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Kertie446 11-05-2008 07:13 AM

Nerve Conduction Studies and EMG
Hi, everyone. :)

I have intermittent Lumbar back pain and intermittent leg pain accompanied by intermittent tingling/numb sensations and hot/cold feelings across my legs, buttocks and feet - these can be in both legs. Theses symptoms occur at the front, back and both sides of the legs and feet.

I have had this after having some sort of virus when I was 17 and at college which made me extremely ill - vomiting, aches and pain from the top of my head all the way down to my toes and hallucinations with a high temperature. I was so ill my Mom even decided to let me sleep in her bed with her. No one else caught this virus which I did think was a little bit strange as if my body was hurting just me with it.

Ever since I had that virus I've never been the same again. I now suffer with back and leg problems which are made worse by physical exercise, standing for too long and sitting for too long. I get relief by resting in bed and not doing any of the aforementioned which start it off. It is affecting my general life as I cannot do anything that may start it off as it takes at least a week to settle again if I start it off, sometimes a couple of weeks.

On Friday I was sent to a Neurologist for some Nerve Conduction Studies and an EMG. The Neurologist only did my one leg (the left one) even though I clearly stated that it also occurs in my other leg. He was also not thorough as although I stated again that I also get pain and other sensations also on the sides of my legs and back, he only tested two areas. I'm very concerned that he could've missed out something that may well be a help to my Neurosurgeon in diagnosing me.

This Neurologist also didn't sterilise his hands (he didn't wear any gloves or even clean his hands before doing the needle EMG) and I'm worried I could have caught something from his dirty practice.

He didn't have any patience with me whatsoever and just treated me like an object, not a person which, I think as a patient who is very interested in healthcare and patient satisfaction (I'm interested in doing a career in healthcare), is not acceptable.

This supposedly professional Dr seemed awfully amature to me - he didn't know how to talk to a patient - he didn't know what 'bedside manner' is. By his bedside manner it meant forcing (he practically pushed my foot in an upward position which really hurt me because the needle was rubbing against my bone) a patient to move his/her leg even though the EMG needle had not been inserted correctly (on the skin above the bone on top of my leg). He didn't do the procedures, particularly the needle EMG in a clinical manner (I could've caught anything from having this done). He had no idea how to evaluate patient's symptoms thoroughly - testing only one leg on a patient with two legs affected.

The other thing that really upset me was when I told him I am not keen on needles he called me a 'coward' which I thought was discriminating and unprofessional. Just because a person doesn't like needles doesn't mean they should be called a 'coward' by a so-called healthcare professional. It's disgusting how he can just say that and think it's funny.

He didn't like his job and that's the exact impression I got from the way his attitude was in the whole of this consultation and tests. He even said "why do you want to work in healthcare? Leave the people and let them look after themselves." in a very funny/odd manner. Was this actually a joke or not, I couldn't tell.

He said 'everything is fine' even though he hadn't correctly inserted one of the needles for the EMG and had to abort the test as it was too sore because he hadn't inserted it properly and just told me to go. He couldn't wait to get rid of me, quickly ushering me out of his room. The other thing, he was late (I had to wait over half an hour just to see him) and he never even mentioned it or appologised which I thought was disgusting - us patients don't want to be stuck in hospital either.

I would be very grateful if anyone could give me a little advice on the following questions I still have;

Is it correct for a Neurologist to only test one leg on a patient that has both legs affected or should he have tested both of my legs?

Also, should he have tested more than just two areas/spots on my leg/foot?

Do Neurologists have to clean their hands and wear gloves when inserting the EMG needles?

Is it ok for a Neurologist to call a patient a 'coward' when they don't like needles?

Would it be a good idea to have this tests done again by another different Neurologist?

I am fed up with being treated like an object rather than an actual living thing. It's disgraceful.

