Wednesday, January 22, 2020

Nerve Conduction Velocity Test...


Today, 22nd January 2020 was my scheduled follow-up visit to the neurologist at Apollo hospital after the first one on 6th January 2020.

Although my condition of the sensation in the toe region has marginally improved with medication and Yoga, I am unable to state which one had a more pronounced effect, at this time. I reported this to the neurologist and he immediately suggested that I proceed for an NCV Test. It stands for Nerve Conduction Velocity test. This test is used to assess nerve damage and dysfunction. Also known as a nerve conduction study, the procedure measures how quickly electrical signals move through our peripheral nerves. I also understood from the technician that NCV can determine nerve damage and or destruction.

It is a 45 minutes shocking (pun intended) procedure.  During the test, the nerve is stimulated, usually with surface electrode patches attached to the skin. Two electrodes are placed on the skin over the nerve. One electrode stimulates the nerve with a very mild electrical impulse and the other electrode records it. When I asked the neurologist for some additional details about the process, he dismissed it simply stating that a mild electrical impulse is given at various points. Not having heard about it before, I went in bravely to the EEG department which has a separate enclosure at Apollo to get this test done. To my surprise there was not a single patient in ‘Q’ – a hospital where every faculty has loads of people standing in a row for getting themselves tested, it did strike odd to me, but then I dismissed it as perhaps my luck that I did not have to wait in a ‘Q’.

It struck me only midway during the test about the absence of any patients in this unit. You don’t pay to be given shocks…as such we get enough from all quarters daily! Believe me, they aren’t mild! The technician started the test with my left hand and gave the shock impulses at various positions. To divert my mind from the shocking impulses, I started mentally counting the number of times the technician was administering. It turned out to be 50, ranging from a mild one, which just tickled the nerve to a strong one which made my arm lift up involuntarily and settle back with a thud. On the left foot however, the number was less at 25, but the intensity range of the shocks were identical. I heaved a sigh of relief when she said it was done and as I got up to step down and walk out, she said, Sir only 50% has been completed. It’s time to commence on your right side. Quite reluctantly I went back to the flat bed and summoned enough courage to receive the shocks once again. But now that I was familiar with the procedure, I started looking forward to the shocks and in my mind I started comparing which was worse, the left side or the right side…The count was identical and the intensity identical, but, I felt that the right side was less shocking! The games a mind can play!
By the time the experiment on me was completed, I had been given close to 150 shocks…my quota of a lifetime, I thought to myself and swore that I would not subject myself to this test ever again.

No wonder people never willingly accept to take this test and it explained why the count was zero at the waiting ‘Q’.

It may be useful to explain a few terms/terminology to help understand a little about this problem. All of us have heard of Sciatica nerve problem and pain. Sciatica is a condition that affects the sciatic nerve, which is the largest nerve running in the human body. The sciatic nerve extends from the lower back and down both sides of the hips, buttocks, legs and feet. Sciatic nerve pain is related to herniated discs in the low back and low spine. When discs in the lower spine and back slip out of position or bulge, the rubber cushions or discs stop acting as an expansion joint (in engineering parlance), and                 the nearby nerves can cause irritation, pain, weakness and numbness in legs and feet (lumbar) and arms and neck (cervical).

An NCV test can help diagnose compression or damage in the sciatic nerve and it can also detect any problem in the nerve itself. The peripheral nerves are responsible for sending information from the brain and spinal cord to the rest of the body and vice versa. When these peripheral nerves are damaged, people may feel weakness, numbness and pain in their hands and feet. Most of the time the symptoms can improve with treatment, especially if caused by underlying conditions such as vitamin deficiency, diabetes, other autoimmune deficiency or simply a bulge (inflammation) around the discs.

While medication can be very helpful when the sciatic nerve pain is on account of inflammation of the herniated discs, it is Yoga and its finely controlled stretches alongside breathing technique that will restore the gap between the discs and release the pressure on the nerves. The best part is, once the pressure is released, the nerve ends can become active and re-establish connections with the brain.

Incidentally, this is the only department within EEG Cell of a hospital where the technician doesn’t offer any interpretation of the test results – the neurologist has to write them down after scanning through the report. When I went finally back to the neurologist armed with the reports, he said everything was normal, considering my age and with time and a daily dose of one tablet “Maxmala” I should be okay within a month. He just acknowledged when I informed him that I had joined Therapy Yoga to overcome my backache problem. He asked me to continue with it to the best of my ability and not undermine the importance of a daily walk. My cardiologist had set me a target of 10,000 steps each day, but so far I have been able to manage an average figure of only 5,000. My efforts have to double…

Finally, Nerve Conduction Velocity (NCV) of 50 to 60 meters per second is normal. In my case it varied between 40 to 60 meters per second. In layman’s term, If I hurt my small toe in either of my legs, information flow to the brain will be delayed and corrective instruction from the brain to the toe will also be delayed…I may not be aware that my toe hurts…     

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