Wednesday, July 15, 2009

The EMG Test

There are two basic components of an EMG, the nerve function and muscle function tests. The former involves getting shocked a bunch, the latter involves getting a two inch needle jabbed in to various muscles while you flex. Fun!

My very first EMG went like this; I started but putting on one of those sexy open-in-the-back hospital gowns and immersing my feet & arms in a pair of sinks. They didn't tell me about the soaking part before my appointment. Well, they sort of did.

Nurse: "Oh good, you're here early. They love it when they can get you soaking."
Me: ...(uncomfortable pause).."Um, soaking?"
Nurse: "Yeah, you soak the part their testing in water. Didn't they tell you that?"
Me: "Must have slipped their minds."
----moments later-----
Nurse 2: "Come on back Colin, we'll get your arms and legs soaking."
Me: "And legs? It's just my left hand."
Nurse 2: "It says here the doctor wants to check all of your extermities."
Me: "Hmmm." (Internally: "SHIT!")

Apparently your skin zaps easier if it's wet. Who knew. The neurologists at the U of MN don't make you soak... they use a needle microphone that goes in your skin instead of on it. Ow.

Once I was sufficiently soggy, the doctor took me into another room & started taped little electrodes to my hand. He then took a medical-grade tazer and started zapping my arm. It hurt a bit, but it was cool to watch my hand flopping around. I asked how many volts the thing put out. He said "Oh, it goes up 150, but the current is only on for 1-2 milliseconds, so there isn't enough amperage to do any damage." Oh good! I thought running household current through my extremities would be dangerous.

After zapping came the Muscle test. He put away the tazer and took out what I can only describe as an electric stethoscope and a large needle that was hooked up to some sort of jumper cable. The electric stethoscope was taped to my forearm, and the needle was inserted into several of my muscles. He'd get the needle in, graph some sort of baseline, then have me flex my muscle with the needle still in it.

All of my subsequent tests have played out pretty much the same. Occasionally one of my muscles, usually a calf, will cramp up with the needle still inside. The feeling of individual muscle fibers sticking to a needle as it's extracted is one of the most stomach turning sensations ever. By the end of the test, you end up feeling like you fell off a cliff while being stung by bees.

But, it's not all bad. Here are some comic highlights from my EMG this morning.

Dr 1 to Dr 2: "I didn't get a strong F wave that time. Don't you hate that?"
Me: "Don't even get me started! F waves these days"

Dr 3 to Dr 2: "I need another alcohol." (referring to an alcohol wipe)
Me: "I'll take an alcohol too. Dry with 2 olives please."

A collection of things the doctors said that totally sounded pervy;

• Put more goo on your probe.
• Now just stick it in.
• Try to straddle his muscle.
• Push it in at a 45 degree angle.
• You might need to get it wet again.
• Yeah, that looks like a good 20 centimeters.
• You've got a nice long humerus.
• This is going to be a big one.
• Now pull it out.

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