Thanks for any help or advice you can give and I apologise for the lengthy post, I just had to get it out as no one else will listen to my concerns and I know people on this board are very good and always listen and I appreciate it a lot in this uncertain time of my life. :)

feelbad 11-06-2008 08:51 AM

Re: Nerve Conduction Studies and EMG
i have no clue as to just what this so called medical professionals title is but no one deserves to be treated like you were,ever. that really is appalling. to actually call you a coward?? whats up with this idiot? i would ask to have that test redone by someone who actually knows just what in the heck they are doing,and treats you like a human being too. the tests you had are supposed to try and determine whether or not any particular nerves have impedded nerve flow,thats about it, it does not give a whole lot of other info like other tests do,just checks nerve flow impairment.

a much better test would be a contrasted MRI of your whole spine. this would gve alot of different types of info that can be used to better Dx your symptoms and arrive at some type of actual Dx. the EMG along with the MRI are something that just work really well together to try and Dx nerve related issues. did you actually have some type of menengitis at 17? what was the actual Dx of what you had? thats what it kind of sounds like given what your axctual symtoms were. you just NEED to know what casued that illness/symptoms you had,its just part of your medical history that also needs to be taken into account,ya know?

i would seriously ask your referring doc to obtain that MRI with contrast now and then a possible referral for another EMG with someone other than the idiot you just saw. thats really pretty sick. you just need it done right and on all the right nerves and areas of potential involvement. but i would make getting that contrasted MRI of your entire spine a big priority right now. sorry you got tortured from this guy. it should not have even happened. he knows better. please keep us posted as to what you find out. good luck,Marcia

Kertie446 11-06-2008 12:02 PM

Re: Nerve Conduction Studies and EMG
Hi and thanks for your help and advice, feelbad. :)

The contrast MRI sounds like a brilliant idea as they've only done a plain MRI of my lower spine and now my Neurosurgeon is suggesting that I have a scan/MRI/images done of my whole spine, including my Thoracic and Cervical spine as he reckons it could be a nerve traped/compressed higher up my spine, not in the lower spine as the MRI of the lower spine doesn't show a trapped/compressed nerve. He is also thinking of scanning my brain as I suffer from miegrains and he wants to make sure that they aren't causing strange sensations like the ones I get in my legs. I'll talk to him about the MRI with contrast and see if he'll let me have one. Hopefully he will.

Is a contrast MRI one where they inject dye into an area and then scan it?

I'm not really sure what sort of virus or if it was actually meningitis as I was never taken for any tests to find out. I'll never really know. I have certainly considered that it may have been meningitis as other people have had it at the college I was at. I had luckily had the meningitis C jab before I had gone to college which probably made it less severe as I didn't have to go to hospital. I was just really weak and tired afterwards and have always, since then, had this back pain and strange sensations in my legs and toes. That jab probably saved my life.

Would it actually still be possible to have tests to see if I had meningitis or would the virus have gone out of my system as I had it in Feb 2005?

Also, thank you for reassuring words as I wasn't entirely sure if I was right or not in being unhappy with the way I was treated. I really appreciate your help and advice and find it comforting that there are others out there that know what it's like to be ill and get treated badly.

It certainly does make all the difference to have a nice doctor or, in my case, Neurologist, as nobody wants to be in hospital. I'm not a great lover of needles or other sharp things being stuck in me. I've had some awful experiences in the past and that, I think, is why I don't like them. He certainly made me feel so much more scared than I already was to start with as I knew it involved needles.

I'm going to ask my Neurosurgeon to have these tests done by someone else and see what he says.

Thanks and I'll let you know how I get on as I haven't got an appointment date as of yet with my Neurosurgeon as I've got to wait to let this Neurologist write up his report. Hopefully it doesn't say anything nasty about me or I'll have to make a formal complaint about him.

Kertie446 11-07-2008 05:16 AM

Re: Nerve Conduction Studies and EMG
Sorry for double posting, but I I've just thought about how they might find out about if I may have had some form of meningitis.

I've heard that they sometimes do lumbar puncture where they take a sample of fluid from the spine and analyse it for anything like that. I'm not entirely sure, but any help or advice would be greatly appreciated.



feelbad 11-07-2008 08:27 AM

Re: Nerve Conduction Studies and EMG
ya know,i really just don't know if having it would leave anything behind to test. asking your neurologist would probably give you that answer. it may or may not actually play a part in some level of ongoing symptoms,again,asking your neuro would be the best person to get the right answer to these questions. sorry i cannot help you with that one.

its really good for you that you at least have a neuro who really seems to want to kno why you are having these symptoms. trust me,you are lucky to have a specialist like that since alot of them really don;t seem to car about their patients like they should,so thats a big plus for you.

