Thursday, 25 August 2011

Dr Doctor my EMG is farting!

We have a very interesting patient on ITU at the moment, who presented with severe rhabdomyolysis (muscle damage) leading to leakage of myoglobin (muscle protein) which caused severe renal failure (because it damages the kidneys). He is interesting because nobody can work out quite why this has happened to him.

One of the exceptionally intelligent consultant electrophysiologists came to review him and test the nerve conduction in his muscles. This involved attaching electrodes to the skin and stimulating the muscles and turning the response into a wavy line pattern on a screen and into a sound signal. He happened to be doing the test during our ward round so we all gathered around to watch.

He checked the monitor, turned the volume up and sent a signal to stimulate the muscle, and there erupted from the machine at about 60 decibels what can only be described as an enormous, prolonged bout of flatulence that echoed around the otherwise relatively quiet ITU! It almost awoke most of the sedated patients, and agitated the poor chap in the next bay to such an extent that he extubated himself! Poor thing looked ever so confused.

Matters were not helped by me being the only one who seemingly could not control my giggles, and the registrar who offered a finger with the old adage "pull my finger" as the seasoned consultant repeatedly stimulated the poor patient's muscle with the same effect, earnestly explaining how this noise meant the patient may well have myotonic dystrophy.

Copy and paste the link below to hear something similar.

http://www.youtube.com/watch?v=xMAu6sZ7ROs

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