MRI, MRI, How Many Brain Lesions Have I in All?

When it comes to magnetic resonance imaging (MRI), I have far more experience than a geezing quarterback or aging pitcher. I’ve been in open MRIs, closed MRIs, even portable MRIs on trailers. I’ve had short MRIs (20 minutes), long MRIs (50 minutes), and hella-long MRIs (100+ minutes). I’ve enjoyed in my Tubes O’ Fun silence, music, and even movies (it’s hard not to laugh during Napoleon Dynamite when he talks of nunchuck skills). All so docs can get a better idea of disease activity. But do you want to see the results?

On the surface this may seem like a silly question. Why of course you’d like to know how many multiple sclerosis lesions you have in your noggin’. You want to be on top of your disease, don’t you? Maybe. But maybe not. Since my first positive brain MRI, which showed two small lesions, I made the decision to remain in the dark (pardon the MRIesque pun). I’d argue—and so would my neurologist, a ridiculously bright man who actually wrote the book on MRIs (well, one of them, anyways)—that your best course of action might be to NOT know. Here’s why.

If your neuro is an MS expert—and you trust your doctor to do what’s best for your health—you personally knowing the number of lesions, in particular if it is increasing, could make a bad situation worse. Say your MRI is lit up like an arena of cell phones during a love song at a Justin Bieber concert. Option A) Doc: “We can’t count the number of lesions there are so many. Holy cow, I’ve never seen so many. Think a firefly convention in midsummer, ha ha.” Result: You stress out, you get depressed (or both) and people who love you cry and worry. Stress brings on a relapse and you get worse. Option B) Doc: “We’re seeing some activity, maybe we should look at other treatment options.” Result: You look at other treatment options… without stressing the hell out and freaking the crap out of your mom who still worries about you just crossing a street. I personally prefer Option B.

Originally published July 29th, 2010