Johnny Cash and Doctors

Sitting in a recliner in a surgical pre-op cubicle waiting for the second set of injections on the left side of my neck was not my most favorite thing to be doing, but it was not my least either.

To clarify again. These are just tests. Nothing that happens today, just as the last one will be permanent relief. That is what the Ablation will do. It will deaden those nerves endings that are pain generators for some time, maybe forever. Likely not but relief can be expected for months pr longer and can be repeated.

Having decided right from the beginning again that I’d not need any medications to sedate worked this time. I went to the surgical center calm,  and I remained calm. Having gone through the experience the day before helped. I still believe that facing the unknown sometimes is the real factor to fear. If taking the time to answer all your questions, even your fears tha may seem silly at the time seems like a pure waste of time; or you’re afraid to take up more of your physician’s time I promise you not doing so makes it worse.

The first injection I went into with thinking it was not any different from the ones I’d had before. Although different types of injections they were injections just the same. While going through the sign up procedure when being admitted I learned about some of the risks and dangers in doing the injections.

The it all came flooding back to me……

………..an appointment long ago with pain specialist Korena, my pain specialist who has been treating me for the past 3.5 years…………

She had been explaining to me that there were little to no treatments available for cervical patients. I thought that is what I heard and I was devastated.  I now can recall her telling me that the nerves coming out the spine in the cervical region are very tiny, tiny nerves. In comparison the Lumbar nerves are much larger.  It was also explained to me that the thoracic area that is in chronic spasms is tough to treat because the nerves are too closely located to the lungs. The fear of treating this area is puncturing a lungs. Okay, maybe I shut down.

To be honest and fair I think a disclaimer needs to be noted here that it has been brought to my attention that my pain specialist Korena may have been referring to the fact that she is a Physician Assistant and does not have at her hand and skill level the same options a physician can offer me. Not that I had no options at all. I’ll clear this up with her when I see her next because I really like her, and I like the relationship we have been building over the last 3 or 4 years. Having a team around you when learning to live, to thrive, with a chronic illness of any kind requires a good circle of medical professionals, they all bring something different to the table.`

I spent an entire 3o minutes or so working myself into a state of anxiety that first injection procedure. And about that anxiety medication that I had told the nurse that I did not need?  I changed my mind. I told one of the nurse to “Please go ahead and bring it on.”  As fast as she could.

This was not going to happen again. Either I was not going to be anxious, or if I was I was agreeing to take the med offered when offered.

For my second injection I knew what was coming. There was no more fear of the unknown as there was no longer any unknown. I’d felt a bit foolish and embarrassed with the first injection and my reaction, I felt required to tell the doctor and his surgical staff I am not normally that way and to apologize. I was able to prove that to them that was not who I was on most occasions, not needing anti-anxiety medications with this second injection.

So love it when a plan works.

No need for anxiety medication this time…. No… Really, I mean it this time.

Test  injections, both times – all three individual injections took about 10 minutes. The doctor first searches out and then lines up the nerves involved, which are called the “Pain Generators” MAKES SENSE , YES?  With the aid of a fluoroscope and a radiologists he looks on a monitor searching for where the tiny nerves are that are causing so much trouble. Once he finds the nerves he believes are involved he first make a mark on my skin for all three spots. C3 -4, C4 – 5.  A small nerve called the dorsal and medial nerve  is a branch of the spinal nerve, and it transmits pain from the facet joint to the spinal cord. Each facet nerve transmits pain through two or three of these nerves.  Medial branch radio-frequency ablation is a technique that makes use of a tiny heat source at the tip of a needle to quiet the pain transmitted by these minor  nerves . Despite their small  size, the medial branch nerves can transmit a lot of chronic neck pain.  The ablation is even less invasive than minimally invasive surgery. Which is why I am opting this route.

When patients have spinal arthritis as I do, so many structures can be reported as abnormal on an MRI, that it only serves to confuse the diagnosis.  The way to tell if a part of the body is painful is to block the pain impulses coming from that part of the body, and see if the pain disappears.  This is called a diagnostic injection.  A diagnostic injection can be into a facet joint or the nerves that go to the facet joint. as in my case  A diagnostic injection often involves more than one nerve branch at a time.  This is because if even a single nerve branch is left behind to transmit pain from the spine it can still feel awful.

