In addition to my long list of health issues, which include chronic insomnia, Restless Legs Syndrome, Sleep Apnea, Fibromyalgia (and the pain and fatigue that go along with it), and hypertension, I have been undergoing treatment for a pinched nerve that causes deferred pain in my arm. The pain, on a scale of 1 to 10, is a 12 when it hits. The MRI shows something floating next to the disk, and the doc doesn't know if it's a broken-off piece of disk or a benign spinal tumor. Initially, I went to a chiropractor, but after six weeks or so, it was clear it wasn't helping and he sent me to the orthopedic surgeon.
Treatment initially was two courses of oral steroids, then I had three cervical steroid injections. I had relief from the first shot that lasted only a short time. The second shot seemed like it made things worse. The third shot helped, and at that same time, I started on Lyrica. I have gained a lot of weight on Lyrica, and some days I am so sleepy I cannot function, but the pain has been under control....but....
I am starting to experience pain in that same spot again--the arm--although not nearly at the same level. But, every day it seems to hurt just a little bit more. It started as an ache, and has progressed to a throb. I had the third shot on January 4; so I was wondering if anyone out there has had experience with this type of treatment and could tell me....how much of the steroid would still be in my system? I am certain that the Lyrica is helping, although it is interesting to note that it does nothing for my fibromyalgia pain, even though it (Lyrica) is often prescribed for fm patients.
But I digress. What are your experiences with steroids? I know my CP is peanuts compared to some of your conditions, but after coping with the inability to sleep (sometimes for weeks at a time), the fatigue, the RLS, the constant fibro pain, the thought of the absolutely unbearable deferred pain in my arm returning will put me over the edge. When it hits (with no warning), it feels like a hot burning knife is stabbing my arm. It drops me to my knees, makes me cry and takes center stage in my brain. The doc told me that I could have only three of the injections. If the pain returns, then we need to consider surgery. After two surgeries in the last 5 years, I can tell you, it would be bad for me. I get very sick from anesthesia. So sick that after an out-patient surgery, I had to be admitted because my blood pressure dropped very low and I couldn't stop passing out. I know of the risks of any surgery, and with my health being fragile, I cannot imagine how I would react to having to undergo this procedure. I am also very afraid of any surgery involving the spine.
I have learned to live with my fibro pain, fatigue and general lack of health. I have good days and bad. I try to make the most of the good days and rest as much as I can on the bad. I am a walking advertisement for my local drug store (you should see my nightstand!) and I am trying my best not to give up on making my life better. But I certainly want to avoid having surgery, particularly on my spine, if I can help it.
Is it just getting worse on its own, or is it because the steroids have worn off, or I'm getting immune to Lyrica? Opinions welcomed (sorry for the long post)!
Treatment initially was two courses of oral steroids
This was more than likely prednisone, a good oral steroid that is often the first line of defense of treatment. It is used to reduce the swelling and aid in healing....A "jump start" so to speak.
then I had three cervical steroid injections.
After the oral steroids, the next line of treatment is often Cortisone. It is much more powerful and specifically treats the area where the shot is administered (if needed). Cortisone is especially good for pain and inflammation. The effects are almost immediate.
I am starting to experience pain in that same spot again--the arm--although not nearly at the same level. But, every day it seems to hurt just a little bit more. It started as an ache, and has progressed to a throb. I had the third shot on January 4; so I was wondering if anyone out there has had experience with this type of treatment and could tell me....how much of the steroid would still be in my system?
Cortisone is often used as a diagnostic tool as well....Meaning if your injury doesn't respond to it, more than likely something is really wrong in there that requires surgery. However, MRIs & etc (which are very expensive) are needed to fully assess the situation...A high level of detail is needed....So a cortisone shot is a good experiment. Most of the time, it does the trick (along with some R&R), therefore saving you and the insurance company big $. There won't be any residual med at this point, and your pain indicates that the injury is more severe.
I know my CP is peanuts compared to some of your conditions, but after coping with the inability to sleep (sometimes for weeks at a time), the fatigue, the RLS, the constant fibro pain, the thought of the absolutely unbearable deferred pain in my arm returning will put me over the edge. When it hits (with no warning), it feels like a hot burning knife is stabbing my arm. It drops me to my knees, makes me cry and takes center stage in my brain.
