Hello friends,

Happy New Year!

I wanted to ask what the best procedure (or if there are any recommendations) for having an endoscopy with a TBI/neck injury. I have been avoiding medicines during this journey because many have begun to negatively affect me after the injury. I figure there are safer ways to go about an endoscopy, such as different types of sedation or anesthetics?

My GERD has remained out of control and I am going to see my gastro soon. I figure she will want me to have an endoscopy next, especially because of how long I have been suffering.

I am happy to have an awake procedure too, especially if that lessens/eliminates risk with head/neck stuff.

Thank you!

Yes I read many years ago about sedation and TBI.It is always a concern for me. I have not had any problems. I did twilight at the dentist, and I had a colonoscopy few months ago. I dont remember the name of it, but some call it the Michel Jackson drug? I woke right up and no side effects at all. I havent been put down hard as of yet to see if other drugs would mess with me.

I had an endo, colonoscopies, hernia surgery. sinus surgery. No problem. Full sedation even though it was supposed to be twilight sedation for the endo. One colonoscopy was twilight. The other was full sedation. The hernia was full sedation.

I refuse any Versed. It is hard on a compromised brain. Propofol is great. I have no problems as long as they do not give me Versed.

Are you seeing anybody to help you with your OCD and anxiety?

DavOD,

Thank you for your response - that is very reassuring! I will see what I can do.

Mark In Idaho,

I have been going to behavioral therapy for about 3 years to help with my anxiety/depression. There has been some improvements, though I feel like some of my progress with these emotional problems has been reversed. I recently had to quit therapy because of financial difficulties, but I am trying to find other things that I could do other than medicines. I’ve tried meditation…

I wish there were some way to get therapy covered completely by my insurance, especially since anxiety has me in such a death grip now.

I think physical therapy has helped with anxiety some too. Being able to go to a place that is meant to help my condition is reliving. But, I think I need to learn not to be anxious with joint mobilizations because, as it turns out, those sometimes trigger my anxiety too. Especially big pops/cracks! This is something my PT can help me with, and provide reassurance/information.

Maybe I should try some exposure therapy. Like, allowing myself a food/drink that I enjoy but would normally stay away from now, just every once in a while. To sort of convince myself that these items won’t significantly hurt me and reduce said anxiety. But that’s just an idea.

Thank you!

I avoid joint mobilization with pops and crack. It is too aggressive. I treated my upper neck with gentle traction and gentle manipulation. It is difficult to find a gentle therapist. She used active release pressure point therapy to cause the muscles to relax so the joint could gently realign.

I had to be very disciplined with sleep posture. It took me 2 years to learn to maintain good sleep posture.

I treated the anxiety responses by learning to avoid over-stimulation.

Mark,

Thank you. I think I realize where my confusion is coming from. I thought joint mobilizations (lower ones, like grades 1 and 2), were gentle manipulations.

The therapist is not doing any aggressive thrusting or twisting/quick turns of the neck. He is applying gentle pressure to encourage the joints to move. What he had me doing at home was the thing where they gently use a towel to the back of the neck to self-mobilize. Another exercise was while sitting, I leaned back on a soccer ball propped against the bed frame.

My neck/back are incredibly stiff from the injury, so it seems like any pressure at all, even very light, causes popping and cracking.

Can you elaborate on the differences for me? Thank you so much.

I have no idea what this means. "I thought joint mobilizations (lower ones, like grades 1 and 2), were gentle manipulations." grades 1 or 2 ??

My PT would have me lying on my back and pull gentle tension on my head as she used her finger tips to massage the vertebra so they are 'unlocked' as she gently rocked my head. She would do this after she use her pressure point therapy to cause the muscles to release.

Other than feeling like she left her finger prints in my muscles as she released them, nothing else ever felt uncomfortable or had any pop or crack.

I never sit or lie in any posture that has a pillow or such that tilts my head forward.

My bed pillow does not lift my head when I am on my back.

Mark,

This is how I understand joint mobilization grades from the articles I have read:

Grade I - For decreasing pain. Applying minimal pressure and not for increasing range of motion.

Grade II - Moving joint a bit more than before, but still nowhere near the end range of motion.

Grade III - Larger amplitude movement, close to the end range of motion.

Grade IV - Small amount of motion, but closer to the end range. Meant to encourage the body flexibility and movement.

Grade V - At the end range of motion, what is usually associated with chiropractic adjustments, or “thrust techniques.”

Thank you for the explanation! Seems there is a lot left I need to learn about physical therapy techniques.
If I could ask, what type/kind/brand of bed pillow do you use? I’ve gone through many, even before the neck injuries, and cannot find one that isn’t painful.

And, yes - I think I need to open up to my physical therapist and confess that I don’t like the current method we are trying, and would rather an alternative pathway in treating my pain. Something gentler, as you describe. What was holding me back was the feeling that I would be disrespecting him, but I realize a physical therapist is meant to help you, and that includes providing comfortable treatment.

Thank you!

For shoulders and neck, I do not believe in Range of Motion as the goal. The goal should be alignment that can be maintained.

PTs want to chart improvement with ROM. That means the joints are flexed to the max. That is counter productive for some joints.

My pillow is a floppy shredded foam pillow. It does not lift my head at all unless I bunch it up because I want to be on my side. When I sleep on my back, I bunch up the sides so my head does not roll on the side. My head is almost flat on the bed.

It took some time to learn to sleep like this.