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    Fast diagnosis

    I'm a 60-year-old white male who was diagnosed nine days ago with MS. My neurologist seems very confident in this diagnosis but since I am newly diagnosed I'm just wondering:


    I feel like my diagnosis of multiple sclerosis was made rather quickly. I've been doing some research and looking around on the Internet and it seems like many people went through a long process of many different tests to finally find out that they have multiple sclerosis.

    It was only three months ago I had an event that might be described as a relapse or exacerbation. That was a sudden onset of dizziness or out of balance feeling that was originally diagnosed as vertigo. However, that symptom didn't go away and it's still with me now. Not very long before that my vision began to change. I was unable to focus as normal. I could only look at objects, printed pages, or television for a short time (only seconds) before losing focus. I recently had an eye examination and received a new prescription because of a change in my astigmatism. Since I was having so much trouble focusing I went back to the eye doctor to verify that the glasses were the proper prescription and my eyes were okay. The doctor said my eyes were in perfect health and the prescription was the correct prescription for my eyes.

    Historically I've only had a couple of symptoms seem to last only a short time (three or four months). One of those was a numbness or tingling in my left arm. I eventually saw a neurologist about that who did tests to check the nerves in my arm with negative results. The problem seemed clear up on its own with no further testing or treatment. Other symptoms I had I attributed to just normal things that occurred to people my age, such as leg cramps for which I started taking*potassium and seemed to clear up with no further occurrences. I've had a general achiness all over for a very long time that I just attributed to age. I just thought that was normal.

    Because of the out of balance feeling, I went to an ear, nose and throat specialist to find out if my inner ear was causing problems. A VNG test was done and the specialist said that my inner ear was not causing my out of balance symptoms. He did determine that I had nystagmus, which would account for the focus issues that I have.

    The ENT doctor referred me to a neurologist. The neurologist ordered an MRI and had a follow-up appointment to discuss the MRI. That doctor suggested that I may have MS or the white spots may be attributed to normal aging. He suggested several courses of action one of which was getting a second opinion. I chose to get a second opinion and the second neurologist was very sure that my symptoms and the MRI confirmed that I had MS.

    My MRI showed many white spots or lesions in many places on my brain. Two were found in specific areas*that could cause the symptoms I'm having now with balance and vision. There was was a total of about 10*spots in different areas of my brain with no clear indication what they may be causing.
    My neurologist said that the MRI is 95% accurate for this diagnosis.

    Am I so lucky that I stumbled upon a short path to determine what's causing my symptoms? Is there some other test that I might have done to lock down that last 5% and determine absolutely that I have MS?



    Ed

    #2
    Originally posted by Ed.Reed View Post
    I'm a 60-year-old white male who was diagnosed nine days ago with MS. My neurologist seems very confident in this diagnosis but since I am newly diagnosed I'm just wondering:


    I feel like my diagnosis of multiple sclerosis was made rather quickly. I've been doing some research and looking around on the Internet and it seems like many people went through a long process of many different tests to finally find out that they have multiple sclerosis.

    It was only three months ago I had an event that might be described as a relapse or exacerbation. That was a sudden onset of dizziness or out of balance feeling that was originally diagnosed as vertigo. However, that symptom didn't go away and it's still with me now. Not very long before that my vision began to change. I was unable to focus as normal. I could only look at objects, printed pages, or television for a short time (only seconds) before losing focus. I recently had an eye examination and received a new prescription because of a change in my astigmatism. Since I was having so much trouble focusing I went back to the eye doctor to verify that the glasses were the proper prescription and my eyes were okay. The doctor said my eyes were in perfect health and the prescription was the correct prescription for my eyes.

    Historically I've only had a couple of symptoms seem to last only a short time (three or four months). One of those was a numbness or tingling in my left arm. I eventually saw a neurologist about that who did tests to check the nerves in my arm with negative results. The problem seemed clear up on its own with no further testing or treatment. Other symptoms I had I attributed to just normal things that occurred to people my age, such as leg cramps for which I started taking*potassium and seemed to clear up with no further occurrences. I've had a general achiness all over for a very long time that I just attributed to age. I just thought that was normal.

    Because of the out of balance feeling, I went to an ear, nose and throat specialist to find out if my inner ear was causing problems. A VNG test was done and the specialist said that my inner ear was not causing my out of balance symptoms. He did determine that I had nystagmus, which would account for the focus issues that I have.

