Pacific Rehab Medicine

943 Broadway West - Suite 140
Vancouver, BC  V5Z 4E1
Tel 604-733-2222, Fax 604-733-2202

Telephone & Courier Hours:

Monday - Friday 9am - 5pm

Frequently Asked Questions (FAQ)

1). What is a Physiatrist?
2). What is an Independent Medical Evaluation?
3). Where is the EMG lab located?
4). What is an EMG?
5). Why am I having an EMG?
6). What happens during an EMG?
7). How long does an EMG take?
8). What kind of preparations is necessary for an EMG?
9). How soon will I find out the results?

What is a Physiatrist?

A physiatrist is a medical specialist in physical medicine and rehabilitation. Physiatry is the medical specialty concerned with the medical treatment and rehabilitation of persons with a variety of physical problems and associated disabilities.  Those include general medical conditions, neurologic disorders such as stroke, amputation, spinal cord injury, acquired brain injury, arthritis, soft tissue injuries and musculoskeletal pain syndromes. 

The Physiatrists at this office are Dr H. A. Anton, Dr. Gabriel H. Hirsch and Dr. Andrew Travlos.

What is an Independent Medical Evaluation?

An independent medical evaluation (IME) is an assessment performed by a medical specialist at the request of a third party, such as a lawyer or insurance company.  The purpose of an independent medical evaluation is to provide medical information to third parties on issues such as compensation benefits, legal claims or disability.  The physician performing the IME is not an employee of a lawyer or insurance company, but rather an independent expert who is expected to provide an objective opinion based on information available to him or her.

IME appointments usually consist of two parts. First you will meet the specialist and provide him or her with your medical history.  During this time you will be asked questions about your symptoms and health.  Following this will be a physical examination focused on your problems.   The examining physician may also review any relevant medical records and x-rays.

IMEs are not performed for the purpose of treatment.  The examining physician will not normally provide advice about treatment or send a report to your own doctor.   The IME report (often called a medical/legal report) will be forwarded to the party who requested your appointment.  If you or your doctor requires a copy of the report, you should contact the party who requested your appointment. 

Your participation in an IME requires that you understand the process and provide informed consent.  Should you have any concerns or questions about the IME or related matters, we will do our best to answer them.  If you do not wish to participate in the IME, then you should contact your lawyer or representative to discuss your concerns.

Where is the EMG lab located?

The EMG lab is located at G. F. Strong Rehab Centre, 4255 Laurel Street, on the corner of Laurel Street and 26th Avenue, 1 block South of King Edward and 1 block East of Oak Street in Vancouver, BC.   Proceed to the basement level where above a set of double doorsyou will see a sign indicating UBC Division of Physical Medicine & Rehabilitation.  There is a waiting area adjacent to these doors --- please take a seat until you have been called.

There is limited visitor parking and street parking may be difficult to obtain, so allow ample time to arrive punctually.

What is an EMG?

Your doctor has just ordered a test called an EMG. EMG stands for Electromyogram which loosely translated means electrical testing of nerves and muscles. The EMG will be performed by Dr. Andrew Travlos, who is an accredited Electromyographer, and Physiatrist. (A Physiatrist is a medical specialist in Physical Medicine and Rehabilitation.)  Parts of the test (the nerve conductions) may be performed by a specially trained technician and a Resident medical doctor will be in attendance as well. EMG is done in clinic and does not require hospitalization.  On average an EMG takes one hour.

EMGs are not a form of treatment---they are a diagnostic tool.  An EMG is only a test, much like an EKG or an X-ray.

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Why am I having an EMG?

EMGs are usually ordered when patients are having problems with their muscles or nerves.  They test the nerves and muscles of the body’s extremities, looking for a problem in either one of these areas.  An EMG may be ordered to determine if you have a pinched nerve in the back or the neck.  If you have tingling or numbness in your arms or legs, an EMG may show if you have a nerve entrapment somewhere or a nerve injury.  Weakness of the muscles or fatigue may be indicative of nerve or muscle disease and require an EMG.  There are many other medical problems that might suggest the need for an EMG.  If you have any questions as to why you need this test, ask your doctor.

What happens during an EMG?

During this test, you will be lying on an examination table, next to an EMG machine (which looks like a desktop or laptop computer). The test usually consists of two parts. The first part is called Nerve Conduction Studies.  In this part brief electrical pulses are delivered to a specific area in your body in an effort to determine how fast or slowly your nerves are conducting the electrical current and therefore in what state of health or disease they may be.  A nerve works something like an electrical wire---if you want to see if the wire is functioning properly, the easiest thing to do is to run electricity through it.  If there are any problems along its length, you will know it by a failure of the current to go through.  To do this, the doctor will attach small recording electrodes to the surface of one part of your limb, and will touch your skin at another point with a pair of electrodes delivering the electrical pulse.  When this happens, you will feel a tingling sensation.

Between the brief electrical pulses you will not feel pain.  As there are several nerves in each extremity which need to be tested, the procedure is repeated 3 or 4 times or more per area studied.  The amount of current delivered is always kept at a safe level.  Patients wearing pacemakers or other electrical devices need not worry since this current will rarely interfere with such devices.  During the nerve conduction study the doctor or the technician performing the study will occasionally pause to make calculations and measurements.

The second part of the test is called Needle Examination and as the name implies, involves needle insertion.  The needles used are very fine and about one and a quarter inches long.  This part tests the muscle to see if there has been any damage to it as a result of the nerve problem or if the disease involves the muscle itself rather than the nerve.  Usually 5 to 6 muscles are sampled in one area, but occasionally, if you have problems in more than one area, additional muscles may need to be studied. The needle is usually inserted in the relaxed muscle and moved inside gently in order to record the muscle activity.  When this is done, you will be able to hear the sound of the muscle activity amplified by the EMG machine; it will sound something like radio static.  During the needle exam, no electrical pulses are delivered.  Also, since the needle probe is used here only as a recording device, no injections are given through the needle into the muscle.  On the average, a muscle can be sampled in 2 to 5 minutes though this may vary with the type of problem being investigated.

How long does an EMG take?

On average an EMG takes one hour.

What kind of preparations is necessary for an EMG?

Few preparations are needed on the day you have an EMG.  You do not need to fast, or eat any particular kinds of food before the test.  You can drive yourself to and from the test.  You can count on resuming your regular activity after the test is completed.  As for clothing, hospital gowns are provided, however for EMGs concerning the lower back, buttocks and thighs, most patients feel more comfortable wearing a pair of shorts that they have brought along with them.

If you are taking a blood thinner, you should notify the Lab where your EMG is being done, since in that case the needle part of the test may cause bleeding inside the muscle.  Also if you are on any medication for Myasthenia Gravis such as Mestinon or other, your medication may interfere with the test, so you should also notify the Lab.  If you have any doubts about other medications you are taking, it is best to check with the Lab to be on the safe side.

How soon will I find out the results?

Full results are only arrived at after more calculations and measurements are performed after the end of the test.The results are therefore usually not ready until approximately 3-4 days later. They are usually not released directly to the patient.   Instead they will be conveyed to the referring physician since he or she has to assess the results in light of the patient’s other findings.

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