mri scheduled

[ELT]

   Well, just got off the phone with the hospital.  They have scheduled my mri for saturday feb 23.  When I asked about contrast, she said, no.  When I asked why, she said it was up to the radiologist, I understand that, what I wanted to know was, what makes him decide yes or no?.  She told me it was a ms workup, or test, or whatever that they were performing, so, they would pick anything up that was there, no dye necessary.  

   She was quite nice, and suggested I make a follow up appointment with my neurologist for two weeks from that date, but, that isn't possible at the moment.  Many reasons.  So, when I asked if it would be possible to also recieve a copy, she said I would need to ask my gp, or I would have to pay for it.  But that I could tell the hospital that I was from out of town, and had a follow up in my area, too soon to wait for the report from my neuro, and they may give me a disk of the mri.

   I said I was having all sorts of difficulties again, in specific locations, she said they would look at it all.  But, I've been there before.  Last year.  And the year before that, and, and, and.....

   Question is, is she accurate about the contrast dye being unnecessary?  And, will difficult to diagnose optic neuritis show up? The trigeminal nerve?  What about it?  I have so much facial stuff going on at present.  I'm quite scared that nothing will show up again.  

   Sigh.  Amazing I WANT an illness, eh? lol lol
   Thanks, Erica

[ELT]

   Thank you, yes you have all helped tremendously, I pity the poor girl who  had to deal with my confusion as she tried to set my appt time.  lol, she was great. very patient, with me, and very helpful. As are all of you in here.  

   I just am soo concerned that, although I am feeling lots, they, again, won't see anything.  I know what I'm feeling, and I know how I couldn't see right, for two or more weeks, 'til just over a week ago.  But, nothing ever shows up.  

   I kind of hope, since things are worsening again, that they will see something, but, I was MUCH worse than this last time it happened, almost three years ago.  Took me almost a year to recover, yet, they saw nothing.

   How can that be?

   Erica

[Quixotic1]

This brings up a very confusing use of the word "active" when talking about lesions and MRIs.

If you are having symptoms from MS you have "active lesions."  This just means that nerves that have a direct effect on the body are damaged and you are suffering from this damage.  In that way all symptoms indicate areas of damage - old or new.

When we are talking about MRIs though, "active" takes on a different meaning.  In the MRI active refers not to the lesion, but to new inflammation "in or around the lesion.  The contrast shows the inflammation around a newly forming or newly enlarging lesion.  So you can be having symptoms, but not have any brand new (less than 6 weeks old or so) areas of active inflammation.  You can't see inflammation in new lesions without the contrast.

Whether they use contrast and who makes the decisions can be determined by the doctors, if they have free reign.  Or it can be determined by an insurance company or a national health service.  If no lesions are seen at all it is unlikely (but not at all impossible) that just enhancing ones will be seen.  So in a cost benefit analysis they might argue that, if there are not lesions, it is a waste of money to run the test again with contrast.  If what you care about is finding every possible lesion, be damned the cost, then you would use contrast each time.

Hope this helps clear up some of the fuzzy areas.

Quix

[ELT]

   Thank you for explaining, I understand, finally, phew.  I can be a little slow, but, I get it eventually.  Problem is, I forget it a few times before it stays there. LOL LOL

   But, thanks, I understand much better now
  
   Challenge me, ask me tomorrow, if I know what the heck you're talking about, lol.  I've read what you said about eight times now.  I should have the gist of it.  At least I know not to worry.  That without anything will be seen.  


   Thanks, Erica

[Heather3418]

Be assured....before they use dye, even the active lesions will show up as white or bright....if they see those and then inject the dye, they will be super bright and the sorrouding brain tissue will "glow" bright white.  So don't worry, even active lesions will show up without dye.  The radiologist will see that even before the dye.  So please don't worry.   If he sees the lesions and can tell that they "look" active" he will use the dye.  Not to worry honey....

Heather

[ELT]

  Please don't think I was sounding annoyed with your answer, I was annoyed I wasn't understanding.  Silly me, yes, I am in ontario, which may be different.  But, what you say, Heather, about the contrast showing only active lesions, I guess that was why I was hoping they would use it, I believe there are active lesions right now.  I have been having an increase in weakness, fatigue and pain.  My vision has just cleared after two weeks of being blurry.  So, I was hoping if they used contrast, they would see any active stuff.  But, I really don't know much about this stuff, I'm still learning. LOL LOL


Thanks again, all

Erica  :)

[Heather3418]

Heres what an old lady of MS has to say....if on the first scan through the radiologist sees lesions, he will then order contrast for the next scan.  If you have lesions, they WILL show up whether you have contrast dye or not.  The contrast is only used to see if they are "ACTIVE" lesions.

