You're going to do what with a what in my where?

Fancy needle work Fluoroscopically-guided epidural injection So..  I have a herniated disc between C5-6, a bulge in C6-7, and three b...

Fancy needle work
Fluoroscopically-guided epidural injection
So.. I have a herniated disc between C5-6, a bulge in C6-7, and three bulges with annular tears (degenerating discs) from L3 to S1. Not only does the bulge/herniation put pressure on my spinal cord, but it affects other nerves. The neck is causing pain mainly down my left shoulder/arm. The lower back affects nerves that control my lower half of my body (if I sneeze I fear losing control of my bladder).

In late July, I went to my orthopedist because of neck pain.  An x-ray was taken but as it didn't show bone issues he conservatively diagnosed me with cervical radiculitis. As I had some success with epidural steroids for my back (2 injections back in 2007), we decided to first try oral steroids and rehab along with rest from boxing. I felt okay until late November, when I started feeling weakness and numbness in my left arm when exercising (such as when doing pushups, planks, or even when boxing).  I went back for the MRI in early December and the MRI showed a herniation. The next conservative step was to try epidural steroids again (not an epidural nerve block).

They inject the steroids into the epidural fat that
surrounds the disc as well as the spine

I booked my epidural at the Sibley Pain Center (same place as my two epis for my lower back) with Dr. Heckman. Below is a rough idea of the procedure:

After administrative intake, a nurse and I did the medical intake.  She took some baseline stats for blood pressure and temperature. She gave me discharge information and then we went over the procedure orally. Dr. Heckman and I then met. He reviewed the CD of my MRI to confirm the radiologist report, we discussed the procedure, and he fielded a few questions.

They would put in an IV with saline in the small chance I of a seizure from Lidocaine injections into neck (miniscule risks are still risks), that way they'd be able to deliver anti-seizure medication without having to look for a vein.

Then they did 2-3 Lidocaine injections around the epidural injection site to numb the skin/muscles and help prevent pain. Next, they use a fluoroscope to guide the epidural needle into the intralaminar space near the affected disc to deliver the steroids (the fat in this area would help draw the medicine to the affected area). I would feel a poke and then some pressure as the steroids are injected. As it is so close to my spinal cord, I cannot move or talk when this is happening.

So that is how the procedure is supposed to go.  What follows was my experience of how it went:
 
I handled the IV without freaking out, but then started feeling very warm and started sweating. We slowed down until I felt better. Between the Lidocaine shots and epidural, my blood pressure dropped out twice and I was starting to have trouble talking. This is a vasovagal response (which sounds way cooler than saying "I started to faint").  As a matter of protocol, they would not do the epidural while I'm unconscious.

The doctor suggested we stop but I told him to continue once my blood pressure stabilized (I told him i didn't come here for nothing and that I would "power through this" and that I had my "big girl panties on"). He re-sterilized the injection site and did 2 more Lidocaine shots, then he proceeded with the epidural. Once he was done, I was fine. My blood pressure stabilized and I was then allowed to have my applesauce and crackers.

my awesome blood
pressure post-epidural
I never lost consciousness. The nurse talking to me the whole time was very soothing and I was able to let them know how i was doing. They knew ahead of time that I was needle phobic and had a history of fainting. It helped them that I kept a dialogue going about my reactions -- so they could help me get through things. Next time i am wearing shorts though. I was too hot.

The whole process (intake, consult with the doctor, prep, injection, recovery took about 1.25 hours. During the ride home I felt every bump and deceleration in my neck and felt a little woozy. Once I was outside in the cool air I was fine. (This happened when i got the epis in my lower back 2 years ago--drove home with the windows open).

The rest of the day I iced the injection site and was able to move around. Steroids worked for a week and then wore off (this is to be expected as one often needs more than one shot (and up to 3 in a 6 month period) to experience consistent relief).

Rehab is lonely and taking care of my responsibilities is hard (I hate losing my independence, and thus am stubborn to a fault). I cannot take pain meds before work as they make me spacey. I have headaches almost every day on top of the tinnitus (a common symptom of cervical herniations) that is driving me nuts (you know that ringing in your ears you feel for 20 minutes after a loud concert... imagine that all the time). I come home and nap instead of eating dinner, cleaning my apt, or socializing. I wake up in the middle of the night and start cursing because my sleep schedule is so out of whack.  My bosses are supportive but I hate not being 100% (sleep deprived, spacey, and otherwise "not all there") while at work.

