Should I get an EMG ??

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Should I get an EMG ??

Postby DaveCH on March 4th, 2014, 11:06 am

Hi my story is as follows. I am 33 male and after a very stressful period and during a sinus cold staring twitching on my cheek which then spread to my calves and then everywhere. Went to my family GP 3 times who did a brief check on reflexs and ordered all sorts of bloods which came back normal along with reflexes etc. GP told me there was no need to see a neuro but i insisted. Saw him 2 weeks ago he did a detailed clinical and told me I had BFS. He said he believes it comes from a virus but stress and anxiety make it worse. I asked did I need an emg etc and he said no i was totally fine and nothing to worry about and that he hasn't missed a case of MND yet and he isn't really interested in the twitching but what shows on the clinical and history he is looking for patterns. He only uses the EMG it there is something of concern on the clinical or the medical history or description of symptoms. I have been twitching for 3 and half months and am concerned as everyone seems to get an EMG and should I have demanded one. However I do have health anxiety and if I get an EMG when does it stop I mean how long before I start to question it and want another one. So my neuro said I don't need to come back. So basically do you all think i should get an EMG or try to move on with my life ?
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Re: Should I get an EMG ??

Postby Scaredlin on March 4th, 2014, 12:39 pm

Hi Dave, another health anxiety case here.

I promised everyone that once I got the EMG I would be a-okay. That last for 48 hours.

Granted it does help, if you can maintain rationality and depending on how much you can stop questioning it and go on with your life. For me, I began questioning, did he leave the needle in long enough, was he just rushing and placating me, he knew I had anxiety so he didn't really "look" for ALS- this is of two drs who I really respect deep down, one who is a Diplomat in neurology.

You know what that led to? Oh, they didn't do the bulbar. So I found another neuro who agreed to stick me in the tongue even though he didn't think I had it either.

My biggest hangup is the various "time" waits you see posted around. I had my EMG super early, at 6 weeks in. So I kept focusing on research that said even with a clean emg and clinical you should wait another 6 or 1 yr of 18 months until you are "truly" clean. HOwever, that theory was debunked by Little Lost and others in a very giant post that happened last weekend you should read it (its 7 pages on the SUpport Forum) you can't miss it. And as Mayo Clinic told Bobajojo, if you are twitching allover and its from ALS, it WILL show on the EMG.

So if you can keep those things in mind, the EMG might be a good thing for you to close it out, depending on how HA you are. For me, I'm physically in a lot of pain and night (burning pains and cramps and twitches) so my mind keeps saying it just can't be BFS there has got to be something more (and I have been tested ad naseum - spinal taps, mris, eegs, emg etc). That's something I need to work through. I also have been fixating on why when I splay my toes out my pinky toe on the right doesnt move as much to the side as the other (this despite me seeming to recall that I broke it years back - a rationale explanation), although I keep saying its "weak." This has become a ridiciulous fixation as I lie in wait for weakness to set in- despite a clean clincical, 3 neuros and EMG. I hope you aren't in it this deep. But as hellish as this has been for me and my disbelief that I am okay, the EMG went a long way into putting the odds in my favor so I resort to that when I really start flipping out. So, all in all, I would say, yes, if you stay logical, it will do you good. A lot of people will say you don't need it, and Im sure you don't, but thats an individual choice and for a person with HA, usually one that becomes necessary to stave off the anxiety.
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Re: Should I get an EMG ??

Postby MarioMangler on March 4th, 2014, 12:41 pm

Personally I don't think anyone should get an EMG. It is a waste of money and now you are just starting down a cycle of testing, then doubting the results, and testing again, which is the trap (that can last years) that so many other BFSers have fallen into. If I were you I would use the money and the time for something that will help you much more in the long run. You should go on a vacation.
BFS FAQ:
1. No, that's not bulbar
2. No, the location doesn't matter
3. Yes, we have all had that symptom
4. No, you're not the exception
5. No, that's not ominous
6. No, you don't need an EMG
7. Yes, you will be fine
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Re: Should I get an EMG ??

Postby J4son on March 4th, 2014, 12:49 pm

Not everybody had an EMG, Dave. A lot of people here did not. An EMG is a medical procedure; it should be performed if necessary. Only the doctor can decide if it’s necessary or not. I don’t think an EMG will ease any fear. When health anxiety is running its course no amount of EMG, reassurance, medical tests, Google search or Yoda wisdom is going to ease anything. How many people here had several EMG and then started doubting the results? Too early, needle not in the good muscle, technician not competent, EMG in limbs and what if it is bulbar etc.