And yes, even in the States, it is sometimes left up to the radiologist whether to use contrast, unless it is specifically ordered by the doctor.

My Neuro will ALWAYS want an MRI using "MS Protocol" and with and without contrast dye.

I also ask for a CD of the scan from the radiologist saying that i need to take it to my Neuro appointment that follows my scan.  They always give me one.  Mind you, that if you get the CD of the scan, be VERY cautious about trying to "read it yourself."  What we THINK we see, may really be nothing.  I am serious, cause this old lady tries to "read her own scans," thinking she is smarter than everybody else and usually wind up wrong about "what I THINK I see."

I learned a long time ago, leave the reading to the experts.  I can only give the CD an uneducated guess.. Sometimes I do know what a NEW ACTIVE lesion looks like...

Heather

[hbananas]

I think maybe we U.S. folks are applying the rules from our book to your situation in Canada.  Maybe there the radiologist really does decide?  Single-payer system and all that, you know?  I hadn't noticed you were in Ontario.  Maybe your radiologist will be right there at the time and order contrast if he/she feels it is necessary based on what is seen in the first scan.  As I understand Quix's excellent tutorials, the contrast helps differentiate new lesions from old, among other things.  Does it follow that if there aren't any lesions at all, there's no point in using the contrast to age them?  Anyway, I'll quit bugging you and wish you the best.  You know we all expect a full report afterward, right?
Holly

[humming4u]

hi, i'm kinda new to this site, but not new with what sounds like a lot of what your going through.I hated to read that you said things such as "they think I'm psycho" I'm so sorry some have made you feel that way. but don't you let them stop you from needing testing and finding answers okay.
I agree that the doctor is the one that orders the test and therefore orders the conditions he should want carried out.i'm pretty sure with contrast is the better way, or else why would they even have it.
may all things go well for you that day, and answers soon follow.
                                                                                       Cathy

[ELT]

Thanks for the advice, all, well see how it goes, I guess.

Erica

[AMO]

hi erica

i'm with them, it should be the doctors cal  on what testing involved, the radiologist is to read the test, the tech to preform the test.
I once had mri without... i questioned the tech over and over, i never had one without so thhis wa s wierd.

Of corse my doctor wanted it both without and with, the hospital had it wrong in paperwork, i should have made them call when i was in there...... he told me he    will alsways want contrast (well until there iiis maybe in the future years no need?)
If that ever happens again to me, I will not  get up f rom the table until they do, take up the precious mri time, and see how they respond

Good you have time be tween  now so you can get it cleared to have them right what the DOCOTRS want.
good luck amo

[kitten o]

WELL THEN I GUESS IT IS OKAY.
GOOD LUCK AGAIN.
I HOPE IT ALL WORKS OUT FOR YOU.
HUGS KITT

[ELT]

   I made sure I asked the neuro, face to face, at my appt.  He said then, it was up to the radiologist, not him.  Then I asked the lady who made my appt, and she said the same thing.

   So, apparently, I don't get it.  And just now, when I asked a friend if it will make it easier, that I'm feeling things again, tho, not so bad as at their worst.  She said it didn't make a difference if it was active or not.

   Erica

[kitten o]

I NO IT IS WEEKS AWAY, BUT STILL I WISH
U GOOD LUCK. I ALSO HAD MINE WITH
AND WITHOUT CONTAST. I AM SURE THE
DOCTOR HAS TO ORDER IT . NOT THE RADIOLOGEST.
I WOULD CHECK AGAIN.
I HOPE ALL TURNS OUT WELL.
YOUR FRIEND KITT

[ELT]

I did ask him, he said it was up to the radiologist too. dang, whats up with that?


I know, they think im psycho, and theyre just amusing me to shut me up and make me go away. You know,  give the chick the test, shell go away for a yr, and maybe wont come back next yr. lol lol

Erica

[hbananas]

Isn't the contrast decision up to the doctor who ORDERED the MRI?  I mean, when I went for mine, the slip distinctly said give her brain w and w/o contrast.  I'd call my pcp or neuro before settling for that.  For heaven's sake, you're already there lying in the machine, why not get the most bang for the buck?