MRI with surprise contrast and results

So, that was fun!  I showed up to the imaging center for my MRI and was surprised with having to get contrast dye placed in my veins.  It was not near as bad as CT contrast!  I was in a closed MRI.  It wasn’t bad… I just kept my eyes closed.  I fell asleep twice.  The noises were loud whirring, jackhammery, mechanically vascular sounds that somehow calmed me.  Truth be told, I have way more going on in my life to worry about this.  Avoidance?  Nah.  Apathy?  Not by definition.  We just won’t go there right now.

Anyway…

So today I received my results.  The big concern was a pituitary gland tumor.  Yikes.  Mostly easily treatable, but yikes nonetheless.

And the verdict is…

NO PITUITARY ADENOMA!  Huzzah and yay all around!

But wait, there’s more!  And I promise I’ll get to that!

A few people remember me getting an endoscopy after some violent tummy trouble in November 2012.  My doc was sure it was my gall bladder.  I had an ultrasound, HIDA scan, and the endoscopy.  Gall bladder = fine.  However, I had crazy H Pylori running around my stomach, gastritis (probably atrophic according to the doc), GERD, and wait for it… Barrett’s Esophagus.

Say whaaaat?

The only heartburn I felt was twice while pregnant with Kavan.  I don’t think I ever got heartburn with Keelyn.  I’m a “silent sufferer” and my LES (lower esophageal sphincter) doesn’t care to work so much, if at all.  Barrett’s is a “result” of GERD where the esophageal lining is hurt by the reflux enough to change its structure to be more similar of stomach lining.  This helps protect the esophagus in a sense, but also makes it susceptible to some nasties that won’t be named but starts with the letter “C”.  Greater chance of it – but not like it’s gonna happen for sure.

That rabbit trail was brought to you by the point of:  Amanda has had testing before for one thought illness/problem, but that once thought illness/problem wasn’t the culprit.

See, I told you I’d get back to the MRI!

So, those results.  Not what I expected.  That’s a good and not so good thing.  Again, my energy is focused elsewhere – so that’s “good”, right?

The following is the actual interpretation from the radiologist at the imaging center.

Currently no intracranial mass, mass effect, or extra-axial collections are identified.  The ventricles are symmetric about the midline.

There are several punctate foci (lesions) of increased signal on the long TR sequences in the white matter.  These findings are fairly nonspecific with fairly broad differential considerations (well, that’s fairly vague) and can be seen in patients with migraines.  There is a small focus of porencephaly (WHAT THE WHAT?!?!  Look it up…!) in the right frontal lobe in a subcortical location with minimal surrounding hyperintensity consistent with gliosis (again… SAY WHAT?) and this is likely related to some previous brain insult.  No mass effect or edema or abnormal contrast enhancement are demonstrated in association.  
I appreciate no evidence for any acute infarction or cerebrovascular distribution infarction  No significant areas or foci of abnormal contrast enhancement are demonstrated.  You appreciate it?  Me too buddy, me too.  Also, infarction is a word that always makes me giggle.  It’s fun to say – or think.
The pituitary demonstrates homogeneous enhancement.  No focal pituitary lesions are demonstrated.  The pituitary stalk is midline.  I appreciate no supra or parasellar lesions at this time.  Aww, I’m appreciated!  The cavernous sinuses symmetrically opacify.
Now, here’s where things get a bit interesting again…

Evaluation of the paranasal sinuses reveals the right sphenoid sinus to be nearly completely opacified.  (Oh good…)  Some of the material within the sinuses at T1 and T2 hypointense are consistent with inspissated mucous (Gross!), though fungal sinusitis could have this appearance.  The walls of the sinuses appear grossly intact.  There is mild mucosal thickening in several ethmoid air cells.  There does appear to be small retention cysts and/or polyps within the right maxillary sinus superiorly and inferiorly and mild mucosal thickening throughout the right maxillary sinus.  There is minimal abnormal signal in the mastoids on the right, likely indicating inflammatory mastoid disease.

That should be fun to get out…

Impression:

1.  White matter changes are present which are nonspecific but certainly can be seen in patients with migraines.

2.  Small area of porencephaly and gliosis (Wow again…) in the right frontal lobe likely indicating some previous brain insult.  I do not appreciate any associated acute pathology edema, mass effect, or enhancement.

