What do I need to know before my first visit? Use this website for directions to our office. Plan on arriving early to fill out the necessary paperwork or download the forms from the web site and fill them out in advance. Unfortunately, the schedule is frequently very full for the doctor all day, so if you miss or are late for your scheduled appointment time, you may need to reschedule for another day so as not to interfere with other patients’ scheduled appointment times.
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I snore. Do I have sleep apnea? The answer is maybe. An estimated 10-30% of adults snore, and most do not have sleep apnea. Snoring is caused by vibration of the relaxed tissue in your nose, mouth, or upper throat. Some people snore loudly but continue to breathe. In other people, however, the tissue relaxes to the point that it closes up the airway, which results in an obstructive apnea (stopping breathing). People who are overweight or have a large neck are more likely to have sleep apnea. Bed partners may notice pauses in breathing, gasping, or thrashing at night. Symptoms of sleep apnea include unrefreshing sleep, excessive daytime sleepiness, drowsiness while driving, morning headaches, frequent awakenings at night, difficulty falling asleep, poor concentration, irritability, anxiety, loss of interest in sex, or depression. High blood pressure or swelling in the legs may also be signs of undetected sleep apnea. Sleep apnea is a life-threatening but treatable illness which can trigger heart attacks, heart failure, or strokes. If you think you may have sleep apnea, it is important to discuss this with your doctor.
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What is a sleep study? Sleep studies are tests that watch what happens to your body during sleep. The studies are performed to find out what is causing your sleep problems. A sleep study is also known as a polysomnogram (PSG). You may have a sleep study in a laboratory or at home depending on your symptoms and exam.
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What is an NCV/EMG? An NCV/EMG is used to diagnose nerve and muscle diseases. This is usually a two-part test consisting of nerve conduction velocities (NCV) and electromyography (EMG). It is routinely just referred to as an EMG. Some people, though, only have the NCV portion depending upon what diseases are being evaluated.

You will first change into a gown. If your arm or leg is too cold, we will warm it by soaking in warm water or wrapping the arm or leg in warm towels. This is important because if the arm or leg is too cold it can give a false response.

The NCV is performed first. Electrodes are covered in gel and then taped to the skin over various nerves. The electrodes are flat metal discs, rings, or bars. One nerve is tested at a time. The nerve is stimulated with a tiny electrical current which feels like little tingles or shocks. Depending on how strong a stimulus is needed for your nerve, the sensations range from irritating to very uncomfortable, but only briefly. The signal the nerve sends out is measured “downstream” at the electrode taped to the skin. You will only feel the sensations where the nerve is stimulated. You will not feel anything at the “downstream” recording site. How big the response is and how fast it travels from point A to point B are important in diagnosing whether a nerve is sick, where the nerve is sick, and how severe the problem is. How many nerves are tested depends on your particular problems. This portion of the test lasts approximately 1 hour.

The EMG is performed next. The doctor puts an acupuncture-like needle into the muscle to record the electrical sounds from the muscle when you are relaxed and when you contract the muscle. These sounds indicate whether a muscle is healthy, whether the muscle has a poor nerve supply, or whether the muscle itself is sick. Nothing is injected and you do not receive any shocks. This is uncomfortable during the test and may leave you with a bruise or mild muscle soreness. Although unusual, this can last a few days. This portion of the test takes approximately 15 minutes.

Dr. York will discuss the test results with you immediately after the test if you have both portions of the test, or she will call and discuss the results with you later if you have only the NCV portion.
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What do I need to know before my EMG? You do not need to fast or eat any special foods before the test. Continue to take your prescribed medications. Take a bath or shower the morning of your test. Do not use any lotions or oils on your arms and legs the day of the test.
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