Questions on EMG Procedure/Findings, THANKS!

[Marzipan]

Hi! Having an EMG done today on my legs. It was supposed to be for legs and arms but she has to do it in two seperate visits for insurance purposes

I have a couple of questions. I found out the neurologist not the technician will be conducting the test. So my questions are this:

1. If the neurologist conducts the tests, do you think she will tell me the results today? It's immediate right?
2. People talk on this forum about clean and dirty EMG's. What does that mean?
3. If the EMG is good, does that point in the right direction that I don't have ALS or Muliple Sclerosis (I know this is not the right place to ask about the MS) just reaching a little.
4. If the results are not good, does that mean more testing or are you automatically diagnosed with a muscle or nerve disorder?

Sorry, I'm a little anxious. I did take your good advise and bringing my friend with me in case I miss what the doctor tells me. Thanks so much for your thoughts.

 

[AKjo]

When Gary went for a "second opinion" (we traveled from Anchorage to the UW Medical Center in Washington) the neurologist conducted the EMG and NCS, sent us out for lunch while he reviewed the records from home, then delivered the diagnosis the same day. I'm sure he knew while he was doing the tests. We had NO expectations of receiving this news as we thought he was having complications from a broken back 5 years previously and never even entertained there might have been something else going on.... thought he was going to tell us about some surgery or miracle cure that would fix him right up! Looking back, Gary's Anchorage neurologist probably knew also, but she gave us the gift of three extra months of ignorant bliss by telling us she "didn't see anything she could treat". Apparently at the time of the first EMG at home he only showed UMN and LMN signs in two rather than three regions. We were happy for the added time of not knowing.

Sorry, but I don't know enough to answer more than your first question, I'm sure that varies from one doctor to the next as to when he will inform you.

 

[gracefullyteaching]

hi,
By no means am I an expert on an EMG, but I had my first one yesterday so I can tell you my experience. Yes, if the neuro does it him/herself, then they will go over results. The dr that did mine actually talked through it so when he saw something normal, he let me know, and when something was abnormal, he explained, and did his best to get multiple readings. I can not comment on clean/abnormal EMGs but there seems to be a lot of back threads you could pull up. I think diagnosis time varies for each case. It helped me to tell the dr how nervous I was and found by the explanations, I calmed down a bit. Good luck.

 

[Marzipan]

Thanks to both of you for responding. AKjo, I'm so sorry to hear about your husband's diagnosis. That must have been shocking.

gracefullyteaching, you gave me a good idea. I will let her know how anxious I am and will ask her to talk through the readings so I know what's going on. Sometimes I forget that I AM THE PATIENT and I should speak up more. I will check the back threads. Have taken a chill pill and hope it kicks in soon. Anyone know why I can't wear lotion on my legs for the procedure. I put it on this morning and then learning this had to take it off. Other than for injection site cleanliness, I hope it doesn't interfere with the test somehow. Thanks so much for answering me. It helps. I should know SOMETHING soon hopefully.

 

[Peg B]

HI,

My first EMG/NCS I had on my lunch hour. (Oct. 31, 2006) He talked through most of it ruling out different DXs. and after 45 minutes told me I had "ALS." I asked him if I had a second choice, he said "NO." However, he also said he wanted me to have a second opnion and sent me to University of MI neurology on Dec. 7, 2006, where the neurologist did another study, and answered my questions and explained what she was doing. She determined I had "Atypical ALS or MMN (multifocal motor neuropathy), which is what I have.

I found it very important for me in those 6 weeks of waiting to say, I have been diagnosed with ALS, as opposed to saying I have ALS. We told our children but also told them, "It's not time to worry yet." That helped them too. My prayers are with you. Peg

 

[Alyoop]

Clean and dirty......silly terms. It's impossible to know whiter or nor people are referring to any abnormalities being ALS related or abnormal, being caused some other disease process. We should probably stick to abnormal or normal. So what does it mean to have a " dirty" EMG......who actually knows.

