Yesterday after three weeks of absolutely debilitating arm, mid back and neck pain, with pain radiating down my arm and loss of use of my left had I had the cervical epidural steroid injection. I am a freak about needles to begin with - was in a terrible car accident as a little kid and as a result spent many summer breaks with visits to the hospital for surgery. Back then there was really no rehab to speak of -just fixing the outer appearance, which included skin grafts on my forehead. Additionally, after/during that ordeal of surgeries I had to have tonsils removed at five (accident was when I was 3 - through the windshield of the car my mom was driving, standing on the front seat no less!). I am sure I had PTSD from this and never totally got over it. Had three kids natural childbirth because of my fear of needles! So when some of the resulting wear and tear on the bad accident as well as genetic spinal issues came together in a cascade of crippling pain about five years ago (it was always there but I winced through it till I no longer could) I was referred to a neurosurgeon. She has been seeing me twice a year now, annual lumbar and cervical MRI's, and monitoring my issues and has told me all along one day a couple of BIG surgeries are in my future. And then told me that there is a good chance, with the amount of degeneration and damage I have, my pain could be no better, worse in fact, but paralysis and function could result at some point if I do not have it. Great!
With my usual bite the bullet approach, I began to walk about 3-4 miles per day, knowing that I have to keep moving or die. The old sciatica that was so bad several years ago abated some; I just can't spend hours in a car or flying to sitting which is certainly life changing. I decided to try to conservatively add some upper body stuff - I have been through PT several times and had notes and experience and thought I was clear on what I can do. But during a workout over three weeks ago, I definitely badly hurt myself. My understanding is that the path that my spine provides for the spinal column and nerves associated with it is so damaged, bent and slender that really almost anything can touch off terrible pain. But - as I said I had been doing pretty well and since I am over 50, post menopausal, low thyroid, all that great stuff keeping my weight right is also important to control blood pressure issues, cholesterol, etc. It is a slippery slope even if you do your best to be healthy. By the way, also have a type 1 diabetic son and although I am not a licensed dietician I think I could be! And I cook everything from stretch and we eat good food.
Anyway, my neuro couldn't see me for over a month when I called after day three of nauseous, constant pain - no sleep as it turned out for three weeks till last night after my procedure. She referred me to a PSHYIATRIST, not an anesthesiologist, who is part of a large very reputable pain management group here in Tampa. I had not heard of the specialty so of course, I looked it up. They deal with not just administering drugs, but with the whole, hurting person. Most of his patients have damage and chronic pain. He also was telling me that a) looking at my MRI's he didn't think there was anything to be done for me from a pain relief standpoint with getting surgery, which I pretty much already knew. What I have been doing is getting the annual MRI's to see if anything is getting worse which so far it hasn't (pretty much] maybe because there isn't much that could get worse!). So I keep on, keeping on. Finding out that there could be relief for this all with pain management in a rather conservative, not overly pill popping way, was a revelation and while I had my days of lying in bed recently, thinking if I had to have the same level of pounding, unrelenting pain as labor was I would rather die, I also know I do not want to be drugged up most of my life.
The qualms I had about the procedure were baseless as far as being scared of the needle thing went. They gave me Toprodol, a non narcotic pain reliever intravenously when I got there, as I had a very bad night. It is like a Mega Motrin dose. My blood pressure was 169/110 when they first took it. It came down after that dose about 20 minutes later to 133/83 even though I was still anxious about the procedure and the pain was not entirely gone. They then gave me Versed, which I had read terrifying things about - waking up feeling pain, knowing you are paralyzed, people getting PTSD from it. All I can say is, they put the Versed into the vein, by the time I got to the room I was groggy and they positioned my face down, sort of like an elevated massage table (I think I joked about oh, I thought I was there for a procedure! Thank God it's a massage!). The next thing I knew it was over. About 15 minutes in all and then some recovery. They do go in through your neck (or lower back) with a small needle, and anesthetic is used to dull that - fentanyl I think (sort of like morphine). Can't recall one thing about that. They told me when the first 24 hours was up I might 'regress' some till the steroid begins to really work, which can take 3 days or so. Right now I have a minuscule pinch in my shoulder blade area, but about a 2-3 out of 10. I slept for the first time without pain waking me up last night. That alone was worth it all. I follow up with him next week then I think there are two more planned. Then possibly a facet joint round of injections for which you are knocked out.
This particular doc told me that the reason he went into this specialty, after looking at the MRI and reports is that his own mom, who is a little older than I am, was in a wheelchair from the kind of stuff I have going on. He seems vested in it because of that I had really prayed for a miracle. I don't know if I have a miracle, but I do have relief right now, and confidence on my plan for care and in my doctor. That is the best at this point I can ask for.
I know other people who have had injections who said they didn't work for them, they hurt like crazy, etc. My understanding of the Versed is that it keeps you totally still. You are evidently awake but I had no remembering of any of it; they like you to be awake to get your input and monitor how you are doing. If you are anxious you may move or flinch and that can affect a bad outcome. All I have is my history and experience but I would say to anybody - get a doctor you trust, educate yourself about your condition and treatment and I think you will be glad you did it. When we read a lot about how certain things make us "fat" or "will have lasting terrible effects" or "you have no voice but surgery" it produces anxiety, a change in lifestyle (giving up or doing less because those things are "inevitable"). I would also personally recommend that anyone who struggles with such issues consider an anti depressant. For some reason, a lot of us hate to go there, but we will do a number of other things that hold us back and hurt our quality of life.