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Old 05-07-2010, 05:10 PM   #1
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epidural of C spine?

Hi everyone. I posted here awhile back about pain from an auto-accident and having herniated discs in my Cspine (C3-C4-C5-C6). Workmans Comp is actually handling my case and its been a nightmare. I have MS, and because I have had MRIs for the past year on my Cspine for MS, its always shown some degenerative disc disease, they tried to deny this as pre-existing....

Long story short, im finally approved to have a pain specialist do an epidural type injection, under flouroscopy, in C-5 area. I know its a standard bandaid for pain control, but im still scared to death!

Anyone tell me what to expect, both in procedure and recovery of this? Im told it takes 15 minutes- but that i will be sore...comments? Im actually terrified of having this done...any reassurance would be appreciated. Being done mid week next week.

nikki
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Old 05-07-2010, 05:37 PM   #2
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Re: epidural of C spine?

Hello Nikki,

I can sure sympathize with your anticipation. I've not had the epidural Injection
under flouroscope. I have a couple friends though who successfully have. They
were very careful after the proceduce and followed their doctors instructions
carefully.

Sorry about your challenges with Workmans Comp. I understand that too.

Like yourself I have cervial spine issues.

More importantly I hope you get some replies to your post from those
members who can share more with you.

I will follow your thread and look forward to reading about how you
are coming along after your epidural.

Janaly
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Old 05-10-2010, 07:42 PM   #3
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Re: epidural of C spine?

I had a cervical epi done a few years back and I had wonderful relief of pain that was immediate and lasted some 6 months. However, I had a reaction to the steroids that initially set me back. I would have it again if I were a candidate. From start to finish was 20 minutes tops and I do not recall any soreness, or tenderness. You stay in recovery for a little bit and I think I was limited in lifting for a few days, but other than that was no big deal. Hope you have good response.

 
Old 05-10-2010, 08:31 PM   #4
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Re: epidural of C spine?

Thank you very much! I needed to hear that tonight. Its scheduled for Friday and Im a nervous wreck! I was told the same thing, in and out in 1/2 hour....but nonetheless, Im terrified. I appreciate your words..
Nikki
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Old 05-11-2010, 08:29 PM   #5
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Re: epidural of C spine?

ESI can be done under conscious sedation or without sedation. When done under conscious sedation you are given medications such as versed and demerol via IV. You walk into the room where the ESI is done, you lay down on the table, they give you a twinge of sedation, and then as soon as it's done you get up and walk back out to a reclining chair (or sometimes if the room with the chairs is more than a few steps away they take you via wheelchair). Within a few minutes you are fully alert and they keep you 15-30 minutes and then let you go.

Some PM docs require you have nothing to eat or drink for 6-8 hours before the ESI. My first PM did this but the one I've been at for the last year does not, they just ask that you eat very lightly.

Some will ask that you put on a gown and take off your clothing, but when I'd have my neck done they let me leave my bra on, just had to remove my shirt. In the PM office I use now if I wear very loose shorts they don't require that I remove my shorts as they just ask that I pull them down a bit to access the area. Each PM and his/her practices are a bit different. Either way wear comfortable clothing that's easy to get on and off.

Also, if you have the sedation you must have a driver to take you home. And since the shot and recovery can be as brief as 30 minutes most places require that the driver remain on premises during the period you are getting the ESI. At my current PM doctor's office they do a few in the morning and they insist my ride stay as they don't have time to watch over me for more than 30 minutes after (both due to staffing and they may need my seat!).

I had no pain, beside a wee bit of soreness, after my ESI ( back and neck ) but I did get to go home and take a good nap. You may feel awake but the versed will make you drowsy.
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Old 05-12-2010, 03:40 AM   #6
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Re: epidural of C spine?

Thank you for that graphic description. I am obviously having a different type of procedure, and definately without any type of sedation since I was told that I would be naked from the bra up, but pants or jeans were fine. I was told I could eat anything I wanted the morning of, and was told in and out in 1/2 hour.
Im also having it done in my Cervical spine, which would make sense why the location is higher...
But I thank you for taking the time to reply.
N
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Old 05-12-2010, 08:41 AM   #7
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Re: epidural of C spine?

Nikki I have read some of your posts & wish you the best of luck.

SpineAZ is correct PMs seem to have their own ways of conducting the ESIs. I am in gown during mine. I also wake up saying things I would normally not say while coming out of sedation.
I recall my last ESI a gentleman walked in with a cup of coffee & signed in for his procedure, no driver & drinking coffee. Have to admitt I was green with envy over the coffee after fasting all morning. The reason he could have the coffee & no driver is because he chose to have no sedation. Not sure how many injections he was having done but I'll take the sedation over the coffee,lol.

I've had several ESIs some helpful some not. For me each one can be different & Im not exactly sure why. I did have success with one & it gave me the use of my right hand back. At times the relief is minor & you don't realize the relief you had until it starts to wear off. Hope that makes sense. I would rather have an ESI over most dental work anyday. I know others have not had such luck but I think the important thing is to remember we are all different & the ESI can also be a great diagnostic tool in many cases. I plan on asking for my cervical to be done my next visit. I have no clue whether it will give me relief or not this time around but Im willing to chance it while I'm looking for a good surgeon.

