Hi all
I was wondering if anyone can help me, i am due to get an epidural spine injection next thurs. it's at t7-8 and am wondering if anyone can tell me what to expect, can i work after this is it painful what are the possble reactions, is it really dangerous at this area. any help would truly be appreciated as i have heard some horrow storys about pain headaches and even getting paralized. anyone please help deb

Hi, Deb, I get kinda confused about days - I mean, for example, by next Thurs., do you mean Nov. 1 or Nov. 8? I'm asking because it's better, I'm thinking, if your ESI will be on the 8; it gives you more prep. time. Nothing to be scared about in terms of planning, and you'll see what I mean...

First, any risks (and, of course there are always risks with any procedure) can be greatly minimized by:

#1) Following your doctor's/nurse's pre-op instructions to the letter. Someone - either your doctor, a PA (physician's assistant) or nurse - should be going over those instructions with you, and also give you them in writing.

#2) Only consent to the prodecure (ESI) if done under fluoroscope. That's another term for live-guided x-ray or the use of a C-Arm. It enables the doctor to place the needle where intended and do the procedure in a targetted manner - as opposed to taking a wild guess about where the needle will land (and taking the "oh, let's guess; this is about right" approach is also dangerous). No matter how experienced or skilled a doctor, that approach can lead to mistakes. There is absolutely no reason for any doctor to do the procedure "blindly" (akin to hit-and-miss). You're not a pin cushion.

#3) Have a candid discussion with your doctor respective of the risks. Low as those may be, just let the doc know you would like to know what they are. Without knowing, you will be consenting to a procedure without truly offering "informed consent."

#4) Drink plenty of water the day leading up until the time your fasting is supposed to start. It can help lessen the possibility or severity of a headache following. It's not a guarantee that you will or will not get a headache. Some people do, but many also do not. (I haven't and I've had a number of ESIs, etc.) Hydration - with water - really helps.

#5) I would not return to work right away. As a fact, my doctor insists that patients do not for at least a day. Each of his patients must agree to it or he will not do any procedure.

#6) Ask you doctor now about medications and any OTCs (over the counter) medications that should not be taken for several hours, for instance aspirin, or days before your ESI. Even if it's a vitamin you might be taking daily, make sure your doc or the nurse knows about it.

#7) Write down any/all allergies you have to medications.

#8) Ask how many hours in advance you will need to fast.


Now, for the prep.:

Avoid negativity, as much as possible starting now... I mean, if there are people who are downers in your life, and you don't have to be around them or speak with them before your day, I would do so. The same focus is better spent on keeping your spirits as high or positive as possible. People tend to do better when happier.

I would also surround myself with other positive influences, such as what I listen to or watch (radio, TV, movies, reading materials) - and for at least 2 days beforehand.

I also make sure to eat comforting foods a couple of days prior - such as pasta with a light sauce (rather than a tomato-based sauce). Before the fast, I also make sure the food will digest more easily. I avoid things such as Mexican food and rich foods. I can always have those afterward .

Be sure to have some easy-to-prepare foods on-hand in case you may not feel like doing much during the time of your recovery.

Set up an area, too, for when you're recovering - make it comfortable for yourself (pillows, TV, bottled water or containers of whatever you may want to drink).

Before starting the fast, I eat a peppermint. It's good for the tummy and any upset. Plus, it's natural .

Wear loose, easy to put-on clothing, such as items that either slip or pull-on. Make it easy on yourself for when you get dressed. I also wear sandals. Mine have velcro so they just slip right on. Nurses don't want to have to struggle with someone's clothing when assisting.

Even if it's not very bright outdoors, I take sunglasses with me. At times, my eyes are photosensitive and I just don't want light in my eyes, particularly after having been consciously-sedated. I also take a blanket with me... in case it's too cold (even with the heat on) in the vehicle during the ride home.


In addition, I don't know how your doc. may do things, so I can only go by what I know, and how my doctor does things.

No driver? No procedure. He will cancel on-the-spot if he does not see the person who is responsible for driving. He requires it of all of his patients. The driver must also sign a form - after a nurse goes over the post-op instructions.

The worst thing I've seen people do before procedures? Eat and lie about it. It is important to fast at the time the doc says to begin. No one enjoys hearing another throw up.

If you need or want to know anything else, don't hesitate to ask. Someone will surely come along and offer ideas, etc.

If I think of anything else, I'll add it later.

