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View Full Version : Need Advice on EMG While on Various Meds




millerfa
10-15-2009, 09:25 PM
Hi,

For the last few weeks I've noticed that the random tingling I get in the fingers of my right hand are no longer so random. It's definitely limited to my thumb, index finger, and middle finger. It now occurs day and night. It starts as tingling but progresses to total numbness, which takes 15 minutes of shaking to return the circulation/feeling. I have no trouble whatsoever picking up things/gripping things; it's just sometimes when I pick up something my thumb, index & middle fingers can't feel it, but they still grasp it correctly.

Today I had an EMG. I'm very needle-phobic. At 48 years old I've adjusted to things like having a shot or having blood withdrawn; but the thought of sticking a needle into my muscle in numerous places definitely upped my anxiety level. So this morning I called and asked if taking a Vicodin prior to the EMG would affect it in any way. While the nurse/receptionist/whoever assured me that it wasn't necessary, she also said it would NOT affect the test in any way. So, I took a Vicodin about 45 minutes prior to my appointment. I'm also taking the following prescription medications:
Advair
Cymbalta
Lisinopril
Prevacid
Simvastatin
Vivelle Dot (estrogen)
Wellbutrin

Well, the 1st guy comes in and does some kind of electrical conductivity test on me, using those adhesive things they use for EKGs, and something that shoots a volt of electricity where they apply it. So the guy tests, like, 2 places on my palm and says "Whoa, you definitely have carpal tunnel". He continued to test all over my right arm, then tested some on my left arm (because he said if you have it on your right you probably also have it on your left). After he was done the doctor came in to do the EMG.

I told the doctor how nervous I was regarding needles, and that I had taken a Vicodin ahead of time to calm my nerves. He questioned me about my degenerative arthritis in my neck, the symptoms I've been having, and a number of other things. When he was done he said I'd done so well that he might recommend a Vicodin to his other needle-phobic patients in the future (of course I only had Vicodin on hand because of some recent dental work). More importantly, when he was done he asked if I was trying to make the Guiness Book of World Records for the worst EMG score. He said I had lost about 80% of the use of one nerve (I think the median), and that they didn't get ANY response from my sensory nerve. He also said my left hand had lost about 50%. He showed me some numbers - which I can't completely remember because I was in a state of shock - but I remember one was supposed to be around 11 and mine was 2. He said if I didn't have surgery IMMEDIATELY for my right hand that there would be permanent nerve damage and I'd have numbness in my fingers for the rest of my life. He then asked if I'd like to know the surgeon he's going to use when he develops carpal tunnel, so I got his name and number.

I've only talked to a few people so far, but most of them immediately said "Get a second opinion". I feel like I already had a second opinion because there were two guys doing two different tests on me that came to the same conclusion. One co-worker said she had carpal tunnel and didn't have surgery until she could no longer hold a pencil; so she thinks mine is no where as bad as hers and the doctor is exaggerating. But she also said she has some permanent numbness and pain, and that they said if she didn't have the surgery she had they might have to lift/move the entire muscle in her arm. My doctor said I didn't have ANY muscle damage, but that the nerve damage was severe (actually, he said gargantuan - sp?). So I'm thinking maybe I didn't have the same symptoms because I don't have any muscle problems, just nerve damage :(

So here's my real question. Could the fact that I took Vicodin before the test, or any other of my numerous prescription medications, affect the outcome of the EMG? The doctor performing the EMG said no, and I believe him. But I want to hear about other people's experiences before I sign-up for surgery. So, do any of you know if Vicodin, or any of the other prescription drugs I listed above, would affect the results of an EMG?

Thanks in advance for any insight you can provide :)




(Broken Wings)
10-15-2009, 11:02 PM
Hi

Had 4 sets of EMG/NCVs. The two different testers are for a reason. One does the electrical impulse side (technician) and the other the neuro/nerve side (neurologist doctor) of your signal.

I've been on different meds at various times. No emphasis was ever placed on any reading being effected by any meds I was taking. I felt like they just inquired as standard procedure, not specific to their testing. No drugs were ever suggested to be withheld prior to testing.

On one set of tests, they used warms towels to heat up my muscles, I think to influence a more "normal" reading in some way, maybe specific to my conditions. Always wondered about that defense technique. They don't warm towels up for nothing. oh, well...

My first pain management doc suggested I take something for anxiety and pain, because I was exhibiting anxiety at the thoughts of another shock and poke traumatic event in my future (2nd set).

Some conditions are surgical. No other way to fix it. So if you're in that group, then I would get a second opinion. Definitely do your homework before laying down for surgery.