I was much like you & scared after going through so many other injections that were not so comfortable. Like many situations I believe much depends on the doctor doing the procedure. I was sore after a few & had some rise in pain after one or two but not for long & the important thing here is to follow the instructions to a T after the ESI is done. Go home relax, ice if instructed, which was a huge help to me & keep in mind all though it may state take it easy for 24hrs you may need that extra day. I have required the extra day with a few ESIs.
I noted you have MS, before my fist surgery I ended up in ER & due to my symptoms the ER doctor wanted to check for MS. I declined at the time because I was scheduled & waiting for cervical fusion. Did make me wonder if MS can cause some of the same to occur as cervical injuries.

In some ways I regret not having the MS ruled out due to what I'm experiancing today which is 11/2 after my cervical fusion. There is MS in my family but Im not at all sure there is a genetic link. Anyway I'm looking forward to hearing how your procedure goes. Good luck & hope this brings you some peace of mind. Sammy

 
Old 05-12-2010, 09:08 AM   #8
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Re: epidural of C spine?

Being told that you'll be naked from the waist up is common for ESI. That's what my old PM had me do. They may also use a surgical marker to place an "x" on the side of the neck they'll inject. Very common these days.Then as soon as you are awake they will aim to have you get dressed and ready to go home.

The unique thing about versed is it also helps you forget the pain and takes it a while to leave your body. I remember being in the car on the way home and realizing I didn't remember getting dressed. Weird feeling.

Any anxiety you have will disappear the second they give you versed in the IV. I had a colonoscopy last week and going in I was starving, when I woke up I had no hunger and felt totally relaxed.
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Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 05-12-2010, 03:03 PM   #9
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Re: epidural of C spine?

SpineAZ, Im not having any IV or versed. This is completely awake and I even declined the Valium they suggested I take the morning of.... I have a neurological disorder and I refuse to take any type of narcotics or any pain killers. A local is all my body will tolerate.

And I recieved specific instructions today, both via a phone call and by a letter which came in the mail- I am able to eat anything I want and able to return to work 2 hours after the injection if I feel up to it. I am taking the day off, simply because I can...I have plenty of personal time saved up. As for being naked from the waist up...I was told, that I will be wearing a gown, no bra, but can leave my pants on- and that 15 mins after the injection, I can leave. And, I can drive myself if I feel up to it, since there will be no sedation, but Ive elected to let my husband drive me and be with me.

Sammy. Thank YOU for your words of wisdom. Sounds like this is a roll of the dice as far as whether or not it will help. My PM doc seems to think its a good thing to do, and Im all for trying to find any relief. Prior to this, Ive had trigger point injections, and they have helped, they just havent lasted. If I got 3 months out of each one, it was alot....

As for your thoughts on MS, MS doesnt go away. You can still have it ruled out. MRIs along with plenty of other tests to rule out everything else is the way its done. There is no specific test for MS, its a matter of ruling out all the other diseases which present like MS does...I take Rebif, which is an injectable shot, which I give myself 3 times a week- which seems to be keeping my MS symtoms at bay; however there has always been a question of whether or not my numb and tingling left hand is MS related or Spinal related. My PM doc says absolutely it is NOT Spine related....and my Neuro is 99% sure it is MS related (so they agree) but Ive been wondering if Ill get any symptom relief from having this procedure done. let you know in a week!


Thank you both for your time in helping me to realize that this is a pretty common thing to try. Ill post and let you know how it goes afterwards. Ive got a second injection scheduled for 3 weeks later - if there are no complications.
Thank you!
Nikki
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Old 05-14-2010, 10:24 AM   #10
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Re: epidural of C spine?

Hi everyone. Just thought Id post real quick. I just got home from my procedure..
First of all, I was wrong. This was NOT an epidural. It was done in the front/side of my neck, into my spine...she specifically told me its not the same procedure as a ESI. Because it was done under flouro- and because I am allergic to iodine solutions, they used some sort of non ionic contrast, which was put into both my arm and my neck...I was numbed with Lidocaine, but completely awake, lying on my side, with one arm practically held behind my back , the other under my ear and straight up. (opening up the neck area).
It hurt. Alot. But mostly pressure type hurt....now that its over, Im sore and feeling like someone ran over my head- and was told that I need to be fairly still today, no pushing, pulling or lifting for 72 hours.
The good news is it is over. For now. I have a second injection on June 4th...
Hopefully, in another 72 hours I should start feeling better and all this anxiety will have been worth it. Thank you all for "talking' me thru this...
Nikki
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Old 05-14-2010, 10:38 AM   #11
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Re: epidural of C spine?

Sounds like a transforaminal ESI (I had that done once). It's unique and gives access to a different area than can be reached from the back of the neck.
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Old 05-14-2010, 11:06 AM   #12
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Re: epidural of C spine?

except it was the front of the neck. Thanks!
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Old 05-14-2010, 01:26 PM   #13
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Re: epidural of C spine?

Right, a transforaminal ESI is done from the front of the neck but still can access the epidural space.
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Old 05-14-2010, 03:06 PM   #14
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Re: epidural of C spine?

I just spoke to my surgeon. It was NOT an epidural of any kind. It was a nerve block, done in between C-5 and C-4 and the spinal cord. She said it will last up to 2 years- that we are doing another one on the other side on June 4th to give me "back up" and as long as I have no negative side effects from this one that its a go...

She is seeing me on Wed to just do a quick look-see. Im kind of swollen and very flushed at the moment, and in minor pain. But overall, Im going to live.

So thats the latest..
Nikki
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Old 05-14-2010, 04:15 PM   #15
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Re: epidural of C spine?

Oooh, then I can see where all the pain came in! Nerve blocks can be painful and result in some irritation. Hopefully the nerve settles down a bit and you have access to pain meds and/or over the counter anti inflammatories?
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