As I mentioned earlier, I was forced to undergo an MRI privately. Private, however, does not mean without a referral... So I went for an appointment. The date was very quick. The neurologist, smiling and full of optimism, immediately offered me to "enter the program," of course for free, if my condition was named "MS." I ignored this statement, although at that moment, the program sounded more like a TV show to me than a medical program. For a moment, I even wondered if my condition was interesting enough to be shown on TV…
Now, Seriously...
The only thing on my mind was to get that damned MRI done and return to my old life without fear of what tomorrow would bring. When writing the referral, questions were asked that were hard for me to answer, considering my then level of knowledge. I learned that during one MRI scan, a maximum of two areas or segments can be imaged — those adjacent to each other.
For those who, like me, didn't pay attention in biology: starting from the bottom, we have the sacrum and the segments: lumbar, thoracic, cervical, and, of course, the most crucial in diagnosing multiple sclerosis — the head, or more precisely, the brain. In one scan, you can image the brain and cervical segment, or the cervical segment along with the thoracic. The last option is imaging the thoracic and lumbar segments.
A Tough Choice from the MRI "Menu"
Changes in the brain are a significant element associated with MS, so I asked for a referral for a brain and cervical spine scan. The next question was: with contrast or without contrast...? Again, I associated it with TV, this time with its adjustment, but keeping my nerves in check, I once again asked for an explanation of what contrast is. I was told it’s a chemical agent injected into a vein before the scan to better highlight the area being examined. OK, now I knew everything… well, almost everything, but already with frustration, I placed my order: "One brain + neck scan with contrast, please." Any other questions???
Of course, that wasn’t the end.
Next, the question was whether I had any of the following conditions:
- Sickle cell anemia,
- Asthma and emphysema,
- Waldenström's disease,
- Seizures of brain origin,
- Pheochromocytoma,
- Glaucoma,
- Hypertension,
- Severe dehydration,
- Acute and chronic heart failure,
- Acute intracerebral hemorrhage,
- Multiple myeloma,
- Iodine allergy.
Fortunately, I didn’t have any of them, although... there could be some debate about the hypertension.
Additional Tests and Side Effects
To keep me from getting bored, I also got a referral for blood tests, especially to determine creatinine levels. This is essential when administering contrast because it is eliminated from the body by the kidneys. High creatinine levels indicate that the kidneys are not filtering well, so they may not remove the contrast after the scan, which could end badly. I was also informed about the side effects of the contrast. Imagine any symptom, and it’s likely among the side effects.
Just when I thought it was over and I’d have the blood test tomorrow and the MRI the day after, the final question came: "Do you have any metal elements in your body, such as implants or stabilizers, etc.?" Smiling, I replied, "No...I can't believe it... I do. I have a rod in my leg from a fracture, which I’ve been meaning to have removed for five years." I need to see a surgeon. Of course, privately, to be quick, pleasant, and efficient.
This Next Obstacle to the MRI
When it comes to this next obstacle in getting the MRI, I can only blame myself. I broke my leg, tearing a tendon due to my own fault, and after a successful surgery, I was supposed to have the stabilizing rod removed after a year. Well, there were so many important things rather than taking care of myself... so I didn't have it removed. Big deal… I'm calling the surgeon.
To be continued next month.
Author: Andy - CEO of Biomelius LTD, who was diagnosed with MS in 2017
