Yuck- Neurologist visit

[Aggie_Ama]

I talked to my co-workers and we have two plans, even the higher ($$$) plan has this issue so at least that is good to know. I only went to the cheaper this year. And my deductible does reset in January even though insurance renews in July. I might as well wait until after the first of the year to get this done and have much of my $1k deductible met for 2009. Insurance can really be a pain. The doctor's office will also give me a list of other offices to do it, maybe one will bill me for it or let me up front pay less.

[snapdragen]

Check to see if your insurance plan has a preferred imaging provider -- that might help with the cost too.

[Miranda]

Hun, I'm sorry you're having to get back in the tube of doom. It is a test that shows a lot of stuff that no other does.

I have been in there serveral times with my neuro junk and other stuff. I am claustrophobia. I need sedation and a driver, though last time I did make it without. Even though the claustrophobia is technically an imagined fear, it causes me emotional upset. Which emotional upset is one of my asthma triggers. Not being able to breath due to an asthma attack, and being stuck in the tube, gets to be a real problem. I think the brain is the worst. They clamp that awful cage over your face in addition the the tube.

For me... eyes closed, washcloth over my eyes, the tech wraps me up in a blanket tight, no music--talk to me instead... asthma meds before, happy drugs. Plus, I go scope the place out before the test. If I don't like the faciltiy, I shop another one. See the room. Meet the tech. "Hello... I'm Miranda and I think I may die on your watch, can we make a plan for that not to happen? I know you don't want to use your cpr skills...". It's amazing how nice people can be when you ask them "right" . Actually, I have my own techs memorized by name now and check when they are working. How high maintenance drama is that?

On the DH, well, I'm married to his brother and then some. I've had my 80yr half-blind mother take me before, kids screaming in the parking lot w/g-ma, and drive us all home with me laid out on drugs. Sounds safe, eh? Actually, my other thought at times was to employ an aid from a home health agency as a driver. Or take a taxi. I know that sounds a bit cold, but really you just need reliable wheels at a minimum. I know such services exists. Maybe the docs office, or MRI center might have a tip?

Mom in her age and wisdom says, where there's a will, there's a way... women are very resourceful creatures. Spirits of positive wishes will be with you from your cyber sisters when the test time comes.

EDIT: IVs... did you know there is also a topical numbing cream they can apply before the stick to take care of the pain of the needle? If you are getting sedated and have to be there ahead of test time anyways is no big deal. Just check ahead to make sure they have it on hand. It's like a thick white skin lotion. Btw, the lab I used to work at did some major university sports teams... the football linebackers were the ones that always fainted the hardest at the sight of a needle.

[Duck on Wheels]

I learned this from one of my PhD students' field notes (She was observing doctors' meetings at a neurology dept.): MRIs are pretty much a standard test nowadays for anything neurological. When they can't figure something out, they tend to say "Hmm. Have we done an MRI yet?" The MRI shows lots of interesting stuff. The results look like an x-ray, but where an x-ray mostly shows bone vs. soft tissue, the MRI differentiates between all kinds of tissues with varying densities and water content. So an MRI can differentiate between bone, muscle, nerves, veins, and so on. That makes it like a "shotgun" exam -- it "hits" just about anything in front of it. Tumor, yes, but also stuff as banal as a pinched nerve or a bruise. Depending, of course, on how close together they take the images, which are like "slices" that they can then patch together for a 3D-view. Close together they're more likely to catch even teensy stuff, further apart and they might miss that pinched nerve.

They can also retune the whole machine to show physiochemical processes, like lactic acid accumulating as you work a muscle. But that does take re-setting the machine, so it's either the tissue differentiation view or the physiochemical view in any given exam.

The magnet is noisy, kind of like a car backfiring. The machine is also kinda clanky as it revs up. But with ear plugs, and maybe some Xanax, the noise shouldn't be a problem. The machine looks like a big tube with a gurney that slides through it. You lie on the gurney, as comfey as they can make it (but it is narrow and confining, so they can never get it to the level of a 5* hotel bed). They slide the gurney stepwise through the machine, taking image after image "slice" by "slice" (metaphorically, of course. there are no sharp edges to this thing, so no actual slicing). Then they slide you out and it's over. Each image can take a few seconds, and they don't want you to move, so they tell you when to expect the noisy bits that you have to lie still for and when you have a wriggle break.

The physics of it all are pretty fascinating too. I'm sure there are actual physicists on the board who can tell me I've got this wrong, but I think it has to do with hydrogen atoms, the way they spin and the way the line up all parallel to one another under the influence of certain combinations of magnetism and radio waves. Somehow, the machine can tell whether they're lined up or relaxed and whether they're spinning one direction or another. It can also tell how long it takes them to line up and relax as the radio waves (or is it the magnet?) are switched on and off, and the difference in these times has to do with the density of the tissue. So where an x-ray machine is sending radioactive particles through you at a film, the MRI is only using magnetic and radio frequency waves. In other words, it's safer than the more familiar (and therefore less scary?) x-ray machine.