I'd just do my best to keep all things in perspective. Not everyone has a horror story to share and not everyone experiences things the same. The risks can be minimized, as I said. Everyone is unique, but risks are known and you'd be doing yourself a huge favor to get the accurate info. from your doc. or a nurse.

Thank you so much bobbi

Oh how I love this board,it was so kind of you to reply and let me know what i am in for. The doctor hasn't given me any instructions at all except to be there by one pm as he is done for the day at 1.30. I won't be working that day because my boss said I was not allowed to come to work, hows that for a good boss now if i got paid that would be the icing on the cake but no such luck. Anyway i have asked my mom to drive me even though no one has said i needed one, but since my brother just died i wanted to get my mom out of the house, and try and have her think of anything else even if for just a little while, I know it's ot like going to lunch but hay at least i thought of something. And yes i am alittle concerned as i have heard horror stories about how u can get very bad head aches and the possiblity of paralyisis, but i really don't know anything about these shots and i really don't think it will work, i quess i shouldn't think this way, but if it could go wrong with me it always does, i hope for once in my life something good happens, well anyway do they sedate you are you in alot of pain and if so for how long, will i be able to work on saturday i have a veery psyical job and have to lift alot of weight everyday but mostly on saturday. well if you or anyone else can anwser these questions it would make me very happy thank you once again deb

You really need to ask your doc (or a professional from his office) how he does the ESIs. It does differ among doctors.

Mine does conscious-sedation (with Versed or such). What that means is: A patient isn't fully conscious but is in a dream-like state. You won't remember what was done (for the evocative stuff the doc does during the procedure to be certain the precise area is targetted) but you also will not be so far out of it that you can't think following; thinking is still believed impaired due to the use of the medication. It puts a patient in a relaxed state so that a patient doesn't jerk or make movements that can cause the needle to jam somewhere it doesn't belong.

Please go in with the mind that it could help relieve some of your pain. Mental attitude going in will factor into the outcome... just because that's how things happen.

I honestly didn't think anything, short of surgery, would help when I had my first epidural. Heck, I couldn't even find anyone (who I know off the Net) who ever heard of such a thing being done - other than for childbirth.

My first one was for occipital neuralgia (severe headaches every day) and my hand being clawed (locked in a fist-like position), which took several hours to "work" loose each day. My arm felt as if it was burning, at times, numb at others, and like it was fractured, but... it was all from my spine.

But... the ESIs definitely helped - a lot.

Only time will tell if yours is effective. I hope that you will give yours the benefit of some time.

For some people, it can take several days. For others, the relief is felt immediately.

You might also feel a temporary worsening of symptoms. Those symptoms should not persist, though, any longer than a week or so. Another thing you might experience (for a day or a few) is, insomnia. But, that, too, will pass with time.

Depending on how you feel afterward, you may be able to go to work on Saturday. But, I usually take about 3 days before I'm able to resume regular activity.

I'd be sure to have ice pack / wraps on-hand afterward, as well. Not saying you'll need them, but it's always best to be prepared. For me, ice helps with nerve pain.

If you have someone who can help you for a couple days afterward, super. If not, just a thought: Maybe your Mom could. You might be kinda wobbly and want the help and the company.

Be sure to give yourself plenty of time to rest.

Please don't push yourself too hard too fast. You will want a full recovery, which also improves the chances for positive effects from the ESI.

You have answered alot of my questions once again and for all you do i thank you so much. I know i ave to try and have a better more positive attitude and i sure will try, it's just that ever since i was 16 my life has been pure hell, except for my 4 wonderful children who i have raised all by myself and if i do say so i have done a very good job my oldet has a touch of autism and the doc said he will never talk work or leave home well he never shuts up works 2 jobs a day pays me rent so 2 out of 3 not bad my next son is just wonderful and so smart he does have depression and ocd with the possiblity of addh, but he is graduating college soon which he goes full time plus a job he likes== you see when i had my 1sy surgery he took over my job at 19 and gave me all the money to pay the bills etc. my 13 girl can be a hand full but she has heart and trys to help plus she loves school has a aplus average and is a great writer and last but not lest my 12yro she is a beuty inside and out though he can be a slob what teen isn't she is learning and she has been the one to take care of me when i was bed ridden god she must hate that cow belll hahah well i didn't mean to get off the subject i just wanted to show u my support group even though i would rather be anywhere else when i am sick they do try but they also fight so it's not a bed of roses as for my mom i have always been a second fiddle there, it was always my brother or sister, so know she will not take care of me, i don't understand it as i am the only one to take care of them though surgery's sickness everything and my siblings did nothing, well u cann't forse someone to love you and i except this. well anyway thanks for all the advice and of you think of anything else plese let me know== by they way do you know if all doc sedate you and do you think he would be willing to presc. something like valium ffrom now till then. i found an old one the other day and it did wonders even helped me sleep and for some reason helped my back pain abit which really surprised me as i don't get much relief from anything they have me on the fentanyl patch 25 and though itg did work wonders i think either i am too use to it or the pain is getting worse, i didn't want to ask for a higher dose as this doc is new to me and didn't want him to think i was a drug seeker. well take care and please write again it makes my day when some one writes to me deb

