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Too many MRIs?
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Too many MRIs?

I was wondering how often is too often for an MRI?  I'm kind of afraid of my kidneys getting too much gadolinium, although I've never had any troubles with my kidneys.

Over the last 2 yrs so far I've had about 10 MRIs: 4 brain, 2 c-spine, 2 t-spine, and 2 lumbar (lumbar was w/out contrast).

They just called me again to schedule another brain MRI. Most recently, I just had one in Aug, then another in Dec, now they want another one in Mar. In fact, I'm very surprised that my insurance is approving all of these.  

Thanks,
Kelly  
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Hi, Kelly.

As you already know, MRIs don't involve radiation, so no one out there need be afraid on that front. Gadolinium, the contrast dye, is harmful *only* if kidney function is already significantly impaired. Otherwise it's completely harmless.

Still, I'm wondering with you why so many MRIs are being ordered. Usually the insurance provider would object, and I can't say as I blame them. These things are expensive!

Can you call your neuro and ask about this? I hope there's no financial incentive involved there. I'd hate to think so but it's happened before. Is there any question about your diagnosis and  treatment? What do they think new MRIs might reveal? And what possible differences in treatment?

These are the issues I'd be wondering about, though I'd find an extremely tactful way of framing them.

Let us know what happens.

Hugs,
ess
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667078_tn?1316004535
Where I get my MRIs they require a kidney blood profile first. If you are worried you could request that. Remind me you are diagnosed or not? They probably are not doing them frivolously since the insurance keeps tabs on such things. Everyone's MRIs are sent to one place in the country by all the insurance companies and they study trends to see if they are over used. It is the most used test in the country.

I think one issue and I saw this in Veterinary Medicine is Doctors who start with this technology rely on it. Older Vets for example do way less testing because the came up in a time where they had to rely on there basic diagnostic tools. I pray my Vet does not retire because he has so much experience he just knows, while his partner runs the bill up with every modern test.For a century or more Doctors diagnosed Neurological disorders with out MRIs. But then again it took over 40 years in my case because MRIs did not exist in the 1960's.

I am looking at another series and am not at all happy because of the copay. I had a brain MRI in August. You can talk to the Doctor. I ask if tests are really necessary all the time and if I can hold off.

As far as the contrast dye I buy a gallon of water and start drinking it as soon as I can after the MRI. I drink more than that, but that way I know I have given my kidneys a good flush when the gallon is empty.

Good luck.

Alex
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Actually, MRI involve electromagnetic radiation, which is a form of non-ionizing radiation.  The same thing we get from light bulbs and power lines.  It is not associated with cellular damage, but some people can actually feel their skin heat up in 3T and 7T MRI.  It is by far much safer than X-ray or even sunlight.

I understand the concern.  I have to go back from my third in a year in March.  

Bob
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Kelly,  I don't know why they order so many of these tests so often.

Alex is right, these younger doctors don't have any confidence in their own 'clinical expertise'.  

Five MRI's per year is allot and they haven't told you why?  I know when a person is being treated or monitored for cancer et al they will have multiple MRI's and other scans per year.

I would ask as soon as you can, to put your mind at ease:-)

Red

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for what is worth,  i   think i had 6   my first year and have 11(?)   in 10 yrs.
i personally do not have and problems whatsoo ever    either kidney or other.

They are reasons for me they have ordered them  and i t is ok with me.
as  they say, you can ask for reasons (but i think docotr should have explained first)
good luck , amo
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1225331_tn?1333369369
Thanks Ess, Alex, Bob, and Red.

Alex, you're right on this one - he is a very young neuro.
I was diagnosed in July of 2010 with RRMS. However, he is the one who wanted me to take Copaxone, but wanted me to wait to start taking it until he could figure out the rate I'm getting lesions. He did give me the option to start the injections - and that's what I chose.

This same neuro ordered MRIs for me in Aug., and then his plan was to wait 6 months to get follow up MRIs.  After my MRIs in Aug, I had new symptoms, so he decided to do MRIs earlier - I had them in Dec. I think they said the MRI in Dec showed a new lesion in my frontal lobe.  

Bob, I bet they'll be calling you soon, since they called me today.

I'm going to call to see if they want to at least push it out 6 months from Dec.

Thanks,
Kelly
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Oh, Sorry AMO. I started typing my last comment and got distracted by cookies. I came back and posted my comment and saw that you had added your comment, too.

