There are only a few reasons you are looking at this article… Most likely you or someone you love is experiencing some odd symptoms whether they are settle or severe; whether they have been persisting for weeks or for years. What could it be? You want to know so bad… You need to know. After doing some research you were led to think that maybe what you or your loved one has is Multiple Sclerosis (MS). So what is the next step? I’ll explain what you need to do to check if you have MS or not but more importantly is why you need to do this.
Most people experience a long diagnosis process when it comes to MS. This can be because they are avoiding the tests do to their fear of the answer they may receive or because of a doctor who is simply dragging their feet… Either way, I can tell you this, you want an answer as soon as possible because the answer is not going to affect your symptoms, it is only going to affect the treatment you can receive for these symptoms. If you are afraid of the answer think of it like this; the sooner you get an answer, the sooner you can identify the source of your problem and pursue a remedy for it. If you put it off and it is MS, your symptoms may do permanent damage (causing long-term disability) or cause you more pain for a longer period of time. But maybe you don’t even have MS! Maybe you will find out it is something much more simple like a pinched nerve that once is fixed will end your mysterious symptoms all together! The sooner you act the sooner you will know!
OK, so let’s say you are ready to go, but now your doctor is dragging his or her feet! Well then demand that you see a neurologist and get these test done, it’s your health and you have the right to get tested! Something you should understand, no one out there cares more about your health than you do, so if you don’t care? A doctor won’t care. So push to get the tests done… worst-case scenario you can check Multiple Sclerosis off the list and start looking for what your problem really is.
The Testing Process
So, there are two tests you need to get done to be diagnosed with Multiple Sclerosis. First, you need an MRI (Magnetic Resonance Imaging) scan of your brain to check for lesions (small white spots on your scan) that may suggest MS. An MRI simply involves you lying in a machine that uses a giant magnet to take images of your brain. Unlike an X-ray, an MRI machine takes images of many layers of an object instead of just one layer (the surface). Also like an X-ray, you will feel nothing. If you do have brain lesions and your neurologist suspects MS then the next course of action would be a spinal tap (Lumbar Puncture) to confirm the diagnosis. This involves placing a needle into your lower spine (lumbar area) and extracting cerebral spinal fluid (CSF) to check for myelin proteins that have broken away from your nerves in your central nervous system (CNS). A positive will confirm Multiple Sclerosis but a negative does not necessarily mean that you do not have MS, it just means that there was no myelin protein floating around the sample of CSF that was extracted when the test was done. There might have been the day before and there might be the day after, for some people it can simply be a game of chance. Because of this, some people have to go in for several lumbar punctures (LP’s) before they finally get an official MS diagnosis!
Lots of people just dread the whole spinal tap (LP) thing because of how horrifying it sounds! But I can tell you from experience, it’s all just a bunch of talk. It really depends on the skill of your doctor. My first LP was “shocking” because my neurologist did not seem to have a steady hand and she hit a nerve. My current neurologist is very skilled at it and so I don’t really feel anything when I do it once a year. Just routine.
So how is an LP actually performed? First, they have you lean forward on something while you are sitting upright or they have you lie on your side almost in the fetal position. Either way, your back should be somewhat arched. Once you are in position they numb the area with a local anesthetic and finally they place the needle in your back between two vertebrae (lumbar bones) to extract the needed spinal fluid. And… that’s it. Quick and easy! You may experience a headache afterward because they just removed fluid from your spinal cord that also flows around your brain so there is now a change in the pressure in your head.
Fun fact; without the spinal fluid in your head, your brain would collapse under it’s own weight!
The best thing to do to minimize the risk of a horrible headache is to drink plenty of fluids (fluids will help replenish the CSF they removed) before the test, plenty of fluids after the test and to plan on lying down for a day or two after the test. If you sit up too much, you will probably get one of the worst headaches ever! A lot of people say this is not true but I have taken the precautions of lying flat and ignored them and when I ignored them? My head felt like it was going to explode but when I stay lying down? Nothing. If you move around too much and end up getting a headache it may become so unbearable that they will want you to come back in and basically do everything over again but instead of removing CSF they inject blood into your spine to try to equalize the pressure. This is called a “blood patch” but since I always follow the above precautions now, I have never had to have one. So I would definitely recommend lying down! Oh and if you have to use the restroom I would just try not to take too long.
I know these test may sound scary but they are not. An MRI is really only bad if you are really claustrophobic because they slide you into a sort of tube and you have to stay steady while the machine is running. They will probably offer you medication to help you relax but I have never needed it and I am pretty claustrophobic. The machine makes lots of loud buzzing, clicking and beeping sounds which are kind of funny if you ask me, I have a hard time not smiling like an idiot while I am in there! A typical MRI for diagnosing MS might take around half an hour to an hour depending on if they are doing scans with contrast or not, if they are also including the C-spine (your neck) and how detailed the images are.
An LP only sucks if your doctor sucks (that might be an oversimplification haha)! Well, that and if you don’t drink enough fluids and lie down for at least 24 hours… Use this time to watch TV, a movie or go on a Netflix binge!
Don’t let the answer you may get or the tests you have to do scare you away… If you put it off it may only get worse in the long run and the unknown of your situation will torment you. LIMBO. Treat it like a bandage; the quicker you rip it off and get it over with the less “pain” it will cause. The sooner you get an answer the sooner you can find a solution!