With what you've described about your children, Deb, it sounds like you've done GREAT at raising them! Way to go. I'd definitely feel proud, too, if they were mine and turned out as yours have.

A good amount of doctors - who do ESIs and other procedures - either sedate or will also prescribe something (to ease the nervous jitters) before doing the procedure. Most actually prefer to sedate because it does better ensure patients don't suddenly jerk when the needle is inserted. A quick call to your doctor's office should be the key in finding out if yours does. If not, just let them know that that's what you prefer. It will help not only you, but the doc, too .

Is it a PM (Pain Management) doc who is doing your ESI? The PM doc will understand, Deb, so don't worry about asking.

I was such a whimp before my first ESI that I cancelled it. The only thing any of my friends knew about Epidurals was that they were done during childbirth. Well, I wasn't giving birth, so I couldn't understand the purpose in having an Epidural. Geeze, I was a bit slow to catch on .

Now, when I can, I hope I'm able to answer questions for people - like you - who are having their first ESI or who have questions before and after. I wouldn't want anyone to feel as I felt when I was having my first one: Too alone and not really knowing what's going to happen.

i wish to thank you for all your help you have been a complete life saver. i do have another question, u said that i may have additional pain after, do you think it would be an appropiate time before the esi to talk to the doc about this and to se if he would up the fen. from 25 to 50, and to aslo ask about xxanax,it really did seem to help or was it valium amd why would it help? I wanted to tell him at my first visit that the fen 25 wasn't working as well could it be , because i have been on the same dose for the past 2 monnths or because the pain is getting worse, i did tell hm it didn't last the full 3 days so he wrote it for 2 days. he told me that he didn't want to see me having to use it for the rest of my life as i don't either, he would rather fix me so that i don't need anything, well this is what we all wnt isn't it, but in the mean time i am sick of the pain, did refill my ambien which i have been putting off for the past 3 weeks and that is the first time in 7 yers that i didn't have it. and joy i did sleep abit last night tho i needed another in the middle of the night. those pills are so expensive. well thank you for any advice you can give me and if i could ever help you just let me know. i have been trying to help others on the board and if i only helped one person it was worth the hoours i spend trying. wwell have to go to work, please write with any input you can

thank you and i hope you have a painfree day one day at a time right

deb

I'd go ahead and ask the doctor about your medication(s) - if ones need adjusting or re-filling. On the pain medications, he might want to wait (for an increase) until after he sees and finds out how you feel following your ESI.

If you do feel a temporary worsening of symptoms or pain, Deb, I should have also pointed out that it will most likely be related to the positioning or posture during the procedure.

If he does use sedation, I'd ask the nurse for x-tra pillows; one under the chest and stomach and one for under the shins. I found out that that really helps cushion (even though I don't remember a darn thing that happens during injections). There isn't as much pain that way from whatever posture.

I don't really know why Valium helps, yet, before I have a brain MRI or travel, my doctor prescribes some. I think it relaxes the thought process and helps with anxiety. I know, it sure helped me, too.

Just think, Deb, one day, someone else is probably going to have questions about ESIs, and you'll be helping ... since you'll know what happens, have some tips of your own, and have been through the recovery and rest time .

I'll let you know if I need anything . For now, I just want you to feel better after your ESI. That'd be the best!

Once again you have been so helpful, i hope i have the knowledge you have once this is all over. And you can bet that I will be more than happy to help anyone I can, It would be so nice to be able to help, as you have me, again if you need anything please let me know, if i can help i would be pleased. Well i am acctually going to go out for once, got stood up (i think) for dinner but thats ok, i'm use to my own company, it's his loss, though it was nothing definite and he knows where to find me, if i am so inclined. gee i most feel better as i am now on a power trip, we go girl.bye till later and thank you so much i believe it was your help that has finnally gotten me back to my strong self yayayay deb

If he stood you up, did you still go to dinner? I sure would!