Radio Frequency Lesioning...

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Broken Medic
New Member


Date Joined Jul 2008
Total Posts : 5
   Posted 7/20/2008 7:58 AM (GMT -7)   
Hello All,
 
       I am new to this forum. I am 47 y/o and suffer from Chronic Lower back. My last day of work was July 21, '07. I was a Paramedic for 20 years. Lifting, pulling, etc. took it's toll. In Oct. 2000 I had my first "Specific" injury. A herniated L 3-4, and a buldging T 12/L1. Went to rehab became stronger, and went back to work. well, over the next 7 years I injured myself to the point where I had to get off the street and take a dispatch job. Well, as you all know...that's not a good solution. Sitting for a long period of time isn't comfortable either. I started missing work, going home early, and had a few "Sit downs" with the suits. I had used up all my PTO, and my Family Leave time. Work was pissed, I was in pain, and tempers short. I basically ended up coming home from work one Friday, and never returned. Once I got to the right people they took me oof work that day, and labelled me "Totally Disabled." My MRI, Bone Scan with CT, showed L1-2 herniation and a L5-S1 herniation. Doc told me this was a precarious place to have two of them as it made the top and bottom of the Lumbar spine unstable.
 
      So, the fun started. A gamet of tests, a bunch of different narcs, and 3 other Pain Specialists, and 2 surgery consults bring me to present day. I am currently under the care of a good Doc, that listens, and doesn't seem like he's pushing me out the door whenever I see him. I first saw him on Feb. 1, 08. Since then he has performed 3 facet joint injections, and last Friday I had an RF done. Well, my dilema is...I am still in pretty bad pain. If my math serves me correct, it's been 8 days since the procedure, and no relief. I researched a bit before the procedure, but maily focused on the procedure. Not so much on the Post Procedure findings. Not sure if all Docs are the same in their sedation. But I got Versed, and Fentynal for sedation. Just as with my Facet injections. So I don't remember to much of the procedure mostly, and hardly ever remember the conversations. Suppose that's why it's good that the Wife is there. Whe remembers one of the nurses stating that it could be up to 2 wks. for recovery, or the signs that the procedure worked.  Has anyone on here went two weeks with this crap before noticing a diff? I have a few schools of thought right now, at 8 days.  1). It didn't work. 2). It just takes longer than a facet or root injection. Don't really know. So, just wondering if I can get some feedback.
 
       I am on Log term Disability, and my first application for SSD has been submitted to the Board as of 3 or 4 days ago.
            Thanks.
If pain is truly "Just weakness leaving the body," Then I'm the Friggin Terminator! ;-)

Post Edited (Roy DeSoto) : 7/20/2008 9:33:19 AM (GMT-6)


PAlady
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Date Joined Nov 2007
Total Posts : 6795
   Posted 7/20/2008 10:33 AM (GMT -7)   
Dear Broken Medic,
I want to welcome you to the HW forum, and our family of support, although every time I say this I wish I didn't have to. Wish none of us had to be here, but as long as we're in the chronic pain boat it's wonderful to not be alone!

I had researched RF procedures awhile back, as I was hopeful maybe I could have one done (ended up with double lumbar fusion). I don't know so much about the post procedure period, but it is a substantially different procedure than the various injections (of which I've had many -mostly of no use). I'm not sure how much time to give it, but I'd suggest calling your doc's office to ask if you early recovery signs are normal. I do know nerves, once injured, can take up to two years to regenerate/heal, and since the RF severes the nerve, I wonder if it takes awhile for those endings to calm down. I'm just speculating here. But I wouldn't compare it to the injections. Oranges and applies - kind of.

Maybe someone will come along who has had the procedure. You might also try searching old threads here to see if the topic has come up before, which I'm sure it has but I can't recall it being recently.

Again, welcome.

PaLady

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13473
   Posted 7/20/2008 5:42 PM (GMT -7)   
Hi Broken, yes I have had the radio frequency done to both my neck and back. It did take a good 2 weeks to know if its was working or not. In fact as more time went by it kept getting better. I had terrible neck pain and always felt like I had soft balls under each shoulder blade, RF took care of that. I had suffered for so many yrs with my neck, it was like a miracle getting rid of the soft balls. I also got good relief for almost a year on my back. I have suffered over 20 yrs with back pain, the neck started in 79 after an auto accident, the back just kept getting worse. Don't throw the towel in yet, give it a little more time. Susie


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13473
   Posted 7/20/2008 5:44 PM (GMT -7)   
OOps, sorry Broken, welcome to HW. I am sorry you have to be here, but you will find this is a great group of people on here. Hope you will hang out with us. Susie


Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 7/20/2008 7:47 PM (GMT -7)   
Hi Broken, welcome to the HW community. I too suffer from chronic lower back pain. They did do the Radio Frequency Liasioning on L3-L5 and it did not help one bit. It was painful and the doc that did it did not use hardly any pain meds before the procedure. I was in so much pain I was actually crying .
HEALTH ISSUES: Herniated discs at S-1-L5, L5-L4, L4-L3. Two level fusion (2000); one level fusion (2002); Revision at L4-L3 (2003). Diagnosed with Failed Back Syndrome, Permanent Nerve damage and Chronic Pain

Medications:

Kadian, Lexipro, Percocet, Temazapim, Lunista, and Robaxin.


tom inpain
Regular Member


Date Joined Jul 2008
Total Posts : 239
   Posted 7/20/2008 8:31 PM (GMT -7)   
Hi Broken: I had RF done also ---did not work at all "for me " i pray it helps you. After all your years of helping people in pain now you are made to suffer that sucks. I was in Law enforcement worked a whole lot with EMT's. funny when i was on the job i never ever thought that one day i would be upside down in my vehicle being cut out of it with no feeling in my entire body by the same EMT's i worked with for years. To the best of my knowledge everyone that was on the Squad left due to neck and back problems. Wishing You the best tom
Tom Lasko


Broken Medic
New Member


Date Joined Jul 2008
Total Posts : 5
   Posted 7/24/2008 10:02 PM (GMT -7)   
Scarred_for_life said...
Hi Broken, welcome to the HW community. I too suffer from chronic lower back pain. They did do the Radio Frequency Liasioning on L3-L5 and it did not help one bit. It was painful and the doc that did it did not use hardly any pain meds before the procedure. I was in so much pain I was actually crying .

Thanks for the welcome PAlady, and StrayDog!!
 
     Scarred_for_life, I always get Versed with Fentanyl for my injestions. So when the nurse starts the IV Lock in my hand and gives me the usual pre procesure gab, sort of faded off a bit until i heard...."Ok. Now for this procedure we don't give you as much sedation as usual." Uhhhhhh...why?" I asked. "Well, we want you to actually FEEL some of this pain, to better tell us where it is, along with the rating the pain."  "You have GOT to be kidding" I muster out. But to no avail. WEll, Yes I TOO felt this pain Scared for Life. In faxt, I DO remember some of the procedure...and I never do with the Facet and root injections. Don't really recall much of the whole appt. with those injections. But this darned thing!!!
      Best thing I can equate it to is the movie "The X-Men." More specifically, Wolverine. You know, those flash back scenes of the surgery/torture that they perfomed on him to give him his new skeleton. I remember the two nurses holing me down and pleading with me to "Please be still!" I am aware of the danger of moving around while there is a needle so close to my spinal cord, etc. But this sucker hurt. And they wanted it to!!! Hello!! The Doc came into the room where the Wife was waiting and told her, "He was in a lot of Pain." Uhhhh, DUH!! What a Moron!
      Oh well, I knew the day I got the EMG performed some 9 months ago, that this wasn't going to be a fun ride. But I am ever determined to get this pain under control, so press on! yeah      Thanks for Listening!
If pain is truly "Just weakness leaving the body," Then I'm the Friggin Terminator! ;-)


Broken Medic
New Member


Date Joined Jul 2008
Total Posts : 5
   Posted 7/24/2008 10:17 PM (GMT -7)   
tom inpain said...
Hi Broken: I had RF done also ---did not work at all "for me " i pray it helps you. After all your years of helping people in pain now you are made to suffer that sucks. I was in Law enforcement worked a whole lot with EMT's. funny when i was on the job i never ever thought that one day i would be upside down in my vehicle being cut out of it with no feeling in my entire body by the same EMT's i worked with for years. To the best of my knowledge everyone that was on the Squad left due to neck and back problems. Wishing You the best tom

