Carpal tunnel syndrrome tests

hugz4u

Going Wed. for a  possible diagnosis of CTS in LE hand/arm.  One test is electromyography. Found out they insert a fine needle into your muscle. Would that be in my bad arm? Is this test necessary?

 Also another test that may be performed is turniquet test where they put an inflatable cuff, applying pressure over the median nerve to produce tingling.  There are other tests to be given but I would like to forgo these two. Don't they sound like a NO.NO?

Anyone versed in CTS. Mine is mild and comes on after typing 15 minutes. I splint at night. Seems worse since I started wearing sleeve and glove this summer 8 hours a day  and now trying to wear up to 12 hours a day. since just diagnosed a couple days ago with stage 2 (truncal too) after being in preventive mode for 6 years.  I really don't want surgery, any altenatives.  Please educate me. thx

kira66715

Hugs--the needles in the EMG hypothetically should be avoided--you can make the decision if you'll allow it--they insert them briefly and stimulate them, and you may want to consider prophylactic antibiotics for 2-3 days afterward (my LE therapist's rule, based on Dr. Robert Lerner who practiced LE medicine in NYC)

Now, the tourniquet test--that one is really problematic as the studies of carpal tunnel surgery on women with LE (sorry, I don't have the abstracts on hand), showed no serious increased LE if they limited tourniquet time, during surgery.

Both of these tests have a risk of 1) introducing infection and 2) worsening LE--but if the need for a test is crucial--are you considering surgery?--then you can consider taking a calculated risk. Also, you may ask the testing physician, how much they rely on the tourniquet test to make a decision reguarding treatment.

Also, if you don't want surgery, do you want to pursue these tests right now, as the conservative treatment is splints and maybe a cortisone shot?

Kira

hugz4u

Thank you for your reply. This will blow you away. So after reading your reply Kira I phoned the CTS clinic and and said "I can't take your electromyography test or the turnequet test because I have had breast cancer and I have Lymphedema." The girl then said, "Oh... if I were you I would take the tests as the doctor is going on holidays until April!." I then said, I don't care if he is going on hoilidays in April what other tests can he give me."  She then explained  other tests that he may give.   I am just going to chalk it up to ignorance.

Now that I have got past her it will be the Doctor nuerologist. that should be interesting as I have heard this doctor knows everything and the patient knows nothing,  I wonder if my glove and sleeve will hit a home run with the doc when he sees it, maybe  he will process that I have a LE problem.

I can't get into another doc as I have being waiting since sept (we're slow in canada)for this appointment and was taken on as a last minute cancelation. Fortunately my CTS is mild and if I wear night splint, lay off the keyboard quite a bit and am careful then I just have numbness and tingling.  Thanks for reminding me about anti-biotics. How about that cortisone shot when times get really bad.  Where do they inject it?

KS1

My physiatrist frequently does EMG studies on LE patients.  No antibiotics unless the person has a history of cellulitis.   Have had two done with no problems.  The procedure is considered a "clean" one, not a sterile one.    KS1

kira66715

Hugs--KS1 is the expert here on EMG's--so they can be done, and he just needs to know about your concerns about the tourniquet test.

Are you going to talk to the neurologist and discuss the risk/benefits of the testing.

The cortisone shot is in the area of the carpal tunnel--inside the wrist.

If you had to wait a long time, please don't cancel because of my post, but just have a dialogue with the testing doctor.

Please let us know how you make out

Kira

hugz4u

Thankyou so much girls, I will discuss my concerns on the tourniquet test. I just don't feel comfey on that one.

Also I will discuss what other tests/risks/benefits he does before he touches me. Because my hand has mild LE I am not sure about the electromyography test. I am scared.   Can you tell me how many punctures they do with that last test I mentioned and is it in my hand they puncture?

 KSI why is it called a "clean one , not  sterile one.  What do they do.  me dumb, dumb on this,  Don't worry I won't cancel the appointment. I will be just very careful.

kira66715

Hugs, I've had an EMG in my leg and they put tiny needles into my muscles--they cleaned the skin and used sterile needles, but it's not like being in a sterile operating room--and then put electricity in the needles and made the muscle twitch. There's a part of the test that just has electrodes, no needles. It wasn't fun, but it wasn't horrible.

