The Brachial plexus Chronicles #2 – 3 weeks later – C7 returns

[continuing the saga of what happened after my mastectomy, when I woke up from surgery to find that my left arm was paralysed.  I apologise if this seems like wallowing in the experience, but I’m writing this partly as therapy, and also for any other poor bugger who has to go through what I did.  I remember hunting on the internet for similar experiences, to discover there was nothing.  This was totally outside the realm of most mastectomy patients.  Hopefully anyone going through the same will walk with me and know what to expect and know you are not alone!]

Electromyography without the Sound Effects. photo credit: faithmedical.com

Three weeks after the mastectomy, I had to go back to the hospital for another electromyography (EMG), a type of muscle test.

A needle is inserted through the skin into the muscle tissue.  This needle is connected to an oscilloscope that measures the activity of the nerve.

On this second visit, I asked to see the results from the test conducted two days after the mastectomy.  For some reason, although I had asked (and so had the physiotherapist), the results were not made available which made me very suspicious.

When I saw the report, I knew why:  the results showed no muscle activity in the arm at all.  I would probably have freaked out had I seen them.  The only way there could have been less muscle activity is if I’d been dead.

Having been through one test, I now knew what to expect in terms of pain.

Here’s what one internet site has to say about the test:

http://www.medicinenet.com/electromyogram/page2.htm#6doesan

“Does an EMG hurt?

Yes. There is some discomfort at the time the needle electrodes are inserted. They feel like shots (intramuscular injections), although nothing is injected during an EMG. Afterwards, the muscle may feel a little sore for up to a few days.”

The heading should have been warning enough.

Discomfort?

That’s an understatement and the writer has obviously never had to have an EMG.

Discomfort like an intramuscular injection?  I’ve had intramuscular injections, and if the pain of an IM injection is a 7 on a scale of 1-10, then the EMG was a 20.

[and isn’t it funny how doctors always say, prior to inserting a needle:  “you’ll feel a little prick/scratch”.  Little?]

The needle itself wasn’t very large or very long.  It’s a fine needle about 2 cm in length, like an acupuncture needle.  Only a portion of the needle gets inserted.

However, what elevated this procedure to the heights of torture is that whenever the neurophysiologist did not get a response from one of my muscles, he would wriggle the needle around, or move it to another position.

The pain was sudden, unexpected and uncontrollable.

The most exquisite moment was when he stuck it in the back of my shoulder and told me to contract the muscle, and then moved the needle.  It felt like white-hot fire and I had to just sit there and let him do whatever he had to do in the name of medical testing.

There was a nurse chaperone in the room and she offered to hold my hand.  I refused because I would have squeezed her hand to death.  Instead I sat there panting with the pain, tears running down my cheeks.

Hell is a 24/7 EMG.

The good news was:  there was some return of muscle function.  My triceps [the muscle at the back of the arm] was showing signs of coming back.  C7 had come back – whoopee!

I could have told the neurophysiologist C7 was back without having to go through the agony of an EMG:  Earlier that week, I’d taken my arm out of the sling, and it had felt less “dead” and heavy.

(It’s not surprising really:  my left arm probably weighed about 6 lb.  That’s about 2 bags of sugar.  Imagine carrying two bags of sugar around in a sling and it’s no wonder my shoulder was aching.

C7 coming alive meant there was now a muscle supporting the back of the arm and my shoulder wasn’t bearing so much of the arm’s weight.  It’s strange, isn’t it, how we take for granted what our bodies do so automatically and naturally, everything works together as a beautiful whole.)

In a fit of gratitude, I actually thanked the neurophysiologist for the test and said that I hoped to see him in the future.

“It has been a pleasure, I shall look forward to it,” he said with the elegant courtesy and gentle tones I understand is the hallmark of the best torturers in history.

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