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  • Intercostal nerve block tomorrow.. Dave

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    Old 09-26-2005, 01:50 AM   #1
    Torley
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    Question Intercostal nerve block tomorrow.. Dave

    HI

    I am having the 6th intercostal nerv block ith another next week and more until they find the place that will numb my pain
    They ar edoing from T5 to T 9 currently, They seem to think it is not visceral, does anyone know much about intercostals or has had them

    I have had a few now and have had others eg splanchnic nerve blocks and CP block but now they are focussing on this

    Debs

     
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    Old 09-26-2005, 09:41 AM   #2
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    Re: Intercostal nerve block tomorrow.. Dave

    Hey Deb, IC blocks are just diagnostic test to see if nerve ablation or possibl y an SCS would offer longer lasting relief. I'm sure you know IC blocks are the nerves that leave the thoracic area and cary pain signals to and from the area that the specific nerve at each level leads too. If you have ever seen a Dermatome map it shows you the area that each nerve covers or iterprets sensation. Damage of that nerve can also cause pain in those areas mappped or called Dermatomes. It may rule out your pancrease as the source of your pain or confirm it.

    What doesn't make sense is to do an invasive procedure a day or two prior to having a medical review. I imagine this a legal matter since the fall happened right after they tossed you from the ER. I would talk to your lawyer, and have him there if at all possible. Often pain is not considered if you are able to function. For exmple a shoulder injury that hurts when you raise your arm above 90 degrees. You may be able to raise it comletely over head, and it may be very painful, but the mere fact you did, means you are capable and that wouldn't help you in any way as far as law suites or proving disability of an aflicted area. How do you prove you have pain when you are able to perform the tasks asked of you.

    Because your eval is coming up, They could also say any problem is simply an exaserbation of symptoms caused by the IC blocks so I would have that rescheduled. Yo could be a mess after having multile blocks and being emotional can either be proof of post concusion syndrome or simply written off as psychogenic.


    AS far as the boss IMing you at home as late as 8PM, I'm not sure that would fly in the US. At what point are you not on the clock and don't have to report in, or respond to IM or emails on "YOUR " time. That sounds like harrasment more than work folow up. If your salaried not hourly, they can ask you not to leave before a task is completed but what exactly are you suposed to do at home. I would explain that your dealing with severe medical isues and hold off treting the symptoms untill you get home as not to imparir yu at work, by the time you getting IM's about what you haven't done or copleted that day you have taken the meds to relieve symptoms. Your employer even suggesting you retrn to an office at 8pm after you have taken opiates is asking you to drive on your time when your under the influence of impairing substances setting you up for an acident or a psossible driving under the influence charge. Don't you just love micro management. Obviously he has nothing beter to do at home at 8pm but your time is your time,

    I would set you IM as being off line so he doesn't know your on the computer and can't communicate any work problem on your time. He can always speak to you in the morning if there is something urgent that needs to be done.Unles you work for the govt in some security type position, he has no buisness calling you at home. Those calls causing you pain isn't the best reason you want them to stop, you want your time to be your time and when exactly is your time yours? Now if you have documanetaion of the harrasment "Copies of the IM's" and the same night your in the ER he would be crucified in the US.

    I would have a face to face and point out that from home you have no abuilty to correct any problem that he has a complaint about. IMing you at 8 pm would not be considered a formal warning or repremand to be placed in your personel file, just proof of an overbearing boss that thinks he owns every bit of your time. Exlain your more than hapy to discuss work while your at work, but once you leave work there is no need to track you down to ask unimportant questions regarding work that can't be solved from your PC at home.

    I don't see how he can use any comunication he has with you after your home as documentation of couseling, written or verbal warnings, etc. I'm not clear on your workers rights in NZ, but what your describing sounds like harassmant, to the point of actually requiring medical attn. Required medical attn proves actual damages. I would formally ask him "In writing" not to call you at home over matters that can not be resolved from home. Would you call your boss tonight to ask if you can take dec 6th off to visit a relative or would you wait untill your at work? That's just crazy, borders on stalkng and is harrasment.

