Posts by wanderingcobra76

Joshua Williams82 said:Thanks to you both.

I suppose I bite my nails because they don't tell me anything at all, so I honestly can't even be sure if there are malignant cells present or not... 🤷

But did you happen to see the biopsy results? Her father likely received them before she was moved to the surgical ward—perhaps he mentioned what they said to someone else in the family?

Joshua Williams82 said:Thanks.

How reliable is punctation as an indicator for whether a tumor is malignant or not?

If the cytologists identify malignant cells within the sample, then they are definitely present—there is a very slim chance of a false positive in those cases.

In reality, a false negative is actually more likely; this happens when the cytology report comes back clear, yet the imaging looks suspicious. In such instances, doctors usually recommend further verification via a biopsy—whether that's a percutaneous one guided by ultrasound or mammography, or even an open surgical biopsy to remove the mass (or at least part of it if we are dealing with an inoperable tumor).

William Smith30 said:Hi there... I was hoping to get an opinion on some test results

I’m 50 years old, and I've dealt with spinal issues since I was a kid. Over the last three or four years, though, my legs have just been giving out on me. It happens so suddenly—no warning signs at all—I just collapse because my legs simply stop working.
For quite some time now, I haven't even been following my treatment plans.

...

Everything described here certainly aligns with degenerative changes due to aging—but does it explain what you're experiencing? Not really.
In other words, while these findings might cause occasional pain in your lower spine, there isn't anything mentioned in this report that would account for your legs suddenly failing you like that.

You really ought to undergo further neurological testing—specifically an emng, as vividsailor7 already suggested.

Casey Rogers47 said:On the native slices through the lumbosacral spine, the vertebral body heights appear normal, and the posterior intercorporeal line is preserved.
At the L4-L5 segment, there is a dorsal disc protrusion that fills the anterior epidural space and impinges on the dural sac.
At the L5-S1 segment, there is a broad-based disc protrusion—more pronounced on the right—which also fills the anterior epidural space and reaches the ventral contours of the S1 nerve roots.
Early degenerative changes in the facet joints are also visible in the described segments.
If there is clinical indication or a need for a more detailed analysis regarding the relationship between the protruding disc and the spinal roots, further neuroradiological evaluation is recommended.

I'm 30 years old, and I ended up in the ER this past Sunday due to intense pain; currently, I'm taking painkillers and have been told to rest. This CT scan was performed last week, and the results just came in today.
I would appreciate some advice—can physical therapy help, or is this something that requires a neurosurgeon and surgery?

Based on the CT findings, there are disc bulges at two levels that could certainly be causing your discomfort.
However, the standard recommendation for these types of findings is to start with rest, followed by physical therapy, and eventually transitioning to home exercises.
Surgery should typically only be considered if there are neurological deficits or if the pain becomes truly unbearable.
The tricky part is that people often jump into surgery, only to find they aren't any better afterward—sometimes scar tissue forms at the surgical site and ends up compressing the nerve all over again.

Since you are still young, I would suggest trying to manage this through rest and consistent exercise first.
It wouldn't hurt to seek a second opinion from a neurosurgeon—they can perform a physical exam to get a much fuller picture of what's happening—but based strictly on the CT, it’s usually better to hold off on surgery unless it becomes absolutely necessary.

Personally, when I was 30, I dealt with very similar issues and nearly identical imaging results. I went through physical therapy, and I feel completely fine as long as I stay "consistent" with my exercises (really, anything active helps).
Whenever I get lazy and stop moving, those pains tend to resurface.😁

Maria Morales31 said:Thanks so much—things are much clearer now.
I was just wondering, though—should it be laser surgery or a traditional procedure? And how long does the recovery usually take?

It would have to be a traditional operation because the sequestrum needs to be physically removed—but honestly, you really ought to discuss both the surgical method and the recovery timeline directly with a neurosurgeon.

Maria Morales31 said:RADIOLOGY REPORT
Lumbar Spine MRI
Sagittal and transverse MRI slices presented using standard techniques.
All slices were performed both before and after the administration of intravenous paramagnetic contrast media.

