Post by billanschell on Apr 16, 2008 1:01:19 GMT -6
I was recently referred to a pain clinic, in the hope of trying a nerve block for my knee discomfort and ankle pain. This, for me, is the last stop, having already tried a multitude of meds plus acupuncture and biofeedback.
There's no huge point or moral to this post, other than to share my story and give a little more info to others who might also be considering nerve blocks.
The first pain specialist I saw didn't bother to read my files in advance, though my rehab doctor had virtually sent my life story. His two main questions were "So what seems to be the problem?" and "Why have you come here?" He examined me very quickly and offered to do an epidural steroid injection. That sounded great until I read about ESIs, and quickly concluded that while they may help some patients (including one who recently posted here), they were completely wrong for me. I have no pain in my back itself, nor does the pain that I do have seem likely to be the result of any swelling near the surgery site.
When I called the pain clinic and said that I thought a sympathetic nerve block would be much more appropriate for me, the nurse (who was familiar with both types of injections) completely agreed with me, but added that the doctor I'd seen doesn't do sympathetic nerve blocks. In other words: He prescribed the ESI because it's what he does, not because it's what I needed. Buyer beware!
So I scheduled a sympathetic lumbar block with the staff doctor who DOES do that type of injection. Today, in the 30 minutes of prep time they allot before the injection, he had a long and thoughtful conversation with me, looked at my MRIs, and came to the conclusion that the sympathetic nerve block would be unlikely to help me except possibly in the very short term. My spinal cord is so damaged that he doesn't feel I could get the "unlocking of the pain cycle" that is the best-case scenario for multiple nerve blocks. So he talked me out of it, at some expense to the hospital; unlike the first doctor, he was a man of principle.
He is a proponent of implanted spinal cord stimulators. Because one could be placed between my spinal cord injury site and my brain (rather than below it, as the nerve block would have been), he feels it could interrupt the pain signals. He describes the result as feeling a pleasant buzzing in place of the old pain messages. He adds that the technology is continually improving, so time is on my side (in other words, if the pain isn't driving me crazy now, I should wait until it's really disrupting my lifestyle before proceeding with the implant). That was especially pertinent for me after reading some of the negative implant experiences some people have described in the archives of this site.
Now you know what I know. Above all, as we've so frequently seen: Don't assume that every doctor has your best interests at heart. Do your research, and be your own advocate.
--Bill
There's no huge point or moral to this post, other than to share my story and give a little more info to others who might also be considering nerve blocks.
The first pain specialist I saw didn't bother to read my files in advance, though my rehab doctor had virtually sent my life story. His two main questions were "So what seems to be the problem?" and "Why have you come here?" He examined me very quickly and offered to do an epidural steroid injection. That sounded great until I read about ESIs, and quickly concluded that while they may help some patients (including one who recently posted here), they were completely wrong for me. I have no pain in my back itself, nor does the pain that I do have seem likely to be the result of any swelling near the surgery site.
When I called the pain clinic and said that I thought a sympathetic nerve block would be much more appropriate for me, the nurse (who was familiar with both types of injections) completely agreed with me, but added that the doctor I'd seen doesn't do sympathetic nerve blocks. In other words: He prescribed the ESI because it's what he does, not because it's what I needed. Buyer beware!
So I scheduled a sympathetic lumbar block with the staff doctor who DOES do that type of injection. Today, in the 30 minutes of prep time they allot before the injection, he had a long and thoughtful conversation with me, looked at my MRIs, and came to the conclusion that the sympathetic nerve block would be unlikely to help me except possibly in the very short term. My spinal cord is so damaged that he doesn't feel I could get the "unlocking of the pain cycle" that is the best-case scenario for multiple nerve blocks. So he talked me out of it, at some expense to the hospital; unlike the first doctor, he was a man of principle.
He is a proponent of implanted spinal cord stimulators. Because one could be placed between my spinal cord injury site and my brain (rather than below it, as the nerve block would have been), he feels it could interrupt the pain signals. He describes the result as feeling a pleasant buzzing in place of the old pain messages. He adds that the technology is continually improving, so time is on my side (in other words, if the pain isn't driving me crazy now, I should wait until it's really disrupting my lifestyle before proceeding with the implant). That was especially pertinent for me after reading some of the negative implant experiences some people have described in the archives of this site.
Now you know what I know. Above all, as we've so frequently seen: Don't assume that every doctor has your best interests at heart. Do your research, and be your own advocate.
--Bill