Thanks for the re-assurance. Maybe your 1st year is the year you-get-slammed-with-multiple-MRIs-year.  

-Kelly
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Funny, my Neuro wasn't in clinic today at RMMS.  They had me see a Nurse Practitioner who did the exam.  She decided to wait for the six month mark from my last MRI to do more MRIs and then schedule a followup neuro appointment after the MRI.  They did do an OCT to establish a baseline.

So at this point I'm on a 6 month MRI schedule.

Bob
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Cookies?  Did you say Cookies, Kelly?  come on over, I just finished two different batches and would be happy to share.

I think most neuros will do multiple mri's if there is clinical evidence that something is changing in your exam.  Not everyone reacts favorably to the same therapy and this gives them clues if yours is working or not.  If the mri shows change you can always review other options.

It does sound to me like you've had an extreme number  - I'm sure that pace will slow down.  Most of us are on yearly MRI's after dx.

be well, Lu
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1225331_tn?1333369369
Bob, I left a message for Becky a little earlier.  We'll see what she has to say.

You're funny Lu - I'm heading over right over, but it may take me awhile.  :-)
We actually just finished baking chocolate chip cookies. Our dog isn't too happy that we're not sharing with her. Perhaps we'll give her an animal cracker, instead.
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I'll meet you halfway..........  mine are heart shaped sugar cookies that need to be decorated tomorrow night and a batch of a white chocolate cranberry cookie with orange buttercream icing.  I love to bake - it is my therapy and relaxation.  I was baking for my neuro appt on Wednesday - I always take the office staff something special.  My DH will whine thaat they aren't chocolate chip - those continue to be his favorite.
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You may be right Kelly about that first year of diagnosis being the year of the MRI.  I counted up and in 13 months I had two each of my brain and cervical spine and one each of my thoracic and lumbar spine.  Still, that's just six.

Since the majority of yours are imaging the brain, I'm guessing also that this has to do with disease tracking by image rather than exam findings or patient reporting.  All too common in my opinion (as if that matters).

I think you are wise to question this, especially if you are concerned that insurance approvals will dry up at some random moment.  It would be most unfortunate to have them deny coverage at a future moment that you most need imaging after approving so many now.


And Lulu, now I understand the great relationship you have with your neuro!  Maybe that needs to be included under the Health Pages on Tips for the First Visit?

Mary
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1225331_tn?1333369369
Lu, that's nice of you to bring them cookies.

Mary, thanks for your input.
I'm pretty claustrophobic, and the only way this imaging place does sedation is with an IV - no thank you.  So, the less MRIs, the less stress for me. Although, I think I'm getting better at being in it for so long, espcially when they do brain and c-spine back to back.

I'm still waiting on the return phone call to see if they might want to push it out to at least June.

Thanks,
Kelly  
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Kelly my girl, I'm super impressed you survived even one of them suckers being claustrophobic!

(Just wondering though, if you have IV access for the contrast, will they not use the same site for sedation?  Or do they want to give you urine producing fluids while you lay in there sleeping and bladder unaware? OMG, please say that isn't so!!)

Mary
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1225331_tn?1333369369
For the contrast, they just bring a needle over and just do a quick injection in my arm. The thought of the needle staying in my arm (with an IV), just doesn't make me feel warm and fuzzy all over.

Ha ha, yeah, that doesn't sound like a good idea to load you up on fluids and then have you lay there passed out or carefree. You may just decide to go...  
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Hi Kelly

I have also wondered about having regular MRI's as I have had probably about 12 in the last year and have a monthly brain MRI with contrast for the drug trial I am on.  My Consultant has reassured me that it is quite safe and like Alex I just try and drink lots afterwards. My main problem is actually getting the canula in my arm as I have small veins and they are often resitant to the needles!

Cheers

Sarah
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1225331_tn?1333369369
Sarah,

You cerainly have had a lot of MRIs, too.  I can see why you have had them so often though, since you are on a drug trial.

I have small veins, too.  Lately it's been taking several pokes to get it. And since my veins are so small, they collapse easily.
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Yep, turns out it was just an order that had been set-up to be automatically called up 6 months after his initial MRIs in Aug.  Since I just had another set in Dec, then they just told me, that I don't need to get this new set in Mar.
Sounds good to me....
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