Some thoughts on my situation

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mvb1212
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Some thoughts on my situation

Post by mvb1212 »

I know this is all something you guys have seen before. All of you seem very knowledgable and in touch with this issue and hope to get an opinion on my situation:

MRI Results- Cerebrum: Scattered foci of subcortical, periventricular white matter T2 and FLAIR hyper intense signal abnormality.

Reason for test- GP ordered MRI after my diagnosis of severe depression and cluster headaches. Plus, my admittance of several concussions.

Bloodwork- normal
Health statistics- 30 years old, normal/above normal health, exercise 5 times week, regular health conscious diet.

Other symptoms- Neck and back moderate pain/extreme stiffness, vision problems (no loss of sight or anything), numbness in hands when moving neck, eye and muscle twitching, moments of slow or no urine flow (thought was unrelated), trouble finding words when speaking sometimes, forgetfulness and overall mentally disconnected and always tired/unmotivated.

I had hoped my medication for depression would finally help me get back to normal, but after nearly 6 months there hasn't been a sustainable change. I am not on who seeks help from doctors or medication. I originally when to the doctor because I know my issues were effecting my wife and my business. I want to be the best for her and get things straightened out for the future. Can you shed some light on the MRI results and how they correlate to my situation?

Thank you and appreciate all the help.
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jimmylegs
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Re: Some thoughts on my situation

Post by jimmylegs »

Hi and welcome :)

Unfortunately there is low correlation between MRI results and patient experience of symptoms. For one thing you can't necessarily tell that you're brain damaged while you're in the middle of it. I can recall having some absolutely dire cognitive difficulties, but oddly I didn't feel like I wasn't normal at the time (which in hindsight is just another indicator of how messed up I was). Other that that, I know concussion MRI looks different than MS MRI but that's about it! Spinal MRI is another story. I think your typical MS patient would definitely feel those lesions in a physical way.

If you are interested in digging a bit deeper on the health and nutrition side of things, let me know. I, and many others here as well, would have said we were healthy eaters before diagnosis, and have learned better since. I have a ton of academic and practical, if not professional, experience with nutrition and have measurably helped folks with athletic nutrient depletion as well as those suffering from the nutrition issues characteristic of ms patients as well as folks suffering from other chronic issues such as infertility, anxiety, and bipolar disorder to name a few. it's just a matter of linking patients up with promising science that hasn't managed to bridge the research-practice divide.

If you're interested, we can chat about it more and I'll probably fire you a list of questions to try and tease out more details of your day to day routine. Plus send you some reading on why it can be problematic if not outright dangerous for patients to accept 'normal' bloodwork results. :)
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Hopeful2015
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Re: Some thoughts on my situation

Post by Hopeful2015 »

Jimmy Legs is partially correct in that MRI is not an accurate predictor of patient experience of symptoms. I say partially (sorry, JimmyLegs) because it is also in my experience been accurate with regard to my symptoms.

Case in point: I experienced a relapse that involved symptoms indicative of damage to the brain stem. Speech issues and swallowing problems being the primary problem, with affected sensations of numbness, placement of tongue "not lining up properly in mouth" and feeling as if it was occupying the wrong space, Inability to articulate vowels and consonants, and worse, choking when trying to eat or drink anything. On an MRI done within two days or reporting the symptoms, my neuro stated that my brainstem showed active lesions.

Now to the flip side of the "partial" disclaimer: All that lesion activity could have been going on and not shown up on an MRI because it was at a sublevel not detectable by our markers (use of dye.) It may have been more diffuse, and/or the tissue not damaged enough to absorb enough dye to show on the imaging. Testing methods continue to grow more and more accurate. As we learn how to look for other markers than just physical damage, we beat the clock on imaging relapses. Better technologies are emerging to show the timeline of a relapse using biochemical markers, emitted by tissues when they are in distress, even before noticeable tissue damage manifests on an MRI. I think it is called positron emission tomography, a branch of nuclear medicine along the lines of an MRI but considerably more sensitive and specific. Any more speculation on the topic will sound like me being a blowhard know-it-all, because I truly know very little about it. You can google it for more info; It is becoming more commonplace and is being used in research of MS processes now.