Through the series of sagittal and transverse MRI slices of the lumbosacral spinal canal, the height, shape, and structure of the visualized vertebral bodies appear normal.
The visualized thoracolumbar spinal cord shows physiological signal intensity.
At the L1/L2 level, there is an intervertebral disc reduction of the anterior subarachnoid space. At the L4/L5 level, a wide dorsomedial and left-sided intervertebral disc extrusion is visible; this extends caudally into the left lateral recess, reaching nearly the lower third of the L5 vertebral body. Post-contrast imaging reveals ring-like opacification typical of a sequestrum, which compresses the dural sac and the left L5 nerve root at its exit, causing dorsal displacement.
At the L5/S1 level, there is a wide mediolateral left-sided intervertebral disc protrusion that obliterates the anterior subarachnoid space mediolaterally on the left, affecting and displacing the S1 nerve root at its exit, though the root itself does not show edema.

Could someone please explain this report to me? I had these scans done because of severe pain in my left leg—I'm 40 years old. Thanks in advance! Do you have any advice on what my next steps should be? Is surgery necessary or not?

Unfortunately, surgery seems unavoidable here.
Between the 4th and 5th lumbar vertebrae, the gelatinous internal material of the disc has largely leaked out—and on top of that, a fragment has broken off (a sequestrum)—which is pressing against the nerve and causing that leg pain.
That material has to be removed; there really isn't any other way around it.

At the level below that, there is also a disc bulge that could cause issues (though to a much lesser extent), so it will be up to the neurosurgeon to decide if they want to address that disc at the same time.

steeljackal6 said:Oh boy, I’m actually getting a little nervous here 😢—I was reading online that this isn't something you can ever fully cure. Just one more thing, though: if I go to the doctor, is it going to be obvious that I'm gay, or could straight guys deal with this too?

In theory, even straight men can get this—though in practice, it’s quite rare.
But honestly, don't let that weigh on you at all... you won't be the first or the last person walking into that dermatologist's office with anal warts—and trust me, they aren't going to be preoccupied with your sexual orientation.
It's just a medical issue that needs to be handled, plain and simple.🤷

Maybe try to charm your way into getting a referral (for instance, tell her you have some growths on your penis—I highly doubt she'll want to take a close look herself!) and make sure they transfer your file right away. 🙂

Olivia Anderson10 said:Is a 1.5T MRI sufficient, or would it be better to head over to the neuro center since they have a 3T? If I go that route, I'd have to travel all the way to New York City—my local clinic only has the 1.5T, so now I'm feeling a bit torn.

For a standard brain MRI, 1.5T is perfectly adequate.

Taylor Hernandez37 said:Can a brain CT scan (computed tomography, with a referral diagnosis of TIA) actually show signs of Alzheimer's disease? I mean, I'm wondering about damage to the basal ganglia located in the brainstem, which—according to some things I've read online—is caused by this disease...

That specific area definitely won't be visible.
Unfortunately, neither a CT nor an MRI can pinpoint changes specifically diagnostic of Alzheimer's at this stage. There are certain alterations that might be detectable through MR spectroscopy, but even those aren't strictly unique to Alzheimer's—and they usually only become apparent once the disease has progressed significantly.

The only thing that might suggest Alzheimer's is atrophy in the temporal lobes and the hippocampal region, along with the widening of the temporal horns (whereas "standard" age-related atrophy tends to affect the entire brain more uniformly).

In the field of medicine, whenever a diagnostic test is ordered, there must be a clear indication—meaning one must know why the test is being performed, what specifically needs to be proven, whether that goal can actually be achieved through this specific test, and whether the resulting data will change the course of treatment.

Essentially, a patient's personal preferences 😬don't dictate the process; rather, the focus remains on what information each individual test can actually provide.
Sometimes, a diagnosis can be reached simply through a clinical examination—it isn't always necessary to resort to "imaging."

For instance, if you are experiencing pain in your leg, there could be dozens of different underlying causes.
A clinician should first perform an evaluation to form a suspicion regarding the cause, and only then, if deemed necessary, request a targeted investigation.

There is simply no such thing as saying, "I would like a CT, an MRI, or a bone scan for my entire skeleton." That isn't how things work here in America, nor is it how they work in much wealthier nations.
It isn't merely a matter of cost, either—it is primarily about following professional medical standards.

Unfortunately, in our healthcare system, these professional guidelines are often bypassed, leading to misdiagnoses for various reasons—which results in exactly what Angela Wright mentioned: the overwhelming of waiting lists.

A straightforward example would be lumbar disc herniations—a condition affecting a huge portion of the population (and perhaps even yourself, as it can present as radiating leg pain). This is often asymptomatic; if there are no neurological deficits, the standard approach is rest during the acute phase, followed by physical therapy if needed later on.
It is precisely these patients who place the heaviest burden on MRI diagnostics, even though their treatment plan wouldn't change whether it’s a minor disc herniation or muscle-based pain—in both cases, they just need to rest. Only if rest fails to alleviate the symptoms is further imaging indicated.

