That's the beauty of Image-Handler ... no more worrying about those _MED and _LRG images!

Image Handler places all of its "handled" images into the /bmz_cache folder. If you take a look at one of that folder's subdirectories, you'll see files named
Code:
some_unique_string.image.widthxheight.jpg
The some_unique_string (for IH-4, anyway) is an MD5-hash of the file's name and some additional values to uniquely identify the base file. The width and height values in the file's name are the resultant image's width and height.

So, you'll see your images' small, medium and large images all grouped together and identified by the actual image's dimensions.