CT Guided Costovertebral Nerve Ablations

[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

[Maria]

Mark,
certainly not wondering about total abandonment of your work.. just modifications that possibly lessen exacerbations which I'm sure you're trying/tried. . Re surgery ..to each his/her own. You've got all the best options available to you so I expect you'll make the right decision for yourself no matter what it might be. Of course I'm on drugs (drug).. same low dose opioid pain medicine that I function much better on than I have since I started it 10 years ago and off all the others I took thankfully at least for the last 8 months. Am quite pleased about this. Mental functioning much better as well now. Maybe one day I'll be off the pain med too tho so far just glad to be where I am at this point!

Maybe I'd be better with more lumbar surgery though what I know is where I am without it and how I feel and for me that's significantly better. I don't ever completely rule out the option or thought of it .. just hope to keep it a distant consideration for myself if possible. Whatever.. cross that bridge when I come to it.

Good luck w/discography if you go there in March and whatever else follows that~

[dshobbies]

Stupid suggestion, maybe you've already thought of it or are already incorporating -

I enjoy painting which requires sitting for long hours. After the point of no return, my thoracic muscles begin to ache beyond reason with pain enough to take my breath away. This is easily remedied by my recliner and in very short order but my day of painting is over.

Now, when I want to paint, I simply wear a very good back brace, something I'm sure most of us already have, and voila - no pain. I can paint most of the day.

I'm not suggesting our problems are similar - I'm simply suggesting you try a back brace to postpone your own point of pain. But then again, maybe you're already doing that!

And btw, if you're dragon program is out of date, you can buy last years version rather inexpensively on ebay.

[mmglobal]

Dale, great suggestion! I only have lumbar braces, but I can certainly give one a try and see if the brace keeping my trunk in a more neutral position will help. I know you are suggesting only specific uses of the brace. For other readers, constant use of such a brace can decondition your core muscles, making the problem worse instead of better.

Maria, your point is well taken. I do need to improve my work habits... specifically not getting ensconced in what I'm doing and taking more frequent breaks.

I'm sorry about the "are you on drugs" crack. Everyone who knows me, realizes that this was said with a laugh and was only intended to make the readers smile. Someone who doesn't know me may think that that is how I communicate. That is not thet case.

Regarding Dragon: I have windows7 on my laptop. It comes with the Dragon speech to text engine incorporated in the operating system release.... very smooth implementation. It is a wonderful tool and if I was worse, I'd use it more. Like most propeller-heads, I type really fast. It is soooo very slow. My laptop is 6 years old and is maxed out at 2GB of RAM, so it's relatively underpowered for the demands I put on it. When I win the lottery, I'll upgrade. But... like your brace suggestion.... I need to get out the headset (6 yrs ago, many laptops still didn't have an onboard mic) and see if I can get better at using the speech to text system. Thanks!

All the best,

Mark

[Maria]

Mark,
I know the "are you on drugs?" question was in jest/lighthearted so no offense taken by me and probably most that post here know your style of communication as well.

Dragon speaking naturally is what I was thinking about in my earlier post and I have a very outdated version of it that was incredibly tedious. Would love something that involved little to no typing as I either sit and give myself a backache typing or crouch and give myself a neck ache typing or sort of semi recline and use the laptop and give myself multiple probs all at once.

However since I don't work I'm only on the computer for fun/relaxation. Sure can get carried away with that too at times!

While I was in Fla. packing boxes at the end (fairly light so I could lift, move and weigh them for a Fedex account yet totaling around 500 lbs all inclusive) then pushing this monster big old fashioned TV on the floor not (you know wiggle this side, wiggle that side and get it to move since I could never lift) I managed to exacerbate back, neck and create some thoracic level pain I've only occasionally experienced. I was told long ago this area would be problematic someday however not so yet (except very occasionally).

Trying to lie down on my back and sleep is when I felt the discomfort/ pain most significantly like it was a dull dagger sticking up thru the underside of my thoracic area about T6 (?) between the spine and the mid to lower part of my shoulder blade. That sucked!!!! Lasted several days. Was holding my breath that I'm not going to start having pain in this part of my spine as well. Hopefully was a ligamental, tendonous, muscular type of pain because it went away.

When I type like now sitting however I start to feel this tightening in that area again and spreads up around my shoulder and into my neck. Guess it's ligamental/muscle related. Not something I want to '"encourage" so on that note ... I'm outta here for walk!

Have thought of a thoracic brace myself to sort of pull my shoulders back instead of hunching them forward (round shoulders). At least to see if that helps with upper back/neck stuff.

[Shebo]

Mark, our pain sounds so similar. The pain level (thoracic) that you describe and what makes it increase is the same.

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.

I recently gave the exact above story to my pain management dr. when she said that I needed to push through my pain during the day and to add exercise. I explained to her that when I push through the pain then I can't control it.

Against her advice, I have changed the way that I use my day. I do tasks in very short amounts of time. It seems to have helped. It is very frustrating, as you know. You get going and want to keep going. I now know that it will send me into uncontrolable pain.

I just had a myelogram done and we have been talking about doing an ablation. I read all of your posts here and I couldn't find the answer. Can you tell me what pain relief (if any) are you having now from your ablation? Is it the same as above? Would you do it again?

Thanks.