We went to the Pain Management Specialist today
 

Alan's doctor really thinks (from the Mri reports, etc) that Alan's neuropathy is from his back. For 19 years we have seen various specialists, and back doctors and no on ever said "Aha, we know why you have Neuropathy", but NOW, it seems with all his disc problems, etc, that it's his back.

So today was the first appointment. The specialist read all the reports that we provided. We answered all the questions and we asked our own.

The consensus seems to be that something is pinching down his back and they will do an epidural steroid injection. I had asked the person who was doing the interview "Can't you just inject something into his toes to stop the zipping and zapping, I mean, can't they inject botox or something" She said "It doesn't work like that".

She took us over to a scale mock up of a person 's back and showed us all the nerves going down the spine into the feet. She explained how when nerves are compressed or pinched, the toes can be hit hard.

So they are doing 3 epidural injections 2 weeks apart.

Now 10 years ago, Alan had one epidural. It was a big thing, he had to stay on the bed for 1 hour before they released him. It did not help him and he never got another one.

I don't know what is in THIS injection but when I asked her she said "it takes about 5 minutes, and he'll walk out of here".

But..... they can't do anything until his doctor clears him to be off of Plavix for 7 days. So we are going to get a medical clearance for that and hopefully, on May 18th, he'll get the epidural.

I know there are no guarantees and I hoped they could have done this today so we could go and have an anniversary dinner tomorrow (we are married 31 years). But she was specific. He MUST be off of plavix for 7 days.

So I shall update when he has this done.

Keep fingers crossed!!

Melody, I'm sorry, I didn't see this until just now. I just had the exact same thing (at least it sounds exactly the same) two weeks ago, and I'm having the second one this Friday. What symptoms did they say this was supposed to alleve? Mine is supposed to address a nerve impingement and help with leg pain when I walk. They told me that this most likely would not help the burning feet.

For whatever reason, I sure do hope it helps!

What symtoms?? They don't actually guarantee anything. It's a wait and let's see what happens. They know all the meds he has been on in the past. He is on NOTHING now, just the lidocaine cream that he rubs on his feet. He says it helps.

And oddly, I told him the other day "Alan, you know we have no guarantee that this epidural thing will aleviate your neuropathy", and he said; "Oh, I just hope it helps with the back pain".

So the back pain is now worse than the neuropathy pain.

Alan explains it by explaining a bell curve. He says that 8 or so years ago the pain was a suicidal kind of pain and that's when they put him on Fentanyl and Vicodin for the breakthrough pain.

I remember way back then. His pain was horrendous.

He has also tried lyrica, neurontin, etc but it just made him sick.

Actually the chiropractor neurologist did something to his back and then he was able to get off of the fentanyl (actually he had to go to detox to get off the final 25 of the Fentanyl) but they made him leave after one day because no drugs came out in the test they gave him upon admittance.

He walked into the detox place wearing a fentanyl pain patch and they too a test. It was a hard night for him. The very next day he walks in the front door and I stared at him and I said "why are you home, doesn't this take 3 or 4 days? He said "they say I don't qualify because they can't detect the drug in my system". So he had to detox at home. Worse experience he ever had.

He did it though. That's why he refuses to take any kind of pain medication.

So we shall see what happens when he goes on the 25th of May. That's when he gets the first injection.

Please let me know how you are doing. You had one injection right? Do you have any back issues? and if so, were they helped by this injection?

Thanks much for writing.

I had one session, which entailed two injections, one on each side. Well, two on each side if you count the anesthesia, which I would highly recommend. Nobody sticks those big needles in between any of my bones without a little shot first to dull the pain! They can do it easily and it's not too much to ask!

I'm not sure what to say about the leg pain. I don't really have any back pain--they just say that the nerve impingement is there--L4 or L5--I can't remember. Sometimes they seem to want me to have back pain because it would fit in better with their diagnosis but I patiently remind them that, no, I don't.

Some days it feels a lot better, but then I get a really bad day and think "well maybe it's not helping." When I go for the second I will ask if that's the usual story. I can't say for certain that it hasn't helped some. I'm just not sure what to think.

I'll be interested to hear what Alan says.

I'll be interested to hear what Alan says TOO!!!!

lol

will update when it happens.

Wishing you a pain free day.

Has your husband ever had any blocks? I am not sure the difference between a block and an epidural injection.
I hope he gets relief

Many years ago (when Alan never had any back pain), they sent him for an epidural HOPING it would have some effect on his neuropathic pain.

It did nothing. It was one injection, they called it an epidural, he had to stay in a chair for one hour after the procedure and then we went home.

I asked about this and now they don't make you sit in a chair for one hour to monitor you. I gather so many people get these injections that you just go in, get the shot and go home.

We shall see.

Well I hope he gets relief. I got a sympathetic nerve block that was placed in my spine but lead to my leg pain but I think that was for the rsd pain. I wonder why they don't treat PN pain with these types of blocks? Maybe they do but I don't hear much about it.

The treatment course for your husband with 3,2 weeks apart was similar to what was suggested for me but then the plans changed. Will they have him do PT during this as well?

