A St. Jude support program helps children with sickle cell disease sail through their MRI scans without anesthesia.
The day of her most recent magnetic resonance imaging (MRI) exam at St. Jude Children’s Research Hospital, Kie’a Boyce seemed oblivious to smiles and curious glances as she boogied her way across campus—from the Hematology Clinic, through the hospital’s winding corridors and into the diagnostic imaging suite. The 9-year-old could not resist the urge to shake, twist and wiggle.
“She danced all the way to the Chili’s Care Center,” says her mother, Eva Curtis.
With the squirming out of her system, Kie’a remained motionless for an entire hour as the MRI machine captured 3-D images of tiny vessels in her brain.
The exam was necessary to evaluate how well she was responding to treatment for sickle cell disease.
The little girl’s pre-scan dance routine was not just a fun diversion—it was also a specific coping mechanism designed to help Kie’a cope with the upcoming medical procedure. The tailored interventions she had received beforehand prepared her to stay relaxed and motionless during the hour-long scan.
MRI scans of the brain and liver are routine for children with sickle cell disease.
Until recently, many young patients required general anesthesia because of their tendency to move during lengthy MRI procedures. However, children with sickle cell disease are at greater risk for anesthesia-related complications. By avoiding general anesthesia during exams, they experience fewer hospital admissions and emergency room visits.
At St. Jude, children as young as 5 years old have a greater chance of completing their scans and avoiding general anesthesia thanks to tailored preparation and support procedures available through the hospital’s Child Life program.
Preparing for the big day
St. Jude Child Life Specialist Katherine Bailey meets with sickle cell patients and families several weeks before their scheduled MRI exams to discuss possible barriers to completing scans.
Together, they develop coping plans to overcome a fear of confined spaces, a sense of isolation during the exam, or the loud noises that occur during the imaging process.
After identifying possible obstacles, Bailey demystifies the MRI process by introducing patients to the sights, sounds and essentials of MRI testing. She encourages patients to dance and move about freely during training before guiding them through exercises that help them lie still.
Bailey and Jane Hankins, MD, of the St. Jude Hematology Clinic, recently decided to quantify the program’s benefit to patients with sickle cell disease.
The pair discovered that children who received the short preparation program before MRI exams were eight times more likely to complete the scans without general anesthesia than were patients of the same age who did not receive the preparation.
Preparation and support procedures are commonly used in U.S. hospitals, but the St. Jude study is the first of its kind to focus on children with sickle cell disease.
Today, St. Jude patients with sickle cell disease routinely attend Bailey’s training sessions to prepare for MRI exams. General anesthesia is reserved for urgent cases or for children who are unable to complete scans despite preparation. In those instances, preventive measures are taken to prevent anesthesia-related complications.
“Each time we avoid putting patients under general anesthesia, we avoid the additional risks to patients and eliminate the burden for families,” Hankins says. “What Child Life has done is a great example of the collaboration that exists at St. Jude.”
Abridged from Promise, Spring 2013