[SpaceCadet]

So I've got a new neurologist, but he doesn't seem like much more help than the last one. I asked for a sleep study, told him I was having sleep disturbances - waking up with complete amnesia, but he insisted on doing a repeat MRI, EEG, and having blood work done first. I guess he didn't think waking up not knowing who you are is that important.

I've had one MRI done and a few CT scans done since my injury in June. The MRI was actually done last month. I brought the copy of the MRI to him and he made copies. My concern is, I don't have insurance. I was assaulted and my medical bills and crime related expenses are being paid for by a program called "Victims of Crime". They only pay for so much and then they cut you off. So I'm wondering if it's really necessary for me to get a repeat MRI done...as it's going to cost a couple thousand and that money can be used for other things...such as future visits to the neurologist, psychiatrist and whoever I might need to see in the future.

I've also had blood work done in the ER back in November or early December that came back normal.

I'll still have some benefit money left if I go through with it, I just want to know if it's really necessary...

[Mark in Idaho]

Another MRI sounds extreme. Plus, an MRI should only cost about $1200 to $1600 max. The insurance companies pay even less. You can look up the Medicaid and Medicare reimbursements online. You just need the procedure codes used.

The EEG also sounds like a waste. An EEG with a sleep session would be more useful. Sounds like this is a generic neurologist. They don't believe anything that they can not see on an X-ray, MRI, CT, or EEG tracing.

The sleep study would be much better use of 'your' money.

Have you had your B-12 and folate levels checked in the blood work?

[pcslife]

Unless you have any serious symptoms a repeat MRI seems to be of not much value. I have done so many MRIs/MRAs/CT scans and it showed the same thing. I even did a spinal tap and they did all analysis on my spinal fluid including for LYME disease.

I also did sleep study and I would highly recommend it. They do collect lot of data when you sleep including teeth grinding etc., For me it showed only mild snoring and no sleep apnea, restless legs etc., No further action or studies needed in my case. But I know something is not right with my sleep. I sleep good (8-9 hours) without any sleep aid but still I am tired all day and gets better in the night. Weird!

[EsthersDoll]

I don't know what to say about this. I had iicp for six months and the first MRI apparently didn't show it, but if I had had a second it may have - but I was dealing with some *very severe* symptoms. Although the neurologist I have (which is also my second) figured out what was going on with me without a second MRI though.

Is the neurologist you're seeing a specialist in TBI? I think getting one who specializes in TBI may be the best route for you, if that's possible.

I also recommend, after getting a Dr. who specializes in TBI, that you see what they think about getting neuropsychological testing and/or speech therapy. (I think a good Dr. will know other good people in related fields.)

A good neuropsychologist should be able to pin point what areas of cognitive functioning you are having problems with and those results will help a speech therapist work on helping those areas with some exercises.

I didn't get any neuropsychological testing, but my speech therapist is very good and she discovered what some areas we needed to work on with her own questions and little tests. She said it would have been easier for us if we had the results of the neuropsych testing and it would have taken less time of the time she has to actually work with me on fixing those areas, but it is what it is.

I truly believe that the work I have done with her helped a lot of the neuronal pathways reconnect that had been damaged in my brain because my recovery noticeably sped up and I had some real leaps in improvement after I started working with her.

Speech therapy isn't only for speech problems, even though I have experienced a lot of speech problems. It helps other areas of cognitive functioning that have been impaired and a good speech therapist should be able to help teach you how to compensate for deficits you are dealing with now that you used to not have to deal with.

I personally think you should put the same money you would have put towards another MRI towards some speech therapy or purchasing a subscription to lumosity instead. But I'm not a Dr... I'm just some chick in CA who has been dealing with a brain injury for about 18 months.

[SpaceCadet]

I don't know what to say about this. I had iicp for six months and the first MRI apparently didn't show it, but if I had had a second it may have - but I was dealing with some *very severe* symptoms. Although the neurologist I have (which is also my second) figured out what was going on with me without a second MRI though.

That's what I'm wondering about...if there is something else wrong, like disease, they would only be able to tell with a repeat MRI since one MRI can't show further deterioration or whatever the disease causes. I can't really tell if what I'm experiencing is severe or not, or if it could be symptoms of disease since a lot of PCS symptoms overlap with diseases like MS. Every time I tell the neurologist what is going on with he just tells me it's normal brain injury symptoms.

Is the neurologist you're seeing a specialist in TBI? I think getting one who specializes in TBI may be the best route for you, if that's possible.

He isn't a "TBI specialist" but he said he's been a neurologist for 30 years. When I asked him if he's treated people for PCS and TBI and he said "only a couple thousand". So the guys got experience. I'm sure he knows what he's doing and there is reasoning behind wanting the repeat MRI.

I also recommend, after getting a Dr. who specializes in TBI, that you see what they think about getting neuropsychological testing and/or speech therapy. (I think a good Dr. will know other good people in related fields.)

A good neuropsychologist should be able to pin point what areas of cognitive functioning you are having problems with and those results will help a speech therapist work on helping those areas with some exercises.

That is something I plan on asking him about, and thank you for reminding me. This was only my first visit with him and he wants to get the initial testing out of the way before doing anything else, I suppose .

I didn't get any neuropsychological testing, but my speech therapist is very good and she discovered what some areas we needed to work on with her own questions and little tests. She said it would have been easier for us if we had the results of the neuropsych testing and it would have taken less time of the time she has to actually work with me on fixing those areas, but it is what it is.

I truly believe that the work I have done with her helped a lot of the neuronal pathways reconnect that had been damaged in my brain because my recovery noticeably sped up and I had some real leaps in improvement after I started working with her.

Speech therapy isn't only for speech problems, even though I have experienced a lot of speech problems. It helps other areas of cognitive functioning that have been impaired and a good speech therapist should be able to help teach you how to compensate for deficits you are dealing with now that you used to not have to deal with.

I personally think you should put the same money you would have put towards another MRI towards some speech therapy or purchasing a subscription to lumosity instead. But I'm not a Dr... I'm just some chick in CA who has been dealing with a brain injury for about 18 months.

LOL at the last part ...

Thanks for your response and advice. Definitely something I will consider looking in to in the future.

[SpaceCadet]

Mark -

Another MRI sounds extreme. Plus, an MRI should only cost about $1200 to $1600 max. The insurance companies pay even less. You can look up the Medicaid and Medicare reimbursements online. You just need the procedure codes used.

I know what your saying. I'm really thinking about whether I should get it done or not. How would Medicaid and Medicare reimbursements benefit me? I'm asking because I'm not eligible for Medicaid through Welfare because I'm receiving Unemployment. Which is weird, since I'm really not getting much per week.

The EEG also sounds like a waste. An EEG with a sleep session would be more useful. Sounds like this is a generic neurologist. They don't believe anything that they can not see on an X-ray, MRI, CT, or EEG tracing.


He gave me the EEG right there on the spot. He asked me if I was up to it and I just went for it. During the EEG, I had a couple "brain shocks" or "body shocks" happen to me as I almost fell asleep. Maybe they will show up on the test and he'll be able to tell me if they were mini-seizures or something.

The sleep study would be much better use of 'your' money.

I was really hoping he would send me for one, but he didn't. Hopefully this next visit I have scheduled he will send me for one.

Have you had your B-12 and folate levels checked in the blood work?

When I had my blood-work done in the ER, I didn't ask about my B-12 levels and they didn't say anything about them. I haven't got the blood work done yet that he sent me for. Who should I ask about it? The people at Quest Diagnostics (they do the blood work) or the neurologist? Thank you for reminding me about this, I will put this in my notes for my next visit.