Supermassive black hole

It's MRI time on Friday.

Or at least I hope it is, last time I wrote about an upcoming appointment it got cancelled, so I may do better to be quieter.

Anyway, it's due at least.

As medical investigations go, I don't mind an MRI. It's not painful and if I'm lucky I'll get to listen to my choice of songs.

I have an MRI CD which, thanks to repeated forays into the tube, has enabled me to choose a song list of tunes that can compete with the metallic bangs and crunches.

Some even complement it. Or so I like to think while I'm lying there, supine and VERY VERY, still.

(Just thought, will I have to wear a mask this time? That'll be a new one to accommodate under the face cage. Better check my letter.)

Sometimes I'm quite optimistic going into an MRI. This time I am not. I have clearly deteriorated over the past two years and I feel quite knocked by a suspected sensory relapse from a couple of weeks ago.

So I'm:

1/ anticipating new lesions

2/ wondering what this will mean for my next round of Cladribine (which I currently can't take anyway as my lymphocytes are rudely refusing to elevate); and 

3/ contemplating the horror of the scan showing black hole(s), which in MS signify irreversible damage.

Although I like to try and be chirpy about these things, I also need to be realistic.

To be honest, I think the best I can hope for from the experience this time round is a bit of a lie down.

:: Supermassive black hole by Muse

Fire

In order to cheer myself up in the middle of this pandemic, I thought I'd do a wee bit of scrolling through Twitter to find some cat memes.

What I actually stumbled upon, due partly to the organisations and people I follow, was a discussion about something called 'smouldering MS.'

Now to me, smouldering conjures up images of heavy-lidded Hollywood goddess Lauren Bacall. It does not, for example, suggest chronic active MS lesions.

Or so I thought. But my Twitter foray lead me to an article about smouldering MS and my word it's a cheering read.

According to the piece on the MS Trust website, a team of researchers have developed a new MRI technique which makes it possible to capture a type of lesion with a dark rim, which grow slowly for many years.

These lesions can appear regardless of the type of MS or - crucially - whether people were, or had ever, taken a DMT. 

The study showed that "people who had four or more smouldering lesions were more likely to have developed cognitive and mobility problems at an earlier age, have lower brain volume and were more likely to have MS that had become progressive, when compared to people with no smouldering lesions."

Plus, "in a subset of people who had yearly MRI scans for 10 years or longer, rimless lesions shrank over time, but chronic active lesions remained the same size or expanded. Smouldering lesions showed MRI features typical of on-going tissue destruction."

The cheerful conclusion to the research indicates that smouldering lesions are common in MS, are associated with a more aggressive course of MS, cause tissue dame, and (this really is the kicker) occur even in people taking effective DMTs.

So, thanks Twitter, that's cheered me up no end. And also given me some questions for my neurologist whenever it is I can next see him.

Sigh.

:: Fire by The Crazy World of Arthur Brown