truivia,

It's been two months since your June post so I don't know what you decided to do. I just found this forum a few minutes ago and this topic which is of interest to me.

My intro:
My PCP has for years considered my back pain 'just sciatica' stating she was sure I had some OA in my lumbar spine but never ordered an xray nor MRI.

In 2005 I was unable to walk, went to ER where they did an xray, gave me IV 5mg Valium & a NSAID - Toradol to get me on my feet shuffling along and sent me home with more NSAIDs - Naprosyn & generic Valium.

I have a hx of CKDIII which was not dx'd in 2006 and cannot take NSAIDs for pain. I have adverse reactions to all opioids so cannot take those for pain. Also have 20 yr hx Chronic Fatigue Syndrome and Fibromyalgia, and 10 yr hx of COPD/chronic bronchitis.

So my PCP ordered PT twice in 10 years which was helpful but not healing. I keep my weight at normal BMI for my height, have no high B/P nor diabetes, am a 61yo female.

Since Nov '08 my PCP had essentially ignored my lumbar pain as 'just sciatica' and as in the past ordered no xrays or MRI. Memorial Day 5/26/09 I spent the day at the ER in agony.

They gave me IV Valium 5mg which barely helped but could not give me any IV NSAIDs due to CKDIII dx. They allowed me to leave with instructions for PCP to order an MRI the next day. PCP has computer access to these records but when I called for her to order the MRI, she again took a 'wait & see attitude' for ten days to see if 'things would resolve on their own'.

I was furious. Finally on 6/4/09 she ordered the MRI which was done on 6/11/09 showed degenerative disc disease from L1 thru L5 and S1-2. More calls, more time passed and I finally got a referral to the Univ/Mich Back and Pain Center where attendings and fellows are all anesthesia pain specialists.

I researched the facility, physicians and procedures prior to my appt and took their first available appt was 7/22/09, filled out alot of paperwork which they actually read.

At that 3 hour appt the attending, a fellow and a physical therapist examined me, had studied 5/26 xrays and 6/11 MRI, went over meds I take and the meds I cannot take and recommended a lumbar epidural at L5 which was scheduled for Wed. 8/5/09. My diagnosis is Spinal Stenosis.

All were calming, kind, knowledgeable and answered any questions I had. Twice I thought of more questions, called and was called back the same day with answers.

Just yesterday morning I had the corticosteroid, Kenalog, injected at L5. The nursing staff was excellent and calming, pre-injection was gowned, had B/P, etc. checked, they went over meds I take, anesthesiologist agreed to let me take 10mgs Valium rather than IV Versed. Was in procedure room, injected with lidocaine then epidural of Kenalog injection took 10 minutes with B/P, heart rate being monitored.

Post-inj I was instructed to walk around for 15 minutes, then saw anesthesiologist again and discharged. They did require that someone be there to drive me and to just rest yesterday. While Lidocaine'd had zero pain.

So far so good. Lidocaine wore off by 1pm Wed 8/5/09. Fibromyalgia pain started flaring somewhat in legs and upper back which was not unexpected.

Today there is mild tenderness at injection site which was expected. I'm moving around normally - I never bend at waist, i.e. I'm just always careful which is normal - with no pain at all in lumbar spine. I did twist awkwardly w/o thinking and got one little twinge in left buttock but that's all.

Every patient, diagnosis is different so outcome can be different. A Board Certified Anesthesiologist with pain management experience IMO is the best physician to handle these types of injections and/or medications.

You wanted the good, bad or ugly. My experience thus far has been very good, no bad nor ugly.

I have a follow up appt on 9/1/09. Depending on the success of this injection, it may be recommended that I have up to 4/yr if it continues to help. The possibility of additional epidurals were not discussed until after I'd had the first one.

Additional PT with the physical therapist I saw in '98 and '08 will be ordered at some point. She has 30 yrs experience, understands fibromyalgia and will help me get abs stronger.

Since my anesthesia/pain specialist is highly trained/skilled and welcomes my questions, I have no qualms regarding further treatment with him.

I've always had a good/warped sense of humor which I find essential in dealing with pain (with life!), and I've learned many ways to distract myself, from the antics of wildlife in my yard to those of my 7 indoor cats. Meditation, biofeedback and other stress/relaxation techniques provide calm which helps reduce pain and I'll take any reduction however sliight.

Maintaining cautious optimism and finding *JOY* & a good belly laugh daily especially with additional stressors (current domestic/foreign events) is key for me.

If you had the epidural, I hope you received some or all pain relief. Good luck!

HTH,

Just Jo