Thursday, August 21, 2008

5’s A Charm--And Your Science Lesson For The Week

At least I’m hoping that will be the case. I had my 5th epidural shot today.

The experience was a lot more pleasant than my last one. Pleasant is a relative word here. In fact, this was very much like the first-third shots I had in the past. I was really pleased with the way those went so I’m very, very hopeful that will be the case this time. So far, so good.

A little background on my procedure. (and lots of over use of parentheses & italics)

I think most people think of the type of epidural (an anesthesia epidural) you get when in labor with an infant. The kind I had today is called an epidural steroid injection (ESI) and is given for a herniated disc.

My Condition

I have a lumbar herniation which is pushing on my sciatica. My pain runs down the right side of my lower back, into my hip and down my right leg. At it's worst I have a painful numbness down the back of my leg and foot. I have nerve damage in my right leg and have lost the reflex in my right foot. My doctors have told told me that the nerve damage is still not deep enough to indicate it would be permanent. I've also been told that my foot's reflex should return when the disc is healed. I have had this condition for over 18 months now. I was pain free after quitting my job in April until the beginning of August. Because of that 3 month period they are treating this as if it might be a second injury, (although it's really more likely that it wasn't completely healed and I did something to make it worse again. What I did; fodder for another post.)

I’ve had both type of epidurals and they’re similar, but not exactly the same. For instance, I don’t have a baby in my belly so I get to lay down while the shot is being administered. I also get to watch the machine measuring my heart rate, Blood Pressure, etc...(my BP was 86/39 when I got there, yes, they took it twice, I'm apparently a zombie.) I also get to watch the machine (X-ray fluoroscopy) that shows where they’re putting the needles; if I want (sorry if that makes you queasy, I think it's kinda cool). I walk into a surgery room and lay down on the table (in labor they come into your room w/a cart & sit you up on the bed). My doctor likes to play music and sing while he’s working, which adds an interesting dynamic (today it was James Taylor which was really relaxing to me, so I liked it. I found Led Zeppelin wasn’t really so relaxing the day he had that going. More like driving music to me.) The doctor first uses the X-ray fluoroscopy to locate where he wants to put the shot, he has metal wand to help him be precise on the machine image and then marks it on my physical self with a pen. (When in labor, they have you hug a pillow and hunch so they can feel each vertebra. I don‘t recall any pen marks, but I could be wrong. I was kinda busy right then.) For an ESI they actually put in two shots (you get one in a labor situation) so you get two marks. In both cases they cover the area (and I do mean cover) in iodine and then give you get a shot of something (zylocain, I think) to numb the area, which stings/burns like crazy. After that they put in the actual epidural needle(s). Epidural needles are actually catheters, if you’re in labor they start the medicine and you feel pressure in your back, hip and leg. Let me make it clear that it’s a very uncomfortable pain type pressure. During labor you notice, but usually your contractions are strong enough that you are quickly over it because you suddenly get some glorious relief! In the case of an ESI, ummm, not so much. First they run some dye in each catheter to see which direction the medicine will spread. (I think this is the most interesting part to watch on the x-ray fluoroscopy screen, but it does hurt too.) Adjustments are made as necessary and then they pump in the medicine. They do this part twice because you have two catheters in you. Double the fun. Once again, huge amount of pressure in you back/hip/leg. This time there are no contractions to distract you so the pressure is a bit more noticeable. Ya think? It feels a lot like it’s coming from both the inside of you and the outside and it sort of feels like that area might implode or explode or something. There’s a part of your brain that will start to freak out because this isn’t good, and ohmygawdgetthosethingsoutnownownow!!! but then it’s done and while it still hurts, it’s better than it was, so your brain calms down. They pull everything out, wipe you down, put on a couple band aids, you change and someone (my dad today) drives you home. (In labor, you’re typically still in labor at this time. You ain't going anywhere soon girl!)

Your body will typically react to the shot (they just put sharp things though your back muscles, so you're probably gonna swell). They tell you to ice it for 20 minutes every hour and to take your pain pills as necessary. My personal experience has found that with this one it’s best to take a vicodin, even if not currently dying from pain. I take one every 4 hours till I go to bed. After that I take them as needed. I did this during the first 3 shots and was ready for my Olympic training the next day. Seriously. All. Three. Times. That’s extremely unusual. My reaction to those was so dramatic they decided a fourth wouldn’t hurt. (Poor choice of words on my part.) Most people do not get more than three in a year as they find the effects to diminish after 3.

Epidural #4 was not this same experience. It hurt like hell. Felt like someone was shooting fire down my muscles and nerves. It was awful. The worst part; it didn’t do anything. I felt like creamed crap from that shot for several days, then I just got back to the same back pain I’d been having, minus the creamed crap part. I was very nervous about my treatment today because of #4. I was scared that I’d have the same experience, all that extra pain for nothing. Both my doctors’ think #4 missed it’s mark, and that’s why it hurt so much and didn’t do anything. I’m starting to become inclined to believe them.

I do believe this many epidural shots and my fibromyalgia may just qualify this as a pain management blog instead of a mommy blog.

Hopefully, this is the last post for pain management and we’ll be back to corralling kiddies all the time again soon.

That being said…….

Tomorrow is orientation for BigSpeak’s starting kindergarten.

On Monday,



nikki said...

I hope this epidural lasts!! Take care of you.

All these blog posts about kids going to kindergarten are killing me!