you really do probably(given past history)need to be scanned literally from top to the bottom of your spine just to see if anything is indeed out of the norm. the contrasted pics would defintely be the way to go too. they simply do one set of pics without the contrast then they introduce the contrast thru an IV they have already set up before the first round,and inject that into your bloodstream. so you get one set of MRIs done without it and one with it. the contrast just really helps to better define certain areas or certain types of findings that just do not always really show themselves all that well with just plain old MRI. and in doing your brain as well,the contrast is ideal for really seeing certain structures or possible malformations that can sometimes just be hidden by other softer tissue structures in there. this is really a good plan to really see what needs to be looked at and evaluated. your doc is very right about there possibly being something much further up in the spine that could cause your types of symptoms much further down. i have actual spinal cord damage and a really messed up c spine and i DO have alot of lower torso involvement just from the stuff way up there. and of course the brain too. this stuff just all needs a thorough look see ya know?

hopefully your neuro can get the MRIs set up soon for you. i would aslo make certain to tell your neruo just what took place at the EMG. that was just appalling and i do think this incident needs to be reported at least to your neuro so he or she wont be referring any more patients to this idiot. why put othersthru what you were forced to have to endure,ya know? please keep me posted on anything you find out,K? good luck,Marcia

Kertie446 11-08-2008 04:00 AM

Re: Nerve Conduction Studies and EMG
Hi, feelbad and thanks for your help and advice, I really appreciate it a lot. :)

I'll talk to my neurosurgeon about the virus and finding out if it might have caused the nerve and bone problems I'm having now and see what he says about it and I'll let you know of the outcome on it.

I've only met him once so far after waiting 3 years just to get to see a consultant (my doctor ignored my symptoms and said that it was just muscular or it's growing pains, etc, until I kept going back and complaining of my pain that I still had after years, then he finally sent me for an x-ray then I got referred from the physio to MRI and then to see a consultant (Orthopaedic spine surgeon) who didn't want to see me for some reason that they never even bothered to state so I then went back to my doctor and complained that the consultant didn't want to see me and he was quite angry at this and demanded that I be seen. I heard nothing from this orthopaedic surgeon but I then got an appointment out of the blue to see this neurosurgeon which was a stroke of luck. The orthopaedic surgeon still hasn't seen me and I don't think he ever will but I'm glad in a way as I wouldn't want him doing anything on me!) and I do feel like he cares as he is arranging investigations that other doctors wouldn't probably have bothered to arrange. He was certainly quite thorough and will probably take in the suggestions on the contrast MRI with interest, hopefully, as I am desperate to know why my nerves seem ok in the MRI and aren't trapped/compressed on the lower spine yet I have nerve symptoms. He is planning on scanning my brain too.

In the meantime I did see an orthopaedic surgeon (thankfully not the one that didn't want to see me) as well as my neurosurgeon and he didn't mention anything to do with the fact it could be further up involved and he said that the virus was just a coincidence, like my family doc said, though I've read that viruses can sometimes also start things like autoimmune diseases i.e. reactive arthritis so I don't understand why most of the doctors and other healthcare people say that it's just a coincidence. It seems to me like neurosurgeons are much better in dealing with the spine.

I will certainly tell him about that EMG incident as I did think it was out of order. I have to say I did see the patients that were coming out before I went into his consulting room and they didn't look very happy and were rubbing their areas where he'd stuck the needles in.

I'd just like to ask your opinion on if it is necessary for the neurologist to wash his hands or wear gloves before sticking the EMG needles in as I'd just like to know as I thought that was also a requirement when dealing with clinical procedures like needle insertion?

Thanks once again for your very informative advice and reassuring help and I will keep you informed on what happens. :)

feelbad 11-09-2008 08:56 AM

Re: Nerve Conduction Studies and EMG
i would imagine that there has to be some type of standard protocal in that docs office,or whoever actually did this. wearing gloves is not always a must(it really does depend upon procedure),but washing hands is just common sense ya know? not washing hands is what can spread major infections in hospitals among other things. he could have possibly washed his hands before he came into the room too ya know? but the way you were treated was just plain appalling,really. that is what needs to be reported to YOUR doc,and possibly the medical oversight entity where you live? in the US,its the AMA(american medical association),not too certain what its called in the UK.

just what was the persons title who did that test on you? was this a doc,or tech or some actual specialist like a physiatrist? my physiatrist(this is not any sort or pshyc doc but physical rehab doc) is who does my EMGs. it would just be really interesting to know what level of so called medical professional this was. marcia

Kertie446 11-09-2008 10:35 AM

Re: Nerve Conduction Studies and EMG
Hi, Marcia. :)

I never saw him wash his hands while I was in there or before I went in as he came out to fetch me and I followed him straight after his patient before me came out.

