Christmas, and Before

W ell, as I am sure all of you are aware, and other Christmas has come and gone. Despite some of the troubles I have been subjected to in the last few months of this year, (of which I vaguely hinted in my last post,) my Christmas turned out to be quite good this year, but then again, Christmas is good for me every year. I still live in the town where I grew up since 1966, and my folks are still with us, and are in great health. My sister, who also lives nearby, and I went over to the house my parents have lived in since 1967, and celebrated Christmas as we have for the last forty years. The only missing aspect of our traditional Christmas at home was my brother, but he lives in Washington state with his two daughters, so he decided to spend the holidays at home. Still, we had a great time, and it also served to remind me how incredibly lucky I am to have the family I do.

As I also mentioned in my last post, I did end up having the nerve root block procedure I wrote about back in October. Essentially I talked a little about my neck troubles, (or more specifically, my cervical spine troubles,) and how the UCLA doc suggested I have a nerve root block at the C3-C4 level of my spine.

Let's take a look inside of me, shall we? (I know we really don't need to, but I do so enjoy loking at pictures.)

Towards the center of the picture above you can see where my problem is. Remember this picture and try to visualize what I endured as I try my best to describe it.

The actual procedure was sort of a strange experience because when I left the office of the doctor who performed it, (it's an out patient procedure,) I was convinced he blocked the wrong nerve. Before he performed the nerve root block he spoke with me about my condition and my pain level. We talked about my surgery and at what level in my cervical spine that it dealt with, so as we walked into the operating room I was sure he knew what he was doing.

I was offered an IV with a sedative no less than three times by his staff, but I refused it each time. I equated the procedure with the cervical epidurals I had a few years ago. (Both are essentially the same thing; a needle is introduced into the area surrounding your spinal cord so that medication can be injected into the spinal cord fluid. Not so bad once you get used to the idea, really.) And while cervical epidurals are unpleasant, no sedation was offered by the hospital where I had them done, and therefore, I felt there would be no need for sedation during my nerve root block.

They had me strip from the waist up, and then the doctor had me lay on an x-ray table face down, and then described what he was doing as we went along. He first wiped down my back with a cold liquid, and told me he was cleaning the site. Then, he covered my back with a sanitary, disposable cover of some sort, and told me he was covering the site to help keep it sterile. Next he said that I would feel a sharp pain as he administered the anesthesia. He said he would give me extra anesthesia since I declined the sedative, and then plunged the needle into the middle of my upper back. My UPPER back.

It was at that point I started wondering if the doctor knew what he was doing. I couldn't understand why he was anesthetizing me between my shoulder blades when the third and forth level of my cervical spine is way up in my neck, but I resolved myself to the idea that he is a doctor, after all, and does this procedure all of the time, so he MUST know what he is doing.

From that point on he never said another word, he just went on about his business. After the initial sharp pain of the anesthesia, I felt some pressure between my shoulders as the doctor utilized his Tuohy needle to gain access to my insides. Shortly after that I felt an incredible amount of pain that shot right up my spine, and down my right arm. It was NASTY, kids, but it only last a moment. Still, it was long enough for me to wish I had taken them up on that sedative offer.

After a little more finagling on the part of the doctor, and some more intense pain on the part of myself, we were soon finished and I was escorted to the recovery room where I was treated to a little juice box filled with, er, juice. Of all things.

I sat there in a mild state of shock still confused over whether or not the doctor got it right. I thought about our earlier conversation, and I believed going in that he was quite clear about where we all believed the source of my pain to be. However, I couldn't reconcile the location of the injection. Why the middle of the upper back? That's a long road to C3-C4. And why did I hear him tell his nurse something about T2-T3? I just couldn't understand why he injected me in my thoracic spine when my trouble emanates from the nerve roots in a part of my cervical spine. It just didn't make sense. The whole idea afterall was to directly bathe the nerve root at the C3-C4 level with medication, so just how was that accomplished from my thoracic spine?

I didn't go to work that day or the next because it felt like someone kicked me in the middle of my back. I spent those two days mulling over the procedure, and looking at the original order written by the UCLA doctor to see if somehow it could have been misinterpreted. Nope. It was written very well, and very clear.

You would have had to have been a moron to get it wrong. So why the middle of my upper back?

Though I couldn't understand how the doctor could have injected me in the wrong spot, I was firmly convinced he had. So utterly convinced, in fact, that I called my family practitioner and the surgeon at UCLA and left messages for them explaining my fears. I was so concerned about this that it distracted me from the real goal of the procedure; did it relieve my pain? Your brain can really do a number on you when it wants to, and even when it doesn't want to, and so
because I was so unfortunately focused on what I perceived to be a pretty major blunder, I totally ignored what the rest of my body was trying to tell me.

I went to work on the third day, and the first thing I saw on my desk was a fax from the doctor who performed the procedure. I picked up the fax, and began to read. I knew at once it was the report describing the procedure, and I was very curious to see what was in that report. As I read it, it all became very clear, and for those of you with any amount of medical background, it may have been clear earlier when I mentioned the needle the doctor used.

It turns out the reason the doctor injected me in the middle of my upper back wasn't because he was a quack, but because that was the site from which they ran the catheter up my spine!

Isn't that a riot?

They ran a catheter up my spine from T1-T2, allll the way up to C3-C4. To give you some idea of the distance that involves, remeber he started from the middle of my upper back, towards the middle of my shoulder blades. awell, from there he ran a tube up to about a spot in my cervical spine perpendicular to my jawbone. That's pretty damn far, and is something you damn well want to be sedated for!

After I finally understood what had happened, it finally dawned on me that I hadn't been experiencing all that much pain anymore. In fact, the only real pain I had was the after effects of the procedure, so I guess it worked! But my relief only lasted about a week, and then I started to feel the pain again. That's OK, though, because what we were really after was diagnosing the actual spot that is causing me pain. So,we might do the procedure again, which
believe it or not is what I am hoping for because the other alternative is operateing again, and cleaning out the area giving my nerve some room to move around. Since the last time somebody opened up my neck and shuffled my deck I woke up feeling like a million little rusty knives were digging into my neck and arm, you might be able to understand why I don't mind having another nerve root block first.

So, that's the nerve root block went. Not to bad all in all, but not all that much fun either. I need to contact the doctor at UCLA and tell him how I have been doing. He will most likely want me to make an appointment to see him again so we can discuss my options in greater detail.

So, until next time, how about we close with a picture of Jackie, Angel, and Thalia all snuggled up with their daddy in his easy chair?

Yup. All in all, life is pretty good.

Posted by Jeff at December 26, 2007 11:03 AM