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Old 04-28-2012, 07:42 PM   #1
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MRI Contrast Types

I had my MRI yesterday. It was a lot different than my first MRI in 2009. In 2009, they made me drink the contrast. This time, they injected me. From what I'm reading, drinking the contrast is only indicated for gastrointestinal issues.

The only OTHER time I've ever been injected with contrast, I remember the tech saying, "I'm going to inject you with the contrast. It will make you feel like you have wet your pants, but don't worry, you haven't." And it really did. So I went in yesterday fully expecting to be drinking contrast, but when they injected me, I said, "Is this the stuff that makes you feel like you're wet your pants?" The tech said, "No, that's CT contrast. You won't feel this one." So now I know when that one was: that was my CT I had to check on sinus issues last summer.

So... my first MRI. I was never injected with contrast and they were specifically looking for MS. Did they do it wrong? It came back clean, but if it was essentially without contrast than that is no surprise, right? Is it ever helpful or acceptable to do a brain MRI looking for MS with drinkable barium contrast? I've tried googling the answer but everything says injectable. It doesn't say DON'T use barium, it all just says DO use gadolinium injection. Is the other ever ok for this purpose?

I don't know my results of yesterday's test yet. If this one is negative too then it doesn't make a difference either way, but if this new one indicates something, and I could have been diagnosed 3 years ago... Well, no point in going there yet. I'll just have to wait to hear from the doctor about the results. How long does it usually take?

 
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Old 04-28-2012, 08:06 PM   #2
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Re: MRI Contrast Types

Barium contrast is not for an MRI. The MRI contrast when used for MSers is to "light up" active lesions. The doctor will compare your images with and without contrast to look for the active and inactive lesions.

The MRI contrast does not last long in your system and if you drink fluids, you will wash it out of your system even faster.

If you are still early in your MS life, you may have a negative MRI. It really varies by MSer. Please know too that the MRI is not the definitive tool for an MS diagnosis. Any diagnosis of MS requires a series of tests which will eliminate diseases which you do not have. Once all possibilities have been eliminated, then you can get a diagnosis of MS. If your doctor relies on a single test- find another doctor. Follow the Revised McDonald Criteria and you should get your answers.
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Old 04-28-2012, 10:34 PM   #3
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Re: MRI Contrast Types

It's my PA who ordered the MRI for me. She is the only person who will listen to me and help me so far. I've been told that it can't be MS because people with MS don't get vertigo, and more recently, because people with MS don't get headaches. I know they're both untrue, and didn't go back to those doctors, but getting ONE referral is difficult enough. Getting another referral (which I have to have for my insurance) is VERY hard because it starts looking like I just didn't like what they said to me. Well, that's true, I didn't like being belittled, lied to, and experimented on (given random drugs "just to see" how I respond). So... I can't get in anywhere. But at least this MRI seems to have been done right. I didn't know there was a right and a wrong way the first time (2009), so drinking the barium contrast was all I knew. When I DIDN'T have to do it this time, I started wondering WHY.

If there are no obvious lesions, I'll probably have to wait until my next episode to try again (this one feels like it's ending; it's been about 5 weeks) because in my experience, if no one believes me when I stagger in, unable to walk properly, then NO ONE cares or believes me when I'm fine, discussing issues that are "in the past." Even though the episodes are becoming an annual event, it's almost 100%-guaranteed a doctor will tell me at some point that it's unlikely I'll ever have another episode of whatever-it-is again. Even the neurologist I just saw told me not to come back until I had *another* episode (and my next one will be #6. How many does it take?!).

Anyway, I'm just trying not to think about the MRI, though I'm a bit concerned about who will be reading it and interpreting it, since my PA ordered it. I can't get an MS specialist to read it without a referral, so if it doesn't show much or anything, I won't GET that referral.

The system is whacked, and I get to experience the brokenness of it. My mother had some random heart palpitations for a couple weeks and got a team of 9 top-of-the-line cardiologists to look at her from our local health-science university. My boss's 85 year old mother racked up $100,000+ in tests and comfort care during her last 10 days of life (they knew it was the end of her life and her advanced directive even said NOT to do those tests or provide the extra equipment). I can't even get a doctor to take 10 minutes to READ my medical history. It seems if you're not a senior or a super-premature baby, you don't get any care. That's just my rant on health "care". :P

Well, I had a great day at the Science Museum with my kids and a nice quiet evening with my husband, so all is not lost. Now I'm off to bed.

