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Posted 11/8/2012 7:06 PM (GMT -5)
So, I had my first round of x-ray guided cortisone injections yesterday. Although it wasn't nearly as bad as I'd made it out to be in my head, it wasn't exactly pleasant either.

The doctor decided to do the injection at L4-L5. Most of the damage is at L5-S1. So I really don't understand his thinking. He seems to think that the ruptured disk at L4-L5 is causing a lot of my pain.

He said it will take a week to get the full effect. So far I've noticed no difference other than more pain.

I have to go back for a second set of injections on the 21st.
Posted 11/8/2012 8:42 PM (GMT -5)
I didn't get relief from my injections and I had 5 sets of 3. I loved the way I felt the day of but I had no relief in the following days.

But I know people who have had success with the injections. I had to have 4 surgeries to correct my issue. I can't say I was pleased between each one but I am virtually pain free now. Weather and over exertion effects me. I can control one but not the other.

Good luck! Don't give up. Continue with the injections and see if they help. Have hope!

Michele
Posted 11/8/2012 8:45 PM (GMT -5)
He may not have been able to get to that damaged area for the injection, or he was concerned about causing more damage by injecting in that site. The nerves come out in bundles from different sites to form into bigger nerves, kind of like smaller veins merging into bigger veins. Most times, if he can't get to the actual site due to damage or actual physical limitations, the backup plan is to go to the next one up, which can still provide relief, because it's still getting to part of that bundle. Next time, he may go to the one below, and catch the other part.

Plus the meds tend to spread a bit, so some is getting to the L5-S1, even though he had to go in one higher.

The pain you're getting right now is soreness from the actual lumbar puncture. There was a needle in there after all. Once that goes away, you should feel the effects of the injected meds.

Were you awake during the procedure, or did they put you all the way out?
Posted 11/8/2012 8:46 PM (GMT -5)
I've had many of them over the years and they have helped pretty darn well for me with the inflammation. It may take a few days to take effect.

The big thing to watch out for is insomnia or feeling restless. I didn't realize this the very first injection and I was wired and couldn't figure out why until I asked my Pharmacist.

I hope that it will kick in a bit and give you some relief with the inflammation.
Posted 11/8/2012 9:03 PM (GMT -5)
Kaely,

Just wanted to wish you well and I hope that you find much needed relief soon from the injection.

I am not doing to well so I just wanted to send you a couple of soft (((((hugs))))) to you. Hope you feel better tomorrow.

Hugs,
Barbara
Posted 11/9/2012 12:09 AM (GMT -5)
Hi Kaely I to have had many injections like that, and usually it takes a couple of days before they have any noticeable affect. The problem I had with most of them is the relief did not last more than three weeks. So it hardly seemed worth the trouble for just that short amount of time. But, my surgeons always asked if I had them and if they gave me any relief. I was told that if I got any relief from them, then it was an excellent sign, that where they gave the injection, that was the major problem area! My surgeon  said they kind of use it  as a diagnostic tool. Oh yes I know I always felt a little worse right after getting the injections, but I was told that was normal.

 

Good Luck to YOU

 

White Beard

Post Edited (White Beard) : 11/8/2012 10:13:33 PM (GMT-7)

Posted 11/9/2012 6:25 AM (GMT -5)
What snowbunny said, plus I always got a very increased appetite. I could eat anything. Like I said before, I wanted to tilt the refrigerator into my mouth sometimes. Keep some healthy foods handy. If there's junk food around, you will want it.
Posted 11/9/2012 7:21 AM (GMT -5)
No, Living I was wide awake through the whole procedure. They just numbed the area some. I was very nervous going into this but it wasn't horribly painful.

Still not noticing any relief but hoping it will kick in soon. I have to go back on the 21st for another round. If it doesn't work by a week after the second set of injections, I'm not going to bother with further trips.

It's an hour and half trip one way. Granted my dad lives in that area and I stay at his house after the injection. The trip itself is hard on me. I drive a standard and it's very painful to drive that far.
Posted 11/9/2012 11:54 AM (GMT -5)
Kaely hopefully you will be getting some relief soon, sometime it just kind of sneaks up on you, and is not a dramatic all of a sudden no pain type of thing, but instead, it can be kind of subtle, and you just might notice when you move a certain way, or do something that it just doesn't hurt as much like it used to. I never take anything when I get injections, my pain doctor offers Xanax to take before getting the injections, but I have only taken it once, and for me the med did not take affect till after the injection was done. So I just refuse  it, also that way I don't need a driver, after the injection. Actually the thing that I always thought that hurt the most was when he injected the lidocaine to numb the area where he was doing the injection, after he got that in, the injection its self was just a bit of pressure, but no real pain. I have had them just about everywhere in my spine, and anymore they are just no big deal.

