Nerve Block Approved
 

Hi All,

The insurance company approved my sympathetic nerve block lumbar area. It is scheduled for 7/8/09. I am kind of of scared as this is my 1st block since being dxed in April of 09 with RSD. Between 2003-2009 I have had 8 ESI/nerve blocks and none of them have helped me. With each one though I always had hoped maybe this would be the one to work. I do have hope that maybe the nerve block on 7/8/09 will help. I know though whatever happens is in God's hands. After all there is a reason why I had to go through 3 fusions of the lumbar in less than a year and a half, have permanent nerve damage at L5 nerve root which caused bladder probs for me. Also has a reason why my RSD had moved into all my limbs and have all the side effects from the RSD like sweating, and red dots on my neck, ect. I have faith, hope, and love that is what gets me through the rough times, that and all of you on here and all my other friends, and family. :hug::hug::hug::hug: gentle to all my RSD friends

I am praying for you and sending good thoughts your way. I hope and pray you will find some relief. Keep us posted. You have lots of friends here who care! :grouphug:

I am on my second lumbar injection...with no results. I am wondering if I too should continue. The only improvement I had was for about 1 hour my foot did warm up and turn a pink color instead of it's purple/gray look....at over 5 grand a shot, I'm not sure its wise to continue.


This is scarey stuff, I'm new to all this too.

Good luck.

you in our prayers,,i believe in prayer,,and we do go thru everything for a reason,,and God is glorified 1st peter 1:6-9 ...... i hope this needle does the trick............bobber

Dear heartbeatmom,

Ballpark, if you started within just a few months of the time the pain first began, you're in the best position for the blocks to help.

If you haven't done so, check out a study I cited on the first page of this thread, "Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome," Ackerman WE, Zhang JM, South Med J. 2006; 99:1 084-1088 at 1087, free full text at http://www.rsds.org/2/library/articl...lion_block.pdf and in particular Table 2 at page 1086, which shows that in a study of 25 people with CRPS in one hand following surgery for carpal tunnel syndrome, of those who received 3 stellate ganglion blocks over a 3-week interval, those who had complete relief from pain started the blocks within 4-6 weeks of the onset of pain, those who had partial relief started at the 10 - 12.5 week mark, and those who got no relief at all ranged all the way from 11.5 to 65 and 1/2 weeks. Interestingly, although all patients were tested until six months after completing treatment, both of the groups with complete relief and partial relief saw that relief end at the same time: 29 weeks following completion of the 3-round cycle of blocks.

As best I've searched, I can't find any similar studies for lumbar sympathetic blocks, but I would be surprised if it differed much from the S.G.B. study we do have, where nearly the same results occurs (success as inversely correlated with lenght of time between start of symptoms and initiation of treatment) with low-dose ketamine infusions, as set forth in my earlier post of the thread. (In fact, I just came across a study that found that the use of a fish hormone typically used to treat osteoporosis [remind anyone of pamidromates/organophosphates?] is effective in preventing CRPS-1 in stroke patients withe severe paralysis of one side of the body if given within four weeks of the stroke, but not after six. Use of Calcitonin to Prevent Complex Regional Pain Syndrome Type I in Severe Hemiplegic Patients After Stroke, Matayoshi S et al, Disabil Rehabil. 2009 May 19:1-7. [Epub ahead of print) abstract at http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum.)

I know that my first L.S.B. did nothing, but the next time my doctor decided to do a "bilateral" block, which is to say that I got two injections, one on either of the spine. And my pain went into remission for two weeks. And I started at roughly 12 weeks out.

So, if you started the blocks within a relatively short period of time after the pain first set in, the odds appear to be in your favor if you have a third one at least - and it has to be done under flouroscopy so the medication is delivered precisely without damaging any nerves - but I would consider asking your doctor what s/he though of doing bilateral injections.

Hope this is useful.

Mike

thanks for that info...yes, it's been since last august when I got hurt and knew it was not a normal injury...so it's been almost a year. The doctor is talking about some tube that is inserted along the spine with a device that will shock or stimulate the nerves...that must be his next move. I'm not sure I like the idea, but I dont like the idea of living like this. This is terrible. My foot looks so deformed and ugly. I walk with a cane and I'm not even 37 yet. I wish there was something that will make it normal again.:(

Dear heartbeatmom -

You didn't say (at least here) but have you has intensive PT including hydrotherapy, where you work out the leg in a large tank with a built-in treadmill? It's something to consider before going to the wires. And on the last point, just run a search for threads containing the term SCS.

Mike

Nerve Pain
 

Wow, I am so sorry you are all going through this kind of pain. Let me tell you I understand your pain. I was diagnosed with RSD in Dec. 2007 and have been trying to deal with it since then. I cut my left index finger and ended up with pain throughout my entire body (very rare, I am told). I did the blocks, different pain medications, saw a neurologist which tried different pain medications. The pain was unbelievable - intense burning 24/7 (7 on a scale of 10) - I could not function nor sleep. In August of 2008, after much prayer, we found a doctor who is a professor of neurosurgery at John Hopkins and he felt the pain was coming from the nerve damage in my finger. I had surgery to cut the damaged nerve and have it grow back - yes peripheral nerves do grow back - slowly - about 1 mm per day. The pain went even higher (8) as the nerve grew back (and I experience all sorts of new nerve pain, stabbing, shooting, vibrations, etc.). During this time I was doing PT and damaged the nerve about 6 weeks after surgery. Eventually, after about 3.5 months the pain was almost completely gone for about 9 days (what a joy that was) then it came back to about half of what it was before surgery (we believe I damaged the nerve during PT). Much more bearable at a 4 but still too high. By May 2009, I stopped using my hand and as long as I did not move the finger the pain stayed around a 1 or 2 but any movement of the hand sent it up (by this time it is 9 months after surgery). My arm has atrophied. I decided on a second surgery to bury the nerve in a bone in my hand to see if this would finally eliminate the pain and allow me to use my hand. I am 2 weeks after my second surgery and still waiting to see if the nerve will calm down.

I saw an article where researches now think RSD is simply nerve damage somewhere in the body. They know people can get RSD from a visable injury to the nerve (laceration, broken bone - Type II) - more and more doctors are now trying to repair the nerve (google nerve reconstruction, nerve grafting, nerve resection). Sometimes people don't remember dropping a can on their foot or hitting their elbow and then a while later they have RSD symptoms. Type I.

While I was at the PT office, I saw a man who simply twisted his arm and have nerve pain and a woman who simply bumped her arm on the fridge door and had nerve pain. They usually start with PT to try and resolve it but it if persists, surgery may be an option.

If they can find the source and fix the problem, the pain should go away or at least lessen.

Most of the doctors I saw (about 4 doctors) said that the cut probably started the problem but it was now its own problem and that fixing the nerve would not help. Well, for me, it did help somewhat.

Find a neurosurgeon who specializes in this.

Don't give up hope! With God, all things are possible!

Hope this helps you!

results of nerve block 7/8/09
 

Hi All,

I had my 1st sympathetic nerve block 7/8/09. So far the only thing the block has done is reduce my swelling in my left side. I did get the warm feeling for a while in my left leg and foot and left arm and hand. The pain was aweful with the warm feeling. Burning, stabbing, aching. ect. I still have horrible pain in my left foot. I am keeping a pain journal from my inj. to help my doc. My doc next wants to do the same block on my right side. Don't know if I want to go through with this again. Bobber I do agree with you God has a reason for everything that happens in our life and He is always there for us anytime. :grouphug::grouphug::grouphug::grouphug:

Kate