Migraine

I'm in the process of preparing for my upcoming appt... as well as the never ending process of keeping up with my records. I got a copy of my MRI films and it ended up being easier getting that CD sent over to my neuro than getting it sent to me, so that's what I did. I gave them a call to let them know it would be coming their way, and the receptionist seemed a little surprised and let me know the doctor preferred reports to films. I let her know I had reports and would be bringing them, and that I wanted my MRI films to take home with me, so they should just keep the CD for my appointment even if he didn't want to look at them.

Is this unusual? A bad omen? Shouldn't a neurologist take a look at such things? I wouldn't consider every MRI reader (whatever the term is) faultless! Different people read them differently--of this I am absolutely certain, and have heard often... that things get missed!! So I felt surprised that he wouldn't want to look and see... it caused an instant loss of faith...

Hi Candace,

Maybe the doctors office is not set up to store each patients CD's. With today's high tech world, I bet the doctor can even read your "films" online.

Not a "bad omen" just new technology -- maybe

It really could be any number of things, and honestly speculating here may not be of much help to you. Why not ask him about it straight out at your first appointment?

My neurologist doesn't look at my MRIs, only the reports. I have a "probable meningioma," a small benign brain tumor, but my neurologist only wants to see the reports of the radiologists who read the MRI.

My neurosurgeon, however, likes to look at the MRI itself. At my 6-month followup, the report said that the tumor didn't show up. I saw the Nurse Practitioner at that appt. The surgeon was in emergency surgery. The NP kept the CD for the surgeon to look at. She said that the radiologist who read the MRI might not have been a "neuroradiologist." Our treatment strategy is "Wait and Watch." I go back in October for another MRI and appt with the neurosurgeon.

I think it's the radiologists that read the films. I don't think my neurologist has the training and experience to read MRIs. But if you want a second opinion, to have a second set of eyes look at the MRI, you can do that.

Do ask your Neurologist about this. Let us know what he says.

Gretchen in Mississippi

Hi Candace

My son has seen several headache specialists and neurologists. A few would actually look at the film. Most of them just wanted the report.

I don't think it's a bad omen at all. The radiologist is paid to review the films and issue the report. The radiologist is the expert. Maybe your neurologist doesn't feel he can do a better job of reviewing them.

Keep the faith!! This could be a great doctor for you.

Jean Ann

Well, you can bet I'm gonna be askin' straight out... I'm feeling frustrated, and like my medical "team" hasn't really been of any help to me. I'm even ready to be aggressive towards my beloved PCP... telling him that I'm tired of being the one with all the ideas--I need a diagnostician, I need a FIX! I feel a tad betrayed by the fact that 1. I have abnormal test results that were called normal because my insurance's tweaking of "normal ranges" 2. he told my that I didn't need any other thyroid tests because my THS was normal, and now I find that isn't the case. If this neurologist isn't fantastic right off the bat, he doesn't get any second chances. I don't have time to play games. I think I sound whiny... but I just feel tired of being the one who seems to have a clue!

Let me see if what I'm thinking makes sense when I write it out...

A radiologist reads the exam, be it an MRI, CT, x-ray, etc. This is what the radiologist has gone to medical school for, reading x-rays. Their job is to read the x-ray and state what he/she saw in the exam.

The neurologist may look at the MRI film and see nothing out of the ordinary because that is not his field of study. Yes, it is neurology so he/she should have knowledge of what he/she is looking at, but to actually look at it and say "yes the patient has X condition" is not what he/she would do. He/she would read the radiology report, which goes in depth about what was found during the study, and then be able to let you know what your MRI showed from that report.

I know it sounds confusing. I work for radiologists so I always get the "what did your doctor do for me?" question.

And, even though the radiologist is reading the exam - it is still technically up to your doctor to diagnos you - even if it was the radiologist who saw something - interesting isn't it?

So that could be why your doctor doesn't really need to see the actual exam. Not that I think he shouldn't look at it, but this may be why he isn't.