 
   Hey, thanks for the support Tom. I often heard folks say that being a Public Servant is a "Thankless Job." I didn't, and still don't. I don't regret my years of service and have seen many things most people will never witness their entire lives. Some I wish I hadn't. But I have some very great memories, and still feel proud to have served. Some of my best Buds are LEO's and are also some very dedicated, and proud people. I honestly never thought I would join a Forum for folks in pain. But I am finding that my loved ones, and friends that don't have Chronic Pain....just really can't understand.                                                                                                                                                                            My Wife is the most Kind and Caring Woman I have ever known. I know there is a place in Heaven reserved for this Woman. She is TRULY an Angel sent to make my life more comfortable, and worth living. She is an O.B. Nurse at a local Hospital, and will soon be the Clinical Coordinator for that floor. But she is always trying to meet my needs, and ever diligent in her pursuit to please me. It truly humbles me. She just wants to make me happy. I thank God every day for her! So she is my rock and my shoulder to lean on. But, yet...as wonderful and understanding (and knowledable) as she is. She is still unable to FEEL my pain. So here I am. Thanks for the support you guys!!  yeah
If pain is truly "Just weakness leaving the body," Then I'm the Friggin Terminator! ;-)


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/24/2008 10:17 PM (GMT -7)   
Broken,
It may depend on whether the procedure is being done only for pain management, or also for diagnostic purposes. Like with a discography - the purpose is primarily diagnostic, so they want to reproduce your pain so they know its location as precisely as possible. That's likely also true for the RF procedure. They want to make sure they are doing the lesion at the location that's causing the pain. Maybe some people would prefer not to know that in advance, but for me I'd rather know so I understand the reason behind the pain. That makes it easier to bear - for me.

Don't know if this helps explain it or not.

PaLady

tom inpain
Regular Member


Date Joined Jul 2008
Total Posts : 239
   Posted 7/25/2008 6:22 AM (GMT -7)   
 Hi Broken:  Thank You for Your comments concerning public service. funny thing is all I can remember after arresting violent
serial criminals ( U. S. Marshall ) is being cursed at and spit on by the crowd that always gathered. for longest time i would respond to the word PIG. Everytime I hear or read something positive it makes me feel good.
                 I join You with having a wife thats a Angel. Now that I am home all the time and being with Her 24 /7 I now know the fear and loneliness She had when I used to go to work She knew that the people I was going after were desperate and chose to run and they would do anything to me to get away. She would see the cuts and bruises i would have when
I came home and see the blank stare I would have after sometimes spending days with a murderer or rapist etc. If I could turn back the hands of time I would have done something else for a living but in public service in another fashion. That would bring me home every night.  Now She worries about both Our sons who chose to replace me ????
               Sorry for going off the subject of pain but I ve found I have gotten way to negative in some of my post's concerning life in pain and have to brighten my comments. Your friend in pain tom
P.S. where were You stationed ? and for what years ? Emergency service=== we always called when we went in to make a arrest ( just in case ) and i can recall many a EMT assisting me with a unruly prisoner.  I would ALWAYS send that department a letter citing that EMT's bravery and a geniune thanks for the help.
Tom Lasko


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13473
   Posted 7/26/2008 1:02 AM (GMT -7)   
Broken, I just had a flash back. I also had an RF of the facet joint at L5-S1 that is messed up. Oh man, now I do remember the pain when he was able to reproduce it. I think I yelled loud enough for him to hear me that he hit it, I spoke a little French too, he, he and I think I remember telling him I was done and so was he. I remember that pain hitting me like a bolt of lightning and getting very sick at my stomach. My pain dr is very tall decent built man, but he truly is a gentle giant. I recently had trigger pont injections , had 7 done in my low back. Dr hit a couple of spots that made me tell him I was done & so was he. He knows when I tell him that, that I am done.lol

Susie


ryand
Veteran Member


Date Joined Dec 2007
Total Posts : 639
   Posted 7/26/2008 9:27 AM (GMT -7)   
You know, it's interesting to hear you all talk about your docs using less ativan & fentanyl during this RF procedure... In my earliest years of this nightmare of chronic pain, I was with my first pain clinic, and of course they were incredibly kind and good to me and they were going to "fix" me right up.

Well, one of the things they decided to try was RF on my back so they started with two "trial" procedures were they injected some temporary anesthetic and I kept a diary of how it worked. Then they did the RF. Okay, so I have a super high tolerance to medications and it usually takes extra doses of everything to work on me so even though they did use sedation during each of these procedures, I remember them. I do remember, though, that the doctor really TRIED to get me so sedated that I wouldn't remember it! He kept saying to the nurses "is she still awake? give her some more." But even though I remember the procedures, they were successful in keeping me as relatively comfortable as possible then. It certainly hurt, but I'm sure it could have been a lot worse.

So, fast forward 2 years... I was back in their office crying like an idiot (I hate it when that happens as I usually always keep my emotions in check in public, but this pain just wears on you - I know you all know what I mean..). Anyways, they were saying how they should try the RF again b/c it helped a little (very little) before. So I agree because I'm desperate at this point. Well the whole process starts over, only this time around they decide I don't "need" any sedation (no discussion allowed) and I'm to be kept completely alert during each trial and the final procedure. WHAT?