 

I will tell you that just to make sure that if you are going to get any relief from them, get the full serries, ( usually of three) so many weeks apart.  Just to make sure that they are either working or not working at all. I know what it is like to have to drive a little way to get to an appointment, I have a 45 minute to and hour drive one way to any of my doctors, and that is on the interstate.

 

White Beard

Posted 11/9/2012 12:45 PM (GMT -5)
Mine is interstate too, which is both better and worse than not interstate. Less shifting but too much just sitting without moving.

Barbara thanks for the hug and hugs back :)

Bunny I'm an insomniac anyway so that's no different than usual.
Living, yeah munchies. All of the munchies!!!!!!!!!
Posted 11/9/2012 1:22 PM (GMT -5)
Living...are you saying you have been put under general anethesia for a steroid injection? I have never before heard of that....

The only time I have ever received general is during my fusion surgeries...Even my many abdominal lap surgeries, foot, and knee surgeries were just twilight...and then with the many cortisone injections, they just numb the area with lidocaine first and have absolutely no medication to sedate.
Posted 11/9/2012 1:46 PM (GMT -5)
I have been put under, as in I don't remember any of it, no breathing tube, just O2 by nasal cannula. Heart monitor and pulse oximeter installed. Versed IV to start, then they push another drug (the name of which escapes me at the moment, but it's white, it burns, and it's short acting), I'm out before they finish putting the betadine on my back. I wake up in the recovery room.

But that's because of the physiology of my back too, I think. It's a real struggle for them to get it in there if I'm tense at all. They did the first one with just the versed, and I told the doc that it was an incredible amount of pressure, and even painful after the local, so they pushed the other drug, it burned like hell going in, then it was lights out. After that, all of mine were under full sedation.

Now, my PM was an anesthesiologist and a board certified PM, as was his assistant. Your mileage may vary.
Posted 11/9/2012 4:51 PM (GMT -5)
I guess I was curious whether it was twilight or actual general anesthesia. With twilight you shouldn't "remember" things as I've had many of these done but the Dr. is talking to you (the patient) the whole time.

My PM is an Anesthesiologist and mine was done under Fluoroscope as it's important to get into the right area..and I have a terrible back with a lot of adhesions as well....but thanks for sharing....I've just never heard of them using general anethesia for just a cortisone injection even in the most difficult of cases!

Didn't mean to hijack your thread Kaely!:)

Posted 11/9/2012 7:27 PM (GMT -5)
SnowBubby21 I have heard of some people having Conscious sedation when having these injections, but I don't think it is all that common. They usually use it for Colonoscopy and other procedures like that. As I had mentioned before my PM does offer his patients the option of taking Xanax before the procedure to relax them and make it easier. I don't take it, I have never had a problem with getting the injection, there was a couple of times  where it got a bit uncomfortable, but it was very brief. I think the prep is the worst part, especially when they swab the area of your back where they are going to inject you, with that seemingly icey cold betadine solution! That alone will want to make you jump off the table! HA And I don't think the numbing shots of the area with lidocaine is very pleasant either!  And of course the position they put you in, so they can see what they need to see with the fluoroscope, is not always all that comfortable either!

 

White Beard

Post Edited (White Beard) : 11/9/2012 5:31:24 PM (GMT-7)

Posted 11/9/2012 7:32 PM (GMT -5)
WB...I can see the concious sedation/twilight needed in some people as I mentioned...I was just surprised that LC said he he got general anesthesia...That is one that I have never before heard...

