MRI – #AtoZChallenge

We apologize for the interruption of this #AtoZChallenge series. (I had vertigo for three weeks and got behind on everything; then I got all depressed because I couldn’t dig out of the backlog. I’m still not out, by any means, but I miss you all.)

We now return to our regularly-scheduled programming.

I wish it were not so expensive to get an MRI — I’d have them annually. Or more often, if they’d let me!  Because it gives a clear picture of the brain and spinal cord, an MRI can give the clearest picture of the progression of the disease, which would keep me from worrying about it so dang much.

When a person with MS has an MRI, the scarring from the damaged myelin (the coating over the nerve fibers) is visible. If the test is done with gadolinium dye injected into the veins, then areas of myelin that are actively being destroyed will actually light up on the scan.

Some people are afraid of MRIs, fearing that they might get claustrophobic in the machine, but I seriously don’t mind them. In case you’ve never had one, let me describe the process, from my experience.

After you dress in the standard very-attractive backless gown and paper slippers, the technicians make sure you have NO metal on you. No earrings, no watches, no pacemaker, nothing. Since the biggest and most important part of an MRI machine is a giant magnet, I suppose it could suck the metal right out of you, but don’t quote me on that.

When you get to the machine, they hook you up to an IV of gadolinum dye and give you some earplugs, if you are lucky. You lie on the table and get slid into the machine just like a pizza into a wood-fired oven or a drawer into a file cabinet. The tube is strangely close to your face; once, I had one with a mirror right there, but I didn’t think it really helped with the strangeness.

The technician speaks to you through a speaker, telling you what you will hear and/or what you need to do. Usually, you don’t need to do anything, but once I had a cervical (neck) MRI and they told me not to cough or swallow. Trust me, there is nothing more apt to make a person swallow than being told not to. I swear, your mouth starts watering like nobody’s business and you are convinced you will drown before the MRI is over.

What is the same with every MRI I have had, though, has been the sound. I do not have any knowledge of the workings of magnetic resonance imagery, but I can tell you one thing: it is loud. It sounds as though all the employees of the hospital have been gathered together outside of your little tube and instructed to pound on it with their own pipe wrenches. Given that your average brain MRI takes 30 to 60 minutes, you begin to think they will bust through the tube before it is all over.

I have a secret MRI-distracting weapon in my arsenal, though. Years back, I decided to try to say an entire rosary during the MRI. Between the soothing rhythm of the prayers and the mental arguing over what is a Joyful or a Glorious Mystery and what is one of those new-fangled Luminous Mysteries, the entire procedure is over before I have finished. Or else I fall asleep. (Hey, it happens.)

When it’s all over, they roll you back out. Do NOT, under any circumstances, expect that the people who did the test will tell you a single dang thing about what they just saw. They can’t, by law or something, even if they wanted to, even if they have the expertise to read the results. I’m hoping they will, still. But no, they just send you back to your little curtained cubicle to put your clothes back on. You have to wait until they give the film to a radiologist, who reads it and then gives the information to your neurologist, who then reads it and gives the information to you.

I just looked up “MRI” on flickr’s Creative Commons, looking for an image of an MRI machine that I could use for this post. I first got to scroll through page after page of MRI scans, which suits someone of my level of morbid curiosity quite nicely. It was cool to see the variety of head scans. Some show the wrinkles of the brain, some show the eyes, some clearly show the different brain sections.

My scans never look like that. They look way more like big gray slices of nothing, which in MS terms is apparently considered an excellent result. I suppose what is shown all depends on the level at which they are taking the images, whether from the brain equivalent of one inch or 10,000 feet. I’m going to have to ask about that. Anyone know a radiologist?

Big MRI” by liz westCC BY

Lesions – #AtoZChallenge

le·sion  /ˈlēZHən/ noun   
1. a region in an organ or tissue that has suffered damage through injury or disease
Stop me if you think that you’ve heard this one before. – Marr/Morrissey

Multiple Sclerosis gets its name from the lesions it causes on the tissue of the central nervous system. Sclerosis means “scarring,” and when the immune system destroys the myelin coating on the nerves, it leaves telltale scars. Multiple scars, if you will.

Now, the majority of people with MS have lesions in the brain. Some also have lesions on the spinal cord. Fewer have spinal cord lesions only. Guess which group I fall into! Yep, my brain is clear; I have lesions on my spinal cord.

Now, the spinal cord is divided into sections (from neck to tailbone, that’s 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal, for those of you keeping score at home), each of which is identified by its section and its number. My spinal cord is damaged at T10 and T11; for reference, T10 is right at the navel.

Why is this important? Well, the area where you have damage/scars/lesions dictates the location of your symptoms, so I could have problems from the waist down, but not from the waist up. I also have symptoms on one side of my body only (the left side! Another L!), which means the damage to the spinal cord is only on one side. Still, it affected both sensory nerves (those that carry information back to the brain) and motor nerves (that bring messages from the brain telling your body to move).

Thus, I have the following: nerves that send too much information about soft touch (making innocuous things like clothing or stepping on the floor feel really really uncomfortable) and not enough about sharp pain (so being pricked with a pin feels like it’s happening through a wetsuit); various areas that are numb; and muscles that don’t work properly and end up making my leg weak or my foot droopy or my bladder unresponsive.

Yet again, I’m afraid this sounds whiny, which isn’t my intention! It’s just meant to be informative, to let people know what MS is like. Believe me, I know how lucky I am.

Kumfs – #AtoZChallenge

(David said my “K” word should be either kleptomania, Kansas, or keratin. These have nothing whatsoever to do with MS. Or with me, for that matter.)

I have been known to fall a lot in my life. I think I had stitches in my head three times before my fifth birthday. I was teased mercilessly by my friends in junior high for falling off my brown leather platform sandals while standing still. (I just keeled over. There’s no explanation.)

Mine were like “G,” although — had I seen them — I probably would have wanted “K” back in the day.

If I’m completely honest, my friends have teased me my entire adult life about my inability to wear heels of any height. (It’s like Joey said about Chandler and bras. I can’t work ’em.)

Now, throw Multiple Sclerosis into the situation!

When I was first diagnosed, I was falling pretty regularly. I had foot drop in my left foot, so I’d catch my toe on the floor all the time. But, just like in 7th grade, there were also plenty of times that I just fell over for no apparent reason.

It got to the point where I was constantly checking in with David on it. “Would anyone have fallen right there? That was kind of uneven, right? I mean… right?” Sometimes he was able to reassure me, sometimes not.

I fall a lot less now. I wear what I call “orthopedic shoes” (almost exclusively walking shoes from Ziera, which used to be called Kumfs), because they are comfortable, supportive, and don’t irritate my sensitive foot. I can get most of the styles in whatever color I want, which is black. (They sell other colors for you people who don’t want to own ten pairs of black shoes.)

I sound like an ad, I know, but it took me a lot of trial and error to find shoes that would work, so if this helps someone who has similar issues, I’m glad. These shoes are spendy, I won’t lie; they probably average about $150 a pair, but it’s an investment in my health. I’ve decided to consider it a fair exchange for all the money I have saved by not dyeing my hair.