early chronic small vessel white matter ischemic disease

Had a MRI with following results: No acute intracranial abnormality, a few tiny foci of increased FLAIR signal in the subcortical white matter may be related to early small vessel white matter ischemic disease. No abnormal enhancement is seen. Also showed some sinusitis problems and deviated septum which I was aware of. .  Wondering if this is any danger or needs further interpretation by neurologist? My mother has recently been diagnosed with a small meningioma and an aneurysm on lateral cavernous sinus area.Her right eye lid is nearly closed and her eyeball has stuck to the outer corner of her facial area and complains of neck pain.  She is to have aneurysm repaired June 1st. Menigioma is slow growing they say and it should present no problem. She is very forgetful, has hard time understanding things but also shows cerebral atrophy and small vessel ischemic disease.  I, too, am becoming more forgetful seems daily. My mother is 77 and I am 52. She has high blood presssure but well controlled on medication. Family history of aneurysms, alzheimers, stroke and cancer. I myself have COPD, polyneuropathy, CIDP, polycythemia, CHF, have had 1 heart attack, have 3 compressed nerves in lumbar, cervical and left elbow, have left foot drop. had one thoracic laminectomy without significant change. losing feeling in left side. left eye seems to get blurry at times amd at times seems to want to close some.. no headaches. no other unusual symptoms other than what I call forgetfulness more than a mild degree for a 52 yo woman. Am concerned due to history. Cholesterol has been ave 150 however my good chol is always low. I am nearly wheelchair bound due to leg weakness, fatigue and pain in lower back. Cannot do surgery due to being a chronic smoker for past 30 yrs(yes, I know the dangers about smoking and am trying to quit) My concern is my MRI needing further evaluation by a neurologist because I know my family doctor will say it is "fine and that it just shows we are getting old" which is a quite common statement from many doctors. I was a RN for 15 yrs before becoming diabled so I am not stupid but a lot of things have changed over the pst 15 yrs I have been disabled.  Any treatment for any of this other that the smoking. I will also add that I take 240 mg Lasix daily due to CHF thus leading to the polycythemia and who knows what else. In a constant state of dehydration. Resting O2 will run 93-94% but with sleep or activity it will drop into 60-80's.  No sleep apnea just drop in oxygen and I do wear oxygen at night when I go to bed. Do I just need a shrink or am I paranoid of losing what mind I have left? LOL Sorry but have to laugh to be able to survive in this painful world I live.  Any answers and help appreciated. Also one other question is wondering if the aneurysm repair will help my mothers memory and cognitve functioning or is she headed toward Alzheimers or just a Dementia?  I seem to be following right in her footsteps and much faster than she. Thanks again and God Bless!

[rendean]

Hello and welcome to the forum. I' m also a disabled RN and have been through several of the dx you have.

Shelly did a great job teasing out your history into a medical timeline you can use to present to an MD. We also have Health Pages,located on the  main page, on the right side just under "Recent Activity" that discuss the importance of time lines when visiting your docs.

You mentioned CIDP as one of your dx. I was initally dx with that as well. How was yours dx? Mine was ruled out by repeated EMGS.

As for the forgetfulness, I would chalk that up to low O2 sats and the COPD/CHF.

I am sorry for all that is on your plate and your Mom's upcoming surgery. Being 54, I wonder all the time if my forgetfulness is age or MS or poly-pharmacy (which is being decreased all the time-yes!). Perhaps this what is going on in addition to the low oxygen levels.

Since your MRI did not list brain atrophy then I will lay aside the fear of your own early dementia.  Stress will definitely increase mental confusion as I am sure you know from your professional past.

I hope we have helped you. I know Shelly's time line is excellent and Sarah offered some valid points.  Let us know if we can help in any other way.

Ren

[SarahL2491]

for starters your post is hard to read for us MS patients, need to break paragraphs up every now and then

am not sure if we are talking about you or your mother!  

who ordered the MRI?  a neuro or your family doctor?  I don't see anything on the MRI that indicates MS.  Perhaps your problem is spinal or nerves pinched.  Since you have spinal problems to begin with, I 'd start with the docs who did that surgery and ask them.

