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erfan 08-22-2004 10:17 PM

Asleep During Discogram
 
I know I was supposed to be up, answering questions, but when I had my disco done about 4 months ago, the last thing I remember was getting the versed/fentanyl i.v. and the next thing I remember was getting drfessed in recovery and being sent for a cat scan.

Yet, I read how everyone on this board can remember the pain and discomfort of their disco.

Why can't I remember?

Flycatcher 08-23-2004 04:07 AM

Re: Asleep During Discogram
 
My first ESI at the PM clinic was much like that, the doc walked in and asked how I was doing. When I said I was really nervous he told the nurse "Give him two more," I was getting the IV Versed/Fentanyl coctail so I'm guessing he was referring to 2 more mgs. Next thing I remember, I was signing the discharge paperwork. I walked out to meet my wife and then noticed the script in my hand, I honestly don't remember getting that but I figured I was suppose to get it filled so we went next door to the pharmacy.

Not sure why they'd medicate you that strongly for your discogram unless they expected you to have severe, unbearable pain from it. I know that's the whole point of the test but hopefully they got the info they wanted.
Jack

dckatz2001 08-23-2004 04:45 AM

Re: Asleep During Discogram
 
Not being able to remember anything sounds a lot more appealing to me than being in severe pain throughout the procedure and remembering the whole thing.

Kissa 08-23-2004 05:38 AM

Re: Asleep During Discogram
 
Sometimes the combo will put you in a twilight state where you don't remember anything. Be happy you don't from what everyone else says its quite painful!!

sherry47 08-23-2004 05:56 AM

Re: Asleep During Discogram
 
[COLOR=Navy][SIZE=3][FONT=Microsoft Sans Serif]I think the reason is sometimes that combo of meds can cause an amnesia affect. You were actually experiencing the pain but you can't remember it. Count yourselves lucky!! :) I was already on a 50ugh fentanyl patch so the drip didn't do much for me. In fact, in recovery room I was in such residual pain that they gave me several more mg of fentanyl but nothing was helping. Then they added my BT meds in stronger doses and I was released afterwards. You are so lucky. My doc just told me on Friday that I needed another Myleogram and Discogram. I told him absolutely no way, been there done that not gonna do it again. He almost fell out of his chair laughing. Seriously. He said they needed to do something because I am having new nerve pain that starts in my pelvis and both legs go numb all the way down. I have a huge knot in my hip where they took the bone grafts for my fusion. I told him I am done being poked and prodded. I have had enough. I have 2 appointments with specialists on the 9th and 13th of September. I am so tired of this fight. They are checking for Lupus, Rhuematoid Arthritis, Liver function, kidney function, all my nutritional levels as I have lost more weight. I am now down to 82 pounds and I will finally accept my anorexia dx. My doctor agrees that it is chronic pain induced anorexia. He understands what chronic pain will do. I will get the results of all those tests this week and then know where we go from here. I really don't care anymore whether it is an inpatient program with feeding tubes. I just need this pain to be managed or my weight will never be where it should. I'm sorry I unloaded all this here.... back to the disco.... as far as I am concerned that was a once in a lifetime test just like the Myleogram.

Take care.

God Bless,
Sherry :wave: [/FONT] [/SIZE] [/COLOR]

Shoreline 08-23-2004 08:34 AM

Re: Asleep During Discogram
 
Hey Jack, "The give hime 2 more" was very likely simply 2 more mgs of Versed, Veersed is a benzo with potent amnesiac qualities, 2 mgs of Fentanyl would have killed you, the standard dose of fentanyl in the ER is .02 mgs of fent. It's simply a pain med and doesn't cause the amnesia. If you were asleep through an entire discogram, there was no way to reproduce the pain of discogenic pain or pinpoint it. You did get a CT out the deal which will show a tear, but how much does a tear effect you if you had no resposnse?

Like DDD. 10 people can have the same degenerated disc space at a young age of 30, It doesn't suggest all 10 people would even be bothered by the DDD unless there is nerve impingement of discogenic pain. Being asleep through the test negates any benefit other than the CT findings, calling a day or two later complaining of pain doesn't pinpoint which disc. I sure hope surgery was not based on that disco, which gave no conclusive findings.

Some degree of pain relief or anesthesia would be more humane, but if the patient is dependent they either have to stand around and wait for the meds to wear off or reverse anesthesia with an antagonist which would send a dependent CP patient into withdrawal. IV fent isn't a bad option because it has less than a 3 minute haf life when delivered IV. So in theory you should be waking in 6-9 mnutes, time enough to place the caths but not long enough to skew results. But the more tolerant you are the more fentanyl you wlll need and the longer it may take to wake, especially if you have been sleep deprived from living with CP.

If you didn't have surgery, and still haven't found an answer, as crazy as it may sound, you probably need to repeat the disco awake.

It's not just my opinion, I've talked to several docs about this and they all concluded that anesthesia prior to a disco negates any qualatative results.There are some fast acting meds like proponol and fentanyl that can be used to for cath insertion, but you have to be awake for inflation to get any type of acurate response.

It would be fine to be sedated for an ESI other than not knowing what the doc may or might have done like scewered a nerve root, punctured your spinal cord and caused a leak untill you get home and start noticing symptoms of something having gone wrong. A little versed "2mgs" usually just relaxes you enough so your not combative during the procedure, it's not meant to sedate you but occaisionally people will respond profoundly to a small doses of meds.
Good luck, Dave

Kayley 08-23-2004 08:47 AM

Re: Asleep During Discogram
 
[FONT=Arial][SIZE=2][B]Sherry, I about fell of my chair laughing at what you said just like your doctor did.LOL Because if my doctor said those things I would have responded exactly like you did. I have had two myleograms and the last one was a nightmare. There was one position they put me in where I was screaming from all the pressure on my spine and they kept yelling "be quiet and hold still". The first one gave me a spinal headache so bad I threw up for two days. My diskogram failed because the doctor couldn't get the needle past all the arthritis in my spine.

I am so sorry for all that you are going through. I know you didn't want to go into the hospital, and now you said you don't mind if they put you in. I hope if you go, they can help build you up so you can gain some weight and strength. You are in my prayers.
God Bless and take care
Kayley[/B][/SIZE][/FONT]


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