Lastest procedure discogram

Shaun's latest procedure included five needles last week. This one was a diagnostic one to inflict pain in areas that are problem areas in his neck. The goal is to pin point where the pain is coming from and to verify to see if there is disc degeneration. It is called a discogram. The doctor inserts small tubes in the front side of his neck. Then they insert thin needles into each of the tubes. The needles then inject dye between the vertebrae. The goal is to see if any of the vertebrae hurt more than the rest when the dye is injected. If all points hurt then the test in inconclusive, since the test itself is uncomfortable. A positive test is when some areas hurt and other areas don't or are just uncomfortable. They did five injection points, three of the five had varying degrees of pain.

C3- 4 no pain
C 4-5 lots of pain
C 5-6 almost as much pain as above
C 6-7 pain, but not nearly as much as the previous two
C 7 -T1 no pain

This is the report that the DR gave us, since Shaun was awake, but remembers none of this. This makes his 9th time under anesthetic in a thirteen month time frame. Though this was a bit different since there was no pain medicine in the anesthesia for obvious reasons. Next week will be number 10, when he goes in for his radio frequency ablation in a new location than his last one that did not take. The original plan was to do the C 3-4 area, but the DR who did the discogram is recommending that the C 4-5 be done in addition. Even though this cauterizes the nerve, it is still considered temporary relief, since the nerves grow back and reconnect. Hopefully this will buy more time than the others have provided since it is in right area.

This procedure left some pretty good bruises. He will have some battle wounds to show off for the next couple weeks. Additionally, it was his lucky day for bruises. He has great veins and has yet to bruise with all the IV's he has gotten, until this time. I am not sure what went wrong, but I have never seen an IV bruise this bad and they got him on the first try. So right now he has a couple of areas he is pretty black and blue. Hopefully next week will be better.

Latest surgery procedure

Well most of you know that Shaun had another procedure last Tuesday. They seem to be a regular occurrence for us. The doctor thinks this may be a regular event for him. He has a healthy nerve that regrows rather quickly and the headaches come back each time. This time they came on with a vengeance. Though we still hold to a hope that one day the nerve will grow back and there be no pain at all.

I am not sure why they sometimes cauterize the nerve with one needle or two, but this time there is a third needle that was used and can be seen in the right top picture. We would not have even noticed it in the pictures, except for the fact we saw the three injection points on his shoulder. Not sure what it did, but it was not near the near area, so must have been for something else.

Any way, because they insert the needles from the shoulder up to the top of the neck (actually the third vertebrae from the top), he of course has had a bunch of neck pain and swelling. He is now in phase two which is the feeling of burning. This is a pretty painful stage. He describes it as though he has a severe burn on impacted area of the neck. If he keeps laying down and ices lots and takes his medications, the pain does not radiate to the rest of his neck. For the most part his vertigo dizziness is mostly gone, which is nice.

Anyhow he hopes to return to work soon. As they are down an another employee and there is only one employee at work handling the work of three. None the less, he knows that if he pushes it to soon then the pain and swelling flairs up and healing takes twice as long.

Cervical Radiofrequency Ablation

I know every one is dying to see pictures from Shaun's procedure he had last week. The first one is from the latest procedure. Yes those are needles in the picture. I will write about more about this procedure at the end.

He has had two actual procedures and two pre-procedures to test if he was a candidate for the actually procedure. The actual procedure is not too far more painful than the pre-procedures, but the healing is much more difficult. After all, they all involve a needle in your spinal area. I will explain each of the procedures and if you really are that interested or have nothing better to do just read along.

This is from the first procedure. It is called the Cervical Facet injection with steroid. I guess the picture is of blood vessels. Not sure what we are even looking at, but hey they gave us the picture, why not blog it.
Any way the first one was to see if he responded to the treatment. They took a needle to the branch of nerves located in the C 2 and C 3 area. This area is known to trigger headaches in some people. It is a last resort of things doctors recommend to those who have not responded to other treatments. This time they did not do anything long lasting. They used some lidocane and a steroid. He was told to keep activity levels down for the first 24 hrs and most of the next 24 hrs. We found he had pain in the area for about 5 days and his daily headache was gone immediately and did not return until day 8. We had to record daily pain levels for the first week. Every one found this to be good and so we proceeded to the next step.