    The ENT doctor referred me to a neurologist. The neurologist ordered an MRI and had a follow-up appointment to discuss the MRI. That doctor suggested that I may have MS or the white spots may be attributed to normal aging. He suggested several courses of action one of which was getting a second opinion. I chose to get a second opinion and the second neurologist was very sure that my symptoms and the MRI confirmed that I had MS.

    My MRI showed many white spots or lesions in many places on my brain. Two were found in specific areas*that could cause the symptoms I'm having now with balance and vision. There was was a total of about 10*spots in different areas of my brain with no clear indication what they may be causing.
    My neurologist said that the MRI is 95% accurate for this diagnosis.

    Am I so lucky that I stumbled upon a short path to determine what's causing my symptoms? Is there some other test that I might have done to lock down that last 5% and determine absolutely that I have MS?



    Ed
    I am not a neurologist, but I feel fairly sure that your neurologist is correct.
    The brain MRI, your vision problems, and numbness all are indicators of MS. How did your spine MRI look? Usually they take MRI's of you entire spine (cervical, thoracic, and lumbar).
    Yes, it could be something else, but your doctor knows more than we do.
    Did he do blood tests for MS?
    If you want a second opinion, do not wait too long.

    If you have MS, since you are over 50, it may be called "Primarily progressive MS." This means it is a later age onset, but the progression of symptoms may be fast. The doctors weren't sure about MS for me. They are guessing that since I am getting better after my cervical spine surgery, that I don't have MS for now. They think I have Transverse Myelitis. They "believe" I have this. Who knows.
    I could have the beginnings of MS and NOT know it.

    I have decided that if I am diagnosed with MS, I want to travel as much as possible and do as much as I can fo as long as I can. I am getting started...San Diego in July, San Francisco in August, and Maui in November.

    I am worried about this so I have decided to act on my instincts. I may be in a wheelchair in a few years. I want to spend less precious time worrying and more time moving around...while I still can.

    Hugs and good luck.

    Comment


      #3
      Hi Ed.Reed and welcome to MSWorld

      Am I so lucky that I stumbled upon a short path to determine what's causing my symptoms?
      The length of time to diagnosis is different for everyone. Some are diagnosed rather quickly, for some it can take years and others if somewhere in between.

      I went from PCP, to neuro,to testing, to diagnosis all within 3 months.

      Is there some other test that I might have done to lock down that last 5% and determine absolutely that I have MS?
      Part of the diagnostic process is to rule in/out other conditions some of which can be done with blood tests.

      A Neurologist will usually order extensive blood work (10 to 12 vials of blood is taken).

      You have already had a brain MRI but if you have not had a MRI of the cervical spine that might be an option. MS is a disease of the Central Nervous System (CNS) which includes the brain, spinal cord and optic nerves. Lesions from MS can show up in any or all of those locations.

      suziq:
      If you have MS, since you are over 50, it may be called "Primarily progressive MS." This means it is a later age onset, but the progression of symptoms may be fast.
      This is not necessarily true.

      It is possible to have MS many more years than the actual diagnosis date. Many symptoms can be very subtle and easily brushed aside.
      Diagnosed 1984
      “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic

      Comment


        #4
        I was diagnosed at the age of 50 with Primary Progressive Multiple Sclerosis. PPMS You can't be sure when the symptoms started. Many people that get a MS dx discover that they have been 'adjusting' to their subtle disabilities. I wish you the best of luck.

        Comment


          #5
          Ed: Your diagnosis is probably correct. I was diagnosed with just a brain MRI with over 10 lesions. Sometimes we are just lucky and don't have to go through the other business. Especially if we have had MS for a while. You can ask for a spinal MRI, but that will not confirm or deny your diagnosis, that will just check for more lesions.

          I suspect at your next MRI they will do the whole sequence. Now it is time to pick out your DMD. You can look on the NMSS website to read through them, then look on our website to check out real life side effects and how people react to them. Choose wisely, this will be with you for a while.

          Be happy you were diagnosed quickly. Some of us were, some of us are not. Some people never are. You just obviously have MS.

          Take care and let us know what drug you go with.

