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trying again....and questions about EMG

Posted by Dona on 9/21/01 at 19:31 (061213)

I went back to the 2nd ortho dr this week. I go for an EMG for the right foot Monday morning to check the nerves. He said we would talk at the end of the week and decide where to go from there. Dr didn't think the mass at the arch was anything to worry about, although it does seem more swollen by the end of the evening. I didn't get around to telling him about my left foot....I've lost the feeling in the little toe but have no pain at all in the foot. This week, I've been getting tingles along the outer edge too. Hm. Is this ANOTHER form of TTS??? A coworker has put off TTS surgery due to concerns over the odds. She has no pain but loses the feeling in her foot if she wears the wrong shoes. I have so much pain in my foot, I can't remember what it was like to just...well, walk. Is it common also to have TTS with no pain? I'm a little nervous over the EMG, but what has to be done, has to be done. I'm hoping it's not as bad as the cortisone directly into the enflamed heel spur area....I'll need to be strapped down if it is. Even tho the dr isn't worried about the mass, will it affect the insertion of the needles for the EMG at all? Do they go into the inside arch area? Where DO they put them? Do they all go in at once or do they do a few areas at a time? About how long did it take, not including check-in? I'm planning on going back to work as soon as it's done...feasible, right? Gee....can you tell I'm nervous???
Thanks for any help.
Dona

Re: trying again....and questions about EMG

Chris M. on 9/21/01 at 20:43 (061217)

Hi. I just had my second EMG done yesterday, and so I thought I'd tell you what info I could. The whole thing for me took an hour. It started with the neurologist doing the needle insertion. The needles were very fine, and flexible, like accupuncture needles. Five or six were put in my left leg (all above ankle, but not above the knee), but not all at once. The doctor put the needle in and then asks you to flex your foot up and extended your foot, etc. Lastly, one needle was put in my left sacral area to check the sciatic nerve. The needle part probably took 10 mins. Then I went into another room and a someone did the shocking part. Both my right and left were done. It is done from the foot to slightly above the knee. They will take measurements of the your legs with tape measures You get shocked and your foot will move (like reflex action) the electric intensity is increased. All in all it doesn't hurt, it is highly annoying though. The only part that pained me was the needle to the sciatic, and maybe you wouldn't have that done, as my doctor was looking for a problem there. You should be able to return to work. I have had cortisone shots, and those were worse than the EMG.
Your other questions, I cannot shed any further light on. But I hope this information does help. I know how it is to feel like you don't know what is going on and what to expect.

Re: trying again....and questions about EMG

cindyp on 9/22/01 at 10:56 (061257)

I didn't have an emg. I did however have the surgery. I see no sense in suffering if you don't have to . Find the best foot and ankle reconstructive surgeon you can in your area. Talk to him honestly get all the tests you can mri emg whatever. then talk to him. My dr. said an 80-90% positive possibility. Don't suffer and don't be scared. It will be okay.

Re: and ANOTHER question about course of treatment....

Dona on 9/23/01 at 07:54 (061319)

Just considering all options before next week.... What usually happens after a positive EMG? How about a negative one when TTS is still suspected? If I'm adamant against any more coritsone shots (due to the experience of the last one), will that delay treatment? *IF* surgery is considered the next best option, is it feasible to put it off til December, at this point? And if so, is there anything that could be done to alleviate the pain until then? (I already take Vioxx.) Mentally, I'm ready for just about anything in order to get rid of this pain, but realistically, I need to wait til December if I'm going to be off my feet for any length of time. After surgery, is it possible to return to work on crutches after 2 weeks at home? (I'm a speech path in a preschool and could pretty much stay in one area and have the kids brought to me.) Between the heel spur and the TTS, it's been over 9 months since I could walk without considerable pain. Six months ago, I wasn't considering anywhere NEAR surgery, but now....if I need it, I'm ready.
Thanks for any information.
Dona

Re: trying again....Thanks, Chris

Dona on 9/23/01 at 08:01 (061322)

You're right. I always feel better when I know what's coming. I don't like going into a procedure blind. Your information was very helpful. Could you tell me: was your EMG positive, or do you know yet? My sister (an LPN) suspects that MAYBE, the discomfort/pain of the EMG depends on two things: 1) a person's pain tolerance, and 2)the amount of damage already incurred to the nerves tested. I wonder about #2...makes some sense that damaged nerves would be more susceptible to pain....or would it be that undamaged nerves would *feel* the pain better? I don't know. I guess I'll find out tomorrow.
Thanks, again.
Dona

Re: trying again....Thanks, Cindy

Dona on 9/23/01 at 08:05 (061323)

Yes, I'm ready for surgery, *IF* it's needed. I agree with you: suffering needlessly is for the birds. My coworker has refused surgery, but she has no pain, just numbness when she wears the *wrong* shoes. I'm not sure I'd elect surgery either if simply wearing proper-fitting shoes eliminated the symptoms. In my case, however, I'm heartily sick of the constant pain. I avoid stairs at all costs, even in my own house. Thank goodness I have children who can fetch and carry from downstairs. :)
Dona

Re: and ANOTHER question about course of treatment....

