CT Guided Costovertebral Nerve Ablations

[mmglobal]

Lauren is 22 and is my youngest of 3. She finished her undergrad degree in cellular bio at UCSB last year and will take the MCAT soon. Next year, she should be in med school. I am a proud Papa as she is my tour guide. She lover her AP art history and AP European History classes and her retention is amazing. I ask a question about a painting and she not only gives me the history of the painting and artist, but also fills me in on the politics that surrounded the work!

This has been a wonderful trip. (Pictures coming soon!)

Mark

[jsewell]

OK i was wondering if she was the little one in the picture. Makes sense now. Funny i have a 22 year old daughter with excellent retention skills also,.
she has just applied to UCSB among others to finish her undergrad. she has been at community college to save money. She also is hoping to get into medical school!!
judy

[Shebo]

That is great, Mark. I hope for the day that I can forget to take pain meds. You make me want to visit Germany. I would love to visit all of those places. Have fun!

[Maria]

Mark,
Sounds so wonderful to be traveling with your daughter and doing all that you both are with visiting the museums and such. Just your brief descriptions and other photos you've posted give some idea of how beautiful and fun this trip must be for you both. I'm very glad to hear how well you're tolerating everything! Also it would be great to be with someone with such great art history knowledge and retention that could make those trips that much more interesting and fun. Just all sounds like a very special trip!

Like others sure wish I could be doing the same or at least some of it! Look forward to continued posts and photos when you've time! Stay well

[mmglobal]

I've been negligent in not posting for a while. Some of you have seen me eluding to these results on other posts. It needs to be here so my story is complete.

Above, you’ve read about the very targeted and methodical approach to identifying pain generators. I’m very happy with the process and still think there is no better way for me to be proceeding; carefully, slowly, not submitting to anything big; or even just large panels of ablations. Small changes following accurate identification of pain generators.

It’s frustrating because the pain I experienced on injection, and the relief I felt seems to be 100% condordant with the pain I feel. Knowing what I know now, I would still make the same decisions in a similar situation.

While I experienced significant relief with these ablations, I still have my number one problem! I am getting by with less meds and experience less pain (for the activity level I sustain), I still have the #1 problem. When I do any “arms in front of me” activities, after a while I get severe pain that puts me down. I have to lie down for a long time. After a while, I can get up, but cannot sit at my computer, wash dishes, etc…

With regards to work time possible, I’m still in the same boat. I’m enjoying more and am more active with less meds, but I still can’t function normally with these types of activities.

Dale asked (on another thread), what is the next step? I’m afraid I know the answer, but it’s not a good one. I have some severely degenerated facets in my very low t-spine, but I think they are too low to be involved here. I also have a herniated T7-8, which is right in the area we are discussing. I have a HUGE amount of room around the spinal cord, so every surgeon who’s looked at it does not think this is a problem. However, just because the spinal cord compression is not significant, that doesn’t mean that the disc itself is not a serious pain generator. IMHO, the next step is discography. However, I am of the opinion that if you are not prepared to act on the results, why do the test? Positive discography would indicate fusion. I’m not sure I’d submit to a fusion at this level. Thoracic fusions are very tough to consider. I did present my case (just over a year ago) to Dr. Pimenta. He’s the top dog with the thoracic XLIF procedures. His advice was to “stay away from spine surgeons!” Perhaps with the additional investigation, he’d more seriously consider my case. I’ll see.

I’m going to try to adjust my lifestyle/work habits to see if I can function better working in small snippets of time. It’s tough, because I actually feel pretty good at times and the hours go by without me realizing it (until it’s too late.)

I will probably go back to Germany in mid March… I’ll make a decision about heading back to Bonn for thoracic discography (or perhaps Bertagnol for that) in a few weeks.

I’ll keep you posted. All the best,

Mark

[Maria]

Mark,
Does everything you do w/arms in front of you involve increase in pain? Like writing by hand as well as typing/using computer? Are all positions in terms of arms in front of you disabling re computer work? Driving for any amount of time.. or is a certain position re extension of the arms that increases or generates your pain?

Can you work w/o doing computer related work for a while (like a year at least) and see how you progress (such in can you have an assistant to do the majority of this type of work for you) or perhaps you're utilizing a very advanced voice activated system (I used really early inexpensive version that was crappy/difficult to use and never tried another one).

It just seems you've made so much progress to date so hate to think of you having more surgery anytime soon (tho we know to what end I go to avoid surgery) esp. something major..

Hope you continue to improve w/o this type of intervention and meanwhile thanks for the update. I'm sure however you'll progress will be very well thought out and with the best advice around.

[jsewell]

Mark i understand on one hand not doing the discography if you will not have a fusion, but i am the type that always needs an answer, a reason for that pain. Thus said i really don't know your personality in that regard.
I , as you know, did have the VATs to remover that very disc with DrRegan. I'm sure he won't abandon you . If i did not have the severe respiratory accident all would have gone pretty smoothly. I have pain in other areas, none are as bad as my thoracic pain was and it is gone wtih the disc(or a few months later) I love it being gone . It has been gone for almost a year and i still worry it will come back some day, but hope it wont'
I woiuld go for the discography (mine was pretty painful) and surgery again , even an open procedure if need be to get rid of that pain.
judy

[mmglobal]

Originally Posted by Maria

Mark,
Does everything you do w/arms in front of you involve increase in pain? Like writing by hand as well as typing/using computer? Are all positions in terms of arms in front of you disabling re computer work? Driving for any amount of time.. or is a certain position re extension of the arms that increases or generates your pain?

Maria, it is not painful for me to work with my hands in front of my. I feel quite normal and comfortable, then wham... all of a sudden, I can't keep going because of very high pain levels. Driving has never been a problem for me, but like most very tall people, I sit quite low with my seat back nearly reclining.

Originally Posted by Maria

Can you work w/o doing computer related work for a while (like a year at least) and see how you progress.

Are you on drugs? I think I'd need to chop my arms off for that. OK, I'll calm down. I actually do that a lot. When things were very bad for the first few months of 2010, most of my work time was spent lying on the floor, dictating letters, emails, etc. It is very inefficient. (Back then, I didn't even get the few hours that I get now.)

Unfortunately, I'm cursed with having a mission. I still pour most of my limited capacity into GPN. I can't imagine stopping it. I'll continue pursuing options, albiet very carefully.

Judy, it's so hard to consider surgery. As bad as I am and the deminished capacity that I have... I'm still a thousand times better than I ever thought I'd be during my lumbar problems. Some of the time, I'm able to sustain such a high activity level. I have periods of normalcy. On most days, I experience pain levels of 7 or 8, but I also spend more time at 2 than at 7 and above. If I can not do anything, I'll avoid high pain levels but it's impossible for me to live like that. If I try to push through, I'll get to a 9 pretty quickly.

We'll see about the discography. I tolerate all these types of procedures very well, but it worries me because I'll be in Germany and will have to travel back by myself. If the discography sets me off, that might be a disaster. I like the CT guided procedures in Bonn, but I've had a ton of radiation. Bertagnoli is an AMAZING needle jockey, so I'd trust him to do it with flouroscopic guidance. I'll see... fortunately for me, all options are open and I frequently get to spend time with the best of the best.

Mark