So in the course of my daily life, I have needed to mount a search for imaging (CT scans and MRI) that is accessible for superfat folks. As I found it rather challenging to locate, I thought I would offer resources so other folks could find this kind of thing more easily. I am located in the U.S., so YMMV depending on where you are.
Most hospitals and locations for this sort of medical testing have MRI and CT scan capacities that cap at 350lbs. The difficulty in finding resources for folks who weigh more than that has been documented; I include some links below. (As a heads up, often the articles are fatphobic.)
- Here is an article in the SF Chronicle
- Here is an article in the Philly Inquirer
- Here is a post on RedOrbit.com
- Here is a 2008 study of access issues in the ER published in Obesity magazine
- Here is an article published on Aunt Minnie
So where do superfat folks go? Starting with your doctor seems like a logical step. The problem is that many doctors do not know about resources for this kind of testing and are often unwilling to search for them. In the Emergency Department when they are working for a quick diagnosis, they often fall back on pre-imaging diagnostic procedures, treating for conditions like pulmonary embolism based on little evidence, mostly because they are life threatening conditions that doctors cannot rule out right away without access to imaging. (That’s what it means when the doctor says they are going to treat empirically; they are assuming the diagnosis but cannot or have not yet confirmed it because they cannot test to rule it out or have not received the results from the tests they can do.)
Outside of an emergency situation, doctors are still often reluctant to search out possibilities for imaging for superfat patients. They will say that kind of testing is not possible, or tell patients to lose weight, or sometimes throw up their hands and say go to a zoo.
However, with some diligence, it may be possible to locate testing that is accessible. The first thing I would recommend is to tap your social network. If you are connected to fat activist folks in the area, you may have access to a whole lot of information about possibilities for medical care. It is worth tapping your network or asking one of the folks you know who is particularly well connected to tap theirs. (For example, I found one real possibility on my own, but by tapping the network of an especially well connected friend, found three other possibilities to explore.)
That said, some folks don’t have access to those kinds of networks, or want to figure things out on their own if they can, or want to augment what they learn from their networks. Here is what I’ve learned in my own searching :
How do you search for these things on the web? Firstly, know what language to use in your web search.
- Imaging technology (CT and MRI imaging equipment) that is more accessible is often called “open or “large bore”, “wide bore” or “full bore” (bore refers to the opening where the patient lies or stands, and standard machines are often too small, capping at 50cm). So searching “open MRI Philadelphia” may get you results.
- Larger MRIs can go up to 70cm, so a search string like “MRI 70cm Bay Area” may gain you information about where to locate the appropriate testing. (CT machines can go up to 85cm.)
- Including the weight limit in your search string can also help you locate a machine. Common weight limits are 450lbs, 500lbs, 550lbs, and 650lbs.
- It can also help to search for the name of the machine itself. Here is an article that lists MRI and CT scanning machines that are accessible to superfat folks, with their specs.
- A search string I tried that I would not recommend: “obese” & “morbidly obese” while being the most common medical terms (so I thought they might help me locate appropriate imaging technology), gleaned me very little in a google search, except weight loss recommendations and bariatric treatment focused on weight loss. Even combined with MRI or CT scan, I got nothing useful.
How do you know if you’ve found a good potential resource on the web?
- Blog posts and articles that name access difficulties often list specific locations where testing can be done. If they are from your area, that may be a great resource.
- Hospitals (especially university hospitals) often seek and create press about the latest technologies they use, so this can be a great resource for locating accessible equipment. So, if you find press like this, or promotional material like this, it can be a great help. (That is how I located something that hopefully will work.)
- Sometimes folks compile lists, that can be accessed on the web (like this blog post). Here is one I found that was created for a medical school, that may be helpful.
So I’ve found a potential resource, how do I confirm that it is one that this patient can access?
- Looking at the website for the specific location can really help, including the pictures of the equipment. Checking this out helped me to rule out the location because it is a standing (upright) open bore machine, which would not work in this particular case
- But nothing compares to talking to a live person. You want the scheduler, ideally, because they know the most about the equipment. Locations that have accessible machines for superfat folks may have knowledgeable receptionists as well.
What do I ask once I can get someone on the phone?
- You need to know the weight limit and size of the bore in order to judge whether this machine will work. This is an area where folks are very unlikely to blur the lines; if the person needing the imaging is 515lbs, folks will not let them use a machine that is rated for 500lbs, for the safety of the patient and of the machine (which is very expensive and they don’t want to damage it). Some places require that the patient was recently weighed by their doctor and can confirm their weight exactly.
- I said something like…”I’m looking for an MRI or CT scan for someone who weighs over 500lbs. I heard that you had an open bore MRI machine at your facility. Can you please tell me the weight limit? And what is the bore size? What kind of machine is it? The patient I’m looking for is someone who cannot stand for more than a couple minutes; is this an upright machine?”
- If you are polite and charming to the folks on the phone, they may be able to refer you to a facility that can meet your needs even if their machine ends up not being accessible. I had great luck that way, saying something like “do you know of a facility that might have something that would work? It would really help me out so much,” and then thank them profusely for all their help (even if you just ruled some things out).
- If you rule a machine out, it can help to ask what the name of the machine is so you don’t chase down that rabbit hole again in your search.
- Cat and dragon (a great website compiling resources for fat folks around health, including a list of fat-friendly health professionals) suggests confirming the weight limit if you think they may be shaving off some, asking for the warranty or asking them to call the manufacturer. They also suggest making an appointment to try to get into the machine and see if you fit.
Of course, you may try all of this and still be unable to locate accessible imaging. Here are a few ideas that I’ve gleaned from my own search.
- This doctor may not search out the information, but another one might. Or further advocacy may pressure your doctor to search it out a bit more. Doctors can often access things we cannot as laypeople.
- I’ve tried to call the people that make the machines or sell the machines to locate places where they are, and could not find a machine close enough that way, but that can be another method that may glean results.
- While zoos are very unlikely to let humans access their equipment, the study published in obesity magazine suggests that a small number of veterinary schools with large animal CT scanners (often with a 1000 lb weight limit) may let them be used for humans. You may also consider reaching out to large animal vets or vet hospitals.
- You can try cold calling testing facilities. I would recommend beginning with university hospitals and teaching facilities as they often have more advanced equipment.
I would be willing to share info about specific locations I’ve found in the Bay Area should that be of interest for folks reading this. Just let me know, and I will send you what I found.
I found an accessible MRI but I am still on the lookout for CT scanner that is accessible to superfat folks in Northern CA. If you know of one, I’d love to hear about it. The closest I’ve found is LA.