I had a followup visit with my PM Doctor to review my Thoracic MRI film. The NS a few weeks ago was fairly certain my back rib pain that I have been experiencing since my ladder fall in June 2005 is being caused by a small herniated disc at T8/9, but that it is compressing the spinal cord enough to generate the pain. The NS recommended that my PM Doctor treat the herniation since surgery is not needed.

When the PM Doctor first looked at my MRI film, he said that the Thoracic looks pretty good, that is until he looked at one of those "sliced" views and than said "ah hah! there it is" . He explained that the disc is compressing the cord enough for the pain and then gave me the option of waiting a few more weeks to see if the pain subsides or to get an ESI as soon as possible.

I kind of looked at him funny when he made the statement about waiting a few more weeks to see if the pain will subside, since I have already waited since June 2005 and no change!

So, I decided to let him to do the ESI on T8/9 and then he starts to mumble that he has not collapsed a lung yet doing a Thoracic MRI. Well, that woke me up! "What do you mean when you say "collapsed lung"? I asked.

He said he would insert the needle from the side and not directly into the center of my back, so I guess he was saying he must insert the needle thru the lung to get the angle he wants with the injection.

So, I do have a question, Did I hear him correctly, that he actually will go thru the lung to perform the ESI??????

Somehow, someway, I think I wanted to block those statements out when he was talking and did not ask enough questions about the procedure, but then again, I wanted out of there after waiting since 12:15, which was my scheduled appointment and I was in the waiting room till 2:30 and finally saw the PM Doc at 3ish!!! So, I was a bit impatient.

Next Tuesday afternoon, I will get the ESI on T8/9 and I guess the Lumbar area will be next, but hoping to hold off on that till after the holidays.

Oh, one other thing, I was given the usual instructions on no food or drink after midnight, no aspirin, and so forth. I asked, since my procedure is not till 1:30PM, is there not an hour amount before that no food or drink, since that is a long time to go without anything.

I explained, heck if I had a 7:30AM procedure the instructions would still be nothing after midnight, so that is less than 8 hours. So, if my procedure is at 1:30, why do I still have to fast starting at midnight??

I got nowhere with the scheduling lady on that question, she said flatly, that is what "they" want............... Her answer was sleep late that day!! Grrrrrrrr

Jyes

hi!
I have had several thoracic esi injections - and the first one did help for a few months. If you have one, get a qualified doc to do it under floroscopy - a living xray machine so nothing gets punctured. You should be sedated, and no eating just in case something goes wrong - pretty standard stuff. I would go ahead and have clear fluids up until 6 hours before - I was told that was ok.

I hope it works!!! I have had about 10 lumbar ones too - but wide awake - eek!!!!

Lisa

Hi Jyes~
I'm having an ESI tomorrow at 1pm at Mayo in Rochester, MN. Since I'm going to be wide awake, I have no food or drink limitations.

I've had facet injections before, but this is my first ESI. Mine's at L4/5, and it sounds like a piece of cake compared to your T8/9! Oh my! I can see why you would be sedated for that one!

They won't sedate you for the lumbar ESI though, will they? I just had this discussion with my doctor 2 weeks ago when I had my facet injections. I had heard on here (the forums) about people getting sedated (or versed?) before getting injections, and asked why Mayo doesn't do that.

He had many answers; the main one was patient safety. It's safer without, costs less for them, quicker for them, less people in the OR--less chance for infection..... That's all I can remember, but there were more. I just found this interesting and thought I'd pass it along.

Good luck with your injections.
Hugs,
Jan

Jan, thanks for the reply, I think a ESI for my Lumbar is next in line, I was surprised he didn't double dip this time and include it.

I think I need the relief more in my lumbar, IF that is causing my pelvic pains than I do for this rib/back pain, but I am hoping this is the cause of this pain in my ribs and will know for sure soon.

Good luck on your non-sedated ESI tomorrow. Oh, my lumbar injection will be sedated, how do I know? I was previously scheduled to get what he called a "selective nerve root injection into L4/5 area and I canceled it a week before and I was to fast for that and be under light sedation.......

Guess that is they way my PM Doctor works, always sedate I guess....

Jyes

Just returned from having my ESI at T8/9 and although I am still woozy, I was put completely under for the procedure and everything appeared to go just right. I have no idea if it helped or not yet, but that would be nice, maybe I will know by tonight, since the pain is most prevalent when in bed and hits me when I try switching sides that I sleep on.....

Jyes

Oh yes, I did fast for 14 hours, but did drink a glass of water about 6.5 hours before the procedure....

Jyes~
I'm glad it's over for you! Let me know results when you kno wsomething!
Hugs,
Jan

Jan, I wish I could say whether the ESI did the job or not, but unfortunately approximately 24 hours after the procedure I started to get a bad pain in my lower right back at the belt line. I have had this happen a few times over the past year or so and the pain is debilitating. Usually it is my right upper pelvic area that hurts, but there have been a couple occasions where the left side is the culprit.

What I think happened is that my L4/5 herniation got disturbed during the ESI procedure and I am now paying the price for that.

I called the PM doctor office and was just told to ice and then try heat and hope it subsides in a day or two.

As far as the ESI, I have not felt the pain in the back rib area so far, so hopefully the ESI was a success and the lumbar flareup will be taken care of later this year.

It might be partially my fault, I did cancel a scheduled selective nerve root injection in August that might have prevented this flareup, but at the time, I wanted a second opinion from a new NS before proceeding....

So, here I am now two days after the ESI and in discomfort from another chronic spinal problem, just cannot win some days.

Jyes

Jyes, sorry to hear about the setback. I hope you feel better soon! If you have a few left over pain killers, it may be worth taking them right now. Post when you are up to it.

Carolyn

(((Jyes)))
Sorry you're having pain! I hope it gets better soon!

Could the pain along your belt line possibly be referred pain? Whatever pain it is, it still hurts!

I definitely agree that your herniation was disturbed and is probably po'ed. I'm thinking also it'll need time to settle back down. I know my SI/PSIS injections three weeks ago set off my Fibro big time, and two facets feel worse now than before--if that's possible......

I didn't want to post this till after you had your ESI, but mine last Friday was one from he!!. I was on the table for 45 minutes and it was terrible.

There was a reason though, and I guess I understand. I have a "Large sacral cyst, intrasacral meningocele", so they had to work around that. They had to go in from the side to reach the L5/S1 nerve root instead of from the top. They kept hitting the bone.

Looking on the bright side, the radiculopathy is now numb, and that I can handle.

I'm not so sure I'll ever go through that again though, even if it is numb.......

Keep me posted how things are going! I hope lots better!
Hugs,
Jan

on wednesday I am scheduled for my 2nd thoracic ESI @ t4/t5. I did the first one wide awake, and it was a little uncomfortable getting stuck two or 3 times in the back. it does seem to be helping quite a bit, does anyone know how long they are supposed to last?? I am getting a total of 3 ESI treatments.