MS will require ruling out all of the mimic diseases so be prepared for a long haul if you think that is what it is.  True MS has a hallmark of foot drop but other things cause it too.

Good luck and perhaps ask your good doctor to humor you and run some mimic tests (such as lyme, etc.)

[deerfisherman]

Thank you for your comment! I apologize for the run together but that seems to be how my brain is functioning at this time. If I dont write it while Im thinking of it-I will forget it. I have an education and can spell and write-my brain just doesnt want to cooperate.

I had some workup when the CIDP was discovered when I have the back surgery which they say is why I developed foot drop. The foot drop came first which led to follow up with neuro and thus surgery. Was neg for Lyme disease at that time.

[SarahL2491]

am told we all get small vessel disease with age (must we?) and I guess I would ask the neuro who followed you after the foot drop and ask him to look at it, for another opinion, but as a fellow RN sister, I don't see it anywhere in your post.

Doubt aneurysm repair will repair memory but will increase her lifespan probably!  

sounds like you have a full plate of things going on.  Hope it turns around a little bit for you.  You could have an LP but then 2% of us (me included) come up with no 0 bands showing so that might not give you any answers either.  As you know, its a long and slow process to figure out.  

How about making some categories (like we used to have to......groan)
and list your symptoms on the left, like a time line, and then try and put them by "X" in the category they fit best in.......(i.e., MS, spinal, nerve, disc, chf,etc)  might show a pix......

Good luck and keep us posted, we all learn from reading each other's posts

[deerfisherman]

Thank you Sarah! Havent seen a neuro now since 1004 when they discovered foot drop and done the laminectomy.  What do you reckon makes some people develop more white matter at an earlier age than others/(other than Gods will) and the small vessel ischemic disease. Will it all lead me to my moms staus of memory loss, disorientation, difficulty understanding sppech, ?Alzheimers, MS, etc. Why me at 52 when she made it to her 70s and her sister made it to 91 reckon?Im not begrudging them, so please understand that Im trying to see if there is something more I can do. I have started a new supplement to increase circulation and it seems to be helping somewhat. Thanks for any information and your kindness and support!  

[sllowe]

Hi there,

Thanks for joining us - I'm going to try to separate this for you, and you fill in the blanks where dates, etc. are concerned. I feel 2nd opinions are always in our best interest, especially where treatment is concerned. 2nd opinions also provide confirming diagnoses, not necessarily different diagnosis.

Tests:
(date/year)
MRI: No acute intracranial abnormality, a few tiny foci of increased FLAIR signal in the subcortical white matter may be related to early small vessel white matter ischemic disease. No abnormal enhancement is seen.

Family history:
Mom (72): diagnosed with a small meningioma and an aneurysm on lateral cavernous sinus area. Scheduled aneurysm repaired June 1st. Menigioma slow growing. Cerebral atrophy, small vessel ischemic disease

(Add Family member) history of aneurysms, alzheimers, stroke and cancer

Symptoms:  Forgetful, leg weakness and blurry vision

Dx history: COPD, polyneuropathy, CIDP, polycythemia, CHF, have had 1 heart attack, have 3 compressed nerves in lumbar, cervical and left elbow, have left foot drop. had one thoracic laminectomy without significant change. losing feeling in left side

240 mg Lasix daily due to CHF thus leading to the polycythemia

Current problems:  left eye blurry at times, seems to want to close
leg weakness, fatigue and pain in lower back.

Past profession: RN for 15 years before disabled by (add disabled dx)

I'm so sorry for all these things seemingly affecting the other. Yours fears are understandable - you have a lot going on!

I too feel if you are able to categorize this it will be helpful for an MD to start weeding through what is causing what. I hope they are able to one-by-one work towards getting some things under control for you.

thank you for trusting us for thoughts,
-shell

[SarahL2491]

Thanks, you did a GREAT job of regrouping that for our friend!

[rendean]

Hello and welcome to the forum. I' m also a disabled RN and have been through several of the dx you have.