Chris M. on 9/23/01 at 13:41 (061337)

I read all the thread here. Let me see what I can add. I do not see why you couldn't wait til Dec. for your surgery. Two weeks post op and then going to work would be more or less OK, but not ideal. If you could sit with your foot elevated then maybe OK. You will be on crutches I feel pretty confident in saying that. Did you try orthotics in your shoes? I have heard some people say they weren't so helpful. They helped me immensely.

Yes, the EMG can be negative in tarsal and carpal tunnel, and the patient still has it. I understand that your nerve can be pressed enough to hurt but still allowing the impulse run across at a decent rate of speed. So the EMG isn't the gospel in diagnosis.

The EMG zapper thing was connected to a computer. At the end of the procedure it printed out the data and then the neuro came in and reviewed the results. I had this initially done in April for left tts. It showed a marginal result. I has surgery on 5/24/01. I just had another EMG done on 9/20/01 because of numbness over the top of the foot. Anyhow it is pretty clear now that my sciatic nerve on the left is the contributing factor.

The EMG really isn't bad. I don't like it, but I don't dread it. I prefer it over dental work! You don't even bleed when the needles are inserted.

When your coworker losses sensation with the wrong shoes, where on her foot is it going numb?

I know what you mean, tts was really ruining my life that I had to try surgery. I was 3.5 months post op before I could get my running shoes on my foot, from all the swelling. I was given too much optimism from the ortho who did it. I learn more from the neurologist. That neuro doctor told me running might be in my life around 4-6 months instead of the 6 weeks the surgeon said. The physical therapist agreed with the neurologist. I expected too much too fast. I am impatient and that didn't help any. I run 1.5 mile 3 days week, now and walk and lift weights. My life is a little better now because I have pain free portions of the day, and then I have the tts pain right up the tibial nerve. But at least I have some freedom from pain now. It is my understanding that nerve tissue is very slow in healing.

About the EMG question: If the nerve were irritated and slightly damaged then I would think the zapping would be extra painful. If the nerve had more severe damage then I would think the zapping would not be as noticeable. So both ways you posed it are true, just depends on how functional the nerve is. My EMG didn't hurt the tibial nerve any more than tts was hurting it. Some nerves are motor nerves and some are sensory, so that may contribute.

Good luck tomorrow

Re: and ANOTHER question about course of treatment....

kelly on 9/23/01 at 20:51 (061374)

chris, i have pain in my sciatic nerve from tts. i had surgery 9 months ago. what did they tell you about it. will it go away.

Re: and ANOTHER question about course of treatment....

Chris M. on 9/25/01 at 15:18 (061530)

The neurologist made no promise on it going away. All she said to me was to take the relafen for two months and do back exercises. She said that the emg/ncs result wasn't severe enough for the mri. I really don't want any more surgery so that is OK by me. I see her on 11/20 and we are to go from there. I am on the middle of the fence as far as sciatica being the root, as it just hit me in september, tts started may 2000.

They are fishing for an answer.

Re: trying again....and questions about EMG

Chris M. on 9/21/01 at 20:43 (061217)

Hi. I just had my second EMG done yesterday, and so I thought I'd tell you what info I could. The whole thing for me took an hour. It started with the neurologist doing the needle insertion. The needles were very fine, and flexible, like accupuncture needles. Five or six were put in my left leg (all above ankle, but not above the knee), but not all at once. The doctor put the needle in and then asks you to flex your foot up and extended your foot, etc. Lastly, one needle was put in my left sacral area to check the sciatic nerve. The needle part probably took 10 mins. Then I went into another room and a someone did the shocking part. Both my right and left were done. It is done from the foot to slightly above the knee. They will take measurements of the your legs with tape measures You get shocked and your foot will move (like reflex action) the electric intensity is increased. All in all it doesn't hurt, it is highly annoying though. The only part that pained me was the needle to the sciatic, and maybe you wouldn't have that done, as my doctor was looking for a problem there. You should be able to return to work. I have had cortisone shots, and those were worse than the EMG.
Your other questions, I cannot shed any further light on. But I hope this information does help. I know how it is to feel like you don't know what is going on and what to expect.

Re: trying again....and questions about EMG

cindyp on 9/22/01 at 10:56 (061257)

I didn't have an emg. I did however have the surgery. I see no sense in suffering if you don't have to . Find the best foot and ankle reconstructive surgeon you can in your area. Talk to him honestly get all the tests you can mri emg whatever. then talk to him. My dr. said an 80-90% positive possibility. Don't suffer and don't be scared. It will be okay.

Re: and ANOTHER question about course of treatment....

