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    Old 02-24-2006, 07:21 PM   #1
    Star-Love
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    Cervical Epidural Block

    Hi everyone,

    My name is Laura. I have had JRA (juvenile rheumatoid arthritis) since I was 18 mos. old and am now 27 years old. The reason I am posting is because for the last few years I have had terrible pain in my neck; cracking, grinding, popping, etc.; with headaches to boot, with no doctors figuring out what it was (I have no idea how) until about a year ago when they did an MRI and found some RA. Even then though not much was done and I was still let to suffer the pain and headaches until recently I couldn't go anymore and saw my own orthopedic surgeon who only took a few X-rays and told me that the arthritis had degraded the C1 and C2 vertebrae of my neck to practically nothing, thus causing the excruciating pain, cracking, grinding and headaches. He said since the damage was so extensive the only options were to live with it (and the pain), steroid injections, or surgery. I decided to go ahead and try the injections since obviously living with it has gotten so bad.
    Anyway, I finally have gotten in to the local hospital where the Pain Management office and anethesiologist is who is doing the procedure. What he is doing is called a cervical epidural block. What my question is, I guess, is has anyone been in a situation similar to this before, or has anyone had a cervical epidural block before and can tell me how it went for them?
    Mine is going to be outpatient, same day, but I will need a driver. He is going to do the contrast-dye X-ray technique with the injection, and he won't be injecting right into the neck where I have the RA (C1,C2), he said it will actually be a little lower down.

    Thanks anyone for advice, help or replies.


    Laura
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    Old 02-25-2006, 03:22 AM   #2
    Kissa
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    Re: Cervical Epidural Block

    Everyone responds to the epidural blocks different and there's about a 50/50 chance it will work for you and unfortunately you won't know the answer until you have it done. It is only a temporary solution.

    I'm not a huge fan of them or any injection into the sacral joint or spine as they do not work for me and they are extremely painful because I fail to respond to numbing medications properly (it takes at least an hour for it to hit then doesn't go away)

    The only thing I can suggest is be sure you are good and numbed before they do they injection, it helps tremendously with the injection pain itself but does not stop the shooting pains that may go down your arms. The arm pain goes away a few minutes after the injection itself but feels like someone lit your arms on fire and is pulling them off during the injection itself. The area itself might have this loose feeling to it and you may get spasms or sharp pains for a few days after the injection if the injection itself doesn't work for you.

    If you do not respond to the first injection do not buy into the "well a second one might work" theory because for most people they don't and you'll put yourself through uneccessary pain. The same is true of steriodal injections as well.


    -- side note.. are you actually having an epidural block or a steroid injection? If it's steriods, do your research and think long and hard about it first. They are NOT intended for the spinal cord and can cause permanent damage, even fewer people respond to steriods than that of a block. There's a difference between a block which numbs and a steriod injection which is supposed to reduce inflamation and lubricate the joint.
    There's a good post on the pain management board about why you should not ever have one done in your spine in any location.
    Also if you do decide to do it never ever have more than 3 injections in your body as a whole in a 1 year period, it is very dangerous and some doctors do not follow the FDA rules and give more than that anyhow.
    Personally if it were me, I'd rather have surgery than go through a steriodal injection ever again!
    FWIW I suffer from OA and have for 32 years (since age 8) and can really relate...

    Last edited by Kissa; 02-25-2006 at 03:28 AM.

     
    Old 02-26-2006, 12:53 PM   #3
    arlo2007
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    Re: Cervical Epidural Block

    I had a ESI a week ago with horrible results. When I woke up from the anesthetic the pain was awful. It was my pinky finger and ring finger and all the way up to my neck. The Dr. said it was the ulna nerve C8 he evidently hit it with the catheter during the procedure. The pain is so bad I don't know what to do. Even so much as a tisue or the sheet on the bed touching my hand or arm is terrible. He gave me all kinds of pain pills and Nurontin but nothing helps. He doesn't thing it will get much better. Its my right hand so can't do much of anything. I'm typing with one hand.

    If anyone can offer any advice or any one who has had this happen , please post. Having a MRI on Feb 28 to see if any oter damage was done.

    Think very hard before having this done. I'm now in horrible pain.

     
    Old 02-26-2006, 08:47 PM   #4
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    Re: Cervical Epidural Block

    If you ask 100 people you will get 100 answers. I have had both ESIs and Selective nerve root blocks. ALl fluroscope and contrast die guided.

    My experience on the ESI was that it wasn't so painful that I couldn't stand it. There is a brief few 15 seconds where it is very uncomfortable just ask the dr. to talk you through every step she/he is doing and what you will feel and what to expect. If you are nervous they can give you something to relax you during the procedure. Once the pain med they start pumping in gets in there, you do get a more comfortable sensation. Afterward I felt better for a few weeks, then it wore off.

    For me the ESI was worse than the selective nerve blocks which are a piece of cake.

     
    Old 02-27-2006, 07:24 AM   #5
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    Re: Cervical Epidural Block

    Hi Laura,

    I had the cervical blocks prior to my ACDF surgery. It helped for about a month, then the pain returned.

    It is not a long term solution.

    Dennis

     
    Old 02-27-2006, 08:53 PM   #6
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    Re: Cervical Epidural Block

    Hi everyone,

    Thanks for all of your answers and advice. I really appreciate them, but so far I'm still confused as to what to do. My injection is scheduled for Wed., and so far I really don't have any other options. My orthopedic surgeon is a really good doctor who I trust, and I believe him when he said that the RA had advanced so much in the C1, C2 levels so much that my options were basically the injections or surgery. (or living with it, which I've basically been doing for years already)
    My pain management doctor did mention the injection would be a mix of saline and Kennalog (I think I have that right...), and that I would be laying down on my stomach, and would get a shot of anethesia first, I'm assuming in the injection site. He didn't mention sedation, which from what I read is better, because sedated patients can't always mention pain to the doctor. He said it would be injected just a bit below the neck (I didn't get a number area, but I am thinking maybe C5-C6 maybe) because then the injection can get a better chance of making it up the the area we're aiming for, C1,C2) He made it sound like it would go pretty quickly, and then they would monitor me for just a bit afterwards and then I would go home.


    Laura
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    Old 02-27-2006, 09:44 PM   #7
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    Re: Cervical Epidural Block

    Hi Laura, these are pretty standard procedure they are done the same. When I said give you something I did not mean sedated as in something for the pain, they can give you a little something to relax, like a little tranquilizer or whater they give. They put something in my iv. i wasn't there more than an hour or so from the time they started to when they said i could go home.

    There are cases of people who have long term results, or those that have short term results. You won't know where you fall until you try one.

     
    Old 02-27-2006, 10:00 PM   #8
    Star-Love
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    Re: Cervical Epidural Block

    Thanks az.

    Yeah, what my pm doc told me, he said it can go from 0 days to a year from what he has seen, in results for help for p.m.

    I really don't know about any sedation or tranqs, he didn't mention it at all, so I'm going off the assumption that there wouldn't be any...
    like I said, I certainly am prepared to be firing away any and all questions and doubts I have. I might even stop in the office tomorrow just to ask and reassure myself, since I will be out for another doc. appt.

    I'm also having my Ortho. surgeon send his report from my appt. with him to their office to help them help assess my case, and I might try and talk to my Ortho. to see his opinion on what the p.m. plans to do. Anyone's opinion on this? (I also plan to get the Ortho.'s report for myself, should have the first time I was there, always good to get a copy for yourself..)
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    Last edited by Star-Love; 02-27-2006 at 10:02 PM.

     
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