On the other hand, those who actually require an MRI simply cannot get an appointment because they are buried under the sheer volume of patients presenting with back pain.🤷

Changes in the sacroiliac joints can certainly trigger pain, though—of course—that isn't always the case here.

To truly pin down what's causing the discomfort, an X-ray alone isn't enough; you also need a physical examination of the patient. Why? Because pain isn't always tied to the bone or joint changes visible on a standard radiograph—it could just as easily stem from issues with muscles, tendons, nerve structures, or even the intervertebral discs in the spine.

Ultimately, it is quite unrealistic to expect someone to look at an X-ray report and declare whether those specific findings are actually the root cause of the pain.🤷

It really shouldn't be causing you any pain—it isn't a tumor, it's completely harmless, and frankly, there is nothing to be done about it because it doesn't need to be.
Think of it as just a tiny little island of dense bone sitting right where the bone is usually more spongy in nature.

Just to give you a better visual—it’s essentially like having a birthmark on your skin.

Carol Roberts18 said:My mother received her results today:
Histological type: Basal cell carcinoma
Location: skin of the nasal bridge area, left side
And there is a mention of about 5mm further down (depth, I assume?)

These results are from the tissue sample removed from the left side of her face—right at the root of the nose, just below the eye.
They basically just handed her the report this morning and told her that since they are nurses, they aren't allowed to comment on it—so she should try to catch one of the doctors tomorrow...
I suppose no doctors were available at the Mayo Clinic at that specific moment😠, and my mother is just the type of person who accepts things quietly—she took being handed such news and sent home without a single word of explanation just completely in stride...

Mom doesn't want me to worry (we don't live under the same roof), so she successfully hid the fact that the results had arrived until this evening—even though we’ve waited much longer for other samples in the past...

I've found quite a lot of information online regarding this specific type of carcinoma.
What I am curious about is if anyone knows what is meant by the "location" section—it feels to me like that might imply whether it has spread or not (I'm a layman, after all; perhaps it means something else entirely).

What is the state of our healthcare system lately? By the time we actually get a doctor's interpretation, tomorrow afternoon will have already passed, and I am already on the verge of a nervous breakdown... 😢
And I have to be at work tomorrow morning—there is absolutely no way I can miss it...

Thanks in advance for any help in interpreting these results.

The information listed under location refers to exactly that—it's the Latin term for the site, specifically the skin on the left side of the bridge of the nose.

As for the 5mm, you really ought to transcribe everything from the report; that measurement could refer to the size of the lesion, the depth, or even just the size of the histological specimen itself... so it's impossible to comment on without seeing the full report. It is also vital to know if there are clear margins in the histological preparation—meaning, was the lesion removed in its entirety?

Basal cell carcinoma itself is actually the most benign form of skin cancer—essentially, it doesn't metastasize, but rather remains locally aggressive (spreading into nearby structures). It might potentially reappear in the same spot, requiring another removal, but your mom likely won't need any follow-up therapy beyond regular check-ups.👍

Scott Allen10 said:Hmm... I don't know, it's not quite that simple in practice... For a CT coronary angiogram to even work, you have to hit certain hemodynamic markers first. The big one is heart rate... if the patient is experiencing tachycardia, the whole thing is pretty much pointless. You have to monitor the patient constantly, which makes the process a lot more complex than people realize. Plus, a radiologist isn't going to step in to medicate a sudden spike in heart rate; you need a different specialist on hand to handle that, and so on... it's a bit more involved than that. At least, in my experience, it is. I'm not saying other places do it differently, but here in the States, when we do a CT coronary, there’s an anesthesia team right there with monitoring gear, ready to give a mix of sedatives and beta blockers via IV to get everything stable enough for a clear shot.
And another thing... a CT coronary isn't some magic substitute for a real-deal coronary angiogram. It's more like a high-tech way to get a general idea of what's happening in the coronary arteries. Honestly, it would be pretty risky to plan any major surgery or jump to a final conclusion based solely on what a CT scan shows.

edit:
My bad, I just realized you already mentioned beta blockers and tachycardia earlier... mea culpa!

