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-   -   Pain doctor baffled,says maybe my nerves are in different location compared to others (https://www.neurotalk.org/chronic-pain/218472-pain-doctor-baffled-maybe-nerves-location-compared.html)

upjo 04-06-2015 07:44 PM

Pain doctor baffled,says maybe my nerves are in different location compared to others
 
Hey, I visited one of my pain doctors for a lidocaine injrction in my abdomen on right side for my chronic pain of 1 year duration after lap surgery. My area of where pain spreads is small and horizontally across to one of laparscopic holes, its almost like if you put 2 fingers together horizontally just below my right chest side, thats how much the area of pain is, but it does cause lots of discomfort. If I pick/fold my skin in that area with fingers, it gets more tender and painful, thats how I narrowed down the area of problem and its in my abdominal wall.

To date, I have had almost 7 procedures of lidocaine injections, intercostal nerve blocks, rectus sheath blocks, TAP blocks, (all of these have been injections in my abdomen- not spine) to cover that area nerves but none have provided any relief, not even temporary. After all the blocks, my side feels normal( except the usual pain), it's almost like the injections didn't happen, I get no feel of numbness, or reduced sensitivity, inside or outside on the surface.

Today, I again had one more lidocaine injection with another doctor, same result. I finally asked him, this is my problem area( the pain gets worse if I hold my skin here), if all other doctors and you with all these injections and nerve blocks have tried to numb the nerves, why does my pain not get any better, or why don't I feel any different after the blocks, his answer was I am baffled, maybe your nerves are in different place to other people. Or maybe your problem is somewhere else.

But both of these don't make sense when even light pulling of my skin in that area intensifies the same dull achy pain( so obviously that's where my nerves are, and the pain is affected in this area), so the problem can't be elsewhere.

I can only think maybe my nerves are insensitive to lidocaine, or whatever local anesthetic they've used, and I need to try with alcohol, phenol ( unlikely I know). Or the local anesthetic is not reaching the nerves, (which also doesn't make sense after so many injections).

I asked him if I get surgery, will they be able to see the nerves or do anything about it, he said I don't know.

I am thinking at the very least if they can't see anything surgically, can't they just completely cut and remove the whole of that small area( skin, fascia, muscles) and just reattach the severed ends? Wouldn't this ensure that whereever the problem area or nerve is, its taken out?

I am wondering if anyone has anything to suggest. I am done with pain managment and going to try surgery, but just not sure if I should get the opinion of general surgeon or will prepheral nerve surgion have better idea. Thanks

EnglishDave 04-07-2015 06:00 PM

Hey Upjo,
I'm no expert on your condition, but I wouldn't think excising the area would 'cure' the problem even if you could find a Surgeon to hack away blindly. My neck injuries/pain cause excruciating pain in my upper arm and lower back injuries cause pain below the knee that can make me collapse.
The body is a wonderous machine where a problem in one area can manifest elsewhere. Keep pushing for a correct diagnosis, one will be out there.

Dave.

Littlepaw 04-14-2015 05:36 PM

Hello,

So sorry to hear about your problem. I had a nerve injury/neuroma form after a surgical procedure so I can relate. You are certainly not the first to have nerve pain after a lap procedure either. I recommend finding a plastic surgeon who specializes in peripheral nerve surgery. There are not a lot of these guys out there but they are the ones who can best identify the problem and fix it surgically IF it is amenable to surgery. If you have a neuroma or scarred down nerve they can fix just that without taking out a whole chunk of tissue. Plastics is very delicate by nature. It's worth a consult for sure, especially when one is miserable! I had to travel to Houston to find a surgeon in Texas with the right training so you may have to drive unless you live in a major metropolitan area.

Good Luck! I am sending Healing Love,
Littlepaw :hug:


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