          Lisa
          Moderation Team
          Disabled RN with MS for 14 years
          SPMS EDSS 7.5 Wheelchair (but a racing one)
          Tysabri

          Comment


            #6
            Originally posted by Ed.Reed View Post
            My neurologist said that the MRI is 95% accurate for this diagnosis.

            Am I so lucky that I stumbled upon a short path to determine what's causing my symptoms? Is there some other test that I might have done to lock down that last 5% and determine absolutely that I have MS?
            Hi Ed: Yes, you did just get lucky that your presentation allowed for a quick diagnosis. If you meet the diagnostic criteria, it doesn't matter how long the diagnosis takes. And as others have pointed out you might have been having subtle symptoms tor a while that you didn't know were symptoms and didn't pay any attention to. That makes the timeline more hazy. But it still makes no difference to the speed of diagnosis.

            What your neuro said about the MRI being 95% accurate fir diagnosis of MS is also hazy. The point is that MS isn't diagnosed by MRI alone so how "accurate" it is is debatable. There are other diseases that can cause MRIs that look just like the ones in MS and I've never seen anything that says that 95% of those MRIs are from MS. If it were that simple there wouldn't be a need for the other diagnostic criteria. So there really is no such thing as giving some percentage of certainty to only a part of the criteria and trying to guess how "accurate" the diagnosis is based on only partial information.

            I'm questioning where your neuro came up with that figure. I've read a lot from doctors who would not agree with a hard number being given to it. So I think that 95% statement has given you the wrong idea. There's not a reliable 95% so no other 5% to "nail down" the diagnosis. If you meet the diagnostic criteria for MS - which includes all reasonable tests to rule out other possible causes - then your diagnosis is already nailed down. There's no reason to question that other 5% because it's a made-up number.

            I'll say here that there's sometimes some interpretation involved with the criteria in determining whether somebody meets them but they don't have anything at all to do with some "percentage of diagnostic accuracy" of the MRI. So with a chronic disease it's always a good idea to get a second opinion. A second opinion looks at those more subjective interpretations of whether someone's history of symptoms and relapses meets the criteria. It's also another head to make sure that all of the necessary tests have been done and interpreted correctly.

            So if you want more confirmation of your diagnosis then it's worthwhile getting a second opinion from another neurologist who has experience with MS. Just know that it doesn't have anything to do with nailing down that other made-up 5% of certainty. It doesn't exist. You either meet the diagnostic criteria or you don't.

            Comment


              #7
              wow - I am 35 and have had those same issues for over 2 years...Same MRI finding but no diagnosis because they want to see a change in the MRI first....I have lots of white spots for my age and nothing else to blame it on.....everything has been ruled out. I have had an LP and a million other tests...trust me I have had it all...and my left arm keeps getting worse....allI get is physical therapy...

              Comment


                #8
                Thank you all for your insight I appreciate it very much. I was prescribed COPAXONE and have been on it for a month. Now I have Co-pay problems and I'm trying to untangle the bureaucracy for that.

                I don't have very many problems with the shots just the typical stinging and welts, that's all.

                All in all I feel fortunate that I have had a quick diagnosis and it is so clear-cut. Now I only hope I can resolve these insurance problems because the $900 co-pays just are not affordable. shared solutions backed out or copay assistance because I have secondary insurance. Secondary won't cover balance due.

                Anyway, I sincerely thank each of you that have responded. It does give me perspective.

                Comment


                  #9
                  medication co pay

                  Ed- if you go to www.assistfund.org they have co pay assistance programs for your medication and will also reimburse you for health insurance premiums and can/will reimburse you for medication you previously paid for going back one month as long as you have proof of payment. They are an awesome organization! Best of luck

                  Comment


                    #10
                    I went to their website yesterday check it out. They have posted on the site they're not accepting new patients.


                    GOOD NEWS. I took my prescription to a local pharmacy to see what it would cost for my COPAXONE prescription. they accepted the rx and filed with both insurances which resulted in my getting my persciption immediately and had no copay. This pharmacy keeps COPAXONE in stock so each refill be available immediately.

                    I went to a lot of stress and bureaucracy by using shared solutions to file my claims. I now believe that was a mistake and from now on I will file my prescriptions myself at my regular pharmacy first.

                    LESSON LEARNED!

                    Comment


                      #11
                      HERE IS A LINK FOR A PPA MY PCP GAVE ME www.pparx.org

                      Comment

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