Saturday, September 24, 2016

A "shocking" morning.......


I never had much to do with nerves, so to speak. Idiomatically or literally speaking.

I cannot recall anyone shaking their head in anger and saying,  "My God, she has the nerve ...."  or anything like that. Being nervous and showing it was not usually an option, and the thing to do was to always get on with what one was doing and look ahead.

So why suddenly this conversation about nerves ?  Because someone decided my nerves were possibly misbehaving, and recommended tests. 

Given that all kinds of medical diagnostic procedures were introduced during my adult life, I have had an interesting time doing things like ultrasonography, mammography,  smear tests, and MRI's. And later blogged about it. Like the MRI's.

Technologies have since gone through versions .  While the technology is impressive  in instrumentation, size and capability,  one has things to say about preparations for the same.  I mean , ultrasound science shows you pictures of your internal tissues by moving a probe over your body, but hasnt been able to find an alternative to all that drinking of water, till you are desperate to go to the loo, and the receptionist telling you to hold on because another patient was inside.  Or having to remove your earrings, bangles and mangalsutra  for an MRI, wear a hospital gown , and lie down on a plank that slowly slides you into a dark sphere which rattles. No one else in the room , and chaps look at you through a glass pane, and click things on a screen.  And whats more, no one can accompany you  and sit alongside somewhere on a chair.  Some tests are downright embarassing in the postures you have to be in, but you see other folks being subjected to the same , and just join the masses .

A bad back problem, a ankle swelling and a burning feet problem, (the burning akin to standing in a kilo of ground green chillies for one hour), had me losing sleep and peace, and I saw a neurologist . After some physical movement examinations,  a lot of diagrams  consequent to my asking questions, I was advised two tests NCV (Nerve Conduction Velocity) and SSEP (Somato Sensory Evoked Potential) .   Fancy names. Very impressed, and I  Googled.

Then I booked an appointment and went in.

Turns out, that these are tests to find out nerve damage , and what kind of damage .  The nerves contributing to my feet burning originated in the spine. Old age does things to your vertebral column ,  and these tests are particularly useful to figure out nerves that may be pinched somewhere, or nerves that may be damaged , say internally . 

 Went to a big hospital in the suburbs where both recommended tests were done . Surprisingly,  while the NCV test is common , not many hospitals will do the SSEP test.

Thankfully , there was no change of clothes into hospital gowns, no drinking water and stuff like that. You lay down on a raised bed,  and someone then proceeds to stick electrodes at places on your scalp, hands , feet, behind your neck, and so on.  You are not supposed to have applied lotions, oils etc that day , and even then they have some conduction fluid thing which they apply after cleaning your scalp areas and rubbing it strongly before sticking the electrode.

After many years,  a rubbing of various areas of the scalp really brought back old memories.  I actually felt like falling asleep. But didnt.

Then the fun part began.  There is a thing like an electrical  two pin plug which they touch to predecided points on your body. The fun part is there is a current running in it and you get shocks.

 How your body responds tells them something about the nerve and how well and fast it transmits sensations  which are detected by surrounding electrodes at a known distance.Your are not supposed to move . Initially the shocks are small, and they gradually increase in amplitude.  There are occasional involuntary cries of "Aai Ga", and the young lady tells me to take a long deep breath , and exhale quickly. I see through it and ask her if all that deep breathing has anything to do with the shocks , and she smiles and says no.  They tell it to people so it distracts them from the shocks.  I tell her to keep the shocks going and ignore my cries . I need to get over with it.

This stuff is repeated for each upper and lower limb, with my lower limbs coming up with some creative shock sensations, thanks to the swellings. A break is announced before the ssep procedure is begun, as an paralytic emergency patient is scheduled for a quick test . I wait outside and try to investigate things on Google on my phone.

I am then called inside for the SSEP procedure .   This is basically designed to see how well the brain and spinal cord can react to messages to and from the various body parts. The speed with which nerves transmit the sensory messages, across known distances.  Brain to tips of the upper limbs, and likewise for lower limbs. So there are electrodes attached to your crown, again with the nice rubbing , and sticking.  A new electrode to your back at your waist, and then lots attached to your ankles. This test doesnt give shocks, but more of a buzz, like a big mosquito bite. Once again they apply voltages/currents, and for some reason the swelling in my ankles seems to behave like an insulation. Time an again i get no sensation from their electric touch, and they keep moving the probe in a certain area, till I overreact, when a slight electric  zing is felt. The test proceeds. I dont sense things going up and down my back, but they see stuff on the screen , and make knowledgeable comments to each other. Two hours later , I am through.

I am simply impressed by the two young girls, who handle these complicated tests, with varied patients. In between they interact with the doctors, as well as the administration/billing people, all this while answering  my questions, They also have excellent people skills, dealing with frightened types, older people who cant hear or language-disabled types.

I realize that while the body has all these glorious systems ticking away inside, it is the brainy high command up there that is kept informed by the nerves about the status of all.  Something doesnt respond to an impulse, something overreacts in pain, something works intermittently. Their are local responses, spinal responses and high command responses. Some nerves, being under an autonomous spinal control, go haywire , and it is sometime before the high command brain figures it out.

Sometimes the nerve itself has gone bad, sometimes the path it follows is in trouble.

And it occurs to me that this is so much like  whats going on in our country., Lots of people, locally controlled, going out of control, making random statements, accusing others, performing faulty actions. By the time people at the top find out, it's too late.

Medicine has all these tests for nerves . I wonder if we need such tests in society.  Backed by science. So we can take action if the person is at fault, and guide him if he is on the wrong path. The tests also tell you if this is a "gone " case, not likely to recover, and likely to lead to some serious affliction. Even then there are ways of making things tolerable.

As for me, I am still waiting to find out my nerve health, and if they have learned any lessons from the shocks they were subjected too .  The report is to arrive in a day.

Just think .Like the country,  sixty plus (and more) - decades of tolerating me, right from birth. I wonder what the nerves will have to say. In society, someone can always get up and give a speech and run someone down with choice epithets.

I think my nerves have more class ...   :-)

Hopefully, it will not be another "shock".......

28 comments:

  1. I can relate,
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    This healthy one, doing everything right
    has severe arthritis, could be worse.
    Glad it did not arrive until 80 :)

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