    Are you aware that while using IM people have complete access to every file on your computer. I have a buddy that's a computer whiz and was talkng to him from the west coast Via IM. In a mater of seconds, MY email was opening before my eyes, quick books and all my finanical info was opening in another window and a log of every web sight I had visited that day was opening. He did this as a demonstartion of the volnerablity that IM creates and allows computer savy people complete access to all yorur files on your computer.

    In the states, there are plenty of lawyers that would love to take on a work harassment case for you and would likely win unless part of your work has been deligated to be done at home as part of doctor ordered work restrictions. You have actual damages that can be proven by hospital records if you end up in the ER the same night he is IMing you about your performance at work.

    Most people prefer to leave work at work, just as employers expect you to leave your home life at home when you come to work. Spending the day crying because you got in fight with your boyfriend at work is just as unexceptable as having your boss call you at home to harass you about what he feels is lack of production while at work.

    He has all day to speak to you and doesn't need to call you at home. Perhaps he has other motives, but the nice thing about IM's is you can print them out as proof of this type of harasment.

    That's what we use caller ID in the states for. What is he going to do, fire you because you have a life and can't be reached at home? Our phones can tell us who is calling before we answer so you can choose not to take the call, as most IM programs have a similar ability to block the fact your on the computer or can set a message saying you are presently away from the computer.I would print out every IM he has sent you should you want to pursue a harrasmant case at some point in the future or to take to his supervisor to show the level fo harasment going on. That's something you don't really want to do untill you have another job ligned up though. It would make the work environment very advesarial.

    Sorry to gt soff track, but that's just absurd and I can't fathom the need to IMor call you at 8pm to counsel you or to suggest you continue working from home to complete a task.

    Hopefully the test blocks will allow them to pinpoint a problem so they can come up with a more permanant way to manage pain than temporarrilly numbing a nerve.

    Take care, Dave

    Last edited by Shoreline; 09-26-2005 at 09:47 AM.

     
    Old 09-27-2005, 02:37 AM   #3
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    Re: Intercostal nerve block tomorrow.. Dave

    Dave

    what is psychogenic? does that mean in your head. I called the workers compo people and they want me to tell the extent of what my bos shas been doing eg messagign texting me on my cell and at home on my hours not at work , an dhis general lack of support, I ended up in hospital during his texting after hours 1 day later in emergency and then on the 2 days in there for 2 weeks. It seems the stress cause sme headache to trigger my abdo pain have you heard of that with pain?

    Thanks fo rall the info , our laws are similar to yours

    On teh intercostal block they did T9 today and it numbed th epain for 1 hour 30 minutes so I think he has got it and nect week he does another he may do the one below it.
    What does it mean if T9 worked, does it show teh source of pain eg as maybe pancreas viserceral or otherwise. So you think they then can use nerve ablation? I am trying to do a search but am not coming up with much but hey its great it worked!!!! he ha stalked about the SCS but when I talk about a pump he is negative I said what is teh cost of me a month on hospital versus a pump??????? He said you can get weight gain, hormonal changes, etc I sia drigth now I have impaired though processes, constipation no sex drive etc so if I have teh choic eI want it, it also allows fo rwhn I have an increas eso I can avoid a hospital it can be adjusted up then down

    what do you think> do you have a good link I can poke under his nose. i said hey teh amount of meds is well reduced etc.

    he seems to think an SCS may help but hey he ha snow been tasked by the general phsyician and gastro doc to itemise each test i have had and a timeline. to see what to do next . I got stuck into this physician an dsaid hey no tests hwo woudl you feel in my shoes to just be told just take it and no we dont know??? i was in a lot of pain at the time and ******? i said i have had no tests for four years so what now?????I was annoye dhe woudl; dismiss me I said if you were in my shoe syou woudl do everythign have every test you wouldnt sit here!!!!!! he was gob smacked he had no retort

    so your thoughts T9 being successful and the above


    cheers

    debs

     
    Old 09-27-2005, 09:04 AM   #4
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    Re: Intercostal nerve block tomorrow.. Dave

