Cervical MRI on Monday - self pay - tips appreciated

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Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 6th, 2015, 11:12 am

Hi All,

My left arm is acting up again: totally restless, lots of twitching, pain from the next down into my arm, internal vibrations and strong heart beat (pulse), with weak feelings/fatigue. NO numbness and NO pins and needles. It actually gets worse when I use the TENS unit prescribed to me, exactly how they told me to use it, when it's actually supposed to help.

Physiotherapists, private neurologist, private orthopedic, psychotherapist, family, husband - they all tell me I have something going on with my cervical neck. ALTHOUGH an EMG of my bicep and forearm (twice) and SEP and MEP were normal. Private orthopedic also believes that the atrophy (which he recognized as atrophy) in my right hand has to do with my neck also, it has been very slowly sinking for almost a whole year. Ultrasound of the tendons was normal.

SO - because in Germany you only get an MRI prescribed if you beg and plead and continue to have symptoms for months (which I have all done/have and they still aren't prescribing me one, they want to wait to see how I am at the end of April), I made an appt for a self-pay MRI this Monday (est. 700€uros). Even if I got the prescription for an MRI, the wait list for 'referral' MRIs goes out over 1 month at the places I called. With self-pay, you get an appt right away, and the report same day as well. My family backs me up here.

Now - because I am going in with no doctor's referral/notes, and I want to make the best of this MRI, are there specific things I should ask for or mention, things that I definitely should or should not say to the radiologist? I want to make sure they look at the right areas. So I am taking any advice about this and will greatly appreciate it!
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Yuliasir on March 6th, 2015, 1:32 pm

as for MRi itself you should not tell radiologist practically nothing except if you have any metalli implants (tooth, filling, any cranial clamps etc.). The doctor would do primary description and list any specific findings (if any), then you should go to neuro with the disk and discuss the results and primary description wiht the neuro. this is usually the way.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 6th, 2015, 2:22 pm

Thanks Julia! I wondered because when I made the appt they asked me why and what for...so I told them a little bit but then wondered if I should say much or nothing at all. To keep things objective but also I don't want them to miss anything. They told me to bring any previous tests, but I can't get my neck X-ray or doctors notes before my appt on Monday. I only have my neuro reports but on there it says I have psychosomatic/depression/anxiety....but it does also mention neck problems.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 10th, 2015, 3:47 am

Ok so I have the pictures of the MRI an hope for the report in the mail later today or tomorrow. They did ask for indications and I just put neck and left arm pain and right thumb atrophy.

I see two areas where there are major bulges by c5 and c6. It is marked up by the radiologist. Then, also marked up by the radiologist, are 3 other discs (c2-c4) which are completely black inside where the discs are (c5 and c6 are also black). The other discs in thoracic and lumbar spine are light, where you can see the disc. I read this can indicate degenerative disc disease. Those are the only two areas marked up.

Now, where I am freaking out about, is where the two bulges are, in the spinal cord itself is a lighter gray color. I read this can be "spinal cord injury" or "edema" and it can indicate either injury/inflammation that can heal or a degenerative myeleating process (MS) or something else auto immune. I found an image online of a MS cervical spine that has about the same look in the spinal cord as mine does. But, in the fat supressed images, that light area does not show up.

http://img.medscape.com/pi/emed/ckb/rad ... 0113tn.jpg

So because this lighter color is right at where the bulges are, they are automatically marked up. I am nervous to receive the report. I am traveling to Ireland right now for a week for work, and my husband will get the mail and read me the report when it arrives.

When I was looking up these MRI images I found that you can tell ALS on spine MRI and I thought you couldn't? It's easily seen in the axial images where white spots appear where the anterior horn cells are (like "snake eyes"). I looked through all of those images of mine and the coloring was consistent (no white). But maybe I misunderstood what I saw online.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 10th, 2015, 3:50 am

Oh I forgot to mention. There is another picture marked up but I am not sure why.....it's of my general spine as if looking at it from the front (I can see my shoulders, neckline, etc), and the cervical spine, all of it, it marked up with several lines that go up and down, and they are not straight. I wonder if that is to indicate my spine is not straight?
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Yuliasir on March 10th, 2015, 3:58 am

Xina,
the only advice is to be patient. Without special knowledge all your or our self-made conclusions mght be and would be erroneous. Since oyu do not have any immediate reaction from the MRI department, I think, there is no direct threats in your findings.

As for ALS, MRI appeared to be inconclusive mainly, probably till the vey late stages at which degeneration of bulk neural tissue occurs, but at those stages people are already clearly disbaled. MRI appeared to be non-efficent as predictive or early warning tool for ALS.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 10th, 2015, 4:11 am

Yes I know. It is so hard to be patient.

And ok, good to know about the MRI in ALS. I understand that the spots would show up then only after disability/diagnosis.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 10th, 2015, 12:48 pm

Ok - so this is the report. WAY too technical for me. I was able to translate most of it from German to English, there are two words in there where I kept the German word and put in what I think is the English word in parenthesis with ??. In general, it sounds to me I had injuries and since physio they lightened up? And maybe what I'm feeling still is like "left over" or "still damaged and needs time to heal"? Or maybe I am way off. I still have pain in my neck, still in my arm (comes and goes) and my left arm is weak. I also still have the right hand atropy problem. Does this mean anything to anyone? I can also try to post this in a spine-health forum. Thought I would start here first.