Dona on 9/23/01 at 07:54 (061319)

Just considering all options before next week.... What usually happens after a positive EMG? How about a negative one when TTS is still suspected? If I'm adamant against any more coritsone shots (due to the experience of the last one), will that delay treatment? *IF* surgery is considered the next best option, is it feasible to put it off til December, at this point? And if so, is there anything that could be done to alleviate the pain until then? (I already take Vioxx.) Mentally, I'm ready for just about anything in order to get rid of this pain, but realistically, I need to wait til December if I'm going to be off my feet for any length of time. After surgery, is it possible to return to work on crutches after 2 weeks at home? (I'm a speech path in a preschool and could pretty much stay in one area and have the kids brought to me.) Between the heel spur and the TTS, it's been over 9 months since I could walk without considerable pain. Six months ago, I wasn't considering anywhere NEAR surgery, but now....if I need it, I'm ready.
Thanks for any information.
Dona

Re: trying again....Thanks, Chris

Dona on 9/23/01 at 08:01 (061322)

You're right. I always feel better when I know what's coming. I don't like going into a procedure blind. Your information was very helpful. Could you tell me: was your EMG positive, or do you know yet? My sister (an LPN) suspects that MAYBE, the discomfort/pain of the EMG depends on two things: 1) a person's pain tolerance, and 2)the amount of damage already incurred to the nerves tested. I wonder about #2...makes some sense that damaged nerves would be more susceptible to pain....or would it be that undamaged nerves would *feel* the pain better? I don't know. I guess I'll find out tomorrow.
Thanks, again.
Dona

Re: trying again....Thanks, Cindy

Dona on 9/23/01 at 08:05 (061323)

Yes, I'm ready for surgery, *IF* it's needed. I agree with you: suffering needlessly is for the birds. My coworker has refused surgery, but she has no pain, just numbness when she wears the *wrong* shoes. I'm not sure I'd elect surgery either if simply wearing proper-fitting shoes eliminated the symptoms. In my case, however, I'm heartily sick of the constant pain. I avoid stairs at all costs, even in my own house. Thank goodness I have children who can fetch and carry from downstairs. :)
Dona

Re: and ANOTHER question about course of treatment....

Chris M. on 9/23/01 at 13:41 (061337)

I read all the thread here. Let me see what I can add. I do not see why you couldn't wait til Dec. for your surgery. Two weeks post op and then going to work would be more or less OK, but not ideal. If you could sit with your foot elevated then maybe OK. You will be on crutches I feel pretty confident in saying that. Did you try orthotics in your shoes? I have heard some people say they weren't so helpful. They helped me immensely.

Yes, the EMG can be negative in tarsal and carpal tunnel, and the patient still has it. I understand that your nerve can be pressed enough to hurt but still allowing the impulse run across at a decent rate of speed. So the EMG isn't the gospel in diagnosis.

The EMG zapper thing was connected to a computer. At the end of the procedure it printed out the data and then the neuro came in and reviewed the results. I had this initially done in April for left tts. It showed a marginal result. I has surgery on 5/24/01. I just had another EMG done on 9/20/01 because of numbness over the top of the foot. Anyhow it is pretty clear now that my sciatic nerve on the left is the contributing factor.

The EMG really isn't bad. I don't like it, but I don't dread it. I prefer it over dental work! You don't even bleed when the needles are inserted.

When your coworker losses sensation with the wrong shoes, where on her foot is it going numb?

I know what you mean, tts was really ruining my life that I had to try surgery. I was 3.5 months post op before I could get my running shoes on my foot, from all the swelling. I was given too much optimism from the ortho who did it. I learn more from the neurologist. That neuro doctor told me running might be in my life around 4-6 months instead of the 6 weeks the surgeon said. The physical therapist agreed with the neurologist. I expected too much too fast. I am impatient and that didn't help any. I run 1.5 mile 3 days week, now and walk and lift weights. My life is a little better now because I have pain free portions of the day, and then I have the tts pain right up the tibial nerve. But at least I have some freedom from pain now. It is my understanding that nerve tissue is very slow in healing.

About the EMG question: If the nerve were irritated and slightly damaged then I would think the zapping would be extra painful. If the nerve had more severe damage then I would think the zapping would not be as noticeable. So both ways you posed it are true, just depends on how functional the nerve is. My EMG didn't hurt the tibial nerve any more than tts was hurting it. Some nerves are motor nerves and some are sensory, so that may contribute.

Good luck tomorrow

Re: and ANOTHER question about course of treatment....

kelly on 9/23/01 at 20:51 (061374)

chris, i have pain in my sciatic nerve from tts. i had surgery 9 months ago. what did they tell you about it. will it go away.

Re: and ANOTHER question about course of treatment....

Chris M. on 9/25/01 at 15:18 (061530)

The neurologist made no promise on it going away. All she said to me was to take the relafen for two months and do back exercises. She said that the emg/ncs result wasn't severe enough for the mri. I really don't want any more surgery so that is OK by me. I see her on 11/20 and we are to go from there. I am on the middle of the fence as far as sciatica being the root, as it just hit me in september, tts started may 2000.

They are fishing for an answer.