Question...are the doctors right?

A family member of mine has been experiencing some MS symptoms for about a couple of years now. We've been to a NUMBER of doctors this past year, who have run just about every blood test and everything has come back perfectly fine. After begging one of the doctors to order an MRI, he finally did, but he didn't indicate on the order that he wants to look for MS.  Instead, she got a 5 minute basic scan of her brain.  The report indicates it was Without Contrast, and it was done on a 1.5T.  All the report says is 6 words:  "No signs of bleeding. Unremarkable Study."

The doctor said that this means she does NOT have MS and she needs to ignore the symptoms the best she can.  He refused to give her medication for her pain and lower limb problems.  So we begged the doctor to send her to a neuro, and when we went to the neuro (about 5 months later), all he did was a reflex exam which showed that she had problems, and then he said "lots of people have increased reflexes..nothing to worry about".  Although he was very very polite, he basically wanted to kick us out of his office after the brief 3 minute appointment.  I couldn't help but think, we waited 5 months for a 3 minute appointment that went nowhere? Thats when  I began advocating for her and talked to him about MS, & asked him to look at the MRI.   He finally looked at the Brain images from the MRI and said he doesn't see anything that would suggest MS or any other neurological problem,  and that we should go back to our doctor if we had any questions or if things got worse.  I then asked if she can get other tests to definitely rule out MS, but he kept saying "but she already got a Brain MRI" and said that it was unnecessary to order more tests.

What should be our next step? Should we travel south (to the States) to get help for her? But how much will that be?
Even if we get a new doctor, and then beg that new doctor to send her to a new neuro, that will be about 5 or 6 months away. We are tired of waiting.  And most likely, we will get the same kind of response from a new neuro, since from what I heard, they're all the same!
Are the doctors right? Is it nothing just because the brain MRI shows nothing?
Help!

[Karen99]

Welcome.  The best answer I can give you is to refer you to our Health Pages because there  is a lot to consider and weigh in your questions:

http://www.medhelp.org/health_pages/list?cid=36

Within those pages will be in-depth answers to your question.  The questions you ask are not easy ones to answer.  :-)  

The typical MRI of the brain when looking for MS lasts at least 1/2 hour - longer if a contrast dye is used.  The strength of the machine can matter in showing lesions, but just as important is the size of the slices/views of the brain.  Smaller cuts/views are needed when screening for lesions.

Hyper-reflexes are a possible sign of a neurological problem.  A 3 minute neuro exam is not adequate.  It saddens me that things have to be begged for.  It is positive that lab work has been done.

Perhaps her family doctor can treat her pain? Is the lower limb problems weakness?  Pain?  Or both?  

It would help if you are willing to be more specific with her symptoms.

[kubbyskoo]

I wish I had all the right answers for you, but I don't. Lots of nuerological, psychological and muscular things can go wrong within our bodies without it being MS. If there really are signs of some kind of nuerological problems, that's where I'd have the doctors expore as to the reason for it. Good Luck.

[LisaJF]

My last MRI lasted 2.5 hours but that was with brain, c-spine, thoracic and lumbar.   Yes, there are a plethora of diseases that can cause your family member the symptoms they are having.

I must admit -- Im not tolerant of any medical professional who poo-poos anyone's complaint of physical nature.  To me they are not "listening" and disregarding what you're saying.  I hate that.  I've had to clean up a lot of emotional messes MD's have caused in a clinical setting because of that attitude.  

Either you need to get a new primary or a second opinion from a Neurologist (or both) that will spend on your family member's first INITIAL visit more than three minutes of time.  That is just insane!

I can feel myself getting annoyed already as I reread what you wrote.  

Good luck to you and your family member.  They are lucky to have you.  Stay strong, stay focused and be persistent.

Lisa

[kelly97]

I definitely think you should try to get a second opinion for your family member.  A lot of us have the same story of not being listened to by the doctor that we see or initially went to see.  And I know the feeling of waiting forever to get in to see the neuro and then when you finally do, they don't take the time to listen - which NEEDS to be part of any good medical examination.

The 1.5T MRI is actually pretty typical. I have a diagnosis of MS and all of mine have been on a 1.5T MRI. However, not using MS protocol could run your family member into diagnostic problems. For an MRI looking for MS, they really need to use the MS protocol  for the MRI, so they can see more slices of the brain. There could be lesions in there that have been missed.

As for tests that definitely rule out MS - hmmmm, I'm trying to think of any that would rule it out, and I can't think of any right now.

The main thing that bothers me here is the neurologist not taking the time needed to do a  good examination. That troubles me to know end.

Good luck,
Kelly  

[ericaMA]

Thanks everybody

[HVAC]

I know it is frustrating. If you come to the States a brain MRI with contrast typically runs about $3000. I do not know if it is less with cash. If you go to a Neurologist make sure it is a MS Specialist. Neurologists in the States specialize and if they do not know about MS they may miss it. You will need a referral in most cases. Sometimes there is a wait. Mine was 8 months for the Neurologist I see now. There is a shortage of MS Specialists in some place in the U.S. My diagnosis with signs of MS on the first MRI and all other tests was still two years. I had to see a half a dozen neurologists, had 4 MRIs all abnormal, a VEP, BAER, SSEP all abnormal, A LP abnormal, tons of blood work all normal. All my Neurological exams were also abnormal. From 2007-2009 all my testing ran about $20,000 all together but that might of been marked up for insurance.

There are hundreds of Neurological disorders and about thirty MS mimics. It takes time to sort out. I found if I hit a road block I would try a new Neurologist. I am not sure how hard that is in Canada.

[ericaMA]

Thanks

[Sumanadevii]

Is the neuro so dense that he doesn't know that you can have MS without lesions on the brain?  A spinal MRI hasn't been ordered?  WTF?

[sllowe]

Welcome - I'm sorry for what your both going through.

A 3 minute or 5 minute 1st neuro appt. absolutely is a substandard level of care and unprofessional at minimum.

Are you responsible to pay for this appt. yourself? Or, is there a healthcare system involved? Either way, what you describe in not a thorough appt. It would not be for any medical profession.

While I cannot speak to what she may be dealing with, I strongly suggest you consider reporting this appt. to the proper authority. I too suggest you read our health pages - they are jammed with useful information.

Welcome - welcome,
-Shell