I’m only 4 months post-twitching and I feel being 90% cured of the anxiety. I went to the neuro a week after the onset of my symptoms he said it’s benign and obviously exacerbated by Dr. Google and no need for an EMG. A month later I went back to the same neuro in a state of panic after experiencing some new symptoms and a hot-spot, he said still no need for an EMG but I will do one if it makes you sleep better but you will have to promise me that after the EMG you will stop seeing doctors for your twitching.

I came back home thought about the whole thing and decided to skip the EMG. First because an early EMG will not change the prognosis for ALS or MND. It makes me laugh when I read papers or doctors saying with a very serious tone that if twitching are accompanied by X or Y symptoms people should be cautious, seek medical advice and do regular check-ups and follow ups. LOL the damned thing is incurable, untreatable and always fatal so why all the cautiousness as if it was a malignant tumor than can be treated if discovered early :) And also because I knew that an EMG will reassure me for a short time, and anxiety, doubts and worries will come back. So I decided that unless I start experiencing true weakness, I will follow my neuro’s advice and skip the EMG.
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Re: Should I get an EMG ??

Postby RGB on March 4th, 2014, 6:21 pm

DaveCH wrote:GP told me there was no need to see a neuro but i insisted. Saw him 2 weeks ago he did a detailed clinical and told me I had BFS [...] I asked did I need an emg etc and he said no i was totally fine [...] should I have demanded one.


There's a theme developing here :)

I'll be blunt... listen to the experts rather than any of us, you'd be mad to do otherwise.

RGB
My history....Jan '13: Widespread Twitches. May 13': Unremarkable Neuro Exam. Jul '13: Clean EMG. Oct '13: BFS Diagnosis Today's Date: Twitching and Healthy!
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Re: Should I get an EMG ??

Postby Cobber on March 4th, 2014, 10:10 pm

If you just have random twitching and the docs/neuro say that you're fine then you really should trust them and not bother with an EMG.

I had an EMG because my left toe's don't work (literally they don't lift off the ground, haven't done for over a year), I have an atrophied left calf (confirmed at clinical) and 24/7 twitching for 14 months in the same calf. At the 5 month mark the neuro said I should have an EMG. Turns out I have a spinal stenosis and BFS. In this case the EMG and MRI were important.

However if you are only twitching and the docs say you're fine then you should trust them.

Note - Nobody should self diagnose atrophy. Everyone has different size body part shapes on the left and right side. Mine was very noticable though so it needed a medical opinion.

Additional note - Even though I have a small left calf and left toes that don't work I still jog and swim 3-4 times a week and feel fine. Just that I twitch all day long :)
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Re: Should I get an EMG ??

Postby DaveCH on March 5th, 2014, 4:30 am

RGB wrote:
DaveCH wrote:GP told me there was no need to see a neuro but i insisted. Saw him 2 weeks ago he did a detailed clinical and told me I had BFS [...] I asked did I need an emg etc and he said no i was totally fine [...] should I have demanded one.


There's a theme developing here :)

I'll be blunt... listen to the experts rather than any of us, you'd be mad to do otherwise.

RGB

RGB,

You are so right, I know that if i get an EMG it is just fuelling my anxiety and I have to listen to my Neuro. I know what I am like and one EMG won't be enough I need to deal with this anxiety asap plus I have been going private so it will be costly to get an EMG and my 10 year old son wants to go to on his school ski trip and the money would be better going towards that . As much as I have needed this site I do feel it's contributing to my obession over all this and I am going to try and take time out from it. The gym really helps me and I think any time I get anxious at home instead of lifting my phone and going onto google or here im going to put my boxing gloves on and beat the crap out of my punch bag lol. I have been reading books and I know one of the worse things is constantly seeking reassurance which fuels the anxiety.
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Re: Should I get an EMG ??

Postby UFGatorGuy20 on March 12th, 2014, 10:49 am

I think that we as a "BFS Community" are "over-EMG'd!" Clinical evaluations are as far as most of us should go. My neuro never brought up a nerve conduction study or EMG during my first 3 visits. But, during the 4th, I was the one that brought it up. I told her about my *LS fears, and my neuro told me that she could tell me with her eyes closed that I don't have *LS. Still, I asked for the EMG and she said it was up to me. I had the study done and every test she did showed up fine. She found "minimal" nerve issues with my right median and left ulnar. She felt like she was torturing me every time she would stick the needle in for the EMG. She was like, "are you sure you want me to continue?" She poked me everywhere in my upper extremities... even my upper back shoulders, and neck.

During and after I felt some anxiety relief. If my neuro had no concerns during and after the test, then I shouldn't! The day after I was SO sore. I couldn't believe it. That was about a week and a half ago and no joke... I think it sent my nerves on high alert because my aches and pains have been higher ever since.

If your doctors don't think you need the EMG, don't waste the time and $. I needed the objective evidence, but part of me wishes I just would've listened and passed it up.
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Re: Should I get an EMG ??

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