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really worried about tests (Read 8728 times)
rosekay
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really worried about tests
Aug 16th, 2007, 10:48am
 
Just when I think I'm all sorted out and calm..........
Last week I saw a neurologist about muscle twitches.  He said he wasnt worried about intermittent twitches like I was having - fine, ok, I was happy about that.  Then he did some reflex tests, and on one, when he moved my ankle some strange way, the bottom half of that leg went uncontrollable juddery, really really weird.  He said it would have to be investigated, and it was probably due to some nerve irritation.  He said he would arrange an MRI scan.  Ok.
This week I suddenly got a letter for an appointment to test my nerves and muscles on Sept 5th  I wasn't expecting that test.  I phoned the hospital today to try to rearrange the date so my husband could come with me, and in the conversation I was told that the doctor had me marked as 'urgent' in her appointment book - now I am just terrified.  I really am worried about it.  Naturally I didn't change the appointment, but I am a nervous wreck.  Please, RLR or anyone - can you help me control this panic?
Rose
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saab
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Re: really worried about tests
Reply #1 - Aug 16th, 2007, 12:54pm
 
Sorry to hear things are not too good at the moment. It may well be that the doctor has marked your appointment 'urgent' as a response to your anxiety rather than because there is something wrong. Even if you haven't told her about your anxiety it will probably be in your notes.
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rosekay
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Re: really worried about tests
Reply #2 - Aug 20th, 2007, 7:10am
 
Hi and thanks saab for your message.  I found out the juddering is called clonus - and made the mistake of looking on the web for info about it.  Big mistake.  It says it's always significant, and talks about things like MS, MND and brain tumours.  Now I'm worse off than ever.  Feeling I'm at the end of my tether with all this - and still have to wait till sep 5 for the appointment.  Feel really bad.
rosekay
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RLR
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Re: really worried about tests
Reply #3 - Aug 20th, 2007, 7:51am
 
Okay Rosekay, you need to calm down and take a breath. One of the worst assumptions that persons can make is over-emphasizing specific aspects of a neurological examination. In fact, many physicians not trained in neurology are sometimes guilty of making the same error.

Here's a general rule that is steadfast in the world of neurology. Neurological signs are significant by the company they keep. In other words, a sign of clonus(and I would want to know whether this clonus was sustained or non-sustained and either unilateral or bilateral) would not really ruffle my feathers unless it was accompanied by other neurological signs in some combination such as increased tone, changes in vision, changes in voice( a type of nasal quality accompanied by thick-tongued speech), episodes of choking or difficulty swallowing, muscular atrophy, unexplained anxiety or restlessness, changes in personality (for the better strangely enough when cited by family members) and supporting diagnostic tests like an electromyography. Your age at onset of first symptoms would also be important. So a lot of symptoms need to be presented in concert for it to become significant. I've seen non-sustained clonus in otherwise healthy individuals and in cases where spinal injuries such as a disc problem are present. So by itself, clonus is not all that remarkable.

If the muscle twitches you are experiencing are instead something known as fasciculations, then it would be of significance with regard to the clonus sign. Fasciculations can appear under two conditions, either spontaneous or demonstrated on percussion. In other words, spontaneous fasciculations appear typically on the extremeties and when examining the outer skin's surface, they sort of appear at random places along the line of muscle groups. If not present, a reflex hammer can be used to tap the surface of the skin and elicit the fasciculations. When the skin's surface is tapped, the fasciculations begin appearing afterward and fade over a period of a few seconds or more.

Fasciculations are an indication that communication between the nervous system and muscle tissue is being disrupted for some reason. Again, this is not to say you have fasciculations, only that they can sometimes be confused with mere muscle twitches of a non-significant variety.

What's important here is for you to take a breath and relax. Clonus can arise for many reasons and your neurologist is simply following through with diagnostic tests to rule out certain diseases and disorders. At this point, it's entirely too early to make assumptions, particularly those that bring about unrest.  

If you obtain test results and wish to share them, I'll be glad to discuss them with you and we can talk about implications. I'm sure, however, that your neurologist will do so at some point. Again, try to relax and for the time being, I'd stay clear of reading too much into this for now.

Best regards and Good Health

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rosekay
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Re: really worried about tests
Reply #4 - Aug 20th, 2007, 10:28am
 
For RLR - many thanks.  You have really helped me sort my head out - again.  I couldn't see beyond the 'urgent' label and the horrors on the web, but am feeling so much easier in my mind now.  The neurologist said he wasn't worried about intermittent twitches like mine, and he saw no evidence of them on exam.  Don't know about the sustained/non sustained thing, but am determined not to start fretting!
I feel so much happier now - I was dreading having to get through the next couple of weeks just worrying all the time.  Whenever I start to worry, I will re read your reply and I am sure it will help.
Thank you very much
Rosekay
ps I am 46 - old enough to know better!!   Grin  Kiss
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rosekay
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Re: really worried about tests
Reply #5 - Sep 6th, 2007, 5:34am
 
Dear RLR
Well, I managed to survive the wait for the test without having a nervous breakdown, with your help!  Sincere thanks.
Had the test yesterday - not sure what it was actually called but it involved sticky pads and electric shocks for the reflexes and needles and wires (twice in each arm and leg, yuk!) to let her listen to the muscles working, and all was normal and well.  I have an MRI scan on the 18th of this month, and am looking forward to hopefully having a clearer idea of what if anything is going on.  And I am NOT intending on looking for any more information on google!!   Grin
All the best and thanks again for your help and common sense approach!
Rosekay
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saab
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Re: really worried about tests
Reply #6 - Sep 6th, 2007, 2:48pm
 
I'm glad the test went well. Best wishes for the MRI scan.
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rosekay
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Re: really worried about tests
Reply #7 - Oct 11th, 2007, 10:59am
 
Hi again
Well I had the tests - and now I've had the MRI scan.  Just had a letter from the consultant, who says everything has shown clear and normal, apart from very slight wear and tear .  He said that means there is no reason showing for my limb symptoms - the clonus.  He will see me again for review in the coming months.  So, all the panic for nothing.  Again!  Perhaps I'll learn a lesson from it!  Thank you so much for all the help, and I really will try not to panic so much..........can't guarantee it though!
love
rosekay   Grin
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RLR
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Re: really worried about tests
Reply #8 - Oct 11th, 2007, 11:59am
 
Well, that doesn't really come as a surprise to me . . .. . Smiley

I'm sure it is a relief to you, however, and indeed should serve as excellent groundwork for learning to establish appropriate levels of concern based upon facts at hand.

As I discussed earlier, clonus and other neurological signs really don't mean all that much by themselves, but more accurately are diagnostic based upon their presence with other neurological signs and other clinical test results. Physicians not properly trained to interpret such signs in this way are typically likely to hold them as singularly diagnostic and it has been known to establish a great deal of worry and discomfort among patients until proper testing rules out serious conditions or diseases.

So you've got a clean bill of health. Use your husband's credit card and go buy a new outfit and have lunch with the girls. You've got your whole life ahead of you.

Incidentally, the test you refer to with the needles that likely produced some discomfort during the procedure is known as an EMG or electromyelogram. It tests the various muscle tissues for signs that nerve conduction to tissues may be breaking down. In your case, however, the test was obviously negative.  

Best regards and Good Health
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