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  • Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose RSD?

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    Old 02-01-2006, 03:45 PM   #1
    sealover
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    Last edited by sealover; 03-08-2006 at 05:31 PM.

     
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    Old 02-01-2006, 04:50 PM   #2
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    Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose RSD?

    Hi,
    I only have a minute, but my Stellate Ganglion Block contained Marcaine and no steroid. I took the steroids orally. I would think that the steroid would settle down any inflammation that might be going on. ??

    The risks that I know of are infection (minor risk) and missing the target/hitting the wrong place. If they us a flouroscope this risk is decreased.

    As far as diagnosis, if it helps then you can assume there is sympathetic nerve involvement. If it doesn't, you can't rule it out because everybody responds differently. Fortunately, mine really worked.

    Best wishes!!

    Julie

     
    Old 02-03-2006, 02:03 PM   #3
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    Post Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose RSD?

    I am a new member and suffer from Short Term Memory problems and a variety of other problems that relate to RSD. If I make posting mistakes, please help me.

    I was formally diagnosed with RSD just two weeks ago. This is my 2nd episode with it.

    The first was after surgery for a neuroma in my right foot, overlapping fourth toe and claw toe. I had already had cortizone injections then sclerosing injections for the neuroma without relief. My surgeon kept telling me that the pain, swelling, burning, sensitivity etc. was normal. Come back in 6 weeks and we'll see how you are doing then. Never having health problems and not knowing about RSD, I put my faith in him and suffered. After I pestered him for months he ordered PT. By then I was neering stage 3. PT was painful and exhausting. Slowly, my foot and ankle responded and am only having minor problems with it now.

    In early December, 2005 I had surgery on the left foot for claw toe, small and large toe bunions. A flare-up of RSD started within days. My surgeon reacted in the same fashion. My family doctor referred me to a Pain Center.

    Treatment 1
    I have had three treatments so far. The first lasted for just a few minutes. It was a lumbar epidural injection of Depo-Medrol into the sympathetic nerve . I was given Sublimaze and Versed by IV. The procedure was done using flouroscopy to guide the needle (very important). There was immediate relief. My foot warmed up, swelling/pain were reduced and the color improved tremendously.

    Treatment 2
    Three days later I had the same procedure above. Tubing and an infusion pump were added to the epidural site. A drip of Naropin was given for approx. 20 hours. I was very closely monitored. Numbness was experienced in my left and later right leg. The drip was slowed down, stopped, restarted, slowed down, stopped, restared. The Numbness was completely gone before I was released.

    Treatment 3
    Three more days later they repeated treatment 2. The drip was maintained at the slower rate. I did not have any numbness. I was more comfortable and rested better through that night than I have since the surgery. When the nurse came to turn everything off and remove the tubing, etc. I asked if I could keep it on and stay for another night. Of course, she told me no.

    I will follow up with the Pain Center M.D. in 10 days. Am seeing my family M.D. in 2 days for referral to PT. There has been a huge improvement from the Sympathetic Nerve Blocks. I was scared out of my mind and made my two grown-up daughters and husband stay with me in shifts for Treatment 2. For Treatment 3 my daughter stayed with me until the drip was set up, husband visited when his work shift was over, a friend visited for a short time and daughter picked me up the next day. I know that hard work in PT is needed to restore full function to my foot and get things under control. Now instead of feeling wiped out and frustrated, I am looking forward to getting moving again.

    No regrets about the Sympathetic Nerve Block procedure that was used for me. I asked questions every step of the way before they did each step. What procedures, what drugs. I'm sure I asked the same questions over and over and had them write things down because of my short term memory problems. Not once did anyone get annoyed with me. You have a right to know every detail. The Pain Center M.D. also told me that there are procedures to help prevent this from happening if you have surgery again. I still need large and small toe bunion surgery on the right foot so it is a relief to know this.

    Good luck to all.

    Last edited by Leftie; 02-18-2006 at 11:50 AM.

     
    Old 02-03-2006, 05:54 PM   #4
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    Smile Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose RSD?

    Hi Leftie,

    I just wanted to welcome you to the board. I have had RSD for almost 20 years and have a morphine/bupivacaine pump now. I hope you like it here. There are a lot of very knowledgeable, caring people here. It's nice to meet you.

    Sharon

     
    Old 02-04-2006, 07:17 AM   #5
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    Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose RSD?

    Sharon

    Thanks for the kind welcome. I hope your new pump makes you comfortable. Do you have constant pain? Good Luck.

     
    Old 02-04-2006, 06:08 PM   #6
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    Hi,

    Thanks. As far as constant pain or not....I've had this for so long that I think I don't feel pain as much as I used to (that might not make sense to some). I think I kind of got used to it over the years. But....the pump has helped me so much so that's part of it too. Talk soon.

