft tissue and muscle.

"We don't see bone very well and our procedure is a lot longer than a CAT scan. We don't have any radiation, and most of our exams can be done without a needle stick, or contrast, or a dye which is what some people call it.

"We have special coils for each part of the body, so that we can get the best image possible. We can image anything on the body."

Said Carol Maher, whom General Electric, the makers of the machine, sent to Bermuda to help Mrs. Donawa get familiar with the machine: "We also image blood clots without giving a contrast injection."

An engineer from GE, Ed Plaskon, was also in Bermuda for about three weeks to oversee the installation.

"He basically brought the machine to life and made sure all the kinks were worked out electronically," explained Mrs. Donawa.

"Carol came in to help me and the other technologists get familiar with the procedures, what the scans can do and how to operate different equipment."

Because of the strength of the magnet within the MRI machine, the area is a highly sensitive one where electronics such as watches, mobile phones, cameras, even swipe cards, are not permitted in the room. Prior to testing, patients are asked a series of questions such as do they have a pacemaker, organ transplants, hearing aids, etc.

"The magnet is about 25,000 times the strength of the earth's magnetic field and because of that we have to have special equipment that can enter the room," said Mrs. Donawa.

"We have our own fire extinguishers, wheelchairs, IV poles, stretchers - the list goes on and on - and they are made out of MRI compatible metal.

Royal Gazette photographers Tamell Simons and David Skinner were not allowed into the room with the MRI machine and had to take photos through the door which was open prior to a scan being performed.

Damage would have been done to the digital camera and not the machine if it was taken into the room "unless he got close enough and it had metal components where it could actually be attracted to the magnet", said Mrs. Donawa.

"If he got close enough damage would have been done to his camera and if he got closer damage could be done to the camera, the machine and possibly any personnel or people in there. Face watches, because they are made with gears that grind, will actually freeze because they get confused about which way they are supposed to turn."

Said Mrs. Maher: "Nowadays people have so many things implanted in them that they usually carry a card that says it is MRI compatible, or a card that says exactly what it is so that we can look it up and say it's okay."

Once the patient slides into the machine for a scan, they have to lie motionless during the procedure. Claustrophobia is one of the main concerns for most patients, but the trained staff help ease the discomfort with encouraging words during the whole process.

There is a quiet time between scans which allows the technologist to check the scan and prepare for the next one. Audio equipment enables the technologist to talk to the patient during the whole process.

"We coach the patient, talk to them and in extreme cases we provide them with medication to help relax them," explained Mrs. Donawa.

"We prefer not to do that, but in cases where a scan is necessary we have to do it. We can't distribute their medication, however, so the doctor has to write them a prescription.

"Sometimes people go in and get a little concerned so I bring them back out and just talk to them and give them time to think about it. Basically we do whatever we can to get the scan.

"If their doctor ordered it for them they need to have it, but at the same time we can't force them in there. The space is a little bit confining, even for the smallest patients."

Mrs. Donawa says she is very familiar with the MRI machine, having trained abroad on GE equipment while at Michigan State University. Presently she is the only one qualified locally to operate the machine, but two others are being trained.

"We can print out pages of the images and we always print a text page which has the patient's name and ID number, their age and all the important information so when the doctor puts it up there is no doubt that this is so-and-so's films," she explained.

"It lists what scan we did and what type of scans we did. We do different scans to see different things, we can adjust the contrast level and get your blood and fluids to look white on one image and black on another image. That all helps us to get a good idea of what's going on."

Mrs. Donawa estimates the hospital will be doing about six to eight patients a day from the outset. Because of the length of each scan, this type of scan will not be used for emergencies, though.

"For something like a road traffic accident they will need something like a CAT scan which is really quick," she explained.

"This takes too long to get to the end result, but once they are stabilised and if they still need more information they can come here after that. It has to be approved by the Radiologist who are the doctors governing the Diagnostic Imaging Department.

"The Radiologist has the final say as to whether or not a scan should be done. An ultrasound shows some things better than an MRI does."

Mrs. Donawa is looking forward to seeing the green light which will signal the MRI machine is open for business.

"There will be a rush for the door and we want to make sure we are ready for that," she stated.

"We want to serve the community properly and efficiently."

Said Mrs. Maher, who has since returned to Connecticut: "Never have I been to a place so happy to get a system. We take so much for granted (in the United States)."