MUGA Tests Demystified

Written by on August 13th, 2013 – 4 Comments

In 2009, I underwent chemo to try and beat down my immune system so I might get into remission. I had four doses of mitoxantrone, which is the chemo they use to treat MS. (Which we now know I actually don’t have. I have neuromyelitis optica (NMO) which I’ve explained here. )

Mitoxantrone is a pretty heavy duty. There’s a lifetime cap of 12 treatments because it has the potential to damage the heart muscle, even long after treatment has stopped. MS specialists will use chemo as a last resort when other treatment options have failed. If your doctor recommends chemo to treat MS, it’s because they believe the benefits (the potential to get MS into remission) outweigh the risks.

Each year since I had chemo, I have had a MUGA scan. (Muga stands for “multigated acquisition”.)  The scan creates video images of the ventricles (lower chambers of the heart that hold blood) to check whether they are pumping blood properly. It shows any abnormalities in the size of the ventricles and in the movement of the blood through the heart.

When I arrive at the hospital, I go to nuclear medicine to check in. Once they are ready for me, they call me into an exam area where I sit on a bed while one of the techs, dressed in a very Game of Thrones lead tunic draws some blood. They label my blood and send it off to the lab for about half and hour where they spin my blood with some isotopes. Isotopes are a radioactive particle that when spun with blood, sticks to the red blood cells.

 

Once the treated blood is ready, they re-inject it back into my arm. I then go into the room where the imaging machine is and lie down on the table. The tech places stickers called electrodes on my chest to monitor my heart’s electrical activity during the test. I have to lie very still with my arms above my head while the special camera uses gamma rays to track the isotopes.

If you look at the photo of the imaging machine, you will see I’ve marked the cameras. Unlike an MRI, you are not actually inside the machine-it’s more like an X-ray where you’re lying underneath the camera 1 and beside camera 2. (Good news for anyone who is claustrophobic!)  The isotopes allow the camera to take pictures to see how well my heart is pumping blood. Images are taken from a variety of angles and the whole process lasts about half an hour. 

Aside from two needle sticks (one to draw the blood and one to re-inject the isotope treated blood) it’s painless. The techs at the hospital where I have my annual MUGA are super nice. They are always friendly and more than happy to explain the procedure, to answer questions and when I ask, to let me see the images of my heart after the test. (I always ask to see-how often do you get to look at your own heart?!)

When I’m about to leave, they give me a special card to carry with me in case I decide to leave Canada in the next 5 days. If you try and cross the border after a MUGA scan, you will trigger security sensors that measure for radioactivity.  Having a card in your pocket that explains you’ve had a nuclear test saves a giant headache!

I wanted to share what this test is like in case any of you reading this ever have to go for one. There’s really nothing to be afraid of and I actually look forward to having my yearly MUGA. I like to know my heart is doing okay!

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4 Responses

  1. danben says:

    Thanks Lelainia for explaining the chemo and MUGA tests, last year my neuro was urging me to get 3 chemo treatments in all of September as he stated I had a very short window or I would be so much worse.Even went as far as saying I would end up in a nursing home.He downplayed the heart risk and risk of leukemia but I pressed him for more info and wasn’t satisfied so I declined chemo.Saw the neuro again February and again was pressured to do the chemo even though I wasn’t worse, in fact I was a lil’ better from more physical activity and eating healthier. They can stick their chemo where the sun don’t shine I say:)

  2. Hi Danben,
    I can totally understand your concern. As with ANY treatment, there are always going to be risks. but if there comes a time when you need to do chemo, the benefits could outweigh the risks.

    In my case, the reason chemo did not work for me was that at the time, my Neuro believed I had MS, when in fact I had NMO. I was on a disease modifying drug for MS, which is you have NMO can actually make you worse because it’s targeting the wrong thing. With MS, the demyelination happens via the T cells. With NMO, it happens via the B cells. MS patients take immuno modulators which go after the T cells. NMO patients need to be on immuno suppressants which target the B cells. Had I been on the right medicine and doing chemo, there’s a greater chance I would have been able to get into remission.

    Chemo is scary for anyone, but if your health is really in jeopardy, it might just be the one thing that makes the difference. My best advice is to follow your gut instinct-listen to what your doctors have to say, weigh the pros and cons and make an informed decision. Just because you chose not to do chemo right now, doesn’t mean you can’t change your mind later if you need to. It’s all about having choices and working WITH your doctors to keep yourself in the best health possible. Ultimately, YOU get the final say.

    Happy to have been able to share about the Muga tests and you found it helpful. I appreciate you letting me know! 🙂

  3. danben says:

    Sorry to hear about the wrong diagnosis Lelainia and the modifying drug for MS made the NMO worse, didn’t help with remission. You mentioned the option of changing my mind later if need be, the neuro and nurse made it clear if I keep delaying on the chemo and wait till I get worse then decide to do the chemo it won’t work.As they were explaining and threatening, in my mind and gut I was so positive I will not get worse, it actually makes my will and determination stronger to defy their opinions. I practically tell myself once a day I will not get worse, being wheelchair bound close to 2 years as far as I’m concerned is my lowest point, how much worse could I get. Nothing will stop me!

  4. Terri-Ann says:

    I actually had the optic neuritis in 1997 which led to my MS diagnosis. Steroids gave me back my vision but I am also familiar with the Mitoxantrone because in 2008 the Copaxone stopped working and I had an attack. That was very scary. There are dangers with the Mitoxantrone and the damage it can do to your heart. I had those tests done on my heart also and I found it so fascinating. Just to be able to see it in real time and picture was awesome. I couldn’t wait to tell everyone how real it was. As for the NMO this is the first i’ve ever heard of it being a misdiagnose for MS. I’ve only ever heard of Fibromyalgia being misdiagnosed for MS. I’ve learned something new. Thanks.

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