You're being too hard on yourself. Everyone's pain is different, and everyone's threshold is different. The fact that you aren't sleeping is a big indication that your pain is severe. IMO. If you were asked to rate it on a scale of 1-10, how would you rate it?
The doc told me that I could have only three of the injections. If the pain returns, then we need to consider surgery.
Steroids are relatively safe in moderation, but not so in large qtys or frequency. See my comment above about the diagnostic tool. The Doc is also probably saying that if things don't improve after three shots, not only is it more severe, but more shots probably won't help.
After two surgeries in the last 5 years, I can tell you, it would be bad for me. I get very sick from anesthesia. So sick that after an out-patient surgery, I had to be admitted because my blood pressure dropped very low and I couldn't stop passing out. I know of the risks of any surgery, and with my health being fragile, I cannot imagine how I would react to having to undergo this procedure. I am also very afraid of any surgery involving the spine.
I think you just have to be honest with your Doc and be upfront about everything. I'd ask him what my other options are? At the end of the day, you have to weigh the "costs" vs. the "benefits" of all the treatment options and pick the best one for you. I, for one, certainly understand how you feel....I swore years ago that I would NEVER go under the knife again, unless my condition was life threatening.
Hope my replies have helped sort things out for you. Best of luck to you.
Last edited by Executor; 03-31-2008 at 09:58 PM.
Reason: Added text
Hey TexMom: I am so sorry you are having so much pain. Please don't ever think your pain is less than anyone else's. To paraphrase what Ex said, one person can feel no pain from an injury or condition and to another it may be excruciating. Pain is pain.
I am a little worried about the possibility that there may be a broken chip of bone floating around in there. The last thing I want to do is freak you out, but depending on how close a bone fragment is to the spine, it could be dangerous. I hope you call the surgeon as soon as you can. I think the first thing he should be doing is finding out exactly what that is. Did the ortho order any more scans? Did he have an opinion as to what he thinks is floating around in there? I know if it were me, I'd want to know.
I know you don't want any more surgery and I don't blame you, but if there is something with the potential to cause you further harm, I think I would consider it. Please know, I'm not trying to tell you what to do. It's just that I care so much for you and all the folks here. I hope I didn't offend you. If I have, please accept my apology.
Please try and rest as much as you can and try to get in to see the surgeon so you can at least talk with him about your options. I'm sorry I can't comment on the steroids, as I have never been treated with them.
I will be sending prayers and positive thoughts your way. If I was closer, I'd come over and give you a hug (carefully) and a shoulder. God Bless, cmpgirl
Thanks to Ex and Cmpgirl for the responses/info. I appreciate the encouragement and concern more than I can say.
I get the feeling that my orthopedic surgeon is not showing enough concern for my situation. On two of my follow-up visits, I saw the nurse practitioner instead of him. As long as I wasn't in unmanageable pain when I visited, it seemed that there was nothing to be worried about. Despite the fact that the MRI showed "something," doc said this was the course of treatment, no matter what that "something" was. Obviously, if I am still experiencing pain (though it is not as bad as it was before the treatments), something is indeed wrong and likely requires some additional treatment. I am also concerned about the weight gain I have experienced with the Lyrica... I just ordered Medifast to see if following a really strict diet will help me shed those extra pounds.
I, too, am concerned about the potential danger of having a loose piece of disk floating around, possibly causing additional pain, or loss of mobility, etc. I wish doc was as concerned as I am, but I probably won't get much of a response from him when I go to see him for my next follow-up. My regular doctor is much more responsive to my ailments and calls to check on me---what a concept! But, for the most part, specialists have not been as attentive to details and seem to prescribe whatever is normal, instead of really listening to me and probing for all the information I can offer. It makes for delays in proper treatment, prolonged periods of suffering, and in some instances, onset of new symptoms/problems. It is so frustrating!
I have had a couple of friends who have had spinal surgery, fusing disks in their lower backs. I would not say that their pain was reduced as a result. I am told that for the cervical disks, they go in through your mouth rather than cutting your neck to get to the problematic area. I don't know which would be worse. I just know that with my history of anesthesia problems and slow recoveries, I am extremely reluctant to go under the knife. I hope it doesn't come to that. It's very scary for me to weigh the pros and cons of living with what I have or going for the surgery.
Thanks so much for taking the time to respond, and for your encouragement. This board has become a refuge for me, since so many others share the experience of living with chronic pain and we understand each other. Unlike the real world, where uninformed people can often judge you when they don't know what you're going through.