If you have an abnormal EMG then if it does not point to anything specific, other tests may be ordered, such as an MRI, to see if they can pinpoint the issue. People can have an abnormal EMG, but with no symptoms. It's not unusual to find a chronic neuropathic process ( my neuro loved that term) going on somewhere that you didn't know about. I had carpal tunnel that was asymptomatic, for instance.

If you have a clean/ normal EMG, then it's just that.....normal. So you take another chill pill and drop the ALS anxiety.
As I have said before, it's not a test for MS. Your answer to that question will not be in an EMG. I may be wrong, but no of my MS patients have ever had an EMG for diagnosis.

So we all have these fancy , Nancy technical tests to rule out this and that. What we need to remember is a very good diagnostician can get 90 to 100% of their diagnosis correct with a darn good thorough medical examination.
So many have sadly lost that skill, especially in countries where they super specialize. Now I will jump down off my bandwagon, bang, just fell off my stool

Hope your EMG went well. Sometimes a ibuprofen tablet taken afterwards, helps if you find yourself a bit achy. Ive had 6 of the devils so I am an expert ( not).

 

[Marzipan]

Peg, thank you for your post. I'm blown away that your neuro told you in 45 minutes you had ALS. I appreciate the prayers and support very much. Alyoop, loved your post. I have finally been able to drop the ALS anxiety. I had my EMG and it was normal. The neuro said that it is "off the table". I only had my legs done because my insurance doesn't allow you to have both legs and arms at the same time. Nice huh? So I was concerned something might show up in my arms but she said that if I had ALS it would have shown up in the EMG to my legs. I feel relieved. I'm off for an MRI of the upper spine and neck to check for disks, tumors, etc. Whatever it is, even MS, I know it can be treated and it gives me tremendous hope. I work at a hospital and stopped by the chapel to pray and I feel God listened and was with me the whole time. I want to thank EVERYONE on this forum for all you do. Allyoop, you are so right about the diagnostician. The fancy nancy tests to rule stuff our just FREAK everyone out. I had a great doctor when I was a teen. They don't make em like that any more. God bless you all!

 

[abbas child]

Marzipan, I'm so glad for you! Now I hope the real culprit can be found.

I was also diagnosed by the Doctor doing the EMG, but we all thought I had MMN--the opposite of Peg B. That said, I have read more than once of the doctor refusing to tell the patient what the findings are, and make them return in a week or something similar in order to talk.

 

[Ms. Pie]

Congratulations Marz!

 

[Zaphoon]

Happy Dance! Happy Dance!:smile:

 

[trfogey]

Congratulations, Marzipan.

Now, keep ALS off the table until a doctor tells you to put it back on the table. That specifically includes being tempted to come back here and ask about the next new twitch you feel. For you, reading about ALS on the Internet is as dangerous to your mental health as that first drink is to an alcoholic.

Good luck to you.

 

[Alyoop]

Great news Marzipan. The sun just shone a little shinier.......now if you can say that fast, your definitely do not have bulbar ALS. I just created a new test for it and it's cheap.

Hope they get to the bottom of it. Do pop back to let us know if you get a diagnosis. It's always helpful for the other dihals people

 

[AKjo]

Congratulations on being one of the lucky ones!

 

[Marzipan]

Thank you all for your best wishes and support. It has meant a lot to me these last few weeks. trfogey, I completely agree with you that these boards to me are like a drink to an alcoholic. It's time to stop and put this all to rest and take it ALS "off the table" until a doctor says put it back on. Thanks your trfogey. You are the voice of reason. This whole thing has taken a toll on my mental health indeed. Just having that test done yesterday and hearing those reassuring words, eased my mind and I had the first great night sleep I've had in weeks. I actually ate a good dinner. Have lost almost 10 pounds in two months with anxiety. I thank you all for the invite to check in and let you know what the culprit is and I appreciate the support. Take care!