3.  Unremarkable pituitary.  How rude!  I think it’s quite remarkable!  🙂  

4.  Extensive mucosal sinus disease (Sounds disgusting) involving predominantly the sphenoid sinus, with involvement ofthe remainder of the paranasal sinuses as above delineated.

End Scene.

Well… oh, my PCP wrote on the front of the report that was sent to me “Bad sinus disease – to Dr. ******* Rest looks ok”
So, onward to the ENT doc.  I’ll see my ophthalmologist on the 23rd and will talk about a neurology referral.  Though the “rest looks ok”, I’m concerned that I have surprise lesions, porencephaly, and gliosis.  Hopefully I’ll get to talk to my PCP before then, but we’ll see.  🙂  I’m good either way.  🙂
That’s what I know for now!  Updates as I get ’em!
Blessings,
Mojo
 
 

 

Optimism in Ambiguity

Well… it’s been awhile.  I started this blog with every intention of writing more frequently, but life happens.  Ironically, I think “life happens” was one of my has-been blog URLs.  I think we had some minor family stuff, then the holiday season trumped everything, and well – I started my new job back in December.  So, I’ve been focused on those things first.  But never fear, I’m still here!  Oh look!  She’s a poet too!  

Writing is an outlet for me – a huge outlet for me.  So, that being said – I’m going to plug into that outlet now.

This year has had its different share of ups and downs.  Different in that I’ve not dealt with these kinds of issues before.  I’ll give a brief update of the months leading up to current.

January:  Joined It Works! as a distributor on January 15.  WOO-HOO!  It’s good stuff and worthy of its own blog page!  🙂  Also, I continued to learn about my new job and really got started going with it.  I work as a Support Coordinator (Case Manager) for children and adolescents with intellectual disabilities.  Yes, it’s every bit as interesting and rewarding as it sounds!

February:  Awesome month with It Works!  Growing that business as well as continuing to love my full-time job.  Eye exam at the end of the month.  Failed the visual field test.  Womp womp.  Weird.  My biological mom also told me she was diagnosed with congestive heart failure.  She’s 48.

March:  Signed a distributor with It Works!  Huzzah!  Another steady month there.  Finally feeling like the other position is sinking in nicely.  Failed visual field test #2.  Visual field test #3 complete with taped up eyelids.  Yes, it was every bit as uncomfortable as it sounds.  Failed that one too.  Why the taped up eyelids?  To make sure that I wasn’t dealing with something as simple as ptosis (droopy eyelids).  Eye doc thinks I have what’s called drusen in my optic nerve.  These are little calcifications that sometimes show up in the optic nerve.  Mine would likely be located in the optic nerve head.  First appointment with an ophthalmologist for an OCT scan.  The hope was that the drusen would show up and confirm what my optometrist thought.  Nope.  Clean.  Doc still thinks drusen, but that they’re buried.  So, onto scheduling another appointment in April.

Also, I went on a nice, relaxing retreat with the ladies from my church.  I have to do a separate post relating to that later.  It was a much needed break!

Oh, then there was when my biological mom ends up in ICU.  Took me by total surprise.  I was actually at a One Team One Mission team meeting for It Works!  I was getting in line to meet our CNO (Chief Networking Officer) Pam Sowder.  I got the phone call from my former guardian and found out mom was ill.  I called the ICU ward and was told she was brought in for decreased consciousness initially.  Drug overdose?  AGAIN?  Nope.  Her screen was clear.  She had pneumonia and decreased cardiac output (likely a direct result of her recent diagnosis of congestive heart failure).  I decided I would go down to Alabama on Friday with my daughter (I wanted a travel buddy!) if she wasn’t well.  She wasn’t.  She was actually on a bi-pap and still had poor oxygen levels.  So I drove.  From Virginia.  To Alabama.  Yes, this girl.  The one who had a driving phobia (literally phobia) for a very long time.  We were absolutely abundantly blessed with amazing travel conditions both ways.  We visited mom and had a nice time back home.  Mom improved and came home the day we came back to VA – March 31.

April:  Man, this first week… I’ve been so tired and preoccupied!  The trip caught up to me on Tuesday and I was SO groggy and drowsy all day.  Kavan missed some daycare days due to fever/cough.  A virus on top of a bacterial infection (he’s on antibiotics)… fun.