    Sharon

     
    Old 02-05-2006, 12:42 PM   #7
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    Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose

    Hi Sealover!
    Sounds like you've had RSD for some time if you've been posting since 2003! Are your nerve blocks stellegate or lumbar? Julie was lucky and had good luck, as others and sonds like Leftie is getting relief. There are lots of good stories out there and then there are some bad ones like mine. I was a wc case and they kept ordering the blocks, which kept getting denied like everything else in my case. Finally I saw one of their (WC Ins. Co.) Neuro, & he said that I had RSD and ordered the stellegate blocks asap. Well by then it had been 18 months since dx'd with RSD, and it was too late
    The sooner you've been dx'd with RSD-- the better your chances are that they will work. Mine were stellegate and a flouroscope was used. They used lidocaine because I have bad reactions to cortizone. The first one I was numb for about 6 hours and the second one he did at a different spot and when he stuck the needle in my neck I screamed so loud that I'm sure everyone in the hospital heard it. I've said it before-that I'd rather give child birth than go through that again. But I was one of the unlucky ones, because they were not ogiven when first dx'd with RSD. Now I have other health issues that are showing up on my cervical MRI's, and the last one says possible tumour at the C6C7 level. This is where I had my surgery done in Dec 2001. This could contribute to the sensitivty in that area. These were done in Dec. 2003. My next step is a repeat MRI this month and then decide on biopsy
    I pray that yours give you some relief. Good luck and let us know, and ask questions. Aloha Skooze

     
    Old 02-13-2006, 12:38 AM   #8
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    Last edited by sealover; 03-08-2006 at 05:34 PM.

     
    Old 02-13-2006, 06:36 PM   #9
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    Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose

    Hi Sealover! You got that right! Alot of people don't get dx'd right away and alot of people could save alot of grief and medical bills and stress, if they were dx'd correctly. That's the problem. It's not a new disease, but I think it is becoming more understood with awareness, but the medical profession still has along way to come. I myself have noticed the new med students that are in some of my doctor's offices who are in training. Whether I am there for me or my kids, they are very anxious to see whar RSD looks like. It upsets my kids if they are with me, because they are paying more attention to me and they don't want to keep hearing the short story, but these new med students are amazed at the color changes in my hand, the movement disorder, etc. I think the newer med students are getting a better education than some of the older dr's. Awareness is the key. We on this board eat sleep and live RSD and the pain, but there are alot of those who are oblivious to the fact. They know what MS is but not what RSD is. That's how I describe it to people. "It's like MS, but instead of the muscels involved the nerves are, and they keep misfiring in the central nervous system", & they seem right away to get the jist of it.
    I read Sealover that the cortizone shots gave you fat pad atrophy on the ball of your RSD foot. I, too had cortizone injections into my left rib cage, 2-- to be exact, and I had breast implants done 2 years before my injury. Well for some strange reason, and all my doctor's have never even heard of this, granted I am a slender person, my left breast implant exploded and caused massive scarring from the coritizone injections! Not to mention PAIN!!!! The dr. injected them behind my left rib in the back of me. I guess we are all guniea pigs in away. By breast doctor, told me he would fix the scarring, whenever they figured out what was wrong with me, but I never went back. They also tried to give me oral cortizone, and I broke out in a rash from head to toe, so they just assumed that I am allergic to cortizone. I wonder if anyone else has had a problem with cortizone??? My physical therapist told me that you are only supposed to get no more than 3 cortizone injections a year, or your muscle tissue is like paper and it will become very brittle.
    I doubt though that you will get much relief from the lumbar block, but you never know till you try. Go into it with an open mind and pray that it helps. Good luck and keep us posted. Aloha Skooze

     
    Old 02-14-2006, 01:53 AM   #10
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    Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose RSD?

    Skooze, that's terrible what happened to you becaue of the cortisone shots. Oral steroids can cause all sorts of reactions, like the rash you mentioned. Steroids can damage soft tissue in the body, too, and can cause osteoporosis if used for long periods. That's why I'm worried about having steroids in the sympathetic nerve block.

    What is the difference between an epidural nerve block and a sympathetic nerve block? I'm pretty confused at the moment about the difference between the two types of blocks.

     
    Old 02-15-2006, 06:57 PM   #11
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    Hi sealover,

    An epidural block is put into the epidural space in your spine. This is in the center of your spine. A lumbar block goes between the vertebra in your spine and it's off to the side a bit. This is my understanding, anyway. As far as people being diagnosed after having had RSD for a while. Yes, it's very common. You can hear that from people so often, it's sad. I had RSD for over three years before being diagnosed. That was in the mid-1980s. I would have thought that by this point, it would be a little less common for that to happen, but it doesn't seem like it is.

    Hope this answers your question a little. Good luck.

