How important is an EMG?

PNMLT, EMG, SSEP, and other Nerve function testing.
The different techniques, results and opinions.
shana
Posts: 121
Joined: Sun Mar 03, 2013 6:24 am

How important is an EMG?

Post by shana »

I have an appointment scheduled for July 22 with Dr. Conway, prior to seeing him he schedulded me for an EMG. How important is it to undergo an EMG? It sounds like it's extremely painful and not so reliable, so what's the point of it?
July is relatively far off, but I'm already stressing about it...

Shana
'08 diagnosed with vulvar vestibulitis
'09 vestibulectomy-Dr. Goldstein-failed
'11 right labral repair and release-Dr. Coleman
2/10-8/12 severe depression, minimal dr appointmen
4 different physical therapists '08-'12 no improvement whatsoever
'13 pudendal nerve blocks-Dr. Chapman
More PT
Dr. Conway officially diagnosed PN/PNE 7/13
9/13 Bilateral hip repair Dr. Coleman
10/13-5/14 Major Depression, no dr appointments
More PT
6/14 Dr. Hibner confirmed diagnosis
Looking for help..hoping for answers
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Karyn
Posts: 1655
Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: How important is an EMG?

Post by Karyn »

OMG!!!! I have an appointment 07/22 with Dr. Conway, too! I'm also having an EMG - but just for the obturator nerve.
I understand what you're saying about the efficiacy of the EMG. But it is part of his protocol. Personally, I wasn't comfortable enough signing up for surgery based on EMG results alone, so I went to NY for the Potter MRI. Both pieces of evidence were helpful with making my decision, along with taking into account all of the failed therapies I'd tried.
As far as it being painful is concerned, well ... I screamed through it. :oops: However, I know of others who didn't think it was a big deal at all. Hopefully, you'll fall into the latter category. ;)
Please let me know if there's anything I can do to help!
Kind regards,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
shana
Posts: 121
Joined: Sun Mar 03, 2013 6:24 am

Re: How important is an EMG?

Post by shana »

Thanx, Karyn

I do tend to handle pain pretty well but what people what are saying is really freeking me out! When I had the pudendal nerve block, the 2nd one I opted to forgo anesthesia and boy was it painful! I basically jumped off the table then buried my head into the table and bit my lip and got through it. Honestly, knowing myself and all the painful tests and exams I've been through I'll survive, but the anticipation of it is making me crazy. I tend to obsess and overthink and picture things in my mind and then when the time comes it's usually not as bad as I had though it would be, so I'm hoping for the best, but I'm still freeking out from it and dreading it.

I see u r 2 years post surgery, how's your recovery? Are you happy you did the surgery? Are you happy with the outcome?

Thanks,
Shana
'08 diagnosed with vulvar vestibulitis
'09 vestibulectomy-Dr. Goldstein-failed
'11 right labral repair and release-Dr. Coleman
2/10-8/12 severe depression, minimal dr appointmen
4 different physical therapists '08-'12 no improvement whatsoever
'13 pudendal nerve blocks-Dr. Chapman
More PT
Dr. Conway officially diagnosed PN/PNE 7/13
9/13 Bilateral hip repair Dr. Coleman
10/13-5/14 Major Depression, no dr appointments
More PT
6/14 Dr. Hibner confirmed diagnosis
Looking for help..hoping for answers
User avatar
Karyn
Posts: 1655
Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: How important is an EMG?

Post by Karyn »

Hi Shana,
Yes, I'm very happy I had the surgery. I don't regret it at all! :D
What have you heard about the EMG, other than my wimpy account? :oops: I understand stressing about the unknown, but maybe I can help alleviate some of your fears?
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
HerMajesty
Posts: 1134
Joined: Sat Sep 18, 2010 12:41 am
Location: North Las Vegas, Nevada

Re: How important is an EMG?

Post by HerMajesty »

I was in the "didn't really hurt much at all" category; it was just humiliating (I mean, I have had EMG's all over, and many are painless and not humiliating, I'm talking about the PNMLT)...but hey, I lost all my dignity and modesty a long time ago.
I didn't get the test done until I already had a surgical date and was fighting with my insurance, and it was EXTREMELY important in the insurance fight.
I'm not sure how accurate a test it is, but assuming accuracy I would say it's also indispensible as a diagnostic tool. before you make a commitment to a treatment you should have all the data possible to confirm correct diagnosis.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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Karyn
Posts: 1655
Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: How important is an EMG?

