PMR 4 MSK,
thanks for your reply. Neither me nor anyone else here has ever scared patients by telling them the procedure would be the worst they had ever had.
Perhaps you are right, I am not cut out to do EMG tests. But perhaps you are wrong and I should go on doing these tests, because I am compassionate, which so many people working in health care are not.
I am still undecided.
Xardas,
thanks as well for your reply. You are of course right that most medical procedures are uncomfortable. But don't compare EMGs to blood-darwing. For blood drawing the needle is inserted only once (provided you know how to do it), for EMG the needles are inserted 10, 20 or even 40 times. For blood drawing the needle is just inserted a few millimeters and withdrawn, for EMG it is inserted deep and moved around. Besides, the patient has to contract the muscle, which is the part when most patients cry out with pain.
And as to falling asleep, I saw that once. But it was an old very sick man who was under heavy sedation and who was almost unconscious when he was wheeled into the room. So many people on whom EMGs are done in a hospital get so many drugs that most of the time they are under sedation. You can't compare them to those who come on an outpatient basis. They are wide awake and none of them will fall asleep.
I have one more question to all of you:
Have any studies been done as to the percentage of EMD/NCS that were necessary? I mean, what would you say, how many of the tests you have done led to treatment or a change in treatment?
Most patients that were tested here were supposed to have polyneuropathy. Many were diabetic, so their sugar level was monitored anyway and the additional knowledge that they really had polyneuropathy didn't probably change anything in their treatment. Medicare does NOT pay for Electrodiagnostics with a diagnosis of Diabetic Polyneuropathy.
Would you agree with me that perhaps 70% or 80% of the EMD/NCS are unnecessary? NO, I would NOT say that I do an UNNECESSARY test 70-80% of the time. Should doctors be advised to think twice before sending a patient to a neurologist to have these tests done? Shouldn't they ask themselves what would change if they didn't do the test? Yes, this should ALWAYS be asked when ordering ANY test. That is the basis of good medicine.If the answer is 'nothing' shouldn't they refrain from having the patient undergo this 'uncomfortable' test?
I get the impression that too many doctors just send their patients here because they think the test, though uncomfortable, is harmless?
Is it really that harmless? Lasting pain, numbness, inflammation, does occur. Has anyone ever done studies on the long term effects of these procedures? I wonder how many polyneuropathies have been induced by these procedures, especially when a great many electric 'shocks' were applied and a great many needles were inserted? NONE- Low voltage/amp current is very safe, and does not cause nerve damage in any way. There are numerous studies about this. There is an excellent position statement at the AANEM website regarding this.
Thanks for your answers.
Hilly