Shelly did a great job teasing out your history into a medical timeline you can use to present to an MD. We also have Health Pages,located on the  main page, on the right side just under "Recent Activity" that discuss the importance of time lines when visiting your docs.

You mentioned CIDP as one of your dx. I was initally dx with that as well. How was yours dx? Mine was ruled out by repeated EMGS.

As for the forgetfulness, I would chalk that up to low O2 sats and the COPD/CHF.

I am sorry for all that is on your plate and your Mom's upcoming surgery. Being 54, I wonder all the time if my forgetfulness is age or MS or poly-pharmacy (which is being decreased all the time-yes!). Perhaps this what is going on in addition to the low oxygen levels.

Since your MRI did not list brain atrophy then I will lay aside the fear of your own early dementia.  Stress will definitely increase mental confusion as I am sure you know from your professional past.

I hope we have helped you. I know Shelly's time line is excellent and Sarah offered some valid points.  Let us know if we can help in any other way.

Ren

[twopack]

Work on finding solutions anywhere you can but PLEASE give serious attention to a new compaign to give up smoking.  You know it isn't helping any of your health problems.  You certainly don't need me to get preachy.

I hope I can encourage you by sharing a recent experience.  I know how hard it is to quit because I did it myself - went total cold turkey - at the age of 55 with a 40 year history (much of it at 2 packs a day).  I actually wish I could still smoke but realize, like an alcoholic, I can't have as much as a puff ever again.  It isn't an option I allow myself now.

The good news???  I went to a pulmonologist this week for some testing.  Five years and four months after smoking my last cigarette I've been told there is NO evidence to suggest I was EVER a smoker!  The damage CAN be reversed.

I know this isn't what you came here to hear but I felt I had to say it because it is your best tool to help YOU take care of YOU.

Welcome to our group.  It's good to have you here.  I hope you get some answers soon and start feeling better fast.

Mary

[deerfisherman]

Thank you! That looks much better. I will try to make me a separate list to take to doctor like that. I take oodles more meds than just the Lasix and need probably a specialist of some kind. I can request one from family doc and he is most agreeable. At this current moment another problem is flairing up and its causing great pain so I cant dwell on anything else right now. Thanks again!  

[deerfisherman]

I agree and am very appreciative!

[deerfisherman]

Thank you, too! My CIDP was made by a nerve biopsy in the ankle and thigh areas/ Doc said it was mild at the time and that was in 2004.  Thanks again!       .

[deerfisherman]

Impressive and congrats on your success!  I have cut down to about 1 pack and hope to continue to quit. I am a strong willed person. Once fasted for 30 days and in 90 days lost 167 lbs.  You cant live without food and I can give that up much easier than cigs. But I will conquer it one day! Thanks again!

[deerfisherman]

It was hard choosing a best answer so please do not think I am ungrateful for any response. I appreciate them all and between what I know about myself and some things you all have said, my fears have been allayed a great deal. Again Thank you all and I will be praying for all of you! God Bless!

[DanielleSs]

You are incredibly lucky , as my uncle was a 40 year smoker, too. He developed COPD, and over five years was continually sick. The fatigue became increasingly worse, along with the shortness of breath. He got a chest xray. and a tumor was discovered. The Dr said he wasn't sure if it was cancer (but was referred to an Oncologist). Long story short: a week later, he was dead. His chronic 'sickness' at that time, which he was given anti-biotics for, turned into bacterial pneumonia, then Sepsis, then he just crashed one organ at a time.  D*mn cigarettes.

[DanielleSs]

forgot to add: like you, he had quit also.

[deerfisherman]

I am so sorry to hear about your uncle.  I know that it is always a possibility esp if cancer runs in the family.  I have been fortunate enough to quit smoking on Dec 27th and dont think I will ever take it back up again.  I have gained 90 lbs and now have to get that off once more in my life like so many times before. I am most grateful that The Lord has seen fit to spare my life despite many times I would have liked to have given up.  Without these cigs, I seem to look forward to the future and some corrective surgeries I couldnt have before due to high CO2 levels from smoking.  God Bless!