Post by Karyn »

Well said, Hermajesty! Thank you for pointing out the necessity of having justification to move forward with other procedures.
HerMajesty wrote: it was just humiliating (I mean, I have had EMG's all over, and many are painless and not humiliating, I'm talking about the PNMLT)...but hey, I lost all my dignity and modesty a long time ago.
Yup - I didn't have the PNMLT, but I can attest that the EMG is equally as humiliating! Thank goodness Dr. Winefield is so very nice and really tries to put you at ease during the procedure.
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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Amanda
Posts: 450
Joined: Thu Sep 02, 2010 2:33 pm
Location: Dublin, Ireland
Contact:

Re: How important is an EMG?

Post by Amanda »

I can only say that the EMG and PNMLT were equally humiliating, however once you have had a baby and had the relevant examinations this was a piece of cake although it hurt in a different area.
I tried to think of blue skies and calming seas while I had mine, deep breathing helped too!
The main thing is to concentrate on the result and hope that it will be positive.
PNE started 2003 following Vaginal Hysterectomy, pelvic floor repair and right oophorectomy; eventually after many tests had BilateralTG surgery Nantes 2004; following this tried many other treatments including 7 day epidural, ketamin infusions to no avail; Trialed and was implanted with a Neurostimulator in 2007- Dr Van Buyten Belgium, this has enabled me to manage my pain much better.
shana
Posts: 121
Joined: Sun Mar 03, 2013 6:24 am

Re: How important is an EMG?

Post by shana »

Thanks you all, I'm glad some of you are saying it wasn't such a terrible experience. I'm not really concerned about the humiliating part, I've been poked and prodded in every area and every inch of my body. At this stage of my journey I have no privacy, it's almost like I'm public property and my body belongs to my team of medical professional and is no longer sacred to myself and to my husband.

Karyn,
I'm very good at working myself up that by the time I get to my appointment to have the EMG done there's a good chance I'll be one huge mess, stressed, tense and nervous. They say it's best to be relaxed when the test is administered...how the hell is that going to happen? As I've said, I can handle pain pretty well, but once the procedure/test is over is usually more overwhelming for me than during the actual test. Right after the EMG I'm seeing Dr. Conway, I'm also stressing that I'll be an emotional wreck from the "trauma" of the experience of the EMG that I won't be in the right frame of mind to ask the proper questions and understand everything he has to say, and my husband is not much of a help in that area.

When I had the nerve block done without anesthesia the pain was abnormal, I've never felt so much pain as he was shoving the needle into my butt, it was excruciating!!! The whole thing lasted about 5 minutes from beginning to end, I didn't scream, I didn't yell through it, all I did was wince a little and bite my lip, but I didn't get over the "mental pain" of going through that experience until a day or two later. I guess that's what I'm most afraid of. I also have a 5 hour drive home afterwards so I'm not sure if the EMG is going to affect my pain level and make the trip even harder than it already is.

That's basically it,
Shana
'08 diagnosed with vulvar vestibulitis
'09 vestibulectomy-Dr. Goldstein-failed
'11 right labral repair and release-Dr. Coleman
2/10-8/12 severe depression, minimal dr appointmen
4 different physical therapists '08-'12 no improvement whatsoever
'13 pudendal nerve blocks-Dr. Chapman
More PT
Dr. Conway officially diagnosed PN/PNE 7/13
9/13 Bilateral hip repair Dr. Coleman
10/13-5/14 Major Depression, no dr appointments
More PT
6/14 Dr. Hibner confirmed diagnosis
Looking for help..hoping for answers
Designer1985
Posts: 6
Joined: Fri Jun 29, 2012 10:21 am

Re: How important is an EMG?

Post by Designer1985 »

Try Valium before the test to take the edge off being really nervous. I've had four spinal EmGs and they are a piece of cake compared to a pudendal or obturator EMG!!! :o
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Karyn
Posts: 1655
Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: How important is an EMG?

Post by Karyn »

Great suggestion, Designer! I wish I had thought of that when I had mine done. ;)
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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