Friday, May 30, 2008

Experiencing Nerve Block Injections:

It was my decision my husband told me, after the doctor explained the procedure and risks involved. I was considering having nerve block injections of cortisone for my neck pain. Since over twelve years ago, due to a motor vehicle accident (MVA), I had a C5/C6 fusion. A fusion is where they place a piece of bone, from a cadaver (deceased donor), into the body to replace the one that is broken, ruptured, herniated or otherwise damaged. The fusion has held well over the years, I've been in three other MVA's without any further damage to it.

However, a fusion is when bones fuse/meld together to where they can no longer bend. This constricts some of the person's movement to that area. Therefore, the other joints in my neck have had to take some additional stress creating now some herniation in the above and below discs of the neck. This in turn has caused even more pain in and around my area of fusion. Thus even some numbness and tingling coupled with pain has preceded down my neck, shoulders and into both arms. This all caused me to seek pain relief from a specialist.

My specialist informed me that due to my fusion that reduces my chances by about twenty to thirty percent of the injections success rate. However, being that the success rate is still sixty to seventy percent with minimal risks I weigh my choice of whether I want to go ahead or continue in pain. My biggest risk is a headache which I will more than likely get due to my history of migraines anyways. I will also have some pain for one to two days, which is normal, before relief begins. There is a three percent risk of the specialist accidentally hitting the spinal column and thus breaking the membrane to where spinal fluid will leak causing me a spinal headache.

I had a spinal headache once in my life following a spinal tap and it was far worse than my migraines. The only way to relieve it is to go back exactly into the same spot, puncture site, and inject your blood (which they draw from your arm) into it. It's called a blood patch and this patch will actually rid you of the spinal headache within five minutes with no side affects or anything. It was truly amazing, I've never had a migraine that's been totally relieved like that spinal headache was--however spinal headaches are not fun at all and I never want one again if possible. Therefore, this was my worst fear. Yet, the specialist informed me he'd only had three cases of hitting the spinal fluid himself, which was a bit reassuring.

I decide to go ahead with the nerve block procedure. The specialist informs me that there will be a series of two procedures performed a few weeks apart. One month following the second procedure we will do a follow up to see if there has been any relief and if it is significant to continue with this treatment. If we continue then we will try and find a treatment plan that fits my body. Some people need to have it done every three months while others only every six months. I'm scheduled and given my instructions to stay off blood thinners and aspirin, motrin, ect. for one week prior to the procedure. Of course I have to have someone to drive me home too. However, I can eat prior to this I am told--that's good news.

The day arrives, I'm too nervous to eat too much in the morning. My husband and I arrive at the Surgery Center and do all the normal paperwork required. I'm taken back, my husband is allowed to accompany for a short time. We talk once more to the specialist who answers any questions and goes into details how the procedure will proceed. Since I am allergic to dye they will not be able to inject the iodine dye that the do prior to placing the nerve block injections. However, the doctor is confident that he will have no problems locating the area without the dye. I'm given a gown and am told only to disrobe from the waist up. I also put on a surgical head cover along with surgical shoe covers over my shoes.

I am led from the room into the operation room. I am told to lie on my stomach, they place my chin on a rest and my forehead on a pillow rest also. This leaves my mouth/nose area hanging in the open with a cloth just draped below the area. This enables the specialist full access to my neck area to where he will be placing the injections. I am not given a general anaesthesia. Therefore, I am fully awake during the entire procedure. The attending nurse then proceeds to cleanse the area with Hebicleanse since I am allergic to betadine. The doctor then informs me he will begin by giving me injections at varying levels of depths to numb me prior to the initial cortisone injection. The first injection of lidocaine is given about about a quarter of an inch into my skin to begin numbing me. They get a few other things ready as I lie there for about three minutes before another injection is given about an inch deeper. I breath through the pain. Within minutes the specialist informs me he will be injecting the cortisone and some pain medication with it. I feel pressure and still some stinging as it is injected into my neck, therefore I breath through it again. About a minute later I am told that the procedure is over and to continue to lie still until the nurse is done cleaning my neck and applying a band aid. Afterwards, I sit up, it is then I become dizzy. Which I am told is sometimes common from the medication and lying on one's stomach. The doctor shows me a x-ray he took of where he placed the injection. Says I did well and goes to speak with my husband.

I go get my upper clothes back on and am given instructions to call the next day. I meet my husband in the waiting room, he has a copy of patient instructions on what I can and can't do for the next few days. We return home. In a few hours the lidocaine wears off and I am in terrible pain. The instructions say to apply a heating pad or ice to the area for twenty minutes then take off for up to one hour. I am not to take any aspirin, motrin or anti-inflammatory for four hours following the procedure (these they have had me off of for one week prior). Therefore, I still have an hour before I can take anything like that so I apply the heating pad. It helps with the pain, I am relieved. When time comes I still require more pain relief and take two aspirin (I am allergic to tylenol and can't take motrin due to it affects my liver). I continue over the whole night and next day with the heating pad and aspirin for controlling my pain. It is a common occurrence for cortisone injections to cause flare ups for 24-48 hrs following the injection. I wonder will it be worth it?

It has now been one week since the injection, I have had some relief. Not a significant amount by far. However, the specialist did tell me I would not know if it would work or not for sure until after the second procedure. I am scheduled to go back on June 18th. Then I will see the doctor a month later, this gives the cortisone time to do it's work. At my appointment we will discuss whether or not it is working for me and if I should continue with this therapy or not. It was as painful for me as was giving birth. However, if I can actually find relief at least by sixty percent from the constant pain it will be worth it. I think I could endure doing it as often as every three months if it meant so little pain for me to endure. Especially since it only lasted a few minutes, followed by two days of worse pain. This has been my experience so far. I will let you know how things progress.

1 comment:

Anonymous said...

Hi, great blog u have here! thanks for linking me up! i enjoy reading your blog!