Tuesday, 26 August 2014

#35 The New MRI

I was tired of these brain MRI’s. I dreaded being confined in that closed space, felt my tolerance to endure it was not as strong as it needed to be. But I got through it. It was September 2013, three years from that fall when I felt L’Hermitte’s Sign for the first time. In my opinion I had been deteriorating, albeit gradually, ever since that time. Not just physically, but cognitively as well. The constant pain was wearing me down. I would spend most of my day in my chair, doing activities that could be done sitting, or in bed because the fatigue was so great I couldn’t hold my head up any longer.

Instead of the 20 to 30 plaques seen on the previous report, there were now innumerable foci. There had been a progression in the disease, with an “increase in both prominence and number of foci of demyelenation…”. So worse, once again.

And the bad news didn’t stop there. In the MRI of the Cervical Spine, there were “multiple patchy foci…” again increased in both prominence and number.

Oh, but wait, we’re not done. At C4-5 there is “hypertrophic degeneration of the facet joints” with “impingement upon exiting right C5 nerve root. The same for the C6 nerve root.

Basically it showed a progression of demyelination and a progression of multilevel spondylotic changes. No wonder my neck hurt.

I talked to the nurse at the MS Clinic, as they had received a copy of the report. She informed me that the neurologist didn’t base his treatment on the MRI, but more on what clinical signs the patient presented with. There’s that old thing about only 10% of the lesions actually causing symptoms.

We talked about how I was managing, how I was feeling etcetera, and for the first time I heard my MS be classified by type. Not the relapsing/remitting that I had been for years, but secondary progressive. Still didn’t meet the criteria for the big guns treatment, and since I was not actually suffering a ‘relapse’ I didn’t meet the neurologist’s criteria for treatment there either.

Now I’m facing a whole new challenge, changes that may be coming that will greatly affect my lifestyle. I guess, when you think about it, I had a pretty good run since my first symptoms appeared twenty four years ago. Have to wonder where I’d be if it weren’t for all that stress. Could I have managed things differently, definite yes, but it’s hard to see the big picture when you’re struggling alone to get through the day.

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