Questions on spinal injections

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nvrthesame98
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Date Joined Jun 2008
Total Posts : 6706
   Posted 3/14/2011 10:40 PM (GMT -6)   
Hello all! I am sorry to say I have not been a frequent visitor here or should say poster as I read daily but have a question here on spinal injections.

I want to say that I have been a CPer for 10 yrs but my knees have been the culprit until a few months back I started having this horrific burning like numb pain that runs from by behind all the way down the back of my leg,my regular meds dont touch it and it is pretty constant since it started.

I discussed with my new PM Doc and he orders an MRI of my lower back and what do you know,alot going on there we didnt know about and I wont go into it all other then to say I have sciatica from nerve impengment and he sets me up for spinal injections which I had this a.m. I was not real up on the ideal but agreed to try and had a horrible experience I might say.

I am legally deaf and and was put on my stomach as soon as I reached pre-op even after asking them not to until we entered the OR since I was NOT going to be able to "see" what was being said to me,they refused saying this is how it had to be,they started the IV with me having all this coming at me not knowing it was coming since I couldnt hear anyone talking to me. Finally we go to the OR and again all I can see is bodies moving around me and can hear nothing being said including any ?s they are asking and not giving me time to tell them I dont know what they are asking,they were in a real hurry here too folks, I could see the lady that was going to put me to sleep,saw the syringe with the meds for doing that and knew she was telling me to do something but have no idea what as I am face down on this table,she finally turns my head sideways and Im guessing this is what she was telling me to do and then I am out.

I wake up and they are sitting me up in recovery and and asking this or that and getting me in the wheelchair and they stand me up and I fall!! Just like that I have no feeling in either leg or my behind at all,nothing! They get me back in the chair and out to the car we go and again as I attempt to stand I go down,they get me in the car and she says are you feeling anything yet? Nope nothing not a thing,completely numb! Done even realize my sandal was hanging off my foot. She gets me out of the car and back in we go.

I sit there and sit there and she keeps asking can I feel anything and I still feel nothing and by this point I am getting alittle more then worried since they seem to be. She again tries to stand me up and I have no bladder control and there goes my shoes and clothes and my 22yr old son is standing there and I am more then mortified so I lost it,upset crying and they go for my Doc and I guess they were told to bring me to his office since he is in the building next to the surgery center. I get there in a gown now with urine still running down my legs and the wait area is full of people and the receptionist tells them to park me anywhere. OMG I start again begging them not to leave me here like this in front of all these people with urine running down my legs and I dont even know it. Im told this is where I have to be.

2 hours later I finally get in a room and see my Doc and he wants to know why I am hysterical? No one informed him? No one told him what was happening to me? He apologizes and goes and gets me scrubs to wear home and asks if it is better,the numbness? Im getting alot of tingling and some feeling in one of my legs back by now so I go on home. He said it happens that way but not alot?

Has anyone else had this happen? It took about 5 hours for me to return to a normal amount of feeling in both legs and my rearend but lord I was scared to death.

He said next time he would not use as much numbing meds since I must have a very low tolerance? Next time? Since I am still having the same pain,the sciatica and have a major headache and my BP is thru the the roof I seriously doubt there is going to be a next time here.

Sorry about the length of this but wanted to make sure you had as much info as possible here to answer my question. I also had cortisone in that injection at L2,3 and S1 by floroscopy?

Thanks for giving me the chance to get educated here and hoping someone can shed some light on why this happened.

desert
Regular Member


Date Joined Feb 2011
Total Posts : 93
   Posted 3/15/2011 3:28 AM (GMT -6)   
Hi nvrthesame98. I'm sorry you had such a terrible time with your procedure. And that does sound like a truly terrible time. sad

I've had four epidurals in the past five months. Mine were in my neck though. I was not put out for the procedure, just some Versed because of my rather extreme reaction to needles. That has me wondering if I'm talking about the same thing. Assuming that I am though... Strong reactions to these injections are not completely unusual. I only had a reaction to my last one and it was not similar to yours. However my post procedure instructions did say that such reactions were a possibility.