Friday rolls around.  April 4.  This is my appointment in Roanoke at my ophthalmologist’s other location to have a B-scan completed on both of my eyes to try and find drusen.  What’s a B-scan?  It’s an ocular ultrasound.  Also a bit uncomfortable.  I thought being the only person under 70 other than my husband (no joke!) in the lobby was awkward.  Try having ultrasound goo on your eyes… nasty.  Shannon was with me.  We had been enjoying a fun day cruising around Roanoke and getting a few presents for Kavan’s birthday (April 7 – party April 6).

Anyway… so I have the scan and wait to talk to Dr. Eng (I HIGHLY recommend him if anyone needs an amazing ophthalmologist!).  He says “…there are definitely drusen there” located in my optic nerve.  He wants to do another in-office test first.  No real reason explained why here.  I’m a little concerned, but I’m good – really.  So, test #2 consisted of staring at a star (I think it was green) while red flashed brightly on the screen and some other dots appeared.  This ended up being a more in-depth OCT like what I had in Blacksburg.  I wait to talk to Dr. Eng again.

He walks in and gets straight to the point.  He’s concerned.  He looks concerned.  He sounds concerned.  Okay, I’m listening.  Again, I “definitely have drusen in my optic nerve” and he’s “uncomfortable with the size” of these calcifications.

Furthermore, he says that he looked over my results of all the tests he’s completed with the records from Dr. Dovie (my optometrist) and he’s “pretty concerned” with the size of my visual field defect.  Really listening now.  He asked if I remembered talking about the possibility of having an MRI completed to rule out anything neurological.  Yes, of course I remembered.  Oh boy.  The type of visual field defect I have is bilateral (superior quadrants of my eyes) I believe.  There are all sorts of visual field defects by the way (and lots of different bilateral defects too).  Mine are pretty homonymous – both eyes have similar defects.  This is the best I could tell.  I sort of geek out when it comes to medical “stuff”.  These defects correspond with different illnesses.

It boils down that he wants me to have an MRI to rule out anything neurological.  He very specifically mentioned concern with my pituitary gland.  “Growths on the pituitary gland can be bad.”  I was listening before…!  He didn’t say I definitely had a growth… just that he wants to rule it out.  The type of visual field defect I have and how it looks on paper after the testing, combined with apparently large, hidden drusen just happens to be indicative (possibly) of a growth.  No biggie.

Seriously though… I’m doing well with all this.  I don’t care for ambiguity, but I’m trying to process all the possibilities.  IF it is a growth, aka the “t” word – most “ts” are benign.  They have to be removed/treated due to the possibility of overproduction of hormones and “…blindness if the growth presses on the optic nerve”.  The prognosis is good.  Huzzah to medical advances!

If it isn’t a “t” or growth, it could be lesions, it could be nothing.  Nothing would be good – but I’m preparing for multiple outcomes.  That’s how I process.  Not thinking negative, “whoa is me”, just educating myself.

The doc said I’d get a call early next week with a time for my MRI and that scheduling happens based on prioritization of needs of multiple patients.  Are you claustrophobic?  Nah, I don’t think so.  I’m good with wherever – Radford, Roanoke – doesn’t matter.

We leave the office after checking out.  10 minutes later, I get a phone call.  Shannon has gone in an auto parts store to get bulbs to replace on the rear right side of our van since those went dead during the drive in Roanoke.  Yes, may I speak to Amanda O’Reilly, please?  This is she.

Dr. Eng’s office.  Calling me already with my MRI appointment.  Seriously – I left the office at 2:20 pm.  I received the call at 2:29 pm.

That was fast.

Even more shocking to me was that my MRI was scheduled quicker than what I thought.  Tuesday, April 8 at 2:45.  Get there at 2:30.  Shannon and I had driven by the place a few times and I commented that I liked the place’s logo.

So… yep.  MRI.  In 2 1/2 days.  In Keelyn terms:  In 3 more wake-ups, I get to go stick my head (or body – if closed MRI) in a machine for about 45 minutes.  Good times.

I’m good though.  Really.  I’m positive and I know I’ll be taken care of.  That’s a fact.

Why the song?  Umm… I like it?  It’s my blog and I’ll post what I wanna?  You’re welcome for the earworm there.

Seriously, the song is a big reminder for me that I can take a BIG step back and be calm and let faith reign/rain down on me.

What can I do???  Let’s see.  Pray?  That seems to work.  Do that if ya’ wanna.  Don’t pray?  Alrighty then.  I will accept your positive thoughts and vibes or whatever have you until I get answers.  I have the MRI on Tuesday, April 8 and will see Dr. Eng on Wednesday, April 23 in Blacksburg.