Emotionally the injury can be worse than the physical aspects. I feel broken and useless when I am in pain. Exercise is not recommended for me right now and that robs me of one of my coping mechanisms. I cringe anytime someone tries to hug me. And so many people have unknowingly hurt me by greeting me and slapping my back between my shoulders. I can't imagine dating when I can't bend my head to kiss a guy, and hate having to explain why I am in pain, and that I don't want pity (but often can't avoid the topic).   

Nurse Jack and Dr. Spike

Getting a checkup by Nurse Jack

 










The cats keep me company on days like this when I am in bed, propped up, and can't do much except use my phone (TV and computer are at weird angles to my head). Again it isn't the pain of the disc and how it is affecting my arm that is keeping me in bed, but the known side effects of cervical hernias: headaches and the tinnitus. It is my hope that a second epidural (and a third if I need it) will alleviate this.

I totally understand why my mom drank to deal with the pain/take the edge off and why she spent so many days in bed. I just don't want to be like that. I am fighting this with all I've got. I'm trying to avoid the medications, lest I get hooked (considering the history of addiction that runs rampant in my family). I am trying to allow my friends in on this, but I still feel it is a lot to ask (in terms of understanding or helping me), and harder to return the favor. I am trying to take things one step at a time and try not to get freaked out by the eventualities of degenerative disc disease.

I'd be lying if I said I wasn't exhausted by and scared of all of this.

Next epidural scheduled January 25.

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17 comments

  1. Urgh. None of this sounds fun at all. (Except for having the kitties as doctors. Kitty doctors are always good; they always seem to know when you need furry hugs.)

    I hope the next epidurals help more, and that you can get back to some semblance of normal soon. <3

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  2. xoxo
    I can so relate to this post & send you lots of strength and yes- gentle hugs too!
    We are gonna be the hottest chicks with walkers! Maybe we can decorate them and make them fancy? lol

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  3. gentle hugs it is...
    and perhaps a scandalous kiss on the cheek? don't move... I'll reach up for you (I'm short).

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  4. Gentle hugs always work... And I'll just stay seated for kisses. :P Thanks for the love, all!

    I hate that any of my friends can relate to this bullshit (pardon the french).

    As for the walker races.... I don't know about that... I want a motorized chair with rhinestones all over it.

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  5. I hope that you feel better soon! I totally agree with kitties a doctors they are the best. When I had my youngest, I was in the early stages of an abruption and kitty would NOT leave me alone, even for 5 seconds. Thank goodness because of him we knew something was not right and headed to the ER. Boots saved both of our lives, so I have much love for the kitty docs and especially the tuxedo kitty docs. <3

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  6. Wow Melissa! What a good kitty. I hope you gave your kitty some tuna fish for that! How does he like having a baby in the house?

    Both of my kitties are tuxes -- I'm going to go back in the entry and add another photo of my other cat. Spike is my doctor, and Jack is the nurse. It's funny how they just know.

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  7. Yep he did! He doesn't mind as long as he gets to eat everything Karter drops! lol

    I've always been partial to the tuxes. The ones I have had are the sweetest kitties.

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  8. I dunno... have you seen all the photos i post on twitter where my tuxies are cuddling.

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  9. If anyone deserves a miracle, its you. You are such a lovely person, and so effing strong it sometimes brings me to my knees.

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  10. Awww honey -- I don't think I deserve a miracle. There are people out there that will die from whatver is hurting or harming them. I'll get through this. This time around i have oodles of support from my lovies just like you.

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  11. I know what it's like to deal with tinnitis but have no idea what you must be going through this chronic pain. You inspire so many of us the way you share this experience in an open way, showing us what it truly means to be a beautiful human being.

    And f*** upper body hugs! Go the Maori way! Example: http://www.tour-smart.co.uk/images/dynamicImages/image/New%20Zealand/maori%20greeting.jpg

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  12. If a guy that hot wants to bump noses with me, I'm all over it, Katie.

    I know you know about the tinnitus (and then some!!!) and how much it sucks. I don't know how YOU do it.

    All I have are my words. When I can't throw punches, I fight with my words.

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  13. Thanks Chris...
    I know you know how much injury sucks.

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  14. I'm a little late to the table but I know how much being injured can take the life out of you. I remember how I felt when I could barely move and it was horrible. I hope that the epidural is working now and that you're feeling better. You've got such a strong spirit.

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<3 Robby