March 27, 2007

Pain 'Management'

So, I'm beginning to see that all of these procedures designed to 'manage' pain, are, actually, really painful themselves!

A little background... I've had a history of neck problems, dating back to who-knows-when. The earliest I can recall going to the doctor for treatment of said neck problems was sometime in 2004. I know I had been previous that year, but the earliest documented, as far as I can remember, was in August of 2004 (I had just suffered during my entire first - and only, to date - European vacation with tremendous neck pain. Didn't take away from the trip, but wasn't pleasant, nonetheless). Anti-inflammatories, muscle relaxers and rest was the prescription. This usually eased the pain, but it never goes away completely. These 'episodes' sometimes were stress induced, sometimes not, but came and went about every 6 months or so for a few years. Then, in August of last year, yet another episode that just didn't respond to any treatment whatsoever. A few visits to the doc, a few different types of meds and nothing. X-rays showed nothing, so my primary doctor sent me to a chiropractor. Nice guy, worked with me on the payments (not cheap, by any means, and that will be yet another *major* vent in posts to come... but I digress...), did his thing and after the first couple of adjustments, I was hopeful. The adjustments themselves weren't painful, but for a day or so afterwards, I was in quite a bit of pain. My primary was kind enough to rx me some pain meds to help me get through the initial chiropractic work and they helped amazingly.

By the fourth adjustment, I was starting to feel more pain, and the fifth adjustment actually hurt while he was doing it. When I called my primary for more pain meds, his response was that I was requiring pain meds for too long of a period, that I should be getting better by this point, and I needed to come in to see him. He sent me for an MRI, as the symptoms had started 'traveling'... down my left arm, and my fingers had started with this constant 'tingling' sensation. He, at that time, suspected a herniated (or bulging, or slipped - they have many names) disc and said the MRI would show if that was the case.

That was certainly the case. The office called a couple of days after the MRI saying I had 'several herniations on both sides' and he sent me for "Pain Management". (This was in November)

Now, I had absolutely no experience with pain management, as did nobody else I know. So, I called and made my appointment (December 21st, 2006) to meet my pain management doctor and start on this journey.

Lovely man, very kind and relays a definite confidence in his practice. I had done my googling, and discovered what a tumultuous practice this could be, what with the DEA looking over your shoulder at every prescription and treatment given. Certainly gave me a new appreciation for those who chose to go into this field.

The doctor told me on my first visit, that I will probably never be pain free. His goal, with me, is to find a 'tolerable' level of pain with the minimum amount of medication possible. Coupled with this, we will try various treatments designed to decrease the pain, but quite honestly, there just is no cure, short of spine surgery.

I've had three cervical epidural steroid injections (ESIs) to date, with no relief. Oh, maybe a very brief period of a light lessening of the pain, but nothing to write home about at all. Those, at this point, are exhausted, as insurance will only authorize three in a 12 month period. And, actually, if by the third one, you've seen no marked difference, any more just simply aren't going to help.

So, he sets me up for a cervical facet joint injection, to inject medicine into the joints in my neck, as there is a 'little' bit of arthritis there that is causing a narrowing of the opening the nerves have to go through. I had this lovely procedure yesterday. Argh! Through the three ESIs, I managed. You expect some pain, at very least, a lot of discomfort, but this one... goodness!!!! Talk about painful. Just the position I had to lay in about killed me. Mind you, I'm there because... well, MY NECK HURTS!!!! So, I have to twist and turn to get my neck 'just right' for the needleS (!) to get to the right spots. That, in and of itself, hurt!!!

Then, the needles go in!!! Most people know that the numbing medicine alone hurts, somewhat like a very painful bee sting. Well, I'm certainly used to that by now, and while it definitely still hurts, I know what to expect and just bear with it. But the actual joint injection... I can't explain the pain I felt from that. All the while trying to remind myself that this is supposed to make me feel better!!!!

I bawled like a big ole' baby through the entire procedure. I kept hearing him tell the anesthesiologist to keep putting meds in my IV. He knew. About 20-30 minutes of this and it's done.

Natalie likes to ride on my lap while they are wheeling me out to the car. I think Steve took one look at my face and *knew* this was going to be a slow ride home. I can't explain what the bumps in the car feel like when you've just had a needle jabbed into your neck. Suffice it to say that it's not pleasant.

So... follow-up in ten days. He tells me yesterday that if this doesn't work, it's a discetomy for me. Then, if that fails, spine surgery. I'm scheduled for breast reduction in June, with the hopes that I can get *some* relief from that. I suppose it'll be a summer full of recouping from surgery for me, as I assume the disectomy will be as soon as possible after the breast reduction.

I suppose there's always hope that the procedure yesterday will do some good, although, I don't hold out for much.

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