Of course it isn't simple 🙂 and naturally, by global standards, a CT coronary scan is a joint effort between a radiologist and a cardiologist; however, from the patient's perspective—once the preparation is complete, including premedication, the EKG, and setting the technical parameters depending on whether they are using prospective or retrospective gating—the whole process isn't actually all that daunting, and the time spent inside the CT gantry shouldn't be particularly long at all.🤷
In my opinion, the most demanding part doesn't even happen until later during the post-processing phase.😬

I didn't mean to imply that anyone would plan surgery based strictly on a CT coronary scan, but if the results look clean, I highly doubt anyone would feel compelled to opt for a traditional coronary angiography in that specific case.🤷

Why go through all this stress?
I mean, even in the worst-case scenario—if there actually is a significant arterial narrowing—they could just perform a balloon angioplasty or place a stent during a standard coronary angiography. Isn't that far better than simply playing the guessing game while waiting for a heart attack to strike?🤷

I think... I truly understand the anxiety here (which might be more a fear of the unknown than a fear of the actual medical outcomes), but please, try to look at this rationally.
Besides, based on everything we've discussed, it seems highly unlikely that there is any major pathology present at all. 😉

As someone in the medical field, I can tell you 😉

There really isn't anything to worry about—it’s certainly not invasive like a traditional coronary angiography. You'll essentially go through the CT process just three times, and the whole thing takes maybe five minutes? (Though, most of that time is actually just the technical setup for the scan).

Chloe Garcia10 said:Hey there!

I'm 37.
Yesterday, I went in to see a cardiologist for a full workup—did an EKG, an echocardiogram, and a stress test.
The EKG and echo both came back normal. As for the stress test, they labeled it "negative to borderline." Basically, even though I hit a solid 12.0 METs and didn't experience any actual chest pain or angina, they saw some ST segment changes. Even though those changes don't necessarily point toward myocardial ischemia, they want to run an MSCT coronary angiogram just to be absolutely certain we aren't missing an ischemic cause. There was also some mention of possible bridging??

So now I’m wondering if anyone here has had an MSCT coronary angiogram done? Where did you go, and honestly, how bad is the contrast injection? Also, does anyone actually know what "bridging" refers to in this context?

I'm low-key freaking out here, even though everything is most likely totally fine.

thx

Injecting the contrast isn't painful; it’s administered via an automated injector through an IV in the antecubital fossa (meaning the medical staff doesn't manually push it through a syringe, but rather connects an IV line to a machine that delivers the contrast and saline at a very precise rate).
The only thing you might experience after the contrast is a warm sensation throughout your body or perhaps a fleeting feeling as if you've accidentally lost bladder control.
Naturally, this can't be done for anyone allergic to iodine-based contrast agents, and your kidney function (specifically your creatinine levels) is also a crucial factor.
Prior to the imaging itself, certain medications (such as beta-blockers) are administered to slow the heart rate, which ensures the images are clear enough for detailed analysis.

Bridging refers to a phenomenon where a portion of a coronary artery (one of the main ones) doesn't follow its usual path along the surface of the heart, but instead dives through the muscle tissue itself; this usually doesn't cause symptoms, but it certainly can.

As far as I know, in Chicago, you can get a coronary CT at a major hospital like Northwestern, or privately at places like Quest Diagnostics or similar specialty clinics, but I'm not sure about other facilities.🤷

Angela Wright said:Just like the title says—I’ve lost all sensation on the right side above my scar, covering about 8 square centimeters. I did some reading online and saw that this can happen if the incision is deep enough to nick certain nerves, but I haven't found many people sharing their actual experiences.
Is there anyone else out there dealing with this? It is such a bizarre feeling—sometimes the area feels itchy, but when I try to scratch it, there is absolutely nothing there.
Is there anything at all I could do to help bring the feeling back? This sensation is just awful. Everything felt perfectly fine four months ago.

There isn't much you can do besides wait. 🤷
It’s actually a very common occurrence; in my own case, the sensation didn't return until about a year had passed.

As for other "side effects," I also used to deal with intense abdominal pain caused by adhesions—I even ended up in the ER once under suspicion of having appendicitis.

Of course I can. Anything you need.

feralridge3 said:Oh goodness—it seems nobody thought to mention that my diagnosis wasn't exactly "pleasant" news. 🙄

I am so sorry—I truly didn't mean anything by it... but surely you understand that dealing with a malignant brain tumor is a different world than managing a simple kidney cyst?
I simply operated under the assumption that someone online trying to decipher MR spectroscopy results would have already done quite a bit of digging into anaplastic ganglioglioma.🤷