I have heard a lot of talk about "gangleon (sp) blocks". I am, tomorrow, seeing my first RSD Specialist/Pain Specialist. And, should this be a course of treatment that he recommends, I sort of would like to know "what I am in for." After a very painful arthrogram, and NVS nerve tests, I am quite frightened of needles, and well, above all (and, aren't we all) of pain; or further pain I should say.

Can anyone offer me some feedback on the following questions:

1. How is this block preformed? Where is the injection site, or, are there multiple injection sites? Are you awake during the proceedure? If so, how painful, truly, is it. If you are asleep when it is being done, how much pain are you in when the proceedure has been completed?

2. How much pain relief, post-proceedure does it provide (I know it probably ranges from one individual to another)? How long does this relief, if there is a good success rate of pain relief, does the relief last? How frequently do you have to go back, on average, if this is required, to get them done again?

3. What other type of proceedures are done by an RSD specialist to provide pain relief in Stages I and Stages II.?

thanks for taking the time to read this and give any honest feedback possible based on your own experiences. you are appreciated!

I got a lumbar block but know of where the sgb for the upper body goes. Most docs who do blocks have a outpatient surgical place where you check in for the block. They give you all the info beforehand, such as don't eat or drink anything, get there early. What they did for me was after I went back I changed into one of those very breezy gowns and they took me to my bed. Started an IV and was given versed and maybe something else. It makes ya loopy and rather sleepy. They wheeled me into the room for the block, it looks like an operating room and get you in position.

With a sgb I guess you'd lay on your back cause the block goes in by your throat. With me I had to lay on my side of course. Anyway, a good doc will use flouroscopy which is a fancy word for live xray. He/She can see precisely where the needle is going so they can be sure to put the block in the exact spot it needs to be. Oh, before they did the block the doc injected a bit of knock out juice in my iv. When I woke up I was in the recovery area waking up! As far as I know most docs put you out for it. It's something that you should ask about though if they are going to want to do blocks on you.

My back was a bit sore but not painful, not from the procedure.

For me, the block did nothing but put me in even more agony, a big time flare for 2 months. I'm an oddball though as this hasn't happened to many people. It does vary, some people get a few hours, others a few days and others a week or two. IF it does help pain then the doc sees how long it lasts and for sure you'll go back for more of them to keep it going and try to break the cycle. Each doc does blocks on his own "schedule" I guess you could say. My doc wanted to do 2 a week for a month. Other docs I've heard will do blocks for you 1 every two weeks others one a week for as long as it helps the pain. It really depends.

First of all you can't look at RSD in terms of stages. They've done away with that particular thing in the medical books because we all will experience symptoms from all "stages" at the same time. So, no doc can classify someone as being in a "stage'.

Besides blocks, there's PT and medications. There's nothing else really to help. Ketamine is usually done for only those people who have failed all other treatements and have no other options left at all.

Hugs,

Karen

Karen pretty much summed it up. My SGB's were done by an Anesteologist and done bascially as she described it. I was put under and when I woke up it was done.

The only side effects that I noticed was talking like Donald Duck and sleeping. When they give me meds to knock me out, it takes me forever to wake up.

I think it's one of your best chances of getting your RSD into remission. Good luck on seeing the new Dr.

Ada

I will have the 7th or is it the 8th one in Feb?? Hmmm.. the first 3 ones
were done without any florscopyand no aneses.>(Twilight sleep)(and all 3 did not take! if they offer no fluroscopy.. leave!! they say oh, we know excatly which ganglion nerves we are hitting.. not so.. you will know if they did it right if you have the droopy eye,(Horners eye, they call it) kinda hoarse voice, stuffy right side or left side of your nose Well, all the rest of my SGB were done by twilight(ANES) I like it better with the twightlight sleep. It is done right near the throat box. depending on what side you have your RSD on, that is the side right or left of your throat(well, by it) ok.. when it's all over, ya have to stay until your no longer sleepy. I was NOT allowed to go home yet, wheather you have a driver with you or not. MAKE SURE YOU HAVE A DRIVER WITH YOU AT ALL TIMES!! If no one called you yet from your doc's office about not drinking/eating anything after midnight, your gonna have it without the anesthesia. Good luck, hope this puts you into remission. Love, Desi

Oops.. sorry.. one more thing.. I had some pain at the injection site and 4 times I had pain so bad that my RSD got worse before better. A lot of times this happens to certain people. You will do fine, or I still wouldn't be getting these so much!! Love, Desi

Good luck tomorrow with the Pain Specialist Rocker!

Please let us (me) know how it goes.
I hope you get a good one and not a quack like mine!

I know...it's frightening to think the pain could actually be worse afterwards, but if we don't try we'll never know.

It really is a gamble, and you'll no doubt have Cindy as well as us helping you through everything.

Lots of love...
GHL

Yes, it really is a gamble, but I remember thinking, ANYTHING to beat this RSD. The first series of blocks helped not at all (they always put me out), and this was from the top guy in the city.

So I went to Southern Cal RSD specialist, and when he decided to try a lumbar block, I handed him a script to read to me while I was out. "A script?" he said. I had written it out already, and it said something like, "You're going to beat this RSD. Hopealot's body, you can heal from this, and this block is going to help you. No more RSD for you, okay? Use this to heal." I told him he had to read it in my ear with feeling, and he agreed to.

When I awoke, I asked the nurse if he'd read it. She said yes. "With feeling?" I asked. "No, not with feeling, but he did read it."

A month and a half later, the detested cold feeling in my RSD foot for at least a year left me.

Jcrew, if you have a block or block series and read Love Medicine and Miracles by Bernie Seigel (where I got the idea of healing under anaesthesia) and write a script for your Dr. Not anything I would normally have done, but desperation brings a lot in a person

This is some information that I found on Google about Ganglion blocks.

There are many types of nerve blocks often used in the treatment of Reflex Sympathetic Dystrophy, but usually the initial block used is called ‘Stellate Ganglion Block’. The Ganglion nerves are situated in the upper neck and are part of the ‘Sympathetic Nervous System’, this system helps regulate the temperature sensation and blood flow in the body as well as regulating pain signals. By temporarily blocking these nerves, blood flow may be increased and pain signals may be diminished, it’s success may help diagnose whether the pain experienced is sympathetically maintained, but it is not conclusive, it is generally agreed that patients who are treated early in their illness respond better than those who have had the symptoms for a longer period (6 months+) patients who are in an advanced stage of the treatment may not respond at all.

The Ganglion block is a local anaesthetic such as ‘Lidocaine’, an ‘adrenaline’ drug may also be added to prolong the effect of the drug. The procedure takes only a few minutes, and involves inserting a needle into the nerve tissue situated at the side of the voice box. Usually a local anaesthetic is used to numb the area prior to the actual block, this is to make the procedure easier to tolerate. The patient should also be monitored for blood pressure and blood-oxygen supply.

Should the treatment prove successful the patient will probably be recommended for a course of further blocks, this may vary from 4 upwards, this varies from patient to patient. After the block, a patient will in all probability experience some nasal congestion on the side of the injection, they may also experience a lump in the throat, droopy eye and reddening of the eye along with headache, however these symptoms are generally short lived and most patients can resume normal activities the following day.

Hope it helps and good luck with the block tomorrow, please let us know how it goes.
Thanks