    Hye DEb, Here is a copy of a dermatome map so you can see what areas the blocks are supposed to ease pain at.
    I'll look for something on Radio frequency nerve ablation and see if Ican find a link for that.
    http://www.merck.com/mrkshared/mmanual/figures/165fig2.jsp

    AS fas a psychogenic, yes that does mean psychlological, but there is a difference between being pure psychological and stress increasing a level of pain. Natural physical reponses to stress are muscle tightnes, inablity to concentrate and several other physical and psychological symptoms that are very real, so although the term sounds like "all in your head" to some degree there is a link between in your head and how we feel. So don't dwell on that. If you got relief from a block I doubt things are entrirely in your head, but psycholgical factors can make things worse or better.

    BRB with info about Nerve ablation or possible use of an SCS, The doc are leaning towards an SCS because t seems to be more effective on nerve pain than opiates. Opiates do help, but it takes considerably more opiates to manage nerve pain than to manage somatic pain or visceral pain where an SCS may be able to block or drown out the majority of nerve pain.

    Hey Deb,If you add Radio frqency or chemical in front of nerve ablation you will get many more hits, these are the two methods used to destroy nerves that recieve signals from an affected area of the body. This was just one of hundreds of hits I got by adding the radio frequency part.The chemical they use I believe is Phenol although RFA seems to be more popular in the states.

    http://denverpainmanagement.com/radiofrequency.htm

    Radio Frequency (RF) Nerve Ablation can be used to temporarily deactivate minor nerves around the spine. The pain generating nerves for many patients are often small, unimportant fibers which can cause severe pain. These nerves can be temporarily shut down using radiofrequency energy to heat the surrounding tissue and deactivate the pain generating nerve fibers. The procedure is performed by accessing the affected nerve under x-ray guidance. Once properly positioned, a special probe is advanced allowing the delivery of radiofrequency energy to the targeted area. Results can last from months to years.

    ope this helps and I hope your feeling well after all those spinal injections. Yikes ..
    Take care, Dave

    Last edited by Shoreline; 09-27-2005 at 09:26 AM.

     
    Old 09-29-2005, 01:18 AM   #5
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    Unhappy Re: Intercostal nerve block tomorrow.. Dave

    Hi dave

    I went to see the occupational physician today re my head injury concussion today he did a number of tests breain memory function and balance etc and hand eye tasks


    I failed most of them especially walking ones with balance, and was depressed and anxious according to the questions I answered I couldnt remember words he asked me to remember I got 1 out of 3

    so now I am off work, he has put me off work said I am severely depressed as a result of head injury and has said I have post concussion syndrome

    eg fatigue memory multi task problems

    I told him how my boss was harassing me with work and emails and texts and I didnít have the strength to fight it right now, that I liked my job just am struggling right now

    Due to the headaches and fatigue etc

    I donít think they can fire me on work compensation due to an ccident Can they????

    I checked out all your other sites thanks

    I had accup****ure today, they also used cupping and chinese herbal medicine it helped I think

    I have also asked for more ketamine as I am running low and will pick soem more up from the hospital on Monday

     
    Old 10-04-2005, 02:02 AM   #6
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    Re: Intercostal nerve block tomorrow.. Dave

    I have another intercostal block on Thursday
    It must be like the 7th one
    I was thankful that when I end up in the hospital that my pain doc come liek in 3 times a day
    when in pain I cant really focus on talking him in the eye. I just cry in pain then they think you must be sad...it beats me...
    They mixed midazolam, haliperidol, and ketamien last time.....It seemed to work so that I could walk out and leave

    But my pain seems to be spirallign otu of control in the last few months, I have been vomiting up meds etc but I dont lose weight....
    It s a little disconcerting
    I dont know why when I eat my pain gets worse it can even be when I drink

    sigh

    debs

     
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