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to push for primary to order MRI or leave it to neuro?

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    to push for primary to order MRI or leave it to neuro?

    Hello,
    Compared to the last neuro I loved my visit with the new one. However, staff not so much and its indefinitely going to be over a month to order an brain MRI? All I got when I called their office a little over a week was "there was is a lot of people in front of you to schedule". My primary offered to order it if they would let her after we talked because although I have dealt with the symptoms for awhile, they are just sort of getting worse and not exactly going away. The B12 injections are helping somewhat with the fatigue, but not much else. However, the neuro had agreed to read the MRI right after I had it done and even do the LP if it warrants it. So, I guess I am afraid that even if my primary orders it in my hometown (neuro is an hour away in larger city) that its going to take just as long to get a follow up appointment.

    Any thoughts on what I should do? This is frustrating because I want answers and I have a really important exam coming up in May. I am honestly getting concerned I won't pass it. I have had to come up with completely new ways to study this past semester because I have found my old ways do not work anymore.

    #2
    you should A brain and C-spine MRI with and without contrast. If your primary is willing to order it, go ahead and get it ordered if it is going to be quicker. Have the results sent to both your neurologist and to your primary. Also get a copy for yourself if possible. Your primary may be able to look into and understand some of it, but your neurologist does this daily and is the right person to view and to diagnose. As you said, it may take you a while to get a follow-up appointment with your neurologist. If you are worried about this, call and ask your neurologist if it is okay for your primary to order it. And at the same time, ask about a follow-up appointment. This should at least give you some insight as to what is going to happen and when. Your neurologist may also ask about the strength of the MRI machine that will do it locally. They may want you to have that done at their facility of choice because they machine may be of a higher strength.
    hunterd/HuntOP/Dave
    volunteer
    MS World
    hunterd@msworld.org
    PPMS DX 2001

    "ADAPT AND OVERCOME" - MY COUSIN

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      #3
      I consulted with several neurologists about having all of the proper an current tests. They all said that getting an LP wasn't important as long as I had all of the MRI's with and without gadolinium. hunterd's advice is spot on. Good luck

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        #4
        I forgot to mention that you should consult an MS specialist. If you don't see a specialist, your general neurologist may be treating you by 'learn on the job.' I had one of those 'paint by numbers' neurologists. Never again.

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          #5
          I am beginning to think I have a knack for finding these people. Turns out my primary already tried contacting them and they had not returned her request about doing the MRI a week ago. This might get done by graduation, sorry but it is frustrating I found a neuro I actually like, but their staff is less than desireable. I am guessing that's why my primary originally wanted me to go to a really large city was for an MS specialist, but the problem is with school time wise is I was trying to get this done before that ended. So much for that. I liked this new neurologists because I felt like she was more observant and listened more compared to the last one. For example, no one else had ordered the blood tests, she noticed the last neuro when he ordered the full spine MRI, he actually put a diagnosis of demyelinating disease on there. My spine MRI was done this pat June after I had an incident where my left leg went out on me and came back, but the MRI came back fine. We will see what happens. Here goes to more waiting.

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            #6
            Thank goodness for an awesome primary, MRI on Thursday and while I won't immediately get the results because its in my hometown and the disk has to be sent to the neuro its one step closer to answers. She acted like the LP was not an absolute test that had to be done either way. I don't know I really liked this neuro, even though she is a general one and her specialty is actually neuro-onc. I think the academic institution is trying to get an MS specialist. I noticed she did the Hoffmans reflex which my other neuro never tested for, along with Babinski's. I guess there is not turning back now.

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              #7
              Originally posted by sparkles9708 View Post
              Thank goodness for an awesome primary, MRI on Thursday and while I won't immediately get the results because its in my hometown and the disk has to be sent to the neuro its one step closer to answers. She acted like the LP was not an absolute test that had to be done either way. I don't know I really liked this neuro, even though she is a general one and her specialty is actually neuro-onc. I think the academic institution is trying to get an MS specialist. I noticed she did the Hoffmans reflex which my other neuro never tested for, along with Babinski's. I guess there is not turning back now.
              You can always ask the MRI outfit for a copy of the report and the disk and you can normally go pick it up the next day after signing for it, just say you need it for a second opinion. If you don't care about the disk they will give you the report when it is done. Normally radiologists finish the report within a day or two.