As the same nurse from the day before came to get me for the injections all full of smiles he said to me, “we really have to stop meeting like this Miss, the staff is beginning to talk.You were just here yesterday and I suppose you’re going to try to come back again real soon to see me.”  I could not help but giggle like some silly school girl.  Too funny. We got into the surgical suite and Dr Swift was listening to Johnny Cash again. I talk about the song writer Jimm Webb, who wrote a lot of Johnny Cash’s music while Dr Swift and his staff began to prep me for the injections. The whole procedure was over before I know it. Painful is not the word I’d use for the sensations involved during the injections. There were times of definite odd sensations in the spine of my neck and some pressure into my shoulder and up into my head. Nothing that surprised or alarmed Dr Swift. Upon finishing the staff reassured me that for the actual ablation they’d be there too for me, always prepared to make me as comfortable as they could.,…..

…. then they told me that they would be playing Johnny Cash’s ” Ring of Fire” for me on the day of the ablation.  Now that’s Creative Thinking!

Rolling back to the recovery area I knew immediately I was not receiving the pain relief as I had the day before with Injection Procedure #1. I said so and was asked to be sure to mention it to the doctor. One aspect of the process is to keep a pain diary for where I was before the procedure at rest, and at my worst position that makes the pain worse.

0 being no pain at all  10 being the worst pain you can imagine.

 

The system of the Pain Scale which is used world-wide was invented by Basim Erzouki  to be able to reference where a persons pain level is so that communicating it to another can be understood and relatable.

The second injections pain diary numbers did not look as good as the first. Even before leaving for home and reaching the 1st hour posit injection I knew something was different. Thankfully Dr Swift was not the least bit put off by my response. As he realized I was getting a bit upset thinking this meant the Ablation was a bust in my case he quickly came to my rescue by informing me that 1st test results were conclusive enough. He told me he had what he needed and for me to go into the Mother’s Day weekend with plans to get better. Praising him and God all at once almost I practically skipped home.

I was compliant in following up on the pain diary anyway as asked and phoned the numbers in to Dr Swifts office today (Monday). I was told that sometimes with a different medicine in the second injection the response I had was fairly typical, and that too it could have been that the injection needle was not put in as deep.

Either way the thing is we made it. The injections are done, the numbers are in, and now we are waiting for the date and time of the actual Ablation

 Yes waiting….. feels like a large part of our life is spent waiting when medicine is  involved. But just imagine what a world would be like without medicine. Imagine what it is like for those people in countries where civilized medicine is low to the bottom on the totem pole.

I’ll gladly wait, even though there may come a grumble or two escaping from my lips its done in good nature, its done with great gratitude that i actually get to wait.

The second series of injections in the same site made for a very sore neck and shoulder when all medication did finally wear off. I had severe spasms even radiating into my left lower jaw. It’s nothing new nor alarming, Nothing that some heating pad time and pain medication didn’t help remove the worst of it.

 The ablation doesn’t kill the nerve.  It just disconnects the nerve arm (axon) from the nerve cell  body which lives near the spinal cord.  The nerve cell body can re-grow its nerve arm in 6-12 months Then it can be done again if desired. And who would not desire this procedure if living with sever spine pain. My husband had his done in the Lumbar region of the spine close to 2 years ago and it’s still giving him great benefit. So I have it on good authority this should be a success.

For a really good explanation about this procedure please visit:

http://www.eorthopod.com/content/radiofrequency-ablation

Its taken me a couple of days to write this. I want to be informative, and hopeful without coming across cheesy. It’s important to me that no one go through feeling like they have no options left. I’m not saying every person I come across is going to have options – or that I am an expert on their case. Obviously not. What I am saying is don’t give up hope, that I will research with anyone – anything they need to find answers. Ur to find someone who has answers,  like was done for me.

  All you have to do is let a hint sneak out that help is needed.

 tjhelser 2012

 

 

 

 

 

 

 

 

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3 thoughts on “Johnny Cash and Doctors

  1. I am so glad and relieved that this procedure is going to give you some much needed break from the pain. You did your homework on this procedure. Good for you Toni!!! I’ll write you later today!

  2. merci mon cher ami
    You are my number one supporter and chapion for my cause. Can I express to you just how much this means? Well maybe, but it cannot be enough.

    You not only support me but you also applaud my efforts. If I learned one thing from the whole implant fiasco it’s reaserch, research and research!

    I am finishing up with WP comments and then hitting email so it sounds like I may find one from you. Awesome!

  3. Pingback: Still Waiting…..and Waiting….On The Man | Lady Barefoot Baroness

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