"Nerve Conduction Torture, Er, Test" by Troy H. Cheek on Dec 06, 2004

Okay, folks, I promise this is the last medical update for a while. Next week we'll be back to the usual mix of humor, parody, and sarcasm which is my life.

For those tuning in late, the recap is that I went to my regular doctor because I was getting some numbness and tingling in my right hand. He poked and prodded and sent me to a hand specialist. The hand specialist poked and prodded and sent me to a nerve guy to get some testing done.

Last Wednesday at the undogly hour of 8:30 am, I received the first in what promises to be a long series of nerve conduction tests. Of course, the hand specialist didn't say it was the first in a long series of nerve conduction tests. He simply sent me in for a (one, uno, singular) nerve conduction test "just to see how bad the damage is." And, according to him, I only need the one.

However, I've played this game before. There are more tests coming. Just wait.

You see, he's already put me on medication for the tingling and numbness in my hand. He's also given me some annoying splints to wear when I sleep. The medication is supposed to reduce inflammation and the splints keep me from bending my elbows, both of which are supposed to reduce pressure on the ulnar nerve which is the source of my problem. And, in fact, they have helped a bit.

Therein lies the rub. I'll go back to see the hand specialist in a couple of weeks. By then, he should have the results of the nerve conduction test. He will also ask me how the hand is doing. I will tell him quite honestly that I've seen a slight improvement since we started medication and the splints. The specialist will then look thoughtful, thumb through my medical chart, and tell me that since my condition has changed, we probably need another nerve conduction test so we can quantitatively determine by exactly how much my condition is changed since the last test.

If my condition gets worse or simply fails to improve as fast as he expects between one office visit and the next, he will order more tests to see how bad I'm getting. If he decides that I need surgery to correct my nerve misalignment, I'll of course need some testing to determine exactly the extent of the damage just before the surgery, then periodic testing after the surgery to assure everyone that they re-routed the correct nerve.

I've been through this with half a dozen other conditions over the years. It's gotten to the point where I could probably write my own test orders and just have the doctors fill in the date and time.

This was, as I mentioned before, my first nerve conduction test, so I had no idea what to expect. Well, I take that back. I knew to expect tons of paperwork, since I'd never been to that testing center before. And I wasn't disappointed. The nice young lady at the desk shoved a clipboard full of forms at me, which I filled out pretty quickly right there at the desk, the forms not asking me any questions I hadn't already answered a thousand times before. I asked what else I needed to do, and was told that was it and I could just take a seat until the doctor was ready for me.

A half hour later, a different nice young lady called me to the desk and shoved a clipboard full of forms at me. I filled these out as well. I asked what else I needed to do, and was told that was it and I could just take a seat until the doctor was ready for me.

Another half hour later, yet another nice young lady called me to the desk. She had only a single form. Emergency contact information.

"Emergency contact information?"

"Yes, sir. So we know who to contact in the event of, well, you know, an emergency."

"Exactly how many emergencies have you had during nerve conduction tests, anyway?"

She didn't think that was funny.

I didn't think that was a joke.

I jotted down the name and phone number of an ex-girlfriend whom I thought my find it amusing to hear that I'd died in a freak nerve conduction accident. I asked what else I needed to do, and was told that was it and I could just take a seat until the doctor was ready for me.

Yet another half hour later, I was told the doctor would see me now and yet another nice young lady asked me to follow her to...

Another waiting room. At least I had this one to myself. And the TV wasn't locked so I was able to watch anything I wanted, as long as it was something that could be picked up on a rabbit ear antenna. Well, half a set of rabbit ears. Sesame Street is brought to you by the letter R, the number 3, and the horrific screams of the man being tested in the next room over.

You'd think they would invest in soundproofing or something.

I waited another half hour. I estimated that, given that winter was fast approaching, it was getting dark about now. I couldn't remember if I had changed that blown headlight in my truck.

One of the previous nice young ladies came back, asked me to stop fiddling with the antenna, and had me follow her to the testing room. There, I finally laid eyes on this mythical nerve guy. I knew immediately that he had a sense of humor because he asked me to remove my coat and then offered to shake hands just as I got both arms trapped behind me in the sleeves.

I was bid to sit down, get comfortable, and be assured that the test was not the least bit painful or dangerous.

Oh, and rest your arm here on this bloody towel.

The first part of the test wasn't that bad. After properly grounding me and hooking up the test leads, he turned a couple of dials for a while until he had properly compensated for my weird electrical field. This is the reason, incidentally, that I don't wear a wristwatch. I get tired of having the change the batteries every two weeks.

Once he had zeroed out his equipment, the fun began. He used a stungun-looking thing to send jolts of electricity into my arm while the computer recorded the strength and speed of the nerve impulses. This wasn't too bad, painwise. It felt like brushing up against a medium-strength electric fence...

30 or 40 times...

for each arm.

The shock wasn't as bad as watching the nerve guy at work. The stungun had a little control wheel which was used to fine tune the amperage. This apparently reset to a default amperage between each series of tests. So, every time he moved to a new location on my arm, he started off at the default and had to wheel up a bit at a time until he reached the maximum, at which time he finally received satisfactory results and picked a new location. Eventually, he started cranking her up to full power right away. This caused some really interesting spasms when he hit a nerve dead on. (Or, at least, that's what I assumed was happening.)

The nerve guy also had a little measuring tape and kept measuring and re-measuring the distance from the test leads to the shock site. Then he'd mumble "No, that's the right distance."

Finally, he peeled off the test leads and made to get up. "No, just one more little test. We need to take some direct readings from inside the affected muscles."

"How are you going to get readings from inside the muscles with those stick-on test leads?" I started to ask.

Then I saw the needle.

And if you think "take some direct readings from inside the affected muscles" translates as "we're going to stick inch-and-a-half needles into a dozen of the most sensitive parts of your hands," you won't be too far off.

"This lets us actually hear the nerves telling the muscle cells to fire. Soft clicking means normal impulses, while cracking and popping indicates nerve damage. Now, don't be alarmed by what you hear. A little cracking and popping is normal even in healthy nerves. Now, try to open your fingers against the pressure of my hand."

I tried. A sound much like bacon frying came out of the speakers. Being forwarned, I wasn't alarmed.

The nerve guy, on the other hand, broke out his measuring tape again.

As I walked out, I saw that the whole thing only took 50 minutes. I was certain that by that point it was a day and a half.

The verdict? Moderate ulnar neuropathy in the right arm and mild ulnar neuropathy in the left. I also have mild carpel tunnel in the right (like this is news). Exactly what all this means and where it's going to take me, the nerve guy couldn't tell me. That would be up to the hand specialist which I'm going to see again in about two weeks.

Which gives you two weeks of non-medical articles. Enjoy!

Copyright 2004 by Troy H. Cheek. Reprint with prior written permission only. Comments and questions to $mail:theview$