Health Anxiety: MND Specialist Visit

[EnlgishBirder]

As you may know from my posts i have HUGE health anxiety. I went to see a well respected MND specialist (I live in the UK) about my twitches - especially the fact it currently seems to be more in my left leg. It feels tighter and I am getting some achiness in my calf but I also think it feels as if its coming from my back. Anyhow, the chap did a full neuro which came back absolutely normal including all reflexes, and he said no need to do an EMG. He said i was twitching due to anxiety, possibly the medication (escitalopram) and the fact that I'm quite a hyper person - I have hyper excitable nerves at the moment.I kind of agreed with him because of my HA and if I'm to get better i need to stop having checks and procedures but everything i read on the Internet says the EMG is the holy grail and people should have that to rule out ALS. Should I go back and have one done? I've heard it's painful. Should I be reassured by the neurologist that he does not think it necessary?I also got paranoid because he gave me his card! Why would he do that?Thanks

 

[garymills]

since you have been examined by a qualified neuro who has said you don't need an emg, you can rest assured that you don't need one. neuros can see issues in the clinical exam that cause them to order an emg, be confident in the fact that yours didn't. here in the u.s., i personally believe most neuros order emgs to alleviate our anxiety (and perhaps to pay for their car payment) and not because they suspect anything is going on with us. take care,gary

 

[Gracer]

Hi dear,I give my cards to everybody I meet (even to my home repair workers) which does not mean I expect they would need some technical translation which is my job))this is just in case. for info etc.as for EMG as a way to clear out ALS, there are different approaches among the doctors because doctors also are different (less nervous and more nervous).practically, if you have clear clinical exam, there is no need for EMG for you. Most of our fellows who pave passed clinical exam with good results have normal EMG or EMG with minor deviations which are not suggestive regarding any MND. There are many fellows here who never had EMG.In your condition, with clear symptoms of HA, there is no need to rule out ALS because your symptoms rule it out pretty well, as they match anxiety disorder by all points in the checklist and do not match ALS in main checklist point which is clinical weakness plus specific reflexes change.

 

[MarioMasher]

There are a lot of people here who have never had an EMG. I've never had one.

 

[EnlgishBirder]

Ok thanks - that makes me feel miles better. I also keep thinking he wouldn't put his reputation at stake by not doing one because he thought i was a nut job anxiety case. Surely if he thought there was a problem clinically he would have recommended one? He spent ages watching my calves and my left leg and said his eyes were as good as doing an EMG. He saw some fasiculations and I kept telling him i was about to twitch and then it happened! He just laughed and said not an issue.Thanks

 

[flyboy101]

While an EMG may at times sound like the last piece of the puzzle you need to move on, it usually is not that way. You can see from numerous people on here that they have had an EMG only to still be worried. Then comes the numerous other EMG's that follow and still the same result. I have had 1 EMG. Completely normal, yet here I am like so many others. Unless my doctor tells me I need an EMG, I'm not pushing for another one. It was a very stressful period going through all that and I know it won't do me any good. As my first flight surgeon told me when I requested my EMG: "Just be aware that the more digging we do, the more likely to find some sort of abnormality." His point wasn't that this was ever anything serious, he was never worried. His point was that other things may pop up. Imagine this, you get an EMG because YOU wanted it, not your doctor, and then there are some abnormal findings yet your neuro tells you it's nothing serious. You really think that would ease your worries??? Take the recommendation of your well qualified doctor for what it's worth.....you are absolutley fine. Enjoy your Friday!!!Cheers,Michael

 

[GlowGreen]

You don't need one to be in the clear (neurologists are smart people) so the only issue is whether you would find it reassuring. I am a scientist so I like the idea of an objective test, but that is more to do with me than anything else. I would recommend though, if you do get one, not to get into the detail of the results. If it is clean then it is clean, any imperfections are because we are imperfect (and more so each year!), leave them to the experts to interpret.I had one (not that I was given the choice) and I can honestly say that it was pain-free. The NHS uses "discomfort" as a code-word for "pain" but in this case it is an entirely accurate description. The NCV feels weird, not painful, and the EMG itself is like acupuncture, not torture.GlowGreenPS They only give cards to healthy people, the last thing they need is ill people having their contact details

 

[JohnnyRocket]

You have BFS symptoms and anxiety like the thousands here that have come before you. Most all of them have been to a neuro, and some have had EMG's....some haven't. The one thing we ALL have in common is that NONE of us had ALS. So what exactly was the purpose of our EMG's? Were they really needed to confirm what has always been true?Don't waste your time.

 

[EnlgishBirder]

Thanks for all your replies. I think that I need to NOT have one at this time. I do agree that the more you start digging the more it can up the anxiety. I did that when I thought I had bowel cancer last year. The mri picked up a problem with my ovary. When I was initially scanned the sonographer told me that as what was there was solid (ie not a clear cyst) it was most likely cancer, but she knows lots of ten year survivors (!!!!) This was a Friday night. I had the weekend of hell imagining the worst, went to see a top prof the next week who confirmed it was not cancer but a benign tumour. I also discovered i have a mitral valve prolapse with regurgitation when I thought I was dying of a heart attack (panic attack) and spent ages coming to terms with that!Hard to believe that 2 years ago i was someone who never went to the GP and never thought about my health.

 

[Gracer]

oh if you are hypermobile, then MVP is very frequent for us and sometimes it may create some troubles but usually not. Practically MVP started to be found in rather majority of people and is considered as somewhat physiological variation.well, our age is a certain danger, it is a new period of life and when I entered my 40s, my mom had warned me that I would be ruin for a while and then will get much much better. She seems to be 100 % right however I still feel myself in a ruin period but getting really better.