There's lots of successful carpal tunnel releases. Keep in touch and let us know how it's going. We all learn from each other.

sukadog
10-16-2009, 07:39 AM
I don't have any info, but wanted to say I'm glad you found this site. I'm sure everyone who sees this is hoping for the best for you! BTW- It's okay to ask friends to help out while you're going through this. Mine are actually glad when I say there's some small way they can help: like a ride to the doctor, or just coming over to watch a movie with me.

millerfa
10-16-2009, 08:00 AM
Thank you for reading my LENGTHY posting. I've never used a site like this, but as you can probably tell I was freaking out at the news. Now that I've calmed down (a little) I've decided to call back the neurologist's office and just make sure that he took all my medications into consideration. If he did, I really don't see a need for a second opinion because he's just going by readings from the test; I mean, it's pretty objective.

Anyway, I'll keep you posted and thanks again!

dance59326
10-16-2009, 09:12 AM
So here's my real question. Could the fact that I took Vicodin before the test, or any other of my numerous prescription medications, affect the outcome of the EMG? The doctor performing the EMG said no, and I believe him. But I want to hear about other people's experiences before I sign-up for surgery. So, do any of you know if Vicodin, or any of the other prescription drugs I listed above, would affect the results of an EMG?

Ok, I had many EMG's, I'm a young adult, but the results were odd. My case is undefined. Ironically, I'm not bugged by needles, blades, razors, electrical shocks, etc. I have a ridiculously high pain tolerance, but no one knows why. When I had my EMG and NCS, my technician told me that he worked on many strong-built and other strong and "tough" men and women, but with the rate of shock that he was administrating and speed, he was dumbfounded that I didn't get bothered, no crying, or tension. As far as the NCS goes, I didn't feel anything or know where my doctor was working with me. However, I had to get two sessions done because with my first doctor, he stated that he was not able to complete the test due to me not having enough strength to be in the different places and movements that he needed me to do. The second test that I had was with a different place and person. I got definite results with him and was he helped me with maintaining the positions. I would definitely say that you should get more different opinions. Many doctors have different views and opinions. You should look for doctors who "think out side of the box," logical thinking doctors, wise, and black-and-white doctors. Each doctor has a different opinion to offer and discuss different treatment options. I highly suggest that you talk with different doctors before you go into major surgery. Sorry, I forgot to let you know that meds will not affect your EMG test. I would check up on that though and look on Wikipedia, MayoClinic, etc. PM me if you want to talk into more details and support. Trust me, you're definitley not alone with this. I'm finally beginning to realize this myself.
Sending you hugs, wishes, and hope,
~dance59326

mrsD
10-16-2009, 10:43 AM
While I cannot comment on the drug/EMG issue, I would like to say something about your Carpal tunnel.

I had severe carpal tunnel when I was pregnant. Lost 80% of my functions too. Most returned after delivery. I did not have the surgery therefore. I still have some, but it is minor now.

Mine was caused by low thyroid functions. Undiagnosed low thyroid is a common cause of carpal and tarsal tunnel. This is because some tissue is made during low thyroid which compromises the spaces under the ligaments in the wrist and foot.

So I would make sure your TSH is 3 or below (new guidelines).

Fluid retention can also pinch this area.

And I am concerned about the simvastatin. Statin drugs can cause peripheral neuropathy, damage to the nerves. Your carpal tunnel may be a sign of this. Simvastatin is very fat soluble in that family of drugs (called lipophilic) and enters nerves more so than other statins (and the brain).
You can read more here:
http://www.communicationagents.com/chris/2006/05/16/statins_may_cause_nerve_damage.htm

So I would make sure you do not have a metabolic reason for the carpal tunnel, before deciding on surgery.

And this article may be helpful to you too:
http://www.sciencedaily.com/releases/2009/01/090127090735.htm

Jo*mar
10-16-2009, 12:07 PM
Also , have you had a recent MRI of the C & T spine?

What kind of work do you do?
Something that would bring on Carpal tunnel or any other RSI?
{ repetitive strain injury?}

Do you have neck & shoulder or upper back pain or muscle tightness?

Just asking as some causes could originate up here and the symptoms will show in the hands and then again you could have both carpal tunnel and secondary cause higher up?

Our Thoracic Outlet Syndrome { & RSI subforum} has more info about this- Our Useful Links - Websites, Articles & Polls -
http://neurotalk.psychcentral.com/thread84.html

I suggest a comprehensive evaluation by an advanced PT or possibly a expert chiropractor - I have found the good ones do a much more thorough job of evaluating the whole body while MDs seem to mainly focus on the place of the symptoms at the time of the appt.

Have you had any PT for the hands yet? wrist brace at night?


I was on lipitor {statin}and it did make my TOS/RSI symptoms worse - more muscle pain as well as cognitive issues.
Quit taking it and began to see improvement in both fronts.

There are other ways to bring down the chol #.
Our Vitamins, Nutrients, Herbs and Supplements forum -
http://neurotalk.psychcentral.com/forum49.html

azoyizes
10-17-2009, 11:31 AM
http://i489.photobucket.com/albums/rr258/azoyizes/373.jpg



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