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First Neurologist appt

So I’ve got my first appointment with the neurologist on Wednesday after being referred back in August. I’ve never had any sort of hospital appointment before so I’m not sure what to expect.

Will it just be a chat about symptoms or some sort of physical examination?

Has anyone got any advice on what questions to ask him or anything like that?

Also the GP wants an MRI done but I’ve read it can take up to an hour for the scan to be completed, are they able to stop it if I need to use the toilet? The thought of being stuck in a machine for so long without being able to have a wee is making me panic.

Sorry for all the questions but after waiting for the appointment for so long I want to make sure I’m ready, if that makes sense :slight_smile:

Danielle

Hi Danielle,

There’s likely to be a neurological examination, which could include pinprick tests (not really a very sharp pin, but just to test whether sensitivity is dulled), reflex tests with the little hammer, checking your balance and coordination, checking whether your eyes can track a moving object - that sort of thing.

I don’t recall having to get undressed for mine, so you should not worry about there being anything embarrassing or intimate, although I did have to remove footwear, so they could test the soles of my feet - though I had reported numbness of my feet. If you’re not experiencing that, they may not test it.

You may prefer to wear something loose and comfortable, as they may want to check range of movement - e.g how far you can lift or bend a leg. If you are in skintight jeans, you may find this a bit impractical!

I think it will be mostly the neuro asking the questions at this stage - he will want to know what sort of symptoms you’ve had, when (roughly - not to exact date and hour) and for how long. Whether there’s anything that noticeably worsens or eases symptoms.

I was asked outright if I drank too much, which I though was a bit of a damn cheek! I answered, as honestly as I could: “Well, how much is too much? Probably, yes, compared to NHS guidelines - Doesn’t everyone? But I’ve never had any concerns about my drinking, and don’t think it would be enough to cause this sort of thing!”

The MRI: an hour sounds on the excessive side. The longest I’ve ever been in there was about 50 minutes, for brain and full spine (right down to tailbone), AND with contrast - which basically means you come out halfway through for them to inject a chemical, and then they do the full set again - so the whole lot…twice!

If, as is much more common for a first scan, they’re just doing brain or head & neck (no contrast), I’d expect 15 minutes is much nearer the mark, and I can’t think why you’d be in there an hour.

You’re not completely incommunicado while you’re in there. It’s very noisy, but you have headphones, so they operators can talk to you (they said helpful things like: “Just one more set, OK?” - so I knew when it was nearly over.) You also get a panic button to push, so that if you need to get out quickly, for any reason, you press it, and they will know to stop the machine and get you out.

If it’s worrying you, I would explain before you go in that urinary urgency can be a problem for you, so they won’t be annoyed/upset if you have to press the button - and also won’t panic that you could be having a heart attack or something! (MRI machines don’t cause heart attacks, but obviously, if you suddenly pressed the button without warning them beforehand you might have to, they would have no idea what was the matter, and might get quite a scare).

I really don’t think it will be an issue, though, as I think you’ll be in and out much quicker.

Tina

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Hello Danielle

Good luck with appointment next Wednesday, let us know how you get on.

Excellent advice from Tina.

I love the the ‘panic button’ as a name for the call buzzer Tina, much more appropriate

I don’t like having MRI scans Danielle…hate closed in spaces but the time does seem to go fast and like Tina says they will stop the scan for you.

I always visit the loo just before the scan, the toilets are normally close by.

Take care xx

Dani you have nothing to fear. This is a good thing and the long wait is finally over!

Naturally you want to make the most of it, so i would suggest you adopt business like attitude.

Go in there armed with a list of symptoms, preferably chronological in order with possible comments on severity. (you might not get to use it but it can help you feel confident you will not forget anything).

By the same token, make a list of questions you have and objectives you want to realise from the meeting.

You will surely get an examination; it is nothing painful nor stressful. They are more like sobriety tests: follow the finger; stand up straight with eyes closed; tiny mallets on your knee caps; can you feel this paper clip on your finger tip; does this feel cold or warm; tiny little tuning forks to test for vibration perception; etc…

As for MRIs… i hate enclosed spaces. i cannot even tolerate sleeping bags! an hour long session is lengthy, not impossible, but probably a ‘worst case scenario’. as said, you have an abort button. each scan lasts a few minutes and the technicians will speak to you through your ear goggles to tell you the situation before most if not all of them; ie. you have ten seconds to scratch that itch, sneeze, cough, laugh, do the hokey cokey… it is no big deal. i guarantee it is far worse in your mind tha it will be in reality. the technology really is phucking incredible (profanity for emphasis).

good luck and enjoy the experience! no needles are involved afterall! :smiley:

Thank you so much for your replies, I feel so much more relaxed about it all now.

I think because I’ve been waiting for the appointment for what seems like forever I really want to get the most out of it and make sure I don’t miss anything , so getting the appointment card sent me into a bit of a panic.

It’s the MRI that’s scaring me the most, I’m awful with confined spaces and my urgency at the moment is so bad that I’m petrified of not making it to the loo and breaking the machine! But I suppose I’m getting too ahead of myself since the scan hasn’t even been booked yet.

Thanks again for all your amazing advice! :slight_smile:

Danielle

I remember asking if it was ok to wear an incontinence brief during the scan and being told it was OK. I assume though that it depends on where is being scanned.

They’re not metallic, are they? If not, it shouldn’t make any difference. If the scanner can see through your skull OK, it can definitely see through a bit of material/polythene/whatever. Should be no way it could “obstruct” the scanner.

Tina

I was thinking that as the radio signal that makes up the scan comes mainly from the Hydrogen component of water , a mass of wee would create a masking signal of its own.

Bob

Hmmm. Interesting point, but in that case wouldn’t people’s normal bladders present an obstacle to properly scanning pelvis or lower spine?

Unusually, for MS, I’ve been scanned all the way down to my tailbone, because they initially suspected a slipped disc. Anatomy’s not my strong point, but I know my bladder has to be in there somewhere, and I don’t remember them ever saying they wouldn’t be able to see my lower spine properly, because bladder (or bowel) would be in the way.

Also, I don’t think a drainage bag was on the list of “prohibited” items or conditions, when you sign the consent form. Admittedly, I probably wouldn’t have taken much notice if it was - realising instantly it didn’t apply to me. But I can’t remember being asked about anything like that.

Tina

Yes, was just a thought, and I think the technology allows them to filter out various features.

Bob

Had my appointment with the neuro and everything went well, booked in for a head and neck mri sometime in the next few weeks.

I was told it would take about 30-45 minutes but I’m ok wearing incontinence pants during the scan so long as there’s no metal or anything like that. Don’t think I’ll actually need them but I feel better knowing I can wear one just in case.

Neurologist was great too, so feeling much more relaxed about everything now. :slight_smile:

Dani

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Yes, the MRI scans are a bit noisy, but harmless.

If you do meditation, the scanner is a good place to meditate.
During one scan, I planned most of a conference paper - and nearly had it finished when they stopped and said that they were finished.

Geoff