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


Anonymous said…
"cell phones during a love song at a Justin Bieber concert" and "firefly convention" haha I just called mine "scrambled eggs"
Well the things I can or can't do still depend on my mood, stress levels and the temperature.. and occasionally the lesions count (no pun intended).
Dave Bexfield said…
Ierene, if you've got scrambled eggs, let's hope it's a one-egg deal (whites only). Let's think healthy!
Niko said…
Hahaha, I had to laugh despite myself this morning when I read your post, Dave. I had my second MRI last week and saw my neuro yesterday, and it pretty much went like that. I cried so hard all day when he gave me the news, freaking out. Thanks for reminding me to laugh again- it's a new day and the race isn't over :)
Dave Bexfield said…
Sorry to hear that, Niko. But look on the bright side--at least you got your tear ducts cleansed and properly flushed. The race is never over. Keep it up.
Unknown said…
I'm in The initial diagnosis stage. I lost muy right eyesight vision a month ago optic neuritis. I have been through 6 MRIs already. They found two small lesions on my cervical spine. Not sure if it is MS, but I'm really scared.
Dave Bexfield said…
Maria, getting diagnosed can be a real scary time. Hang in there. And if you need it, check out my other blogs on getting diagnosed. Hopefully they will help you cope with they uncertainty and brighten your day, if even by just a little.
Debbie E. said…
Dave, thank you for taking the time to put together your blogs.

Yes, getting diagnosed can be scary, but I subscribe to 'I'd rather know and be able to handle this head on vs. not knowing and guessing what is going on'.

I personally don't mind the MRI's (both open and closed are fine, I just close my eyes), the lumbar puncture now is a different story.

I trust my neuro. I advocate to anyone that is facing the possible diagnosis of MS, to find a doctor they are comfortable and who will handle this disease.
Dave Bexfield said…
Good advice, Debbie. A good neuro is invaluable.

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