Aa
I am shocked...MS dx with just one mri!
A very good friend of mine told me her Aunt was dx'd with MS. When I asked questions she told me she had one mri and was told she had "Tier 2" MS.... Has to be the fastest MS diagnosis on record! Now we all know what we have gone through to get a dx. The dr isn't even a neuro... told her to have her aunt get an appt. with a neuro asap - preferably an MS specialist. Unbelievable!!!
I had gone to 3-4 neuros with no luck then went to one who looked at my MRI (that everyone else looked at and said no) and he showed me all of the lesions and said you have MS. This was a 2005 MRI; so I was Dx in 2011 by this new neuro (this is his specialty) and my 2012 MRI showed 3 new lesions (but rad people said none) and he showed them to me also, many of the old ones had disappeared (glad I saved the 2005 MRI disc) but now I can't have any more MRI's, the pacemaker company who put in new pacemaker said absolutely not. Still on Ty after 2 years on it.
Update spoke with my friend today, her aunt has an appt. with a neuro next Wednesday.
she is concerned as something is definitely wrong. but is waiting until she sees the doctor to completely freak out, unfortunately not an ms specialist but that appt. would have taken 3 months.
she is concerned as something is definitely wrong. but is waiting until she sees the doctor to completely freak out, unfortunately not an ms specialist but that appt. would have taken 3 months.
I would hope that most doctors leave the official diagnosis of a neurological disease to the neurological doctor.
In my case, the ER doctor said this to me: "Based on your brain MRI and symptoms, I strongly believe that you have MS, but the neurologist has to be the one to diagnose it."
In my case, the ER doctor said this to me: "Based on your brain MRI and symptoms, I strongly believe that you have MS, but the neurologist has to be the one to diagnose it."
I agree totally with the thought that a primary doc shouldn't be going around diagnosing MS at the drop of a hat, and especially then claiming no neuros need get involved. It's not as if the patient has bubonic plague and so must be put in isolation for fear of dooming the whole city or some such. That guy must be a real hot shot to be around, no?
And of course it's also true even the most experienced MS neuros are hardly likely to proclaim PPMS at first pass. Very often new members here are upset because their doctors could not or would not tell them what variety of MS they have, when in fact, no one knows at that point.
But still there are situations in which a neuro who really knows MS can make the diagnosis quite soon, as several people have pointed out above. It takes a combination of thorough knowledge and very classic and uncomplicated disease presentation for this to happen, though..
Wishy-washy neuros and doctors in general can be maddening, but at least they're reluctant to jump the gun and saddle someone with a very serious and chronic disease without incontrovertible evidence.
Had I been the woman in question, I hope that I too would have realized that this particular Dr. House has an ego problem, and would have gone elsewhere pronto, for all medical needs. But if I were a babe in the woods in terms of serious medical issues, maybe I wouldn't have. Chilling thought. Still, it probably wouldn't have taken long for others in the medical community to have caught on to this lunacy, and meanwhile, at least he wouldn't have been able to do irreversible harm.
ess
And of course it's also true even the most experienced MS neuros are hardly likely to proclaim PPMS at first pass. Very often new members here are upset because their doctors could not or would not tell them what variety of MS they have, when in fact, no one knows at that point.
But still there are situations in which a neuro who really knows MS can make the diagnosis quite soon, as several people have pointed out above. It takes a combination of thorough knowledge and very classic and uncomplicated disease presentation for this to happen, though..
Wishy-washy neuros and doctors in general can be maddening, but at least they're reluctant to jump the gun and saddle someone with a very serious and chronic disease without incontrovertible evidence.
Had I been the woman in question, I hope that I too would have realized that this particular Dr. House has an ego problem, and would have gone elsewhere pronto, for all medical needs. But if I were a babe in the woods in terms of serious medical issues, maybe I wouldn't have. Chilling thought. Still, it probably wouldn't have taken long for others in the medical community to have caught on to this lunacy, and meanwhile, at least he wouldn't have been able to do irreversible harm.
ess
Apologies, I just did my eye drops and was excited to find the site and admit I haven't looked into details. Promise to when my sight isn't so blurry.
COMMUNITY LEADER
Hi and welcome,
Unfortunately we've heard way too many hair curling stories about neurologists, though usually they are failing to dx and not quick to dx.
http://www.medhelp.org/health_pages/Multiple-Sclerosis/Lies-My-Neuro-Told-Me/show/1265?cid=36
You might like to read out health pages found below and start a new question to introduce your self to the community :D
Cheers..........JJ
Unfortunately we've heard way too many hair curling stories about neurologists, though usually they are failing to dx and not quick to dx.
http://www.medhelp.org/health_pages/Multiple-Sclerosis/Lies-My-Neuro-Told-Me/show/1265?cid=36
You might like to read out health pages found below and start a new question to introduce your self to the community :D
Cheers..........JJ
I am a mid-level practitioner and let me reassure you I don't know of many providers that arrogant.
My sister was diagnosed with primary progressive 15 years ago. I will be going to get an MRI shortly because now the right side of my face and my right hand is numb, added to the overwhelming fatigue, vision changes and balance/proprioception problems, I think I know what it will show.