I'm just the curious type! LOL
Posted 11/16/2012 1:49 AM (GMT -5)
So, It's been over a week and I see no difference in pain levels. Should I even bother going back? I have an appt for another shot next week. Not sure it's worth the bother.
Posted 11/16/2012 2:25 AM (GMT -5)
Hi Kaely, as much as I don't want to, I think you need to go ahead and try. My thinking on this, is that if it definitely doesn't work, you will have tried both rounds, for sure, and the PM will hopefully accept the results, and treat you accordingly. In my little experience, I've found doctors to be pretty apprehensive about continuing to treat a patient, when they refuse a treatment. Ultimately, it's your body, and you know your relationship with the PM, I'm only thinking of the impression that I got from my first PM who did my injections, he was very set on doing the injections, and dismissed a few patients who weren't willing to try them, those arguments always made it out to the lobby, his thing was always that he didn't want.to.continue supplying a patient with medication, when they didn't take a possible opportunity to decrease or get off the medication.

Good luck, let us know what you decide to do.
Posted 11/16/2012 8:47 AM (GMT -5)
Those injections have to be tried more than once. The steroid put in there is an anti-inflammatory, so it may take a full round of 3 to get anything. It's not like throwing a switch.
Posted 11/16/2012 10:29 AM (GMT -5)
Kaely it is not uncommon for people not to get any relief until they get the 2nd injection. If there is no improvement after the 2nd one, many times the dr will not do the third one. That has been my experience and I have seen many members here at the forum stop at two with their drs blessing if there is no improvement. Unfortunately, these injections are a real hit or miss type of thing, there is no guarantee of improvement when having them. Some drs feel it is not worth doing the third one. Also a patient can take a round of Medrol DosePak and have wonderful reduction in their pain, but again, its no guarantee.

I hope they work for you....Take care...Susie
Posted 11/16/2012 10:56 AM (GMT -5)
I also agree that you should go forward and do at least this "set" that the Dr. is wanting to try whether it is 2 or 3. Many times it takes a few times for it to work well.

As mentioned, it's really for two reasons...One, it really could end up helping with your pain. Or two, the Dr. will see that you were willing to try these to see if it could help.

I'm praying that you get some relief either way!
Posted 11/16/2012 3:05 PM (GMT -5)
Well I'm going to go next week and get that shot and see what happens. If it doesn't work I won't be going again. The other thing that bugs me is that most of the damage is at L5-S1 yet he decided to do the injection at L4-L5 where there is a mild ruptured disk.

I'm diabetic and these shots make my blood sugar shoot up for days. It's also an hour and a half drive, one way. I drive a standard with no cruise control which makes for some ugly muscle spasms.

Although I think most of this PM stuff is a bunch of hooey, I'll still give it a shot just in case it works for me. It would be worth it to me to get off the narcotics or cut them down to a bare minimum. I'm only 45 and apparently this can't be fixed so I hopefully have a long haul still to go and I don't want to build up tolerance to narcotics this early.

My pcp handles my meds not this PM. He doesn't prescribe meds and leaves it up to your regular doc.
Posted 11/16/2012 6:48 PM (GMT -5)
Kaely that seems to be a drawback for diabetics when steroids are being used. I have heard this from a lot people. I would talk to my primary care and see what he has to say.

Actually, if a person has a good pain mgt dr, it can make all the difference in the world. But, finding that good dr can really be a challenge for sure. With the new rules & guidelines out for drs that rx narcotics, most primary care physicians say no thanks, I am not putting up with the DEA or jump through hoops just so I can write scripts for narcotics.You are lucky yours is still taking care of you. Most primary care drs say I will refer you to a pain mgt dr. if you need anything stronger than hydrocodone.

People will become tolerate to their pain meds after a certain period of time, just like they will any medication they take long term. I run into this with blood pressure medications. I have been on meds for over 20 yrs and been on many different blood pressure meds during that time.

Good luck next week....Susie
Posted 11/16/2012 10:43 PM (GMT -5)
Hi kaely, I just had a comment about the placement of your shots... this is what happened to me.

My damage was at L3-4, no damage at L4-5. For some reason, when I got a copy of the surgical notes it said two catheters were placed at L3-4, and 4 were placed at L4-5. I had an appointment with my back.surgeon the next week, and asked him about it, he said, it's pretty common to do an an injection at the adjacent level, when there's severe damage; and also said, that it would take an extra couple of days, but the steroids would get to the damaged level. He said, when there's major damage present, they don't want to make things worse by trying to place to much in an already narrowed area.

Just a thought. I'm not sure if that's what happened in your case. But it made sense to me after the surgeon explained it.
Posted 11/16/2012 11:05 PM (GMT -5)
Guess I'll just see what happens after the next shot then. So far it's not worth the high blood sugar.
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