I am going to complain about it to my Neurosurgeon so that he has me have these tests done again by someone else. I do wonder if it's possible my Neurosurgeon could actually do these tests rather than a Neurologist.

This guy's title is a Consultant Neurologist so he should've, in theory have known better really.

Thanks for your help and advice, Marcia. :)

feelbad 11-10-2008 08:37 AM

Re: Nerve Conduction Studies and EMG
you could possibly try another doc at the same place or another place all together ya know? i don't think your neurosurgeon would actually be able to do this type of test on you. it takes very specific training to even do an EMG and most NSs really have better things to do with their time kind of thing there? in other words,its kind of 'beneath" them and their level of training and expertise. if he(your NS) could at least refer you to what is called a physiatrist(a physical medicine rehab type of doc?)? this type of doc routinely does these types of tests on their patients looking for specific nerve damage. this is who does all my EMGs. it also wouldn't hurt to just get the opinion of a physiatrist either. they really know nerve and muscle and all the ways our bodies are supposed to move? they can tell with just some very simple hands on tests(or just even watching you walk),what areas may be involved even before sticking you with any needles. its just their area of expertise. just a suggestion,and i know they do do EMGs themselves.

i cannot believe that doc did not even bother to wash hands(or at least use some dang gloves??). its a pretty basic protocal before even touching another patient ya know? just speak with your NS and see what he recommends for you to do. i would suggest the physiatrist tho. please keep me posted,Marcia

Kertie446 11-10-2008 09:00 AM

Re: Nerve Conduction Studies and EMG
Hi, Marcia and thanks for your help and advice. :)

I found all of your advice very informative and has helped me a lot in working out what to do next. I will certainly ask my Neurosurgeon about seeing either a different Neurologist or/and a Physiatrist as I feel that the other Neurologist I saw wasn't thorough at all and missed lots of points - i.e. not even checking the other leg or my arms and hands as my Neurosurgeon, I think wanted the arms and hands testing as he suspects there might be a nerve trapped/compressed in my neck.

This time, though, if he or she doesn't wear gloves or at least clean their hands before placing a finger on me, I'll walk away out of the room as the last thing I need is to come back with something else i.e. an infection or even some sort of blood-borne disease.

Thanks for your very informative posts, Marcia and I'll keep you posted of the outcome.

Kertie446 11-14-2008 05:14 AM

Re: Nerve Conduction Studies and EMG
I'm currently awaiting another appointment to see my Neurosurgeon.

My doctor has ordered a blood test to look for any autoimmune disorders i.e. arthritis related illnesses as my mom's grandma had Rheumatoid Arthritis and the Neurosurgeon and urogynaecologist told me that it'd be a good idea to see a Rheumatologist to also check why I am so bendy - I can hold my thumb on my one hand to make it touch my wrist and my body constantly clicks all the time. They are also suspicious of some form of arthritis as they took an x-ray of my foot when I was having trouble walking on it due to pain radiating down it into the balls of my underneath foot where my toes are joined and going into my toes and they spotted degeneration of my first MTPJ (big toe joint) which is unusual for a 20 year old.

I hope I haven't got anything as bad as arthritis but only time will tell once I've had the blood test.

Not much else to report on as of currently.

feelbad 11-14-2008 08:17 AM

Re: Nerve Conduction Studies and EMG
its always good to simply cover your bases and rule in or out other things,so that really would be a good idea. you simply need to know whats going on,unfortunetly it takes time and testing to get there. sounds like a good plan tho. keep me posted. Marcia

Kertie446 11-14-2008 10:26 AM

Re: Nerve Conduction Studies and EMG
Hi, Marcia. :)

I agree 100% and more. Like you said it will take time getting all these tests done but hopefully they will give a better explanation of the problem. It's taken 3 years and maybe longer just to get my doctor to refer me to a consultant as they tried to say there was 'nothing wrong. It's only a muscle strain or growing pains' but I knew that having pain after a few months that it wasn't just what they'd tried to suggest but something a little bit more. Pain means there could be something wrong and it needs investigating thoroughly as pain doesn't just appear for nothing usually, though sometimes it can but not very often.

I'm going for this blood test next week. I'm not keen on needles but then again if it is what has to be done to find out the problem then I've got to do it. Ouchies!

Thanks for your help and advice and as I said before, I'll keep you posted. :)

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