MRI Results, Brain Nerves, Methotrexate, and the Plot Twist Nobody Saw Coming

It has been almost 10 years since my pituitary surgery in 2016, and I truly believed my brain and I had reached a respectful truce. You behave. I function. We don’t reopen old storylines.

Apparently, my brain did not sign that agreement.

This latest MRI came back with updates—not dramatic, not catastrophic, just inconvenient enough to remind me that chronic illness loves a sequel. And while my nerves were busy acting up, I’d like to point out that I have personally been doing the most.

For example: I’ve lost over 130 pounds since December 2024.
So yes, my body is clearly capable of big changes—just not always the ones I ask for.

Let’s break this MRI down into normal-people language.

The pituitary area itself looks mostly unchanged. Old surgery changes are still there, along with mild enhancement that doctors have been watching for years. Nothing shocking. Nothing new. However, the pituitary stalk—the little connector that links the pituitary gland to the brain—has new enhancement.

Think of it like the pituitary itself behaving, but the cord connecting it to the brain lighting up like it wants attention.

Now for the real stars of this MRI: brain nerves 2, 3, and 5.

Brain nerve #2 is the optic nerve, which controls vision. Both optic nerves now show new inflammation, worse on the right side. Translation: the nerves that send images from my eyes to my brain are irritated, which explains blurry vision, eye pain, and moments where things just don’t look right.

Brain nerve #3 is the oculomotor nerve, which controls eye movement, eyelids, and focusing. Also inflamed on both sides. Translation: the nerve that tells my eyes where to go and how to behave is overwhelmed and possibly considering early retirement.

Brain nerve #5 is the trigeminal nerve, which controls facial sensation and pain. Yes, that one too. Translation: the nerve in charge of face feelings has decided to be dramatic.

The actual brain tissue itself? Completely unbothered. No new damage, no stroke, no swelling, no bleeding. My brain is sitting there like, “I don’t know why the nerves are acting like this. I’m fine.”

So in plain English: after nearly a decade of stability, there is new inflammation affecting the nerves for vision, eye movement, facial sensation, and the pituitary connection. Not a crisis—but definitely not nothing.

Now comes the medication conversation, which is where things get layered.

My neuroimmunologist didn’t say “good luck.” She said we may have to revisit older medications—you know, the ones we already tried that caused other issues. Basically the medical version of, “We might have to go back to that ex, even though it didn’t end well.”

Not ideal. But also not off the table.

Meanwhile, my rheumatologist stepped in like, “Hold on—we’re not done yet,” and introduced a new player: methotrexate.

Methotrexate is taken once a week, six tablets all at once, possibly moving up to ten. Because nothing says gentle treatment like taking a handful of pills in one sitting. Side effects include fatigue, nausea, brain fog, and hair loss. Luckily, I’ve already embraced wigs and started building a collection, so honestly… this feels very on brand.

The first dose, taken on a Friday, put me completely offline. I slept until Sunday. Not rested. Just unconscious.

The second dose, taken earlier the next Friday, came with a full-blown hangover feeling, which is impressive considering I don’t drink anymore. During that same dose, I hallucinated and saw people—who are very much alive—standing in my room. That was unsettling and absolutely not part of the treatment brochure.

By the third dose this past Friday, I assumed I knew what to expect: hangover vibes, balance issues, feeling like gravity was optional. Then I saw a bird flying around my room.

Naturally, I thought, “Okay, hallucinations again.”

Plot twist: the bird was real.

Apparently, my mom had the front door open, the bird flew in, wandered down the hall, and somehow ended up under my bedroom door. I couldn’t walk straight enough to deal with it that day, so the bird stayed overnight like an unexpected roommate. The next day, I removed the bathroom window screen, opened the window, and let it fly out safely.

No birds were harmed.
My dignity remains questionable.

But here’s the part I don’t want glossed over: losing 130+ pounds while juggling MRIs, meds, chronic illness, and occasional wildlife is no small thing. My body may be messy, unpredictable, and occasionally dramatic—but it is also resilient, determined, and capable of doing hard things.

This is chronic illness life. MRI surprises. Doctors debating options. Medications that knock you out or mess with reality. And sometimes… major victories hiding in the middle of the chaos.

If you’re reading this while waiting on your own results or adjusting to new meds, hear this clearly—you’re not imagining things, you’re not weak, and you’re definitely not alone.

Sometimes the MRI explains it.
Sometimes the medication is a wild ride.
And sometimes… even on the hardest days, you’re still winning.