I would say you got terrible support staff at that hospital. When I've done it I've been just slightly unsteady on my feet with irregular breathing and they've had a nurse walk me around the hospital a bit to make sure I was going to be ok. My hospital takes falls very seriously. If I actually fell there would be a group there to help in no time flat and I would be back in post-op for a long time while they made very sure everything was ok. And I don't think that's only my hospital, a lot of the forms for falls list some kind of big organization that handles the processes and procedures for falls at medical facilities.

I'm none to happy at your doctor either. Two hours to see you for a reaction that you had to a procedure that worried the hospital staff enough to bring you back to his office? Unacceptable. If he had been in another procedure that would be acceptable, but if he's just in his office he needs to make sure nothing has gone very wrong as quickly as possible. At least he was more helpful than anyone else.

I guess that's enough of my venting about your medical staff, but I want you to know that the treatment you received is not what I would consider normal (or even acceptable) for this kind of procedure.

As far as not yet feeling an effect. First thing to know is that it takes 3-7 days before you'll feel the effects of the Cortisone. Also many people do not get a reduction in their pain symptoms until after a second shot. (With the second shot being soon after the first one, two weeks is usual.) I definitely understand not wanting to go through something like that again. It may still be an effective treatment for you though. Of course I'm not a doctor, so there's no way I could know one way or the other. One thing you might try if you decide to try the second injection is to see if your doctor does procedures at multiple hospitals. Maybe a less convenient but hopefully better staffed location could give you better results. If nothing else, talk with your doctor and make sure you are lined up to have the staff ready for a similar reaction and to let you recover in the hospital before trying to shove you back out the door and into a car.

If you decide to do another one of these I sincerely hope it goes better than that last one. If I'm actually talking about the right procedure, let me know if you have any other questions or if I didn't answer well enough. I did a lot of research before I did my epidurals. Sorry if my post got a little frazzled in the middle there. Poor medical care is apparently one of my push buttons, especially when it is to one of my fellow HW CPers. I strongly believe it is something no one should ever have to deal with. People in a hospital usually feel bad enough already without having to put up with that stuff.

Hope you were looking for something to read for a while. tongue Also hoping you're having a low pain night at least.

-Jeff

nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 3/15/2011 5:50 AM (GMT -6)   
Thanks Jeff for your responding so quickly and as you can see I didnt get alot of sleep.LOL. One of the nurses assured me this procedure was done numerous times a day there and this was NOT a hospital it was an outpatient surgery center in a bank building no less? I certainly know my patient bill of rights and know that I can choose the facility I wish to have the procedure in and I most certainly will be better prepared if and when I decide to go again.

Not one of my d/c papers said anything close to any of these things occurring except that if they do GO to your nearest hospital and call your Doc!! Since I was already there that was not an option of course.

I have had tons of cotisone/lidocaine injections in my knees and shoulders thru this nightmare but never a problem other then they work or they dont,maybe a little soreness. This was stunning and the staff didnt seem to know how to proceed, I actually think they didnt believe me until I stood up and fell and lost bladder control on their floor and didnt even realize I had!! Im not saying the whole staff was rude and ineffective but the staff as a whole were.

This procedure was simply listed on my forms as spinal injections of cortisone/lido under fluroscopy with general anesthesia and the stuff in the syringe was the same white milky mixture I recall being given each time I had knee surgery under general seeing as how my arm was over my head and the syringe was all I could see I got a good look at it. Now I am one of those that ask what is being put into my IV's since I have numerous drug allergies and I know charts dont always get read adequately when staff is hurried. She simply said its to put you to sleep and that it did before I could ask again for a name.

My Doc seemed a little surprised as to my treatment after I talked to him finally and of course just said it was miscommunication between the surgery staff and his office staff.

I feel ok this morning and all the residule after effects seem to have cleared up but that was scary since I was totally 100 percent paralized below the waist for over 4 hours. The humiliation of the scene is another matter.