Kira

hugz4u

So someone at the doc office must have got wind that I was not favoring an EMG as I made it clear.  They gave me the Electrode stimulation test (eeg?) Guess what. NO CTS!

 Now that I have that ruled out, maybe since I have been in my sleeves daily for at least 8 hours since last summer I wonder if it is my sleeve/glove pressing on one of my very bad tennis/golfer elbow nerves. Or since I have been recently moved to stage 2 maybe the LE swelling is pressing on the nerves. I know my night splint helps but typing  next day is baaad. Just stabbing a guess here.

Nuerologist did some tests pushing on my neck as I told him I fell 2 stairs last april and whip lashed my spine, including neck. He thinks maybe It may be affecting my arms.  So he is sending me for a MRI which will take about 4-6 months to get into (Canada has long wait times, Glad I am not dying in  major pain waiting like other poor souls) It will be a neck MRI and maybe to include the shoulder,

So here we go again. Where are those needles with the dye placed? I have arm/truncal Le.

I heard this doc was moody and allowed no room for discussion but I was impressed that I snuck a LE enlightment in. I must have played my cards right. He saw my sleeve/glove and I said it was Lymphedema.  He was preplexed that I got it a few years after my Dble masectomy. He made it known to me that you get LE the day of your surgery, immediately your arm swells! I was so pleased to tell him that you can contract LE up to at least 25 years after surgery. He looked at me like I was unreal but didi accept the facts. By gosh I think I have educated the educated!

Thank you girls. no one else but this forum would understand this garbly goo. 

carol57

Hugz, 'I think I have educated the educated!' is a spectacular way of putting it!  Chuckling here about that.  Best wishes as you continue to navigate the LE problems, including that MRI wait.

BeckySharp

Hugs--I don't think there are any better educated in LE than all of the gals on this forum!

Binney4

Hugs to you Hugz! Really good job both protecting yourself and "educating the educated." (Love it!) That's what it takes, for sure!

Last MRI I had I called ahead and warned them I needed the dye in the foot and they scheduled it for when the right person was there. If you only had surgery on one side you can use the opposite arm.

Do you have the same problem when you wrap your arm as when you're wearing sleeves? It might be possible to experiment a bit with some foam padding and see if that relieves the pain. That would tell you a lot.

Keep us posted, please,
Binney

hugz4u

   So, I found out it is a neck/thoracix MRI. I am confused.  Can they put dye in my foot for my Neck/thoracix MRI?  Me dumb ,dumb again! 

 I had a bilateral mast. with nodes taken out of the LE side but I am aware that I can get LE in both sides and make careful decisions.

Binney- I don't wrap, my MLD girl has not given me this in my bag of tricks yet. I should probably make  a date with my self on a fri night and learn how just in case.  So should I try  to sneek some artiflex foam in my  juzo sleeve as a pain releiver and where would I put it? Big thanx

Binney4

Hi, Hugz,

I had a head/neck MRI with the dye injected into my foot. And she was so good at it I wanted to hug her!

You definitely need wrapping as a tool you can use! Artiflex probably isn't as effective as thin foam, and your therapist would need to figure out where to put it. An experienced therapist can cut a foam piece to fit your needs and show you how to use it. Or, depending on the location, a Swell Spot or chip bag (same thing, only a chip bag is homemade) can really help ease unwanted pressure and pain. Worth a try, so do ask your therapist for help figuring it out.

Be well!
Binney

hugz4u

Thank you Binney.

I have a palm swell spot that I don't use.  I am going to experiment with it although it might not be big enough. I don't see MLD for a couple weeks and will ask her about trying foam, etc and wrapping education.  Now that I am offically off the board as a lurker and a participater I am really enjoying these boards but... I can feel my hand starting to tingle.  I'll rest up abit.

I will definaltely be calling MRI dept once they issue my appointment and request this. foot method. I know this could be a challenge for some professionals. If I get flack,I am going to pull this out of my hat.  "So mamm or sir, I wondering what you do when you have a double arm amputee come in for their MRI?"  Gotta love it, huh!