Early MRI, When & What to Consider?

[Charlottes Web]

I have a standing MRI appointment, every 6 months, for life, (next one in 2 months). My Neurosurgeon has always instructed me to call for an early MRI if I experience changes. I would be in an MRI every day if I took that literally and only consider calling if I have a major change.

Oddly, I'm not sweating below my chest. I have no idea how long this has been going on but noticed it the last few weeks during this record breaking heat. When I'm outside, my legs feel cool to cold to the touch while my arms warm to hot, but my legs/feet have felt cold to the touch since the accident.

In addition, I've lost more sensation in my left side, abdomen, hip, legs, ankle, around my foot, and tailbone since the last MRI. This I don't worry about much.... it's the usual.

My question is, would the lack of sweating be considered, and/or does it warrant having my MRI done early... does 2 months really make a difference?

If I call this into my NS's office, they won't ask my NS but tell me to go ahead for the MRI. They play it safe. MRI's mess me up and I don't want to go in early if it's not needed, so thanks for any opinions!

Thanks in advance!
T

[Wise Young]

Originally Posted by Charlottes Web

I have a standing MRI appointment, every 6 months, for life, (next one in 2 months). My Neurosurgeon has always instructed me to call for an early MRI if I experience changes. I would be in an MRI every day if I took that literally and only consider calling if I have a major change.

Oddly, I'm not sweating below my chest. I have no idea how long this has been going on but noticed it the last few weeks during this record breaking heat. When I'm outside, my legs feel cool to cold to the touch while my arms warm to hot, but my legs/feet have felt cold to the touch since the accident.

In addition, I've lost more sensation in my left side, abdomen, hip, legs, ankle, around my foot, and tailbone since the last MRI. This I don't worry about much.... it's the usual.

My question is, would the lack of sweating be considered, and/or does it warrant having my MRI done early... does 2 months really make a difference?

If I call this into my NS's office, they won't ask my NS but tell me to go ahead for the MRI. They play it safe. MRI's mess me up and I don't want to go in early if it's not needed, so thanks for any opinions!

Thanks in advance!
T

Charlotte,

You are have two reasons to go for an MRI. The first is that you have lost sweating. Sweating is controlled by sympathetic nerves that come from the spinal cord. After injury, people often change their threshold for sweating above and below the injury site. Above the injury site, there may be too much sweating and there may be little or no sweating (except when it gets very hot) below. It is true that you might have had this from the beginning but simply did not notice it until now. However, if it is new, the loss of sweating alone is reason to do the scan.

The second is that you have lost sensation over 5-6 dermatomes. This amount of sensory loss, particularly unilateral and involving so many dermatomes, is suggestive of a syringomyelic cyst related loss. So, if I were you, I would probably go get an MRI. Makes no sense to wait.

Wise.

[Charlottes Web]

Not what I wanted to hear! BUT, thank you for your time and advise, Dr. Young. I'm honored!

The lack of sweating is new, maybe since this Spring. A nice perk in 104 heat! To clarify, the lost sensation is mild and fluctuates, with the exception of the hip and tailbone. Still walking and climbing the stairs...

In any case, I'm scheduled to see my NS, NP, next Thursday. She will send me for the MRI, asap. My NS referred me to CC. He has the utmost respect for you and speaks highly of your work! The mere fact that he follows the trials, tells me a little sompin, sompin!

You have amazing focus, Dr. Young! Isn't it great to do what you love and love what you do!?!

Thank you again for your time - but I hope you're wrong re: syringomyelic cyst.... jeez, I don't even know how to pronounce that!

Cheers,
T

Originally Posted by Wise Young

Charlotte,

You are have two reasons to go for an MRI. The first is that you have lost sweating. Sweating is controlled by sympathetic nerves that come from the spinal cord. After injury, people often change their threshold for sweating above and below the injury site. Above the injury site, there may be too much sweating and there may be little or no sweating (except when it gets very hot) below. It is true that you might have had this from the beginning but simply did not notice it until now. However, if it is new, the loss of sweating alone is reason to do the scan.

