EMG

PNMLT, EMG, SSEP, and other Nerve function testing.
The different techniques, results and opinions.
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A's Mommy
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Re: EMG

Post by A's Mommy »

Griff522 wrote:

What I want to do is continue with my PT for now, schedule a MRI with DR Potter and see what the results are. If there is no entrapment or problem and my current PT doesn't improve my pain, then I want to travel to Jerry Hesch. If there is entrapment and some kind of surgery is needed I would probably try to see Hibner. That's the plan I have been considering. Now I need to talk it over with my husband and get him onboard.
Griff,

I agree with Karyn that the MRI with Potter is a great idea. However, (and these are Dr Potter's own words to me) "the decision to have surgery should be based on clinical symptoms and not on MRI findings." So, it's a great idea to go have the MRI if it will lead you to seek out a PNE specialist, but I believe that clinical symptoms are most important, too. Then again, I'm not a doctor... they know best. Dr. Hibner is great and I'm glad he did my surgery. Now it's just up to God and time for the rest. You need to feel comfortable w/ what surgical approach you will take.

I applaud Karyn's decision to go to see Shobeiri even though he is new, because everyone was a "newbie" at one time. Dr. Hibner's first PNE surgery, on a gal named Ramona, was 100% successful. Shobeiri is a pelvic reconstructive surgeon and I'm sure he is up to date on all his training and knowledge of the PNE. Experience is good, but a surgeon's confidence in that area is paramount. I personally loved the idea of the neurowrap because after reading about it and it's use in plastic surgery, I felt more confident knowing that it at least helps prevent future scar adhesions. It may cost more, but who knows. I didn't get my bill yet and I hope I never do.... if I do get a bill we are going to find the medical director of our insurance company, hunt him down, and badger him till we get our way (LOL).

Good luck, Griff, and don't hesitate, make your appts sooner than later. You can always cancel.

With love,
A's Mommy
Daughter grew completely on left side of pelvis
Multiple uterine surgeries to fix uterine adhesions, septum, and endo
Had all the conservative workups done, 3Tesla (Potter), recovering from L sided TG (Hibner) 11/10, Botox 6/11 failed, bilateral anterior PNE decompression (distal Alcock's/perineal branch), Aszmann, Vienna, 10/11; dx'd with CRPS Type 2, 12/11, Ketamine @ CCF 2/12, doing 75% better PRAISE JESUS!
http://fighting-pne.blogspot.com
http://www.thepelvicmessenger.org
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Karyn
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Location: Lowell, MA

Re: EMG

Post by Karyn »

A's Mommy wrote:I applaud Karyn's decision to go to see Shobeiri even though he is new, because everyone was a "newbie" at one time.
Thanks for the support, AM! I guess this will be a learning experience one way or the other for all of us! I do know for a fact that Dr. S. uses the neurowrap, too. I'm pretty sure all TG surgeons (with the exception of Houston) use the neurowrap.
Love ya, AM! Mmmmwaaaaaaa!!!
Griff - what kind of improvements have you been experiencing with PT? Maybe you could start another thread under the PT topic ... we're getting off topic here ;) .
Warmest 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.
Griff522
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Joined: Sun Oct 10, 2010 7:42 pm
Location: Michigan

Re: EMG

Post by Griff522 »

A's Mommy,

What exactly do you mean by "clinical symptoms"?
Burning vulva pain began 10/09
Treated for SIJD 9/10 and burning stopped and pain localized to rt side
Surgery w/ Dr Dellon 5/11 - didn't help my pain
2012 - PT, massage therapy, and ART therapy from chiropractor
MRI showed labral tear and US of groin found hernias
2/13 - surgery for sports hernia
5/13 - still have obturator internus spasms
5/13 - appt with ortho spine dr
8/16/13 - Arthroscopic surgery to rt hip for FAI and torn labrum
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Violet M
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Re: EMG

Post by Violet M »

Linda, I'm not A's Mommy :lol: but in answer to your question about clinical symptoms that would be the things listed
on the symptoms page of the website http://pudendalhope.org/node/9:

The main symptom of pudendal neuralgia (PN) and pudendal nerve entrapment (PNE) is pain in one or more of the areas innervated by the pudendal nerve or one of its branches. These areas include the rectum, anus, urethra, perineum, and genital area. In women this includes the clitoris, mons pubis, vulva, lower 1/3 of the vagina, and labia. In men this includes the penis and scrotum. But often pain is referred to nearby areas in the pelvis. The symptoms can start suddenly or develop slowly over time. Typically pain gets worse as the day progresses and is worse with sitting. The pain can be on one or both sides and in any of the areas innervated by the pudendal nerve, depending on which nerve fibers and which nerve branches are affected. The skin in these areas may be hypersensitive to touch or pressure (hyperesthesia or allodynia).

Possible symptoms include burning, numbness, increased sensitivity, electric shock or stabbing pain, knife-like or aching pain, feeling of a lump or foreign body in the vagina or rectum, twisting or pinching, abnormal temperature sensations, constipation, pain and straining with bowel movements, straining or burning when urinating, painful intercourse, and sexual dysfunction – including uncomfortable arousal or the opposite problem, decreased sensation.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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quilter
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Re: EMG

Post by quilter »

Can anybody tell me which doctors in California are qualified to perform PNMLT or any of the other electrodiagnostic testing to rule in/out PN/PNE? My new pain mgmt physician would like to know (I was hoping he knew of someone I didn't, but he's looking for someone to help evaluate other patients). Thanks!
Acute left vag/rectal pain 1999 lowering into chair. Dx 2006 with PNE/VV by PTs, Dr. Garcia, Weiss, Hibner. Many shots. PNMLT: left PN barely fuctional. Left TIG by Dr. Hibner 2007 (ST lig). 75% improved 1 year postop, slow decline. Pelvic floor Botox 2010. Left sacral SCS 2011 after good trial; removed 2012 due to NEW left S2 & rectal pain, bowel freq. Re-do left TIG by Dr. H & 5-day ketamine 2013; 1-1/2 years postop 70% improved. New post-SCS Sx are worse than PN Sx.
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Violet M
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Re: EMG

Post by Violet M »

There are a couple of doctors on our list but there may be others we aren't aware of. Dr. Mann is in Northern CA and Dr. Jordan is in Southern CA. You can find their contact info here:

http://www.pudendalhope.org/node/58#CA
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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