I'd like to know what others have experienced in terms of follow up MRIs. Wouldn't I need one to see how I'm responding to Rebif therapy or is there another test for that?
Also, did I read something that after time my body can build up antibodies or proteins causing the Rebif to no longer work? How do I know if that happens?
Thanks for your help! Vicki
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These are the answers I've received.
1. No follow-up MRI unless needed. Need would be dictated by occurence of significant NEW symptoms. In other words, major relaspse(s) in spite of the Rebif. (My Neuro)
2. Yes there is another test for that.
- How are you doing?
- Rebif is doing its job - or do you want to take a chance by stopping it to find out for sure. (My GP).
3. Test for antibodies - pick an answer:
Sounds like an interesting idea but I have no idea how to order such a test. (My GP)
Yes, it can be done but its too expensive and results mean little. (My neuro)
Not very important as the production of antibodies will cease and things will go back to normal. (an article I read online somewhere)
All my MRIs have been virtually identical to one another (any differences could easily be attributed to the slightly different angle of the imagery). On a side note, it's kind of cool to see the images side-by-side, and step through the series of pictures. I think some of my symptoms have probably been caused by inflammation in my spine, but I've never had an MRI beyond the brain and brainstem. My neuro's thought on this is that the vast majority of myelin and axon material is in the brain and brainstem and so if there's any disease associated inflammation, you should pick it up with the brain MRI. For this reason, he thinks the spinal MRI is an unnecessary expense. I haven't pushed this point, but may some day.
As for neutralizing antibodies, I had a blood test for this when I had one of these new mild symptoms. I can't remember if this was around 6 or 12 months after starting Rebif. The levels were indeed a little elevated, but not alarmingly so. So I stayed the course and was re-tested 6 months later, when the levels had dropped back down. I've heard/read that this pattern of temporary elevation of NAbs is fairly common.
after a chat with my neuro about what i was doing, how i was doing, he asked me if there was anything else he could do today...? and i said 'um, a followup mri maybe?' and he said 'sure!' and did the paperwork right away. i could choose a spine only and wait 2 months, or spine+brain and wait 4 months. since i'm moving away for the summer we made it for september. i can tell you that this made me really appreciate my original mri experience where i was referred to him by my family doc, and coincidentally ended up having my dx attack the week of my appointment wth him, and he got me in that machine the same day, and i had another one for the brain very soon after. and the LP. ugh! it was a whirlwind of medical speed.
so, i haven't had to try to talk anyone into an mri. he practically handed it to me on a platter.
I can't speak to Rebif as i'm not on it though.
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