I would ask what is in the epidural injection and get the written report. This way if he see's another doctor and they ask he will be able to say.

It's cortisone. I asked Dr. Fred. He explained the whole thing to me.

Each of his doctors knows everything he's going through. Except his neuro who doesn't seem to know ANYTHING.

Doh! Got to the intake lady (nurse?) and remembered that I took aspirin yesterday morning! I completely forgot this time around that I wasn't supposed to because of the potential for bleeding! They say you could even wind up paralyzed (I wonder if that's a rare extreme, but I don't want to test it, you know?) So I had to go home without getting the injection yesterday. My own stupid fault.

So I have to wait until Monday to make another appointment.


But you know what? When I was walking into the building, it made me think of when I last walked in there for the 1st injections and what a struggle it was for me and how it didn't seem so bad walking this time. So maybe it is helping! I'm just afraid to jump to conclusions...I know you all know how it is with the ups and downs.

Joan:

The only thing Alan was told to go off of is Plavix. No one mentioned anything about aspirin. He even asked the pain management specialist if he should go off of aspirin and the 4000 of Omega 3 fish oil he takes and she said "All we care about is that you go off of Aspirin".

so ANYONE!!! Alan's doctor wrote the note clearing him for the procedure and wrote that he can go off of Plavix for 7 days prior. What do we do about the aspirin and the fish oil??

thanks much

Typically before surgical things, all substances that thin the blood should be stopped.

Fish oil
NSAIDs, aspirin
Vit E
Blood thinners (like Plavix)
Even SSRIs, because they increase bleeding

Contact the pain specialist and get more specifics. Every office is different in degree.

Hi! I just had an epidural shot into the neck. The physiatrist had me go off fish oil, aspirin, anti-inflammatories (i.e. ibuprofen) and all vitamins 1 week prior to the procedure. The reason they told me that I had to go off the vitamins is there could be something in the vitamin that thins the blood. Aspirin and anti-inflammatories are thought to thin the blood, too. Definitely check again with the place during the procedure.

It is basically an in-n-out procedure. Some anesthetic to numb the area, then the medication is injected, then you are monitored for a few minutes afterwards to make sure the vitals are okay.

Jeepers, Mel...maybe I was stooooopid for a reason! You better check and maybe it's a good thing that I made a mistake and then mentioned it here!

Contacting the pain specialist first thing Monday morning.

THANKS MUCH

P.S. When Alan and I were sitting being interviewed by the person who takes down all the info and she's the one who said "You MUST get a release from your doctor to go off of Plavix for 7 days prior to the procedure", Alan chimed in 'But I'm on aspirin, and I take Fish Oil".

She said "We are only concerned about Plavix"


I remember that conversation like it happend 5 minutes ago because we both said "But isn't Aspirin a blood thinner and isn't fish oil a blood thinner", and she again said "We only need you to be authorized to go off of plavix" Alan was going on and on about the supplements he takes and the lady said "no, we are only interested in the Plavix".

But believe me, I'm calling on Monday
I guess each office has their own rules

It is possible that the "release" they seek is a legal thing...
Plavix is RX and all the rest are OTC. Doctors must give RX for Plavix but OTC things are up to the patient.

I am concerned because ALL blood thinning things should be included in the final directions to the patient. So while it is true, legally they need that release from your doctor for the Plavix, it is their responsibility to see that YOU the patient do not consume other drugs or OTC things that can thin the blood.

You know I have been researching Fenugreek, (put a thread up on Diabetes forum), and Fenugreek has blood thinning potential too. Does Alan eat those sprouts with you? Many herbs including ginger have warnings to not consume with Coumadin, because of this blood thinning potential.

The doctors doing surgical procedures typically have lengthy lists of things to avoid. I don't understand what is going on at this place Alan is due to visit. It is possible to hit a blood vessel doing spinal injections. The bleeding warnings are to cover this possibility.

I'm sure it's a legal thing. They were specific about not doing anything unless his physician wrote an actual clearance for going off of plavix.

Sending you a PM.

Melody

You know if Alan stopped his Plavix without his doctor's release, to have another doctor do a "procedure" and he then had a heart attack, the surgeon could be liable for being sued. This is to protect the surgeon, NOT Alan.

Here is a typical pre-procedure guide:
http://www.spineuniverse.com/treatme...ural-injection

It is interesting that the OTC things including aspirin are not included. I know a gal who had one in her neck, and the doctor hit a hemangioma, and she bled into the spinal canal and was severely injured as a result.

I'd call the doctor's office just to make sure.

Now you KNOW I'm calling the doctor's office.

lol

Hi All.

Just got off of the phone with the Pain Management Doctor. He says Alan can stay on Aspirin and Fish Oil.

I wanted to make sure so I asked again and he said "no, there's no problem"


So, because Alan takes 4000 a day of the Omega 3, I simply said "Alan for the 7 days you will be off of Plavix, just go down to 1000 of the Fish oil"

he said 'sounds good"

So that's all set.

I guess different doctors have different criteria.

But lowering the fish oil for the 7 days, well, I think it's better than taking the 4000 a day.

Melody