Blood, Sweat and Tears

My first stop early on day 1 (we're talking 6:30am) is registration, and then an interview with a neurologist, who takes a comprehensive history, and gives me some rudimentary strength and nerve tests. She goes back to order a series of tests, and eventually they present me with a schedule that will keep me busy for the whole week. I keep asking people when I will get to meet Dr House, and some of them get the joke. No sign of Cutty, or anyone looking even half as hot, which only shows how fictional medical TV series are.

1. Blood
This place is a factory. First stop is specimen collection - I have to collect 24 hours worth of pee, and they give me a generous bottle, as well as an opaque bag to keep it in as I walk around. Because I have had fish on the plane, I have to wait until the next day to start this. Then it's next door for some blood tests: I ask for have it lying down because I'm a queasy woose about these things, and the technician is very sympathetic and does an excellent job in taking eighteen tubes out of me. Man, that's a lot of blood!

Next stop is for a skeletal survey. This department is very busy and all appointments are running late today, and I end up waiting well over an hour to be called. They have a few TVs and computers with internet in the waiting area, which is very handy. Eventually they call me in, and x-ray just about every bone in my body. In the middle, someone comes in to tell me that I'm going to be late for the EMG test scheduled for later that day, and they've shuffled it around to the next day, and prepared a revised schedule. I am overwhelmed by how well-organized this place is.

2. Sweat
From there, I go for an autonomic test - something I've not done before. They put you on a table, attach a bunch of monitors, and test how you sweat during certain activities. This test measures how the nerves work that control blood pressure, heart rate and sweating. This was quite innocuous, and because my EMG was moved to the next day, that was it for me.

The next morning, day 2, I had the thermoregulatory sweat test. Now this one is a doozie. You strip down, lie on a bed, and they cover you with this powder. Then they slide you into this "hot box", which is progressively heated up to 38C (100F) over a period of around 45 minutes, and they monitor how quickly and where you do or don't sweat. The powder changes colour to purple as you sweat. The box is all sealed, but has cameras so they can take pictures of you all (or half) purple covered in only a loin cloth!

After a while (and it's not easy to keep track of how long you've been there), the heat gets quite oppressive. Of course you have to lie completely still through all of this, and listen to the muzak they have playing. It was like being trapped in a lift on a hot day with the air conditioning broken down. Eventually, the operator offered to change the music selection - in addition to both kinds of music (country and western), they had some Sheryl Crow, which was the best of what was on offer.

3. Tears
Next test for that day was the big one - EMG. They do a nerve conduction study first. That part consisted of sticking electrodes to my arms, zapping me with electric shocks at various points, and measuring how much I flinched (sort of). Last time this was done, they found conduction blocks in both arms, which is what gave rise to the diagnosis of multifocal motor neuropathy in the first place. Some of the electric shocks are pretty full-on. I've never been shot, but I imagine that's what it might feel like - a very sharp, intense and localized pain at various points on my arms and legs.

The whole thing was being observed by a visiting neurologist from Switzerland. He seemed like a nice enough fellow, and I didn't have a problem with another person watching my pain.

The second part - the EMG - was done by the neurologist. This involved sticking needles into various muscles, and "listening" for the electrical signals going through as the muscles are activated. So, say, with the needle in my hand, he would push down on a finger, and ak me to push upward. The pain is nothing short of excruciating, particularly in a few spots around the fleshy part of the hands below the thumb. After a few on the left side, I started shaking and teeth chattering. He then moved to my leg, and finally did just one on my right arm before deciding it was enough.

After it was over and they all left the room, I broke down in tears. I just felt so awful. Perhaps it was the pain, perhaps that I was holding it in (to the extent that I could) during the test itself, or perhaps I just needed to open the emotional floodgates through this whole process, and that was an opportune time. Eventually, I composed myself, and fortunately that was it for day 2. Back to the room to rest and relax.