 
Old 04-28-2012, 10:38 PM   #4
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Re: MRI Contrast Types

Once you have the MRI info, perhaps the PA can arrange a referral. It should be read by someone who knows what to look for with regards to MS.

I am glad you were able to enjoy a museum visit. At least you could unwind! Stay strong!
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Old 04-29-2012, 05:07 AM   #5
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Re: MRI Contrast Types

Social,
Where are you? If you care to share that information, we can probably get someone to help you find a MS specialist or neurologist in the area to help you. You can also call the MS society in your state and they will help you to find someone who takes your insuarnce.

Also, for insurance purposes, all insurance companies have case managers- these are RNs (nurses) who work with the patient to help them navigate the system. It will take some work on your part, but if you are patient and respectful and incredibly grateful while on the phone, youll get thru to someone at your insurance company who can help you.....I would honestly do that, because until you get to the right doctor, youre not going to get the right tests or answers.

Backing up. Barium is ONLY used for CT scans - so you had a CT scan when you drank the stuff, not an MRI. Gadolinium is ONLY used for MRIs and is ALWAYS injected. Funny enough, for some people, usually women, it can cause a quick burning or feeling in your groin which COULD be described as feeing like you wet yourself. It doesnt happen to me, but I do know it can happen and have heard it from many patients.... nevertheless, it was performed right.

The good news, is that hopefully a radiologist with neurological training is reading your films..not the PA or even the doctor. I want you to go back to where you had it done and get a copy of the films, or a CD if thats all they will give you. THEY HAVE TO GIVE IT TO YOU. And, then, when you see the PA, ask (nicely) for a copy of the report. Youre going to need this. Eventually youll have to go see another doctor, a neurologist who does specilize in MS- and it will be time saving if you can carry these in with you. Starting now, any and all tests you have- radiographic or blood, or even eye or nerve tests, start getting copies of the tests and results. Its really important.

Try to breathe through all this, its a learning curve and you are just beginning to learn. But most important, please know that no one will be making this easy for you (except us!). Youre going to have to be your own advocate and really dig for help with your insurance company....but there is help avialable. You just have to know where to look. Start with calling your insurance company on Monday and asking to speak to someone in referrals or physician notworking...tell them you are looking for a doctor who specializes in MS, at the very least, get the names of other neurologists and start making calls to find out which one has the most amount of MS patients ...you can ask the receptionist how many MS patients each doctor treats approximately each week. GO with the doc who sees the most. While you are on the phone with the insurance company, ask if there is possibly a nurse to talk to.......there always is. Tell her that your question is that you feel like you are getting the run around because you may have MS and youre scared. That you need to find an appropriate doctor which they will approve of- see if she can help you. Im willing to bet she will..

One day at a time. This is very overwhelming and its easy to get frustrated and break down over this...but that wont help your symtoms. Try very hard to attack this head on without emotion- and be strong. You can do it!
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Old 04-29-2012, 10:47 AM   #6
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Re: MRI Contrast Types

I'm in Portland OR. I want to go to the MS clinic at OHSU. It's a research hospital, a good one, and they have a clinic just for MS. I found it on the Providers page on my insurance. But they won't see me without a referral from my physician. I will try calling the insurance as you suggested. Maybe if the insurance authorizes it they won't need a physician referral, OR if the insurance approves it then my PA will agree to give me the referral. The worst they can say is no, then I'm in the same position as I'm in now, so I might as well!

 
Old 04-29-2012, 11:15 AM   #7
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Re: MRI Contrast Types

I think you know what you are doing. You might contact your local MS Association or Society office and see if you can enlist their assistance in getting a referral. If you had to go to the OHSU emergency room, they would put you into their clinic. This is what happened to me. Do let us know, at least we can brainstorm together! What ever the outcome, you are not alone in this part of your journey. If you find you have MS- well, you will never be alone!
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Old 04-29-2012, 01:45 PM   #8
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Re: MRI Contrast Types

agreed! Thats why we are all here, to help each other navigate this disease!

Youre not alone...and you should never feel that way. im glad you have a good hospital system, now lets help you figure out how to navigate it without feeling like you do right now!

One step at a time, let us know how things turn out with that phone call.

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