Today I went to an initial physical therapyappointment for a jaw/facial condition (TMJ). During the evaluation, the therapist mentioned that he needed to take my neurological pulse. To do this, he put his hand on my calf (I was lying on a table) over my pants and looked at his watch for a bit. He then announced it was 1 pulse/X number of seconds.
I was a bit curious what kind of pulse he could possibly detect in my calf through my jeans, but his explanation was pretty vague. A quick google search didn’t yield the quick explanation for which I was hoping.
Temperature measurement on neurological pulse generators during MR scans | BioMedical Engineering OnLine | Full Text seems to indicate that a MRI is contraindicated if you have one implanted:
Implanted electronic devices like neurological pulse generators used for instance in the treatment of chronic pain or advanced Parkinson’s disease are commonly considered to cause a contraindication for the use of MRI. Neurological pulse generators are typically used in the treatment of Parkinson’s disease. Located in the chest region under the skin they stimulate certain areas of the brain, namely the thalamus or subthalamus.
So … he thought you had a generator implanted in a whacktastick part of your anatomy, to control pain or parkinsons tremors, or he was checking for tremors to your extremities, or he was seriously yanking your chain with some sort of fucked up crystal worshiping alternative nonmedical practice.
Let’s just say that this is not a maneouvre I ever learned in medical school, nor is “neurological pulse” a term I have ever come across or used in my daily practice other than in the context of pulse generators.
If you don’t understand the explanation he gave- keep asking him to break it down for you until you get what he is trying to say- a good therapist or doctor will be more than happy to do that without getting vague or evasive.
Huh. Never thought that Homer Simpson had the right idea here.
Dr. Hibbert: Homer, I’m afraid you’ll have to undergo a coronary bypass operation.
Homer: Say it in English, Doc.
Dr. Hibbert: You’re going to need open heart surgery.
Homer: Spare me your medical mumbo jumbo.
Dr. Hibbert: We’re going to cut you open, and tinker with your ticker.
Homer: Could you dumb it down a shade?
chrisk I’ve had almost that exact conversation with patients on more than one occasion…
Most recently I’ve had a conversation that went something like:
“We want to perform a coronary angiogram”
“??”
“A dye test of the heart arteries”
“??”
" We are going to put a dye into your leg artery. This travels all the way into your heart. We can see the dye with a special scan, and if it isn’t flowing in an artery in the heart we know it is blocked up and if we can open it up to restore the blood flow to that area of the heart wall"
“??”
“Your heart is sick. We don’t know where. We will take a special type of Xray that will show us. For the Xray we need to put a needle in your leg.”
“Ok”
You do what ever it takes so that your patient can understand what is going on. If that means saying “gullet” or “food tube” instead of “oesopaghus”, you do it.
(Otherwise you get situations where you point to the scar extending from the patient’s jaw to their groin and ask what operation they had done and why and they give the single word answer “nesopagnus” and can’t tell you if they had their oesophagus removed, stented, biopsied, repaired or what- because they think that “nesopagnus” is the name of the type of surgery they had done. True story.)
Well, it was not so much that I didn’t understand his explanation – it was that it (coupled with the way he measured the pulse by lightly touching my pant leg) immediately struck me as appearing new agey/pseudo-scientific. “Your pulse is slower than normal because your body’s energy is being diverted…” I suspected that the more I asked him to break down and clarify his explanation, the shakier it would seem, and the more my skepticism would be apparent. Whatever. He’ll also be doing some massage work and helping me stretch some muscles. If he wants to think that he is bringing my neurological pulse back into a normal range, thats fine with me. Who knows – maybe in the future the “neurological pulse” will find some scientific footing.
Don’t know but craniosacral massage therapy uses a pulse in the spinal column as part of treatment. This is not an evidence based treatment and the pulse can only be detected by craniosacral massage therapists.
I don’t know that that’s what your therapist was doing but if mine did, I’d get a new one.
Again… is this a licensed PT, or is it someone like a chiropractor?
If it’s a licensed PT, you may want to double check that cred for your own peace of mind. Before someone starts pulling my joints around, I’d want to know they’re not following some crackpot stuff that’s going to cause damage.
He was listed as a physical therapist in the list of providers that blue cross blue shield provides for the county. Chiropractors are listed separately. I just checked now and an internet search found him as a licensed physical therapist.
When I returned from my appointment I mentioned “neurological pulse” to someone who had gone to school for massage, and she recalled it being based on the movement of spinal fluid. Whether or not that is a valid phenomenon is one question…the other question is how would he detect such a thing by putting his hand on my calf?
Spinal fluid should not be found further south than the base of your spine. If it’s in your calf, you probably need a trauma surgeon, a neuro surgeon and an orthopedist