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                #8
                So its officially been a week since I had the MRI, I am hopefully taking this as a good sign. Atleast that is the positive way I am hoping to look at because I never had any follow up scheduled because the MRI was supposed to be read right after so since we deviated from the original plan and had the MRI in my hometown. Guess I could always give them one more week.

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                  #9
                  It seems like you have a good handle on getting to the root of this. I can't stress enough that an MS specialist is the your best chance for an accurate diagnosis. If you can't find one, at least tell your general neurologist that you are aware of the 'sub-specialty' called 'MS specialist'. I hope that you will find a specialist for a consult. Good luck

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                    #10
                    Originally posted by JerryD View Post
                    It seems like you have a good handle on getting to the root of this. I can't stress enough that an MS specialist is the your best chance for an accurate diagnosis. If you can't find one, at least tell your general neurologist that you are aware of the 'sub-specialty' called 'MS specialist'. I hope that you will find a specialist for a consult. Good luck
                    Sparkles -- Your primary is another good option for finding a specialist, and getting a referral to one. That's the route I went. I, also, really liked my neuro. He was very responsive to his patients. However, my MS was fairly a-typical, and, with him, it just wasn't under very good control.

                    I told him about my plans to begin to see an MS Specialist. Hadn't really thought about whether I'd continue to see him, too, or not. However, he brought it up and suggested that it would be like duplicate visits. He was very supportive of me seeing a specialist instead of him, and even requested that I have their office send him all of my records, because he believed that he could learn a lot from her.

                    He also offered to continue to manage my rx's, if I wanted, as he was local, and the specialist was three hours away. Was a good working rel'p. He has now retired (made the switch seven years ago, after five years with him).
                    ~ Faith
                    MSWorld Volunteer -- Moderator since JUN2012
                    (now a Mimibug)

                    Symptoms began in JAN02
                    - Dx with RRMS in OCT03, following 21 months of limbo, ruling out lots of other dx, and some "probable stroke" and "probable CNS" dx for awhile.
                    - In 2008, I was back in limbo briefly, then re-dx w/ MS: JUL08
                    .

                    - Betaseron NOV03-AUG08; Copaxone20 SEPT08-APR15; Copaxone40 APR15-present
                    - Began receiving SSDI / LTD NOV08. Not employed. I volunteer in my church and community.

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                      #11
                      So after finally deciding 3 weeks is a little much of a wait time for an MRI result I get the nerve to call and they never got the report. Plus the physician is out until tomorrow so I guess tomorrow is the day I find out my results. I have a pretty busy next two weeks so if it says there are more lesions there may have to be a couple weeks wait on a possible LP is we have to go that route. However, I am very hopeful that the brain MRI showed nothing. If it does I may be seeking an MS specialist after this mess.

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                        #12
                        Thanks for the update. Please keep us posted.
                        ~ Faith
                        MSWorld Volunteer -- Moderator since JUN2012
                        (now a Mimibug)

                        Symptoms began in JAN02
                        - Dx with RRMS in OCT03, following 21 months of limbo, ruling out lots of other dx, and some "probable stroke" and "probable CNS" dx for awhile.
                        - In 2008, I was back in limbo briefly, then re-dx w/ MS: JUL08
                        .

                        - Betaseron NOV03-AUG08; Copaxone20 SEPT08-APR15; Copaxone40 APR15-present
                        - Began receiving SSDI / LTD NOV08. Not employed. I volunteer in my church and community.

                        Comment


                          #13
                          So I called again today because I called on the 6th and oh we don't have your brain MRI results. Really because I called last week and you were supposed to get them. I am about to follow there's advice and go get the report myself because I am applying for jobs and need to know what do as far as benefits in case this was something. Anybody else got any advice on what to do because the MRI was literally 5 weeks ago and not being able to go to sleep because your leg is spasming is not the greatest feeling in the world.

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                            #14
                            Neuro all the way

                            I would just make an appointment with the neuro. It sounds like the primary is giving you the run around. How would a primary to know exactly what to look for anyway. You're best bet is a neuro because in the end if it is positive then you will wind up going to one anyway.

                            Comment


                              #15
                              It is the neuros office

                              this is the neuros office giving me the run around. I understand they are an hour away from where I had the MRI, but this is getting a little frustrating. I had the MRI 5 weeks ago. I also understand I don't have a brain tumor and she specializes in neuro-oncology and has much more critical patients than me, but this is getting a little out of hand.

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