Well, this time the trials didn't work, so they didn't get to the actual RF, but then a few months later they ended up doing a discogram and guess what - no sedation for that, either! Okay, so I understood they wanted me alert for that one, but seriously a little ativan couldn't have hurt, could it? And then before they started that one, I told them I was concerned that I wouldn't be able to discern if the pain I was having was my "normal" pain or the pain from the procedure, so I asked what to expect?? And the doctor has the nerve to tell me that I have a history of "not tolerating" procedures very well. I said "what do you mean?" and he says (not kidding here) "the amount of meds we've had to give you to get you to relax for procedures is unusual. most people are okay with less." Okay, wait - so I'm a wuss because it takes more to knock me out than the norm?!?

Anyhow, eventually this pain clinic gave up on me altogether and decided I should just "learn to accept that I would have a life of constant pain." and when they decided they could not offer me any more help, I began looking for a new doctor. I went and collected my records from this clinic and read them over, and as I reviewed them it began to occur to me that the longer I was there, the less they seemed to worry about my comfort during procedures - like the RF. It almost seemed like the longer things lasted the more they began to think they needed to "rule out" the potential that it was all in my head, so they started to worry less and less about my comfort during procedures. In fact, I almost wondered if they didn't allow me to experience the full pain of each procedure as sort of a precaution against hypochondria.

Maybe I'm just being grinchy here, I don't know. I do wonder, though, how often we are forced to feel the pain of procedures unnecessarily. Somehow I think it might happen more than we realize.

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/26/2008 10:18 AM (GMT -7)   
Interesting commentary here. i remember having my discogram and being concerned that I'd be given too much medication and then I wouldn't be able to give them the proper feedback when they did locate the source of the pain. I so wanted it to be found so, hopefully, something could be done. While I was in the waiting area with IV line in the anesthesiologist came in and wanted to give me something to relax a bit before they wheeled me into the procedure room, and I declined. But they did give me something once I was in there. I think enough to relax muscles but to enable me to feel nerve pain. Turns out they never could reproduce the pain. One of my disks was so collapsed doc couldn't even get the needle in. RF was never a real option for me because my pain could never be precisely reproduced enough. I guess what I'm saying is there are ways they can make us comfortable if they want to, at least in most cases. Although it's true when they locate the source of the pain it's going to hurt. I always found that a relief because that meant they found at least a part of the problem.

PaLady

ryand
Veteran Member


Date Joined Dec 2007
Total Posts : 639
   Posted 7/26/2008 11:30 AM (GMT -7)   
Yeah, I completely understood the need to feel the pain with the discogram too. I was just surprised they did not allow me anything to help me relax prior to the procedure. I tried hard to force myself to relax (meditation, visualization, etc.) but I was very tense for so many reasons - my fears of what they would/would not find, my worries that I would move wrong whilst a needle was in my spine, my concern that I would not be able to give them enough information or not be able to discern the induced pain from the pain I was already in, etc.

I think the thing that most intrigues me about the records from this clinic is the obvious difference between the two rounds of RF trials, though. Obviously their clinical practice was to use sedation during these procedures since that was what they did the first time, and the doctor's notes from these procedures include comments such as "it took an unusually high dose of medication to sedate the patient" and "patient alert and oriented x3 despite repeated large doses of IV ativan." Then the 2nd time around I was just told I was not going to be given any sedation. Period. It wasn't an option. I was not given a reason and was too physically spent to push the issue at the time. It just didn't make sense. And then to have him later insinuate that I was being a wimp about the pain involved in those procedures when I'd had to undergo them without the sedation that most patients are allowed... Well, it just really frustrated me.

I should note that I really do think quite highly of this doctor - even after all of this. He did work for quite a while to try to help me before he gave up, and I think he really wanted to help me, but whatever this is just must be outside of his area of expertise. I don't mean to disparage him or his clinic or the profession at all. It's just interesting, like you said. The more I read on this forum in the various threads, the more I am amazed at how vastly different procedures and treatments can be from one doctor's office to another, or one state to another.

Ry

PAlady
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Date Joined Nov 2007
Total Posts : 6795
   Posted 7/26/2008 12:16 PM (GMT -7)   
And the trouble is if we ask too many questions about procedures involving medications, sedation, etc., it starts to raise red flags to them instead of them seeing us as patients who want to be informed about our bodies and what's happening to them. And as people who have some intelligence and can understand if procedures are going to vary for understandable reasons.

PaLady
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