Just talked to the receptionist at the pm doc office, am getting at epidural spinal injection tommorrow but just found out they do not give you anything for anxiety or pain nothing and they don't use anything to guide the needle. she said they just take you in the other room and give you the shot- hello i don't think i like this idea too much isn't it painful ,i know i can not sit stilll as soon as they touch this area i jump with pain, and how will they know the exact area with out some kind of machine and isn't this very dangerous? I just don't know what to do, this injury had messed up my intire life. I cann't work like i did so the creditors are calling , they aare even calling my job. my dept is so overwhelming. sometimes i don't want to wake up, I don't even get out of bed anymolre unlesss i have to be at work and thats if i even go in as trhe pain ism so bad, oh ssorry got off track once again , could anyone give me some advice about what to do tommororw thanks deb

I had two ESIs which makes me no expert, but they did use a flouroscope. I know they also offer sedation regardless of the level. Mine was C7/T1 and C6/C7 and neither time did I require sedation.

I'm not sure whether there are types of ESIs that DON'T require a flouroscope - I'm hoping someone else can chime in here and give you some better info. It might be a good idea to look for a new PM.

Good luck.
Kelly

it has taken me a yea or more to get to see this pm have been to 4-5 before and all of them said they could not help me, wouldn't even give me the pain med that i know helps, this one is willong to give me the meds. but asked me if i wanted to stay in,pain the reat of my life well know i just want my life back hich i don't see happening . no oonw seems to understand the physical financial and emotional aspect of a sppinal injusry except thew one who have had it happen to them.. i do thank you so much for you answer and am hoping someone else can give me some more input. But i really don't understand how he can do a thoric (t7-8) esi without atlest an xray. what is this a guessing game, and what if he misses. i am going to my regular doc in the moning before the shot and will ask him more, though he didn't want me getting the esi either, so i just may cancel i don't know sorry but i am so confused and have to get to work, don't even know if i amde any sence. thank you to all who abswer this deb

Dag,

You aren't going to like what I have to say. But in all honesty no doctor should go blindly in and do an ESI! If I were you, I would cancel. I am sooo sorry because I know you want relief. I had a friend that was going to have a stellate ganglion block by TOUCH alone! I had her see my own spinal PM and he said...absolutely not...never, ever have any kind of spinal injection WITHOUT flouroscopy! Not only that but she didn't need it as she found out in the long run.

Honestly, though as far as pain or anxiety or holding still goes...you CAN do it. It is NOT that bad. But if you are anxious you CAN take a Valium or Xanax; they don't consider them "pain meds" so they are okay. And my own doc, just the other day, gave me Versed but only because I hate facet injections and mine were high up...C2/C3. Honestly, I worked myself up over nothing....piece of cake.

But as for this other, please don't allow them to do it without fluoroscopy. Are you POSITIVE she said no fluoroscopy? If so, please cancel. I hate to say this, I really do. But I wouldn't risk it at all! But if by any chance you find out differently, and they do use it, just remember...you can take something for anxiety if you have anything like that. Just don't take alot!

Hi Deb, I have to agree with Kathy. I would never allow them to do that without flouroscopy. I think that is very arrogant of that doc to not offer pain meds, anything for anxiety and the worst is to think that they can go in blindly and hope nothing goes wrong.

I had a selective nerve block done today and he always uses flouroscopy along with versed right before the procedure. I am still awake and feel everything, although it is not very painful. I did feel the pain in my usual spot in my shoulder and arm so he knew he was in the right spot but as soon as he added the numbing medication it went away. In seconds, literally.

If it was me I would cancel and try to find a doc that will use flouroscopy and also think about your comfort and anxiety beforehand. Can you call around and ask other pain docs about how they do their procedures? There are docs out there who can help you. Do you have insurance? Maybe you can call your insurance company for a list of pain docs. They are sometimes listed as anestheologists also. Good luck and I hope you find some answers...Sue

PS I just reread where you say you have contacted 5 or 6 pm docs in the past. I am so sorry that you can't find someone to help you. Maybe if you post where you live you can find someone familiar with docs in your area.

Deb, I'm with Kathi and Snoozie on this; there is no way any doctor would ever do a procedure on me if that doctor isn't using flouroscopy.

In this day an age, it is plainly barbaric for a doctor to risk doing a blind approach. A little guesswork here and there and that is what poses high risks.

Now that you know about ESIs, you've got something to ask other doctors about - ones who will use flouroscopy.

When the machine has been down at the surgery center, my doc has cancelled the procedure. He ain't a fool. Nor am I.

Please find another doctor... but, first, just to be sure:

I'd call the doctor's office again and ask if you can speak with a PA (Physician's Assistant), not the receptionist. Possibly, the reception mis-spoke - especially if s/he has not been present during an ESI. The receptionist could be mistaken. I'd want to find out for sure before deciding.

((((((Deb)))))),

I've had epidurals done -- both cervical and lumbar.

They only used the fluoroscope one time. And this is a major teaching hospital in Boston.

The ones that they do in my neck always work. Thanks be to G-d.

The only one that's ever worked in my lumbar region is the one that was done with the fluoroscope. It lasted close to 18 months I consider that one of my *life miracles*. It was so bless-ed to not feel that horrible pain.

I have the same concerns that you do. How the heck can they tell what they're doing without the fluoroscope. I have weird architecture in the lumbar area -- some of my facet joints are fusing to my pelvis and I also have a hemangioma. I wonder what would happen if they ever hit the hemangioma

The last time I had both neck and back epidurals -- one late spring and the other in early summer, I knew they wouldn't use the fluoroscope in my neck -- I just wanted pain relief. I specifically made the appointment to use the fluoroscope in the lumbar region. The doctor had no assistants (other than the nurse) and he just did the procedure ...

a waste of the steroids. I didn't even get the relief that you get from the anesthetic. I got no pain relief at all. I didn't even get the steroid rage that I usually get -- which makes me think the dang thing went off into spinal limbo somewhere (and I ain't talking about no dance ).

I can only get three injections per year. That means that I only have one left for two areas There should be a place in 7734 for doctors that don't use the safest procedures available.

I agree with everyone else. The thoracic area is very complicated. They have no idea what you're like internally in that area because they've never used the fluoroscope (at least I had one prior one to tell him where to do). I wouldn't let him touch me.

They get $1,000 for doing each one of these things. Some of these doctors are just needle jockeys -- they pass out the injection and go on to the next one.

Don't let him touch you. If he's a competent, intelligent doctor, he will listen to your concerns and use the fluoroscope (after all, he can get more money for doing it fluoroscopically).

BIG HUGS. I hope you get you pain relief. I hope you get your miracle.

Barb