How can we minimize the chance of getting GDD when we undergo GBCA-enhanced MRI?
I have always loved the quote from Shakespeare in the play Julius Caesar, Cassius speaking to Brutus: The fault, dear Brutus, is not in our stars, But in ourselves.
I think this applies to most things, but certainly to this condition. This I take to mean that it is not our fate that things happen, it is do to us and what we do.
The two critical things we have control of are:
1. do not be dehydrated before and for atleast 2 days after GBCA injection.
2. do not be in a state of self-determined metabolic acidosis.
In practical terms that everyone can understand, these are the two commandments:
1. make sure to drink a reasonable amount of fluid (preferably water, even more preferably alkaline water) before and for atleast 2 days after. Essentially to the point of being not at all thirsty - but not to the point of being sick (everything in moderation).
2. do not engage in intense physical activity from 2 days before to 5 days after a GBCA-enhanced MRI.
Tragic stories about GDD include individuals who prior to the GBCA were excellent athletes, and afterwards horribly sick and incapable of any exercise. The event that happened is that following the MRI they underwent within a couple of days intense physical activity. A little activity is good, a lot of activity bad. Essentially they created in themselves a state of metabolic acidosis. This may also pertain to saunas that may have some benefit to subjects who already have GDD - but in the immediate period this may cause an acidotic state which will have the exact opposite effect of that desired.