Can a PET/CT and a MRI be completed on the same calendar day? - 1256793

dkm5859
Posts:89

My Mom has a 3 month PET/CT to be completed on June 7th can a MRI of her skull be completed the same day? My Mom's last MRI was completed on Aug. 5th 2012... she was/is up through her most recent CT on 05/02 and her last PET/CT indicated no recurrence and or new lesions/tumours but with a caveat that she had definite radiation pneumonitis and esophagitis so they could not absolutely rule out recurrence in her treatment area. Anyway.. she just recently started to state she was experiencing some dizziness...so... a possible concern might be brain mets...God forbid... would it be wise to ask or insist for an MRI of the skull very soon and can a skull MRI and a PET/CT be completed the same day or would that not be possible or not advisable. Thank you in advance for all of your help, information and caring.

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Reply # - May 28, 2013, 01:17 AM

certain spring
Posts: 762

I don't see why it would not be possible ... depends a bit on how organised they are at the hospital and how well they can coordinate appointments. Quite a gruelling day for your mother, though - I personally wouldn't want all that on a single day, although I can see that some people might prefer to get it done all in one go, especially if the hospital is a long way from home.
Dizziness can occur for lotsand lots of reasons other than brain mets - low blood pressure, for instance. I'm sure you'll talk to her oncologist about it first.

Reply # - May 28, 2013, 08:31 AM

Dr West
Posts: 4735

It's feasible to do these studies on the same day. I think it's appropriate to discuss the potential need for a brain MRI, but I don't think it's quite appropriate for a patient to insist on one if it isn't clearly medically needed, which I would consider to be a judgment in the realm of the doctor(s) involved.

Good luck.

-Dr. West

Reply # - May 28, 2013, 10:06 AM

dkm5859
Posts: 89

Hello & again thank you very much. The post re: my Mom's usage of granular Nexium, gabepentin, & steriods is related to this one..I was not sure to start a new one or not. Her B/P and hear rates have been varying at times a good amount...low BP & higher heart rate, higher BP & higher heart rates & then at times both are near normal. Could these varying BP's & heart rates alone and or in combination with some of the medincine(s) she is taking be the cause of her dizziness. She states that she gets dizzy especially after taking her gabepentin mid morning after she eats & her Nexium an hour before she eats earlier in the morning. Sterioids usually are mid-afternoon...the dizziness subsides normally by early evening if not completely gone until she take the gabepentin at night.
Also I need to please explain my usage of "insist"..I do not want to be rude to anyone especially on here but I need to give it some context and please tell me if I am out of line for what I write immediately following. I must state that the very large majority of the people in the medical fields are highly intelligent, highly educated, very hard working, very caring...very good people. Unfortunately for some members of my family..brother & mother..had some bad to very bad experiences with some of the medical professionals in my local area. It is the primary reason I travel(ed) with my mom a far distance to seek her treatment.
My brother died from pancreatic cancer within about (40) days after finally being dx'ed. My brother was in extreme pain for at least (3) to (6) months. They ran many tests for about six to twelve months..nothing was determined and he suffered. I found out and knew prior that pancreatic is difficult to dx but...??!! His PCP would not even Rx him simple pain medicine, My mom for year and half had a nagging cough and the same PCP would not order a simple X-ray. So..please understand I am NOT trying to be problematic but I'm just trying to be an advocate for my mom. Sorry&tu

Reply # - May 28, 2013, 12:37 PM

catdander
Posts:

These are some pretty specific questions about drugs. I will ask our oncology pharmacist to comment but it may be that this is just such a specific and intricate question that shes needs to be seen by the people caring for her.

I hope she is feeling better soon,
Janine

Reply # - May 28, 2013, 01:03 PM

dr walko
Posts: 102

DKM,

My biggest question is whether your Mom is taking any other medications, especially heart medications. Gabapentin can definitely cause dizziness/confusion, steroids usually cause more of a "jittery" feeling though this could be described as dizziness. I could see changes in blood pressure/heart rate with steroids, unlikely with Nexium. I would wonder about dehydration or other medications causing the blood pressure/heart rate changes.

best wishes,
Dr. Walko

Reply # - May 28, 2013, 03:02 PM

dkm5859
Posts: 89

I'm fairly certain she is taking at least one hear related medication..metropole I believe. I will get her most important ones or all if needed & the details and be back with you all. They have changed quite a bit over the past three months or so. In my very humble opinion I do not think dehydration is a big factor but then again she has been drinking more liquids than she use to..much more prior to her cancer diagnosis. I thought steroids can mainly give the 'munchies' but that varies with different people and or their particular circumstances...can steroids drive the thirst factor also? I will be back sometime tonight with her meds if that is ok... I know you can't make a complete dx and or recommendations but I greatly appreciate everything. Thank you very much.

She takes (1) 25 mg Lopressor tablet...one half in the morning & the other half at night. The only specific heart related medicine she is currently taking. She is taking other medicines currently but nothing else directly 'FOR' the heart per what I was informed. Please let me know and thank you very much.

Reply # - May 28, 2013, 08:20 PM

Dr West
Posts: 4735

I understand what you're saying about some people in the medical field being less than stellar and needing a lot of prompting to do the right thing. I've found myself in that position myself with some other doctors in the last week. For someone who suggests it's not quite fair to insist something of doctors, I'm as pushy as anyone when I feel it's needed (often on behalf of my patients re: care from other doctors).

-Dr. West

Reply # - May 29, 2013, 02:20 PM

dkm5859
Posts: 89

for Dr. Walko and or Dr. West regarding her medicine and such:
She takes (1) 25 mg Lopressor tablet...one half in the morning & the other half at night. The only specific heart related medicine she is currently taking. She is taking other medicines currently but nothing else directly 'FOR' the heart per what I was informed. Please let me know and thank you very much.

Related to possible lack of professionalism by some people: Just a personal observance on this:
I am not sure if what might seem to be the absence of true caring or a lack of thereof is directly or indirectly caused by years of heartbreak when people who work in these fields see the sorrow, pain and agony suffered by their patients, caregivers and families. It must be hard to deal with at times or likely every time. I am not sure I could do it. But if it just a job than I think these types of people should consider a different line of work. I am not sure where a 'happy medium' might lie.
As for my & my family's experience with some of the people who were to be on the lookout for our best interests they were very lacking at times and at other times I do think they were very close to being negligent as they contributed to very sad, trying,& painful times that in some ways could of likely been avoided or at the least mitigated. Thank you so much Dr. West and all the people here who are the very best. I cannot thank you enough for all that you do.

Reply # - May 29, 2013, 03:57 PM

Dr West
Posts: 4735

That's a very low dose of lopressor, so I think unless she already has a low blood pressure, that's not likely to drop it into a problematic range. It might, though, if she were dehydrated from eating and drinking poorly, or from diarrhea, for instance.

-Dr. West

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