The second is that you have lost sensation over 5-6 dermatomes. This amount of sensory loss, particularly unilateral and involving so many dermatomes, is suggestive of a syringomyelic cyst related loss. So, if I were you, I would probably go get an MRI. Makes no sense to wait.

Wise.

[smashms]

i would agree with wise on this and i also wish you luck and hope it isn't the worst!!

[smokymtn memories]

I lost the ability to sweat below injury level after my first surgery, but after the second surgery, I notice pretty much no sweating. The biggest problem with that is your body has no way to cool itself off in these hot temps! So, I have to stay with the ac just about all of the time now in the bad heat of summer. If not, I get sick, can get AD and that's not good! So be careful out in this heat we're having!

[Charlottes Web]

Thanks, Smash! I hope so too, but if not, I'll learn how to properly pronounce that cyst you and Dr. Young reference. In the meantime, I'm inclined to say it with a French accent.

I'll post back with the outcome.

Have a great weekend!
T

Originally Posted by smashms

i would agree with wise on this and i also wish you luck and hope it isn't the worst!!

Being somewhat clueless to when it started has me feeling a little tupid, Smokymtn! Other than what little bit I've read here, I'm tupid about AD! Assuming AD, is Autonomic Dysfunction? ...I'll do more research tomorrow. I'm sure there's plenty of good info here.

BTW, I'm blaming this on my doctor for changing my pain medication ...LOL!

I would become bitter quick if I had to stay indoors! I bust a move on the household chores and hit the screened porch to recover. With the exception of these last hot days, I keep the laptop outside for CC visits.

This question will probably make me sound even more ignorant, but is there a suit available for temp control to AD sufferers? Certainly not something ins would consider paying. Nope, it's not medically necessary to enjoy the outdoors.

We reached 116 on our thermometer today and an official, all time record breaking, 109, for Nashville. What was your high today? It's really nice out now, at 1:00 AM - I don't want to go to bed, I want to enjoy the cool breeze!

YOU be careful in this heat too - we have another week of it!

Thanks for the heads up on AD!

Hope you're feeling better and get a good nights sleep!!!
T

Originally Posted by smokymtn memories

I lost the ability to sweat below injury level after my first surgery, but after the second surgery, I notice pretty much no sweating. The biggest problem with that is your body has no way to cool itself off in these hot temps! So, I have to stay with the ac just about all of the time now in the bad heat of summer. If not, I get sick, can get AD and that's not good! So be careful out in this heat we're having!

[Charlottes Web]

No sweating from head to toe after noon today. Crazz-zy in this heat!

From what I read, AD has a broad range of symptoms. Other than over heating, I'm not sure what to watch for. My husband has wanted to check my BP all day. It's fine!

[Charlottes Web]

My MRI showed no change. I saw the NP today, and my NS still has to look at the scan, but I feel confident with her findings. It also looked the same to me.

She contributes the symptoms to stress and the record heat. She told us she has seen a number of her SCI patients with increased symptoms and pain.

She sends special thanks to, Dr. Young and all of you for the good advise.

I thank you as well!!!
T

[avictoria]

Oh good I'm glad everything seems fine. Stay cool and safe--life has been exciting between heat and bad storms.

[Charlottes Web]

I spoke too soon. I received my MRI report by mail yesterday. The Nurse Practitioner was correct in stating there was "no change", however that applied only to Charlotte, the arachnoid cyst at T2-T4, and the lesions, T6-T8.

But, there is a difference from the MRI preformed 4 months ago. My MRI, report reads, "there is mild bilateral facet hypertrophy at T10-T11." No central spinal or foraminal stenosis.

I've googled and searched here for this but still don't know what to make of it. I'm assuming it's the reason my spine has feels like it's sticking or catching when I move, and possibly causing the additional loss of sensation, increased pain, and lack of sweating.

I'm hoping some of you will have more information and appreciate any input I can get! Learning and taking it as it comes!

Thanks
T