Cervical spine in steep position. In segment C5/C6, vertebral disc prolapse subligamentous with a deep expansion of 2,5mm with protuberance of the dural sac. Free foramina. No clear affection of the root.

At C6/C7 left eccentric circumferential vertebral disc herniation with relative recess stenosis left and initial short segmented “retrospondylophytär” (retrospondylolisthesis??) crashed components also in Neuroforamen of the right side. Also here, no compression related Myelopathy findings. No vertebral height reduction. Relevant paravertebral abnormalities are not shown. No “unkarthrosen” (uncarthrosis??)


The two pictures they marked up:

https://roxythegray.files.wordpress.com ... ked-up.jpg

https://roxythegray.files.wordpress.com ... ed-up2.jpg


Then where I see stuff around my C5 and C6 - also note the black discs and that white colored area in the spinal cord next to the bulges (that I mentioned before).


https://roxythegray.files.wordpress.com ... tions2.jpg

https://roxythegray.files.wordpress.com ... ations.jpg
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Buzznerd123 on March 12th, 2015, 9:04 am

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Last edited by Buzznerd123 on May 1st, 2016, 11:56 am, edited 1 time in total.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Yuliasir on March 12th, 2015, 10:59 am

Usually the next part is to talk to neuro - but if the summary does not list any specific wrinings - then it is just more or less expected issues.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 22nd, 2015, 11:41 am

I went back to the Hand surgeon because I still can't bend my wrist that well. He said the wound is "verklept" which means "stuck together" so I have to massage it with a Special cream and I should not force bending it.

He said he saw my concern with my thumb/index finger, looked at my MRI and said this would come from C7 area, but the MRI said no compression so he is not sure that the herniation is causing my Hand Problem. He referred me to a neuro for more testing with the words "suspect of ulnar nerve lesion" - so at first, that freaked me the he** out, but then I found out that means ulnar nerve entrapment - I think?? And I am concerned because all neuro tests so far showed nothing, and this Hand issue has gone on now for a year, so if a nerve is compressed somewhere, and it's not my spine, would it cause my Hand to slowly shrink and the weakness Progress slowly? It's getting worse where I get pulsating and vibrations in my thumb (thenar) and my index finger (on the inside of it) and I am noticing that I can't really press down as hard as I used to with my index finger.

Then, my left arm, it stopped constantly vibrating/pulsating/twitching and being painful for a few days, but it's all back now. Pain into my left arm, and even radiating into my fingers, weak/Fatigue Feeling (like when I hold my arm up straight, it sways on its own, can't really hold it in one Position) - and all of the twitching and pulsating is back too. One time I could literally feel the pain go from the spine in the middle of my back outward, so I can only believe this is from my neck issues, but...then I get confused because the Report said "no compression". ??

Going to a private orthopedic doctor this Thursday to get a second opinion on the MRI (he's going to look at all of the Pictures) and just get his Overall advice. Also going to make a neuro appt on Monday when they open.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 22nd, 2015, 11:54 am

Oh yea, two other symptoms bothering me:

1) Body/leg jerks. Will just pop up/out at random times (not just before sleep)

2) Including my jaw/mouth. It will just move out suddenly, hard to explain.

Could that be due to neck spine issues? Anyone have opinions there?
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Yuliasir on March 23rd, 2015, 12:15 am

Ulnar compression usually occurs not at the spine level, but at the level of elbow joint, and carpal compression - at the wrist joints level. It has nothing with the disk compression/hernias. And yes, any compression - whether at the disk level or at the joint one - causes slowly progressed weakness, atrophy and even paresis. Thumb is slowly getting closer to the rest of palm loosing human-specific outstanding position, and this is called 'monkey hand'. People who have to work hard (especially older people) demonstrate this position quite often - when the tumb is alsoms under the index finger. That is becasue of compression due to repetitive motions and age-related atrophy.

can not say anything definitely regarding your pops, but I remember that when I was especially heavily stressed, I has those involuntary movements throuought all the body and even sometimes in the jaw. Maybe it is your case too.
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Xina535 on March 23rd, 2015, 12:48 pm

Thank you, Yulia! I hope these pops are stress related! :shock:

When I look up ulnar nerve compression at elbow or other places, it mentions issues with the last two fingers, and also elbow pain or other things that I don't have at all. Just thumb/index finger with the snuff box and my thumb knuckle becoming less. Also that dip in my first dorsal interrosaeous ....I get tingling in thumb Thenar but no atrophy there. So this confuses me. I hope to get more advice from my visit this Thurs and my neuro appt is set for 8-Apr (at a new clinic, as it was the closest appt I could get).
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Re: Cervical MRI on Monday - self pay - tips appreciated

Postby Yuliasir on March 23rd, 2015, 2:09 pm

Well, thumb and index finger means not elbow (ulnar) but wrist (carpal) nerve damage which is exactly your case I think. Pain is at the wrist level or irradiates at the level of casual glove (2 inch above the wrist or so).
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Re: Cervical MRI on Monday - self pay - tips appreciated

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