One thing we both agree on though, is to avail ourselves of every tool available to treat our MS. Both of us still agree is using a holistic approach not only through medication but also lifestyle. Good luck, OP.
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jimmylegs
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Re: Some thoughts on my situation

Post by jimmylegs »

careful hopeful, i said there is low (as distinct from 'no') correlation. there's room for your xp in what i said - and mine too :)

here's some related research that may be of interest:
MRI in multiple sclerosis: correlation with expanded disability status scale (EDSS)
http://msj.sagepub.com/content/5/4/283.short
Magnetic resonance (MR) imaging is very sensitive in showing disseminated MS lesions. Subclinical MR progression occurs frequently, explaining why MR is now used to monitor treatment, even without measurable consequences, of new MR lesions to the patient at this moment. In the light of this clinico-radiological paradox, the significance of MR in MS is discussed, particularly in relation with the expanded disability status scale (EDSS). Gadolinium-enhancing lesions correlate with the occurrence of relapses, CSF myelin breakdown products and, in patients with relapsingremitting disease, with higher EDSS. However, the predictive value of the frequency of enhancement for changes in EDSS is only weak. For conventional T2-weighted MR imaging, the cross-sectional correlation with EDSS varies between 0.15 and 0.60, and is limited mainly by the inherent lack of tissues specificity of T2-weighted images. Both T1 black holes and magnetisation transfer (MT) parameters show a better correlation with EDSS; it should be noted that lesions in which those abnormalities are found go through an initial phase of enhancement as well. For T1 black holes, a correlation up to 0.81 has been reported for SP patients. Post-mortem studies show that black holes and low MT ratios are in vivo markers of axonal loss. Preliminary data indicate that progressive atrophy also correlates with progression on the EDSS scale. More should be learned about the fate of new MR lesion with regards to development of axonal loss, which at present is difficult to predict in the enhancing stage. The existence of escape mechanisms, including remyelination, make a simple correlation with EDSS extremely unlikely, and perhaps not even desirable. Nevertheless, while the clinical effect of a given new lesion may be difficult to ascertain, the absence of (new) MR lesions is prognostically favourable, as will be the degree to which new lesions are prevented by treatment.
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ElliotB
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Re: Some thoughts on my situation

Post by ElliotB »

MRIs are typically a good diagnostic tool but keep in mind that some people are diagnosed with MS with a normal MRI (about 10% of those with MS). Also keep in mind that one can have symptoms without leisons and leisons without symptoms.

While you may not want to use doctors (who does?), your situation seems serious enough that you need to use them at this time to accurately determine what is going on.

As far as depression, there are effective ways to treat depression besides/without pills. Since the pills are not working, you may want to consider other methods. But they are not quite as simple as pills. If you are serious about battling depression, do a search on the internet using the following phrase "treating depression without pills". I am happy to share what I have done/do if want. Let me know.
mvb1212
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Re: Some thoughts on my situation

Post by mvb1212 »

Thanks for all of the responses and appreciate your thoughts...

Jimmylegs- ya, any further incite to more progressive tips on healthy eating would be great. I have been an athlete my whole life. Once graduating college and playing semiprofessional, I vowed not to let my health to get out of line. Nearly 10 years later I have succeeded but will always welcome other opinions.

All- My appointment with the neurologist is not for another 2 weeks. Although the first appointment, hopefully the doctor will shed some light on my situation. In your opinion does my scenario sound consistent with individuals with MS?
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jimmylegs
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Re: Some thoughts on my situation

Post by jimmylegs »

hey there, sorry i missed this earlier. i will re-read and follow up :)
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jimmylegs
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Re: Some thoughts on my situation

Post by jimmylegs »

OK!! have been super busy. back now. still there/interested. mvb? say the word and we can dig in, as it were :)
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