20211208 : MEP test

I have had many kinds of teats after my stroke. The ones I remember the most is referred to as the MEP test . I underwent it 4 times I think. Thrice when I was conscious and could know what was going on and once when I was in la la land still.

That was initially when I was in the ICU and hadn't yet come back to reality.

That particular time, I was convinced they were harvesting my organs as part of some racket. I wanted to get out of that place asap - I didnt yet know I was in a hospital.

The last one I think was November end last year.

I want to describe this test, mainly because it was always done in the ICU and unlikely anyone from family or friends would have seen it. The test was what it was. I have described it the way I experienced it.

The MEP test - Motor Evoked Potential test. I think it is to check how much of the signals from the brain propagates to the limbs.

I don't know how many places they do it.

Anyway, it had to be done only in the ICU - I guess just in case they end up needing all the emergency attention and equipment. That should have alerted me - but it didn't the first time. After that, I knew what to expect.

I was wheeled into the ICU on my bed and taken to a separate room (isolation ward maybe?) not in the common area.

It took sometime to get all the players to the field. The main doctor, the supporting doctor, rest of the crew...

After they brought in all the gig, I felt at home - like I was back in our electrical lab. There were loads of wires, connection panels, indicator led lights etc. There were other monitors too - which was turned away from my sight - so I don't know what it showed.

I was amusing myself with all this, and the supporting doctor started setting up.

First the extremities (feet & palms) were cleaned with a cool liquid. That's usually done to clean the skin with some alcohol based fluid to help the electrodes stick better.

Then she opened a packet of wires. I did wonder then why new leads? All other cases, like ecg, ncd, etc, they reuse the leads. I didn't think much about it.

It was very colourful - red, blue, green, yellow, brown, etc. Not a single lead had a repeated colour.

They were single strand wires, same size as any single strand wire. All of them had a jack at one end and the other end free. That was strange. Almost all leads have a circular patch at the end - to smear some gel to improve the conductivity. 

Now I was irritated. Why not do all that beforehand instead of wasting the patient's time. I was on an empty stomach for 6 hrs for the test.

Each of the wires - the jacks went into the big panel to specific slots (colour coded I presume)

I was waiting for the cold feeling when the gel is put. Except, no gel.

Instead, I felt a immense pain in my feet. Like a very big syringe/needle injection. It was completely unexpected. The wires went straight into the skin at designated points. I would have screamed - except I had no voice. So I screamed inside my head.

It was 2 wires on each of the feet and 2 on each of the palms. It bled quite a bit. Not because of just the puncture to the skin, but because I was on continuous blood thinners and slow to clot.

Took a few minutes, wiped clean and fastened with micropore tape.

It was done. Either it stopped paining or I just got used to it I guess.

Then came a jabbing pain in my head. No it was not inside, it was the leads that were inserted into my head directly now. I counted 3 of them.

Next I was asked to open my mouth. It is to insert a "bite block" - which pushes the tongue back so that we don't inadvertently bite it off... 

Of course I could not open my jaw. They tried to muscle their way , but were not successful. Finally they gave up and stuffed lots of sterile gauze to get the same effect.

Then I was asked "ready?". I think that was rhetorical. I don't know if "no" after all the trouble was an acceptable answer. So I nodded my head to indicate "yes".

Then, one of them said "clear" and everyone took a step backwards.

Now, this is a scene I had only seen in movies - where some doctor with paddles in their hands tells "clear" to others before giving a jolt trying to revive some poor soul. The next scene is of the monitor - the poor blip of the heartbeat struggling to rise. This is what was running in my head.

Sure enough, next came the jolt. This jolt however was not trying to crank up the heart, it was a lightening bolt trying to knock off the head.

I think I didn't realise anything for a few seconds after. The "bite block" is certainly a good idea!

When I came to my senses, I could see the main doctor asking me if I was ok. I don't know what anyone would say. Even if I could speak, the mouth was fully stuffed.

But I was glad it was over and I could go back to the ward and sleep, be fed, whatever.

Then I heard him say "take it up to 250". I don't know if he meant "volts" or " milliamps" or some other damn unit. But the familiar "clear" came next.

The process was repeated 3 times in all.

Followed by what seemed like very mild currents for a few minutes. I guess it was to see the fidelity for different waves - I don't know.

Felt like very mild tingling.

Then the dismantling. More bleeding when the wires were pulled out. No pain, just oozing.

Then came the most torturous part. I had to remain in the ICU for 15 minutes or so under observation.

So a bunch of monitoring stuff were connected and everyone went away.

I couldn't call anyone. There was just music for company. Music created by all the various machines beeping away at different intervals.

So I lay, in the isolation room, staring at the ceiling, for what seemed like an eternity till I was rescued by 2 GDAs (General Duty Assistants - a.k.a ward boys) and wheeled back to the room.

The subsequent times was easier. Not that it was any different - I just knew what to expect. The surprise element was removed.

The last time it was done - end Nov 2020, the doctor, with excitement, had told me that there were some signals flowing to my right leg and I would start movements within 2 months.

He also said there was no signals in the right arm, so can't say - have to repeat the test in 6 months and see again. This bit was not told to me directly. But I overheard him talking and telling to the other doctor.

2 months later I was happy. There were no movements in my leg. That meant the test uncovered nothing predictable or accurate. So it couldn't have been right about my hand either. So there was still hope....