Another thing to put out there for you (and this is from my BIL who works with radiologists to train them on software his company has developed). Radiologists for the most part are very good at reading films for MRIs and such and seeing them in 3D, whereas most doctors just see them as a flat image. Radiologists usually can interpret them better and more quickly see how things inter-relate and fit together in your body. Meaning, they can more quickly spot things that are normal or abnormal in films, which is why their reports are very helpful.

This may seem strange, but keep in mind that, like Eileen said, this is what they went to medical school for and this is their specialty. So while it may be distressing that your new neuro doesn't want to see your films (and I do think you should ask him why he doesn't), keep in mind that the report he's reading is written by someone with a specialty in reading films. So, yes, it is possible that the radiologist writing the report missed something in reading the films, but it's not as likely as if you or I were writing this report for your doc. Does that make sense?

Yeah, you guys are making really good points... I just feel like I'm ready to jump ship already... like any little anything will set me off. Just feeling a little on edge today. I liked the naturopath I saw, but he really destroyed my faith in the small semblance of a "team" that I had.

I've also just heard too many stories about things being missed on MRIs... it makes me antsy. Just five days to go to my new appointment. Topamax on 200 mg, head pounding and nerves on high alert. Doctor, here I come! (good luck, mister!)

i don't know if it's a bad omen - but every neurologist i've seen (including 2 headache specialists, one at the diamond headache clinic) has wanted to view my MRI for themselves, to make sure it was normal. seems to me, the more eyes that look at it, the better. less chance of missing something, right? i agree w/the other posters, i'd ask the doctor about it.

emily

Candace,

I can totally understand how frustrating it must feel to feel like you are the only one on your medical team that is doing anything. Both my wife Sol and I have spent a lot of time and effort over the past few years to educate ourselves on her migraines, lupus, and other health issues. We realise that we aren't doctors and that the doctors on my wife's "team" are all very skilled but we feel empowered to come to the table with some knowledge about her conditions and her health care. She has 7 doctors on her "team" and we have been blessed to only have to "fire" and replace one doctor (her Endocrinologist).

My wife has had two brain surgeries and many scans before and after each surgery. Her neurologist has not seen any of the scans as he felt the radiologist writes up a very detailed report and he feels satisfied with just reading what the radiologist has to say.

Her neurosurgeon did want to see all of her scans and even made sure he showed us the scans and went over with us what it all ment. My wife's neurosurgeon is a very thourough doctor who took all the time we needed to answer any questions we had and encouraged us to audio tape our appointments with him so that we didn't miss anything.

I would try to go into the appointment with an open mind and ask the doctor why he or she prefers not to see the MRI. The answer may surprise you and they may beable to effectively answer any questions or concerns you have by going over what the radiologist wrote about your MRI. Perhaps during the appointment when you are face to face with your neurologist you can explain that you really would prefer for him to look at the MRI and go over it with you.

My wife and I are thinking of you and wish you the best with your appointment.

Peace,

Dave and Sol

Take a look at this article, Candace, if you haven't seen it before:

Excerpt - "Living Well With Migraine Disease and Headaches"

Thank you for your kind words, Dave & Sol. You sound like you've been very fortunate with your health care team! I have a good PCP, but the rest of my team is just "ok" or a major work in progress!

I've read the article once before, but read it again, just to remind myself. I find that in the "scheme" of an appointment I'm usually pretty good at being a good self advocate for 70% of things, which is a huge improvement on where I used to be... but still not where I'd like to be. (it's a big weakness for me) I totally forgot to ask my doc today about why he didn't want to see my films, probably because I had determined I was giving him one time to impress me. My guess is that he just isn't trained to look at such things... he did look at the report, and even noted the name of the person who wrote it, noting that they were "good"... but he also at the last minute, decided he wanted my films to be read by someone else across town for a second opinion.

So it feels like he's being straight forward about not being knowledgable, although he didn't say as much--but sending my films to someone he considers to be even better is something I appreciate. I can't fault him if he doesn't know something... I'd rather he not do something he doesn't know about than look at my films and pretend they mean something to him!

Hi Candace,

I tried to "chat" with you but it came back!! Do email me again please, so I can re - send you my reply, ok?