May 15, 2015
Vampires - They Bite!
There is nothing sexy about vampire bites. They hurt. Bad. OK, so I wasn't actually bitten by a vampire. A couple months ago, I had a Cervical Transforaminal Epidural Steroid Injection. I never thought I'd subject myself to such a thing, but it's amazing what you'll convince yourself of doing in the name of feeling better. Chronic pain blows. It affects my every day and it's begun to drive me mad. Simple tasks like blow drying my hair have become unbearable. Taking out the trash is a huge chore. I can't exercise. I haven't slept a full night in ages. Sitting in a desk chair feels like a torture device. I haven't even considered a ride in the RZR, speed bumps alone, cause me grief.
I've been in and out of doctor's offices. I tried 10 weeks of Physical Therapy and only my range of motion improved. I've had Nerve Conduction and Electromyography studies done because of numbness down to my hands and fingers. What a joy that was being shocked and having needles jabbed into various arm muscles. At least, Carpal Tunnel was ruled out. Next, I followed up with a pain management doctor. Which seems to be my last resort. That was fantastic too, I was forced to give a urine sample for drug testing - My first ever. Apparently, it's a requirement of PM patients. Too many abusers of pain killers, I suppose. Ironically, enough, I've never taken anything stronger than Ibuprofen. Anyhow, the PM Dr. agreed with the Ortho that ESI would be my next course of action. It is believed that the Anti-inflammatory of the steroid will reduce the inflammation caused by the bulging discs in my cervical spine. This inflammation is responsible for my pain, discomfort and numbness. Some doctors will administer these injections in a series of three. My doctor will typically only do two, because too few benefit from the third. Half feel improvement with the first, and about 75% do after the second. There is no change for approx 25%.
I was extremely nervous about the procedure. Initially, I was convinced I wouldn't do it. I felt it was too much risk without any guarantee. I hate needles. PERIOD. A giant needle inserted into my neck did nothing to ease my fears. Even if it is guided by Xray - they were still only using the best guess for the proper location. But I wanted my life back. I'm tired of the burden, the depression and not being me.
The procedure was done in a surgery center. I had to stop my Ibuprofen days before, no food or drink eight hours before. From check in to discharge, it took about two hours. First, I was given a gown and hair net. I only had to undress from the waist up. I had to give a urine sample to test for pregnancy. Once we got the negative result, an IV was started with fluids. I was asked a bunch of questions and then I was led into a waiting room. The staff was incredibly kind and patient with me, knowing it was my first time and that I was pretty nervous. I was excited that this could be a turning point of making me well; but I also feared it could make me worse or without change. I tried not to focus on the latter.
They turn these injections over like clock work. My name was called, batter up! I was given instructions to lie on my back with square pressed between my shoulders. I took a deep breath, tightened up my big girl panties and saddled up. The Xray was in my vision, but I chose to keep my eyes closed tight. My doctor said, "hello" and they went to work, setting me up with oxygen, O2 meter and blood pressure cuff. Then, they secured me to the table with straps to prevent movement. They pulled down my gown, cleaned me with iodine, positioned sterile towels across my chest and face. Meanwhile, twilight anesthesia was administered. This kept me sedated, but able to perform commands. It's supposed to provide an amnesia effect and I was woozy. However, I recall an uncomfortable pinch followed by a second that was much more painful and it caused me to buck. Had I not been sedated, I'm sure I would've passed out then and there. From there, I remember being extremely dizzy. I wasn't able to move without assistance. They wheeled me to recovery. I recall dressing with the aid of a nurse. The dizziness lessened a bit but it was replaced with a blaring headache. My pain had only increased. The injection site was terribly sore, my neck and shoulders ached and this headache grew more and more intense. They gave me a snack and drink, measured vitals one last time and I was discharged. Frank got me home and into bed. I was given a pain diary; I was told to journal the next four hours, every 15 minutes. There was never a change. I just hurt.
The headache lasted two days. Ibuprofen didn't touch it. I was miserable. I was able to remove the bandage and shower the following day. The adhesive from the bandage burned by skin and made it even more uncomfortable. My neck remained tender for days. Sneezing was positively the worst. A week later, I still felt like I had been clotheslined, tenderness remained near the injection site down to my collarbone. Hand/arm numbness comes and goes. I tried to remain positive and hoped that relief was near.
At my follow up appointment the doctor believed the injection is helping, because the occurrence of numbness in my arm/hands has decreased significantly. I do still have localized pain in neck & shoulders. He suggests cervical facet radiofrequency neurotomy to help with the pain. However, relief is not guaranteed and the likelihood is that is only temporary and would need to be repeated in the future. It also requires medial branch nerve blocks before the procedure could be done. It's pretty invasive and I did not bounce back quickly from the steroid injection so I'm extremely reluctant. I would only need to repeat the cervical injection if numbness returns.
As the weeks passed, the pain improved. Stretches and exercises I learned in PT build strength and maintain range of motion. The pain/discomfort is manageable with ibuprofen, and flexeril when it's really tight. The hand numbness happens less frequently. I cannot tell you how ecstatic I was the first full night of rest I got. It has been months since I slept thru the night. I had forgotten what it was like to dream. I'm still working toward recovery, but at least hope has been renewed.