    Sharon

     
    Old 02-15-2006, 09:45 PM   #12
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    Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose

    Hi Sharon & Sealover!
    Sharon you answered the question somewhat. I think Sealover wanted to know the difference between stellegate and lumbar nerve blocks., in addition too. Sharon you were correct in that respect, however where RSD is concerned, those who have it in the lower extremity get the lumbar bloc, where those with RSD in the upper extremity get it in the C4-C7 area. I thought, and correct me if I'm wrong, that stelligaite nerve blocs. As Sharon mentioned, are used to numb the pain for , hopefully, it to have a long term effect if done early enough.
    Which always, unfortunately is not the case. They can do the blocs in different positions of the spine, or neck. My second one, since the first one wasn't as effective, was placed to the side of the c6-c7 area, to hopefully provide a better response, BUT the pain mgt. dr. hit a nerve, when I screamed bloody murder, which I'm sure everyone heard on the 2nd floor. He went to the side just an iota and hit the nerve dead on. I said I'd rather give child birth than go through that again. No cortizone was used, because of my past reaction, and they used lidocaine instead. My pain mgt. dr. said this was a positive test that I had RSD.
    It's interesting that cortizone can cause soft tissue damage (I thought it was mainly muscle fibers--could explain my breast implant fiasco) and oesteoporisis. Right now I'm dealing with a repeat MRI on the neck, because after the blocks & cortizone, I still had neck pain, and when they did another MRI on my neck they are now finding a possible tumour and the MRI is abnormal. Rather than do a biopsy 7 months ago, I agreed to wait till feb. and have the MRI repeated. I'm flat out scared.
    But I don't even put that C word in my head.
    Sealover, try to ask your dr. if you can have lidocaine instead of the cortizone. The lesser of 2 evils. Remeber to keep an open mind. Hope this helps. I don't think since the 80's they haven't perfected a thing. It's all the luck of the draw. Aloha Skooze

     
    Old 02-20-2007, 12:45 PM   #13
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    Re: Sympathetic nerve blocks-what meds are in them & how are blocks used to diagnose

    Quote:
    Originally Posted by Leftie View Post
    I am a new member and suffer from Short Term Memory problems and a variety of other problems that relate to RSD. If I make posting mistakes, please help me.

    I was formally diagnosed with RSD just two weeks ago. This is my 2nd episode with it.

    The first was after surgery for a neuroma in my right foot, overlapping fourth toe and claw toe. I had already had cortizone injections then sclerosing injections for the neuroma without relief. My surgeon kept telling me that the pain, swelling, burning, sensitivity etc. was normal. Come back in 6 weeks and we'll see how you are doing then. Never having health problems and not knowing about RSD, I put my faith in him and suffered. After I pestered him for months he ordered PT. By then I was neering stage 3. PT was painful and exhausting. Slowly, my foot and ankle responded and am only having minor problems with it now.

    In early December, 2005 I had surgery on the left foot for claw toe, small and large toe bunions. A flare-up of RSD started within days. My surgeon reacted in the same fashion. My family doctor referred me to a Pain Center.

    Treatment 1
    I have had three treatments so far. The first lasted for just a few minutes. It was a lumbar epidural injection of Depo-Medrol into the sympathetic nerve . I was given Sublimaze and Versed by IV. The procedure was done using flouroscopy to guide the needle (very important). There was immediate relief. My foot warmed up, swelling/pain were reduced and the color improved tremendously.

    Treatment 2
    Three days later I had the same procedure above. Tubing and an infusion pump were added to the epidural site. A drip of Naropin was given for approx. 20 hours. I was very closely monitored. Numbness was experienced in my left and later right leg. The drip was slowed down, stopped, restarted, slowed down, stopped, restared. The Numbness was completely gone before I was released.

    Treatment 3
    Three more days later they repeated treatment 2. The drip was maintained at the slower rate. I did not have any numbness. I was more comfortable and rested better through that night than I have since the surgery. When the nurse came to turn everything off and remove the tubing, etc. I asked if I could keep it on and stay for another night. Of course, she told me no.

    I will follow up with the Pain Center M.D. in 10 days. Am seeing my family M.D. in 2 days for referral to PT. There has been a huge improvement from the Sympathetic Nerve Blocks. I was scared out of my mind and made my two grown-up daughters and husband stay with me in shifts for Treatment 2. For Treatment 3 my daughter stayed with me until the drip was set up, husband visited when his work shift was over, a friend visited for a short time and daughter picked me up the next day. I know that hard work in PT is needed to restore full function to my foot and get things under control. Now instead of feeling wiped out and frustrated, I am looking forward to getting moving again.

    No regrets about the Sympathetic Nerve Block procedure that was used for me. I asked questions every step of the way before they did each step. What procedures, what drugs. I'm sure I asked the same questions over and over and had them write things down because of my short term memory problems. Not once did anyone get annoyed with me. You have a right to know every detail. The Pain Center M.D. also told me that there are procedures to help prevent this from happening if you have surgery again. I still need large and small toe bunion surgery on the right foot so it is a relief to know this.

    Good luck to all.
    I know how you feel and am heartened by what you describe. I was told I had RSD 12 years ago when I had surgery for neuroma removal. Was in pain for over a year. Now am facing surgery again as it is causing me problems. Glad to know you made it through.

     
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