Myotrac?? TES?? which one??

[Drake's Mom]

i am trying to get the Myotrac but i'm not sure what i am suppose to get. The link
http://www.tascnetwork.net/_pdf/ChicagoWS2.pdf
talks about the MyoTrac 'Infiniti neuro PD' is this the machine that everyone is trying or is this something more?


But then Dr. Karen Pape also stresses the use of TES
BMT NT 2000-TES unit
http://ubpn.org/awareness/A2003tes.html

Which one am i suppose to be getting? Do people have both? i'm really confused as the difference between the benefits of each machine. I know the MyoTrac is a surface EMG and the TES is a stimulating device, so again which one does my son need? I finally have a therapist that will write the letter for my insurance so i don't want to be asking for the wrong thing or do i ask for both?????? HELP

Teresa

[hope16_05]

Teresa,
if your insurance will go for it the MyoTrac Infiniti neuro PD seems like it woould be awesome! But I am guessing that one is incredinly expensive. The myotrac we are chatting about is a single channel until costing around $450 if I remember right.

Sorry I dont know anything about TES, I used NMES for my e-stim.
Good luck!
Hugs,
Amy 20 years old ROBPI from MN

[F-Litz]

TES is the stim that you use at night. What it does is bring circulation to the arm (blood and growth hormones that are released at night) and lets the brain know all night long that there's an arm. All good. It's purpose is to regrow atrophied muscle. It does not cause a muscle contraction.

Once you have muscle growth and there is less atrophy and more normal muscle fibers, then you can use regular stimulation (NMES). NMES will cause the muscle to contract - it's like giving the muscle an aerobic program to follow. But if you did this aerobic program on atrophied muscles you might blow the muscles. There needs to be enough regular muscle fiber for the NMES to have something to work with.

The sEMG stim unit that Dr. Pape sells is not a replacement for TES but the next step. It is a replacement for the regular NMES unit. The sEMG stim unit (myotrak) works with the individual's current function. You do a movement and machine senses when your movement has come to the end of its potential, then the stim turns on and completes the movement. It teaches your brain what the end result should be and helps the muscles get there.

The other Myotrak unit that Amy is talking about is just BIOFEEDBACK. And this is also an excellent tool that will tell you what muscle is working at any particular time. But that's all it does. It doesn't stimulate anything - it just reports back to you on what works and what doesn't. But what's really great about this unit is that it helps you isolate muscles so that you can work on the correct muscles rather than the compensatory muscles. We have this unit as well and it has shown us that Maia has a co-contracture between deltoids and biceps - quite interesting for us to learn.

So the biofeedback unit helps identify what muscles are doing what and helps you isolate muscles so that you can strengthen them individually. And the sEMG stim unit does that AND stims the isolated muscle.

So there are 4 units I just basically discussed
(1) TES, nighttime stimulation, for circulation & sensory - this unit feels like an on and off fluttering
(2) NMES, daytime, stimulation, for muscle strengthening - depending on what unit you purchase this will feel like a deeper buzz and it could "sting" more or less
(3) biofeedback (myotrak), to identify which muscles are working so that you can isolate them in your workouts - you feel nothing with this machine
(4) sEMG stim, same as biofeedback with the additional stimulation - you get to stimulate the muscles that have been isolated - you feel a very smooth buzz with this machine, not sting-y

TES and sEMG stim is purchased with tascnetwork.
Their site is http://www.tascnetwork.net and there's an 800 number there, too. Sometimes it takes a while for her to get back to you - I think they travel - do courses, symposiums all over.

NMES and Biofeedback can be purchased on line at many different suppliers - just google them.

Which one should you use? Well if you're asking this question I'm thinking that you don't have a lot of professional support to help you with this. You need to work with a therapist who is experienced and will understand what you need to do... someone who can teach you what to do, someone who understands what muscles need to be worked on and why - there needs to be a plan in place. I've listened to Dr. Pape's lectures multiple times and one thing that she always says is that it's important to do the right thing at the right time in the right way. If and when you contact tascnetwork - have them give you a list of therapists who are trained and experienced.

-francine
francine@litzfamily.com

[Drake's Mom]

I LOVE THESE MESSAGE BOARDS!!!!!

I find out more here then anywhere! Well all along i know our problem is that we do not have the doctors OR therapist that are helpful and supportive! The big problem is that his current therapist IS on the list of certified therapist on the TASC network!! I asked her about the TES and she said she hasn't seen enough notable improvement with other cases to try it on Drake. From what i am reading we are pointlessly using his NMES at home for his extensors and deltoid. I have told his Doctor all along that almost every time we try to stim his extensors in the fingers and wrist we only get his flexors to work. And i know it's because his muscles are basically gone and we are just stimulating the ones that are there and that's the flexors (which work fine and we do not need to be stimulating!). When we went to the Mayo, that's one thing the orthopedic doctor said, is that Drake had the most amount of atrophy that she had seen in a patient. So it makes sense to use the TES until you have something to stim in the first place. I haven't listened to his doctor or therapist and have stopped using the NMES awhile back.

