Monday, December 29, 2003

The Spinal Tap appointment was for 10 AM but I should have asked them to push it "all the way up to eleven." Didn't. So I got there, and they had decided to reschedule it to tomorrow. We are getting a cold sloppy rain here, and I suspect that my doctor extended his snowboarding vacation at Tahoe. He has every right to, but his very bright and able assistant swears he in is town. As for the spinal tap, they make you lie on your back for an hour afterwards, just so you don't drain your brain. Then there are conflicting reports of whether you must lie on your back all day or not. I'll find out. But all was not for naught. I got a cool plastic jug that I get to collect my pee in tomorrow. I got an appointment for them to suck blood out of me Wednesday. I got a copy of the MRI report. It says that the scan with the contrasting agent shows no difference from the one without it. I am told my neurologist will be going down to the MRI lab in person and looking at the images on the big computer monitors there. That will give him a more detailed view. The films I have seen look like a series of X-Rays, but in neat slices.

The written report says that both scans show some problems in the right hemisphere, and the same areas effected, in a lesser way, on the left hemisphere. I get the impression that it is not all on the surface of the cortex:

Abnormal increased FLAIR signal is identified of the right internal capsule on the right extending superiorly to involve the white matter of the right parietal region. A lesser degree of abnormal FLAIR signal is also identified on the left also within the parietal region. There is no evidence of mass effect, midline shift or extra-axial fluid collection. The appearance of this abnormal increased signal is unusual. Differential diagnostic considerations include ischemia and demyelination though the appearance is not typical for multiple sclerosis. Vasculitis is also a consideration. A neoplastic process is considered less likely.


Ischemia means inadequate blood supply. Vasculitis is swollen blood vessels. Demyelination is when the insulation around your nerve cells goes away. Neoplastic refers to cancer.

The fact that it looks less likely is reassuring right there. A lot of you seem a lot more worried about this than I am. Some of you are losing sleep. Don't worry so much. Whatever this is, it seems unlikely to kill me right away (knock on wood). Let's wait until the lab results come in. Maybe it will be some kind of heart disease or something treatable. I actually feel pretty chipper right now. Which isn't to say that it is all so very easy. Here is how they described my freaked-out, claustrophobic panic attack (when they attempted the 2nd MRI on Christmas Eve):

The patient ... could not tolerate the procedure secondary to anxiety.


I just got a call saying they are going to do an EEG today at 3 PM. That means they are going to look at the activity in my brain. Those poor, helpless people. I must warn them, whatever happens, not to hook the EEG output up to the sound system.
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