This one was done by the same doctor. There are three pictures. The first one shows the needle really well and the other two have pen marks pointing to the area they targeted. This one was more of a targeted nerve block. The goal was to target the actual branch of nerves that was causing the headaches. They used lidocane to isolate the area and see how long relief lasted in a temporary state. This time no bed rest, but was asked to moderately do activities that would normally increase his headache. We had to record every half hour starting just prior to the procedure and for the following six hours. It was different from the other procedures in the fact that his headache was still present following the procedure. Went from an level 8 out of 10 down to a 3 out of 10. It continued to decease until 2 hours after the procedure it was gone and then returned slightly at 5 hrs post and maintained that level for the duration of our recording. It was nice that he was finally able to do some household things during that time and still felt fine. (Any Exertion activities normally caused a more severe headache to the headache that was always present, such as mowing lawn, running, lifting items that require a bit more effort, and sudden adrenaline response (like braking quickly in the car). This time he was sore after the injection for about 24 hrs.

Now the third one was done on Christmas Eve. It is called Cervical Radiofrequency Ablation. It was to be the last step to end all headaches. At least so we hoped. It was done by a different DR, he gave us only one picture, but a bigger version of it. Yes that is two needles. The goal was to add a little steriod and lidocane, additionally the needle would heat to a high tempeture to cauterize the nerve. The headache was gone immediately. Recover was hard. It required him to be in bed and use of ice and regular use of pain meds. This came with episodes of vertigo. He was told to take it really easy the first week, and that it sometimes takes a couple weeks for the pain to go away, but things are usually pretty good by day 10. Well, Shaun took off from work from Christmas Eve on until New Year's Eve, which he needed to work, so others could have the day off, since he got Christmas Eve off. He was lucky to be able to come home early that day. Friday was Jan 2nd and was day 10, his first full day back at work. I remember him coming home after working the full day and seeing he was in excreciating pain. He described the pain felt like a severe burn. We later found out why he felt that, but thought that was strange at the time. We made it through the weekend with no improvement and were able to call the doctor's office first thing on Monday. He was told that he had inflamation of the nerve. It is a rare side affect that can happen occationally. He was told to lay down as much as possible, use ice to reduce swelling and use pain medications. One thing we noticed as the swelling increased so did the vertigo. If we could keep the swelling down then he would be fine with his balance. He was told to not lay on this side at all and that in time the pain would go away. It took another week for the pain to noticable decease and from there it went away quickly. All in all, about 4 weeks to get back to feeling normal.

This was great. No headaches and we were free to live life normal. (Finally after 10 months of very rough times.) Only thing was a spot on his neck that had no feeling.

Over time the spot gained feeling and then the headaches returned gradually. We knew then the nerve was growing back, but hoped the daily headache would not return. But then it did. We were told the procedure was expected to last 3 to 18 months and each time the nerve grows back slower. Even with the regrowth of the nerve, there was a chance he would never have those headaches again. So this time we got 4 1/2 months and we hoped this was his only time to need this procedure. So now we know we were wrong, but at least we know what we need to do to get on with life.

Today is day 5 from his latest procedure, and he is still in quite a bit of pain. He has to stay on the ice and not be up much in order to keep the swelling down, but we have great hope that in a matter of days he wil be feeling well and that recovery won't be quite as long as last time, but time will tell. This time he is not going back to work until day 11 (Monday) and if need be he will work half days for the first few days. I hope it is pretty much better by Monday for his sake. All in all we are lucky with the weekend schedule and Memorial day, he is only taking 5 actual days off from work.

For more info:
http://www.eorthopod.com/public/patient_education/6953/radiofrequency_ablation.html

http://www.pain-docs.com/painprocedures/radiofrequencyablation.html

*****UPDATE******7/9/2009 This last procedure healed much faster than the first. Back at work on day 11. Work almost a full day and then full days after that. Each day was better and he was not wiped out from work like the last time. For those wondering how long the pain last. Hang on. It does get better and your quality of life will improve hopefully. Best advice to give is ice will be your best friend until it stops hurting. The more ice he used, there was lessened inflammation and it helped with the pain. So stay on top of the ice.