Tests and appointments

(2) The MRI / First visit with Dr. Rookie

Two days after seeing a NP at my primary care clinic, I had an MRI.   Fortunately, the results revealed no tumor or stroke as an underlying cause of my woozy-state, right side numbness and tingling.  At this point I was still worrying about my pictures  (see blog post #3) so I probably did not appreciate the good news as I should have.

The lead time for an appointment to see a neurologist was about a month.  By the way, my doctor and this specialty clinic are a part of one of America’s  leading university and research hospitals. ( It was in the top 10 last time I checked.)

The initial appointment with the neurologist– I’ll call him Dr. Rookie because this was apparently his first year out of residency– was one of the best appointments I have ever had with a doctor.  He spent nearly two hours with me, performing the classic and not so classic tests regarding neurological functioning.  He took a detailed history.  And he kept looking in my right eye:  He did so in the first round of the physical exam and then, in the middle of talking about something else and with no explanation, he pulled out his fancy light to stare into my eye again.  This happen three or four times.  After the second time, he said something like, “I just want to check that again.”  Finally he admitted that he was having trouble seeing my optic nerve. . .  that some vessel seemed to be in the way.  (Huh?)

At the end of the visit, Dr. Rookie’s assessment was that I may have a small cerebral spinal fluid leak.  The light-headed, woozy and mental fog plus the numbness seemed congruent with this– especially in light of the fact that I did have a somewhat recent history of probable mild whiplash ( while moving furniture three months prior)  and violent vomiting (intestinal virus before the flu).  Whiplash and other sudden neck movements can, on rare occasions, cause a slight tear in the dura portion of the brain, hence causing a small leak of the fluid that cushions the brain in the skull.

He ordered two MRIs– with contrast this time:  one on my brain and one on my upper cervical spine. “If you do have a tear in the dura, the likely location would be somewhere in the base of my brain or upper cervical region,” Dr. Rookie explained. He wanted to do a Lumbar Puncture ( LP or “spinal tap”) to test my cerebral spinal fluid  (CSF) but felt that he should wait. If I did have a CSF leak, then a LP– taking out CSF fluid for testing– would really exacerbate the symptoms I had of feeling woozy, etc.

Ten days later, I found myself back in the MRI tube.  By this time, I was feeling a lot better as far as my balance issues, feeling so out of it and numb/ tingly symptoms were concerned.  I did not expect the MRIs to find anything interesting or unusual.  And I was correct.