Neck and Back Update

Exactly a week ago today I had my second nerve root block in my cervical spine. You may remember that before Christmas I had my first nerve root block, and at the time I was very concerned that the doctor had injected the medication in the wrong spot. It turned out, thankfully, that I was wrong, and the doctor did indeed block the right nerve, but I was so worried he had gotten it wrong that I didn't even think about whether or not the procedure actually worked as intended until two days later. When I reported in with the surgeon about the results all I could tell him was that for perhaps five days after the procedure I felt about 50% less pain, and then maybe 20% less pain for a few days after that. The surgeon told me that, based on my report, if he went ahead with the operation there was a good chance I would have 50% less pain as a result.

I told him I wanted to have another go at the nerve root block because I wasn't sure of the results, he agreed, and that is how I ended up getting another injection.

When I showed up at the pain management office last Monday, I told the doctor that I was there to verify the results of the last nerve root block because there is a possibility I might have surgery on my neck again, and I was looking for some reassurance. The doctor told me since that was the case, he would perform the block a little differently. He said instead of coming in between my shoulder blades and running a catheter up to the site and administering only steroids, (an anti-inflammatory,) he would come in through the side of my neck, and he would add an anesthesia along with the anti-inflammatory. He said doing that way would offer him more precision in getting the meds right on the nerve root that is giving me trouble, and the anesthesia would give instant results as far as my pain level was concerned.

Before we went into the operating room I was again offered an I.V. of sedatives. After the first go around I swore if I ever did this again I would take the I.V., but after learning the doctor was going to do the procedure without the use of a catheter I decided I would be OK without any sedation. So, off we went to do it again.

The second procedure wasn't as bad as the first. They had me lay on my left side, and strapped me to the bed. They told me to bend my knees a little, and to keep my right arm down along my side. After I was given a local anesthesia I never really felt much pain at all. The first time I had done this I momentarily felt a great deal of pain radiating from my neck down through my right arm when the catheter reached the nerve root. This time, however, all I felt was the slight pain you typically feel whenever a needle breaches the skin, and before I knew it the procedure was over and I was being helped off the bed.

The doctor told me that I should be feeling relief from my pain inside five minutes. We waited for a moment, and then he asked me how I felt. Believe it or not it can actually be kind of hard for me to tell whether or not I feel any difference in my level of pain. For one thing, my condition comes and goes; one day I may have a great deal of pain, and the next day not so much. That morning I was having pain, but while I sat in the waiting room my pain had subsided, so just before the procedure I wasn't in all that much pain.

Another problem is that pain is relative. My pain just before the procedure might be more than a normal person is used to, but since I regularly have a lot of pain, what I had that morning wasn't all that bad. In other words, after living with a lot of pain for a long while it gets a little tricky trying to discern between somewhat normal pain, and pain that indicates a serious problem.

My medications also are a factor. I take some very strong pain meds, and I have to take these meds regularly whether I have any significant pain or not. The reason for that of course is because I am taking narcotics, and your body doesn't like it much when you abruptly stop taking narcotics after you have been taking as much as I have for as long as I have. My first dose of the day is typically an hour before I get out of bed. That way I have a fresh dose of medication already in my bloodstream when I get up, and that makes the beginning of my day a lot smoother than if I were to take it just as I get out of bed. That morning I took my meds at around 6AM, so by 8:30 my pain was fairly well masked. The word "painkiller" is a misnomer because the medication never really eliminates, or "kills" the pain, it just changes the way the brain perceives pain. After the medication has worked it's magic I don't feel much pain, but I do feel what I can only describe as the shadow of the pain. In other words, I still feel something, but it just isn't all that painful.

Anyway, after thinking about it for a moment I was able to tell the doctor that my pain level did seem to drop, and in fact I felt like it had dropped significantly. It remained that way for maybe two hours or so. Since then I have enjoyed much less pain than what I have become accustomed to, so I guess it is time for the $64,000.00 question.

Do I want another surgery?

Posted by Jeff at January 28, 2008 2:02 PM