Before MRIs, MS dx used to be made strictly by the history the patient gave and the physical exam. Spinal taps don't show what kind of MS a person has, and if it's negative doesn't mean a person DOESN'T have it. But if you know you have the symptoms and the MRI shows plaques, I think the DX is confirmed.
My sister was diagnosed with primary progressive 15 years ago. I will be going to get an MRI shortly because now the right side of my face and my right hand is numb, added to the overwhelming fatigue, vision changes and balance/proprioception problems, I think I know what it will show.
Before MRIs, MS dx used to be made strictly by the history the patient gave and the physical exam. Spinal taps don't show what kind of MS a person has, and if it's negative doesn't mean a person DOESN'T have it. But if you know you have the symptoms and the MRI shows plaques, I think the DX is confirmed.
I am a Physician Assistant and had been following a patient for 5 years with primary complaints of memory loss, weakness, fatigue and vision changes. After her first exam I encouraged her to have an MRI and explained I suspected MS. She also had a history of CO2 poisoning 15 years prior to developing symptoms, so there also was a chance she had progressive damage due to that event.
The first radiologist read her MRI as Lunar infarcts, otherwise normal.
I left the practice but filled in after 2 years, and was able to follow up with her. We decided to do a repeat MRI, and in doing so sent the original MRI for comparison. It was deemed the first reading was incorrectly read and the demylinating disease was evident, and had shown definite progression.
The first radiologist read her MRI as Lunar infarcts, otherwise normal.
I left the practice but filled in after 2 years, and was able to follow up with her. We decided to do a repeat MRI, and in doing so sent the original MRI for comparison. It was deemed the first reading was incorrectly read and the demylinating disease was evident, and had shown definite progression.
I am thinking this happens more common that you think.
I was unofficially diagnosed by an ER doctor when they did a brain MRI to rule out a stroke. I saw a neuro that day who ordered additional testing the following week. Within three weeks I had the official diagnosis. I had lesions in my brain, cervical spine and thoracic spine so that probably made it easier.
I had been ignoring a lot of stuff for a long time. I bet if I had sought medical attention at first onset of my symptoms I would have been in limbo land like a lot of other people here.
I was unofficially diagnosed by an ER doctor when they did a brain MRI to rule out a stroke. I saw a neuro that day who ordered additional testing the following week. Within three weeks I had the official diagnosis. I had lesions in my brain, cervical spine and thoracic spine so that probably made it easier.
I had been ignoring a lot of stuff for a long time. I bet if I had sought medical attention at first onset of my symptoms I would have been in limbo land like a lot of other people here.
The ego some docs have is mind boggling :-) No need for the doc to call, him/herself to tell her she had the worst possible kind variety of an incurrable CNS disease. It's not worth their time! And no need for fancy treatment either. Stop by and they'll give you some antibiotics :-)
Everyday I thank God for the very hightly qualified NYC neurologist who told me I had MS but she was not an MS specialist. She then told me I needed an MS specialist! A year later her I wrote her what was basically a love letter :-)
Kyle
Everyday I thank God for the very hightly qualified NYC neurologist who told me I had MS but she was not an MS specialist. She then told me I needed an MS specialist! A year later her I wrote her what was basically a love letter :-)
Kyle
Found out more info - this was her pcp. Had brain mri nurse practioner called her on the phone and said well no brain tumor but you have primary progressive ms. They said no need for neuro we can treat you here. After flipping out for a day she has researched and found an ms specialist and is making an apt for a full battery of tests. And she is looking for a new pcp!
My DX was bing, bam, boom. I went to GP She ordered Brain MRI and referred me to Neurologist. Based on one MRI and clinical exam neuro said "I'm 85% certain you have MS. You need an MS specialist. MS doc filled in the remaining 15%. Total elapsed time from first GPO visit to confirmation by second MS specialist was 6-8 weeks. I should add that I also had LP and C-T spine MRI in the 6-8 weeks.
Kyle
Kyle
I just want to add another side to this discussion. It might seem that doctor sees patient, doctor orders MRI, doctor diagnoses MS, voila! But I wouldn't want our newer members to get the wrong idea from this, and then feel that they themselves have been somehow cheated.
Presumably the doctor knows a bit about the patient's health history, if only through the endless forms we all have to fill out. When he meets the patient, if he's a good neuro he can tell a lot just by the way he or she moves. I'm talking about before the actual neuro examination. If he then does a thorough exam, he is able to spot weaknesses, odd reflex reactions, unsteadiness of walk, and a lot more, and also to see what is perfectly normal. Years of training and precision can allow him to 'cut to the chase' in ways that we as patients are totally oblivious to.
Sometimes a neuro will order an MRI because he's puzzled, and sometimes an incompetent one will do it because he doesn't know what else to do. But very often this test will be ordered because the doctor has a hunch, or more than a hunch, as to what is wrong. Or possibly he thinks it could be one of two things (as described above). In these latter cases, the MRI merely provides the evidence needed to make the diagnosis with greater certainty. If his suspicions are confirmed by the MRI, and especially if it's textbook imaging of MS, the diagnosis is easy and quick.
