An odd question-my new primary physician assigne by workers comp, (who has legal issues outside if a few states causing him to have his licensed permanently suspended from anesthesia to having sexual relations with a unstable patient,etc), has mentioned to me on two occasions something odd about sympathetic blocks.

I had 4 sympathetic blocks in my neck, stellate ganglia blocks, to help with my RSD in my right arm with my previous pain specialist. My new pm has said to me that he thinks the blocks I had were too low and that the area where it was given, low on my front neck, only effects the hand not the shoulder and arm and that there are other higher up ganglia that can be injected.

I had educated myself on blocks before I had then done being that I work in the medical field, (although with animals not humans lol), and everything I read about stellate ganglion blocks pointed to the area where I received them-just like the pictures show. When I asked the new pm again about what/where he was talking about, saying that I only knew of one stellate ganglia, he wasn't really able to give me an exact name but stumbled on it beig called the sympathetic ganglia?? He basically said there are three ganglia along the cervical
neck. I just have not been able to find out any info on other areas to inject for the shoulder in the neck region-in fact-every website points to the stellate ganglion being the area to inject or an upper extremity.

The reason we were discussing this is because instead of giving me a referral to a specialist as a pm should, he wanted to try as treat me first by trying a higher block and then performing pulsed radio frequency-although he explained he would charge it to my workers comp ins as radiofrequency ablation since as he stated "it is a newer procedure so most insurances won't cover it".

I am very confused by the information he has given me and trust me I am not pursuing a procedures with him at this time. I am just wondering if anyone knows of either of these two things? Am I totally uneducated and judging my dr too quickly? I do know that although illegal, many drs bill insurance companies incorrectly on purpose to get paid so that is not main concern-although I would not feel comfortable being put under on drugs knowing that although we discussed doing a specific procedure, he can do the other without my auth since the paperwork will say so and I would never know until after a point of no return. My main questions are: stellate ganglion-multiple injection sites? Only does hand? And has anyone had this pulsed radio frequency procedure?

Thank you in advance

Cozyc, You're askiing excellent questions! Although I don't know all the answers, I'll try to help and hopefully, others will pitch in!
I was given blocks by Dr S in Philly (now, retired, and it still takes 2.8 years to get an appt. w/ his successor) Which, I will do.

He treated blocks, as though they diagnostic only. I agreed.
He numbed me up good, but the pain remained. Especially in the upper thoracic area, when he sent me to Jefferson's hand center to get TOS confirmed. (Still I was the test dumbie for TOS, He brought in droves of students, at least a dozen/day, probably more, and I was told to 'stick em up", hands up, at a 90 degree angle, then rotate or force the shoulders back. You can do this yourself, if you have someone, and you have TOS, they'll notice that you lose your pulse when you do this maneuver. Also, your hands will turn pale, due to lack of circulation.

Also, first and foremost, check with your attorney, (with W/C you need one, don't pay more than 25%) and FIND A NEW DOCTOR!
Talk clearly, but calmly to the ins. company, or take your attorneys advice, not mine!
Some Attorneys can be too aggressive, and tick off the ins adjuster, just what you don't want!

I wish you the best!
I have friends in similar situations, and I've been through this, although with Auto, not W/C.


God Bless.


Pete


asb