His therapist, who is the one listed on the TASC network will be out for THREE MONTHS because she has to have surgery on her c6 nerve. So we are with yet another therapist. She is THE most helpful Drake has had and she is very interested in getting whatever we need to help him. So someone is finally helping me get the letters i need for insurance. So i'm am trying to make sure i am asking for the right ones! I'm thinking he needs the TES and the Myotrac. There is one other name on the TASC network and i am going to see if she can see Drake but she is the only other one on there that is remotely close.

So basically if i can get insurance to cover the MyoTrac Infiniti Neuro PD then that is the better bet because it is the biofeedback and stimulation. So on the website, lifematters, is it this one:
MyoTrac Infiniti Home T9800US
Francine do you have both the TES and MyoTrac for Maia? Do you have the MyoTrac with stimulation.

Thanks for your help and i will keep calling and emailing the TASC network and therapist to find out more.

Teresa

Oh yea i had a question about TheraTogs also~
Does this help with scapular winging? Do you also have to go thru a therapist to get this product? I just found there website so i haven't had a chance to read more. Drake's scapula is getting pretty bad and his shoulder doesn't look good either. I am going to take pictures of the atrophy and scapula for just added info to send to the insurance and his doctor (because his doctor hasn't seen him since September) so i will send a link so everyone can tell me what they think about using the TheraTogs for him. And if others have encountered this much atrophy.

Thank you so much!

[F-Litz]

Hi Teresa,

The one thing about all the units is that the muscle has to be innervated. So if you are TES'ing a muscle that is not innervated, then you're not going to get a response.

We saw a change in Maia's arm after 6 weeks of TES - we saw "fluidity of motion". It was genuine. We also immediately saw a reduction in edema. Her arm was swollen during the day and after a night of TES, her arm was NOT swollen. And on days we didn't use the TES - she woke up with a swollen arm. And the swelling is very easy to see - her hand and fingers get painfully swollen. We also used TES to clear up infections in her hand that weren't clearing up and TES cleared them up over night. So for Maia, we have the proof that indeed it increased circulation in her arm. I cannot tell you if she regrew muscle BUT if I think about it for a moment, I guess I can tell you that it probably did because we did TES on her scapula stabilizers for two years straight and she does NOT have scapular elevation and winging so maybe that did it?

I would call Wing at TASC and tell her about the extenuating circumstances with your therapist and maybe another trained therapist can come to the rescue - even if it's long distance and in a supervisory relationship.

About Togs - what it does for a child is dependent on how the tog is applied and how and what strapping systems are used and how committed you are to donning the set daily. I think that you need to go to a therapist who is expert at assessing your child and fitting the theratogs.... even if you have to go and get Billi Cusick herself to do the assessment which can be possible if you go to where she's teaching - the list of classes should be on her website. I think Togs are great - we saw great improvements with them. Maia is on a "no tog diet" right now - so you have to pick your battles and right now she's agreed to wrist bracing - so parents have to go with the flow sometimes. But if it were completely up to me, she'd be in them all the time - they are fabulous.

We have the units but we are at a standstill for now because she has bigtime biomechanical issues in her shoulder joint that's causing secondary problems and we're just trying to find the right time (and right way) to do the next surgery.

-francine
francine@litzfamily.com

[jg's mom]

Fran thank you so much for spelling all these differences out with the machines. It is really helpful. It is so kind of you to share your wealth of info with all of us and your personal experiences . Thanks to everyone else who shares too. New moms to this world like me are trying to find anything out there to help our children. Jill will be 1 this month and we are trying very hard to help her reach her full potential and a pain free future.

[F-Litz]

Hi Jeannette- thanks for your kind words.... we're all in this together - we have to help each other - we all have the same goals - pain free life with as much function as possible. I wish it were easier to attain though. -francine

[jordan1]

My insurance needs a diagnosis code and procedure code for the myotrac to see if we are covered and my doctor does not have it. Would you know what they were?

[F-Litz]

The insurance codes are as follows:

Diagnosis: Disuse Muscle Atrophy 728.2

Equipment:

The E-stim Unit: E0745
Electrodes: A4556
Lead Wires: A4557
Batteries: E1399

[jordan1]

Thank you very much for that info.