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-   -   Thoracic ESI this Tuesday (http://www.ispine.org/forum/ispine/2151-thoracic-esi-tuesday.html)

mmglobal 09-18-2011 09:06 PM

Thoracic ESI this Tuesday
 
These recent days are tough as I've knocked off the Mobic. Everyone should be aware that before these and most other needle procedurs (and surgeries as well), you have to stop taking any blood thinners. Most of the NSAIDS are blood thinners and substantially increase the risk of complications.

I'll let you know how it goes.

Mark

dshobbies 09-18-2011 11:34 PM

Here's hoping Mark -. Good luck, Dale

Maria 09-19-2011 05:00 PM

good luck
 
Mark,
I was advised to stop taking Nsaids or any blood thinners (aspirin) 2 weeks prior to eye surgery. I remember thinking.. hmmm I'll just sneak a Toradol injection in there for my aching back. Glad I thought better of it and didn't. Duh..

Sure hope you get some relief! Miss your humor so thought you might be hurtin'~ take care!

newhere 09-21-2011 08:57 AM

so mark....news???

mmglobal 09-22-2011 12:03 AM

I had the ESI yesterday morning. All went well. Dr. Barreto is an amazing needle jockey. There was no distress during the procedure, pain levels very low. I couldn't even feel the pressure when he injected the cocktail into the epidural space.

For the first few hours, I was pretty good. Last night I felt like I'd been kicked by a horse. Today is a pretty average pain day... maybe a bit worse than average. I'm back on Mobic and that should help.

The injection was clearly in my pain area. If I was better from the steroid, but worse from the trauma of the injection, how could I tell. I think it's a bit early to be expecting relief from the steroid. I'll say I'm worse from the injection. The next few days will be key.

Gotta go.,

Mark

jsewell 09-22-2011 12:38 AM

Marc,
I've had my share of ESI's and i always feel like i've been beaten up the days after, mostly the next day.
after that the pain from the injections subsides and only then can i tell if it will help. My most dramatic help were the ones i got after surgery , well 20 days later. I went in barely able to put weight on my right leg and it cleared up in the days following to feeling like a normal leg. It is still good although i did have a few days of some return of mild to moderate symptoms.

My doc always makes us wait 10 days to decide if they helped.
I wish you the best. I used a lot of ice for the beat up feeling.
judy

dshobbies 09-22-2011 05:57 PM

Mark,

Your poor body is hopefully reacting to the trauma. If you feel like dancing in a few days - don't.;)

Dale

Maria 09-22-2011 10:40 PM

re ESI
 
Hope you'll feel better soon. I only had one that I felt much worse from and that was my first (out of 10 years worth). It was very bad for what seemed like 3-5 days (as I recall) and then felt great when the steroidal effect took hold.

So of course I hope your results will be like mine;)

mmglobal 09-23-2011 04:10 AM

Today was day 3. No luck. I would have expected this to be the day. It still may be possible that reduced pain from the steriod is replaced by increased pain from the injection trauma. Maybe tomorrow will be better?

This blows my theory about the systemic value of the steroid being the key. The joint injections seemed to be determinative. The ESI seems to have no meaningful improvement associated with it. Back to the joints?

Next step may be bone scan?

Mark

jsewell 09-23-2011 07:54 AM

Mark i am sorry to hear you have no improvement. I had the same situation when i had my thoracic injections.
Judy

Maria 09-23-2011 11:56 AM

bummer
 
Well that sucks. Was hoping to hear you'd be feeling much better tho it is what it is. Still hope of course that the steroid will kick in.

Only once when I had L3 targeted re ESI did I get no effect. Supposedly I had an annular tear there or disc disruption but guess it wasn't really the problematic level.

Here's a real stupid question .. how did the thoracic area get accessed and what level/levels were targeted? Just thinking about it seems painful..

jsewell 09-23-2011 06:36 PM

Maria, mine were accessed right through my back under floroscopy . Same for the discogram. that was the only test that proved positive for my bad discs.

Mark, give it a few more days before you totally right it all off, some times it takes a little longer.
judy

Aaron 09-24-2011 06:17 PM

See,

I dont remeber ever feeling like a horse kicked me the next day, but I do remember feeling the medicine hit the area and I almost came off table. I have had 4 esi in thoracic and only 1 worked. I don't know why it worked and others did not. The last two were done exactly the same and I got relief from one and not the other. Who knows???

mmglobal 09-27-2011 01:05 AM

I guess the jury is in. It's been 6 full days and there is no improvement.

I'm actually glad that this is so unambiguous. There is diagnostic value here. Injections into the joints are successful, but the epidural injection is not. I'll have to reverse my opinion that the facet an similar injections have a cumulative systemic value that generates postive results even when they are not in painful joints.

Maria, this epidural was over about T7 or T8 and was done right over midline. All my other thoracic needle procedures approached from about an inch or more off midline.

Bone scan next. I'm also considering a standing MRI to see if my benign looking disc herniation might not be so benign under axial load.

Mark

dshobbies 09-27-2011 04:35 PM

Mark,

Even when we know from where our pain comes, we still wonder which road to take. When you don't know, you can't move forward. You can only tiddle your winks until you know something positive. Very frustrating and I suspect even more so for someone who's been around this block twice. I can only shrug my shoulders and hope the next test reveals something. I'm really so sorry -

Dale

Maria 09-27-2011 06:26 PM

re value
 
Mark,
Was the ESI done in order to create a steroidal calming of a supposed disc level or ? nerve impingement? Would it then mean that either the area targeted isn't the area of pain or that it's not the discs targeted?

Seems like Judy and I are the fortunate few that have good results with ESIs (lumbar at least). I'm sorry that you've not gotten relief but if this procedure not helping has helped in some way in terms of what it might not be then I guess there is value in it.

Sounds like a painful area to have gotten an ESI in.

With regard to your next step are you doing as much work up as you're able here in the states with insurance and whatever can't or won't be done getting done in Germany in terms of diagnostics?

I hope for spontaneous relief which is wishful thinking tho why not. Other than that I hope for an accurate diagnosis that will still have minimal invasiveness involved.

Thanks for keeping us posted. Can you suffer a few cadillac margaritas?

jsewell 09-30-2011 04:42 AM

First of all i am ready for the margaritas.

Mark, i'm so sorry you have not gotten any relief from this ESI. I have had many that were also useless in regards to relieving pain.
Have you already had the discogram for the thoracic region. That is when my bad levels were identified.
Thanks for the update.
judy

mmglobal 10-01-2011 07:05 PM

My doctor called me a couple of days ago. He agrees that a good next step will be a bone scan. As soone as we get approval, I'll start a new thread about it.

Maria, the reason I went to the BetaKlinik for diagnostics was the capability to do single injections at a time. Also, IMHO, the CT guided procedures are likely to be more accurate than the procedures done with flouroscopy. I'd seek CT guided procedures here if I thought I'd be able to do single injections, but I don't think that's realistic here (without huge sums of money involved.)

Mark


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