Thursday, June 24, 2010

I Didn't Even Know I Have Facets!

As it turns out, everybody has facets. No; not the kind diamonds and precious stones have and this is not a fancy way of referring to other "sides" of my personality. Uh uh. They are on the bones of the spine where the bones are joined. So it is a common name for that part -- usually referred to as a facet joint. I didn't know that!

The idea came up after Dr L observed the results of the second epidural he gave me. Unintentionally, I have become a bit of a challenging patient. See, I find it difficult to clearly remember the level of the pain, the location of the pain, my activity / diet / mood prior to the onset of the pain when Dr L asks me about it. {Okay; so I am exaggerating -- he doesn't ask about food or mood -- I was just trying to make it easier to make an excuse for forgetting.} But he really asks for details.

And he is tricky too!

After a few questions in a row, he'll ask another question which is almost the same as an earlier question but phrased a bit differently. When my answers haven't been consistent, he reminds me of my earlier answer and asks me which is more correct. Aiy!

It's not that I am trying to mislead him; not at all. It's just a challenge to recall the specific details he is asking. The good thing is that he is diligent and eventually gets me to feel I have remembered and confident that I am giving him the best information I possibly can. And from what I describe about the location of the pain, he believes arthritis in my facet joints could be causing the nerves to get irritated. Check the illustration above -- it shows exactly what he's talking about. [Click the picture to go to Hastings Chiropractic where I found the illustration. They have lots more information on facet joints and the way they are known to be involved in back pain]

There you go... Isn't that just interesting?! Well, it is to me and as long as it helps us make progress with this next injection -- Count me in! Probably the insurance company will provide written pre-certification and we can go for it again sometime next week.

Keep your fingers crossed & drop me a line (comment) so I know you're out there pulling for me!

- Mark

Tuesday, June 15, 2010

We're Going For Lucky #3

The results are not everything they could have been. We did not get total relief from the pain. We got a bit of relief though. There is nearly no pain in my keister (my fanny) but it still sends signals that hit me in that very same spot, then run down to the muscle in the middle of the back of my left leg like microscopic drag racers burnin' up the tracks!

As long as I take the medication Dr L has prescribed on a regular schedule, I am fine -- no racing allowed. But if I let it go too long once the pain starts rising up, then pushing it back down takes a lot longer. And before the meds can shut down the nitro-fueled funny cars again I end up feeling pretty awful for a while.

Rather than try to get the timing of the meds just right, we are going to go for another epidural. There is a third spot that might shut down the races for a longer period of time -- not permanently, but hopefully for months and months. We're going to take that shot on Friday.

Tuesday, June 08, 2010

Where Does It Hurt? There? How 'bout there? Is that the spot?!?

Laying face down on the operating table with nothing on besides my smile, I tried to answer. My Doctor was moving his finger around and pressing down. He needed more information to best understand how to proceed and really challenging. Each touch seemed the same. Well, almost. It was kind of stressful.

No doubt every answer was changing his concept of where to place the needle. Dr K was working with him to work out the positioning. Getting this right was critical -- to them & me!

Maybe if there was no percoset already working to block out the pain it would have been easier. That was allowed -- the Doctor told me to go ahead and take pain medication in the morning. Too bad. I wanted to be more accurate, but didn't feel like I was able to perceive the differences between the different spots he was touching as he asked, "Is it stronger here? How about here?"

He got the information he needed before Nurse A slipped an IV into the vein on the back of my hand, taped it down and Dr Pete popped in some light anesthesia then we were off to the races.

Dr L must have deadened the area of skin above the crack in my butt (Hey! That is where the epidural injection goes in; Okay?) with some lidocaine. Then he used the fluoroscope - live action x-ray machine - to work out the placement of the epidural needle. In a couple minutes, he settled on the first location. When he sent in the first dose, it felt like a tiny hot balloon was being inflated under my skin. The heat only lasted a short time, I think. Time was become a bit uncertain because Dr Pete kept playing around with the anesthesia going into my hand through the IV line. Not enough to make me sleepy, but it was like a layer of cotton was wrapped all around me for a while there.

He worked out a couple more spots to inject and then we were done. Just like that. No fuss, no muss and we were done.

The folks in the Recovery area all wished me the best and Dr L and Dr Pete and Dr K had a serious conversation about the placement of the injection and their prognosis for my treatment so that Femi could hear it directly from them. Then back up to my room in the Day Stay unit.

One of the regular uses of an epidural is to anesthetize the lower part of the body for surgery or childbirth. No baby was going to come popping out of me, but they did a serious job of making my legs go to sleep. But I didn't really appreciate that until I was fully dressed and ready to go home.

Everything felt normal, but the floor just seemed to be much further away than before. So standing was no problem, but taking steps was hard. When the foot reached the floor, it felt like jello or something.

That was when we asked for a wheel chair to get me to the car.