Remember that the McDonald Criteria don't require that a slew of other tests be done as 'rule-outs.' Not that this is a bad idea, but at times more testing isn't necessary. Even MRIs aren't necessary, and way back when, weren't even available. The doctor posits lesions based on his examination and knowledge of the patient, and with luck the MRI confirms them.
Of course the situation with most of us isn't so slam dunk. Sometimes MRIs can even get in the way of an accurate diagnosis. I'm a good illustration of this, as are a great many others who have posted here. With me, my older age made me an outlier, and my MRIs, though abnormal, were non-specific. So they slapped the microvascular ischemia label on me, despite the fact that I had no history or findings to indicate ischemia, and several of my other tests, including pretty comprehensive office testing by a series of neuros, did point directly at MS. But it took me years to get a diagnosis.
I guess the bottom line here is that there indeed are cases where symptoms and findings lead quickly to an MS diagnosis. I have no idea what percentage these represent, because human nature being what it is, people with fewer questions or difficulties seem much less likely to join an online forum. Some do, of course. But it's my belief that we are likely to become vocal quickly when we're frustrated and often in pain for years, with no answers.
If any patient's confidence in the doctor is shaken by too quick a diagnosis or way too much shilly-shallying, of course another opinion is a good idea. But in the right circumstances, quick can be right on.
ess
Presumably the doctor knows a bit about the patient's health history, if only through the endless forms we all have to fill out. When he meets the patient, if he's a good neuro he can tell a lot just by the way he or she moves. I'm talking about before the actual neuro examination. If he then does a thorough exam, he is able to spot weaknesses, odd reflex reactions, unsteadiness of walk, and a lot more, and also to see what is perfectly normal. Years of training and precision can allow him to 'cut to the chase' in ways that we as patients are totally oblivious to.
Sometimes a neuro will order an MRI because he's puzzled, and sometimes an incompetent one will do it because he doesn't know what else to do. But very often this test will be ordered because the doctor has a hunch, or more than a hunch, as to what is wrong. Or possibly he thinks it could be one of two things (as described above). In these latter cases, the MRI merely provides the evidence needed to make the diagnosis with greater certainty. If his suspicions are confirmed by the MRI, and especially if it's textbook imaging of MS, the diagnosis is easy and quick.
Remember that the McDonald Criteria don't require that a slew of other tests be done as 'rule-outs.' Not that this is a bad idea, but at times more testing isn't necessary. Even MRIs aren't necessary, and way back when, weren't even available. The doctor posits lesions based on his examination and knowledge of the patient, and with luck the MRI confirms them.
Of course the situation with most of us isn't so slam dunk. Sometimes MRIs can even get in the way of an accurate diagnosis. I'm a good illustration of this, as are a great many others who have posted here. With me, my older age made me an outlier, and my MRIs, though abnormal, were non-specific. So they slapped the microvascular ischemia label on me, despite the fact that I had no history or findings to indicate ischemia, and several of my other tests, including pretty comprehensive office testing by a series of neuros, did point directly at MS. But it took me years to get a diagnosis.
I guess the bottom line here is that there indeed are cases where symptoms and findings lead quickly to an MS diagnosis. I have no idea what percentage these represent, because human nature being what it is, people with fewer questions or difficulties seem much less likely to join an online forum. Some do, of course. But it's my belief that we are likely to become vocal quickly when we're frustrated and often in pain for years, with no answers.
If any patient's confidence in the doctor is shaken by too quick a diagnosis or way too much shilly-shallying, of course another opinion is a good idea. But in the right circumstances, quick can be right on.
ess
Me too! I want to doctor with headache & ear pain.
He sent me for MRI, 20 mins after I had the MRI he called & said you have MS.
I
He sent me for MRI, 20 mins after I had the MRI he called & said you have MS.
I
She told me the dr thought she had a brain tumor. did the mri and said no its MS. I kind of thought SPMS too cause never heard of the tier 2 either. told her to take a deep breath and make an apt with an ms neurologist.
I told her how many tests I had and while every case is different she needs to do research and get another opinion!
Have a great evening
hugs..Tracy
I told her how many tests I had and while every case is different she needs to do research and get another opinion!
Have a great evening
hugs..Tracy
That's my story, too. I had the MRI - PCP called me to come in and meet with her. She said i mosty definitely had MS but she wanted the MS neurologist to be the one to say so and get me started on treatment. It took a while to jump through his necessary hoops, but start to finish I was all done with the entire process - waiting for appt times, more tests, LP. etc - in about 6 weeks. It was incredibly fast.
I'm not sure what Tier 2 mS this doctor would have meant - probably SPMS - and i certainly would not believe that doctor's assesment. Tell your friend that it won't be a surprise if the neurologist has a different opinion and slows down a bit for the dx. but you already know that!
hugs, Laura
I'm not sure what Tier 2 mS this doctor would have meant - probably SPMS - and i certainly would not believe that doctor's assesment. Tell your friend that it won't be a surprise if the neurologist has a different opinion and slows down a bit for the dx. but you already know that!
hugs, Laura
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