He did say that next time he would back off the numbing meds since they effected me in that way and I believe maybe being under general anesthesia is not the norm for this type of procedure since I had to pay some money for anesthesia that medicare would NOT cover they said. I asked about this and said he chose that route in part because of my B/P being high and my inability to lie flat on my stomach with by bad knees straight? The position he needed me to be in but if that was the case and it was certainly a medical benefit choice I would have thought medicare would have to pay for the meds and I will ask them for sure. $60 bucks is alot to those of us trying to survive on SSD.

Again thanks so much for your help and input and although I am glad we have this place to come to I certainly wish none of us had reason to be here.

desert
Regular Member


Date Joined Feb 2011
Total Posts : 93
   Posted 3/15/2011 7:59 AM (GMT -6)   
Sorry you didn't get a good night's sleep. Not getting sleep just makes everything worse. I share your woe in that one, posting at half past three in the morning. My pain doctor does the procedure many times per day, mostly on lower backs. My first one, it was good they ask what I was there for because they had been doing so many lower back ones that they were thinking that was what I was there for too. That would have been a surprising needle poke shocked . The doctor actually knew, but the rest of the room staff was preparing for the wrong procedure. In fact I'm surprised that they started your procedure without first making sure you are responding to questions. I usually get the third degree before they'll inject the wacky juice, as I call it.

Ah, an outpatient surgery facility. I've had nerve blocks at those. The hospital I go to seems to have a better setup. I don't know if that is because it is a hospital or just a better facility. Outpatient surgery facilities always seem to stress that they are not hospitals as if that were a good thing. But I always figured it's better to be in a place with all the resources that could be needed no matter what happens.

Not believing patients seems to be a rampant problem in medical professions these days. I mean that one's pretty easy to test before throwing you up on your legs. "Please try moving your legs," would probably work fairly well. They could get themselves into some major trouble doing that kind of thing. I mean can you imagine if you had broken something when you fell?! Paralysis had to be insanely scary. I'm glad it's all worn off at this point. I cannot even imagine waking up to that. Or being packaged up and sent out the door still feeling like that. Medical stuff rarely seems to be designed to help us maintain our pride, does it? And you got the bad end of that stick for sure. I hope that's the last time you ever have to face that sort of indignity.

There is often a local anesthesia mixed into the injected cocktail for this procedure, like the one in yours. Mine have had it too, makes the pain from the nerve feel much better for a few hours. Sounds like that's what the doctor was talking about. I was confused until my brain kicked in on that because I thought what was being discussed was the local anesthesia used to make putting the epidural needle in more comfortable. Which I couldn't figure out why'd you need with general anesthesia.

I have no idea how Medicare works, but it would seem that if a doctor concludes that general anesthesia is a necessity for the procedure that it would be covered. It's not like you requested it. My Versed is covered by my insurance and that's closer to something that could be considered unnecessary than your general anesthesia.

Yeah, I wish there were no such thing as chronic pain. It is so helpful though, having a community of understanding people with whom to share issues and to find experience. I cannot express how helpful it has been for me. I am only too glad if I can ever offer others any help here.

Well the sun is finally up, so I can finally get up as well. Keep feeling better and let us know how you're doing.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5004
   Posted 3/15/2011 9:42 AM (GMT -6)   
Hi Never -
You need to let the doc know about the headache. It should be gone by now. If it's not gone you could still have a spinal fluid leak. (I had a headache after one injection and had to stay until it went away.)

You should not have been sent home until the inability to walk went away.

You should ask, no insist on, a patient advocate or at least a friend or relative with you at all times to help with communication. You should even be able to have someone gowned in the OR if you are going to be conscious at all and need to be able to respond to requests. I would be complaining to the facility's patient relations or whatever thay call it. Your treatment was abominable!

What in the world was the reason behind the anesthesia? Were you so scared that you needed to be knocked out? I've had lots of these procedures, never so much as an IV! The milky stuff was probably propofol. Whatever else you do, don't let them give you Versed. It does nothing for pain, just makes you compliant and gives you amnesia, sometimes for a really long time. It doesn't wear off fast. Tell them up front you refuse it! Local anesthetic is plenty. There's a bit of pain in these injections even with a local, but it's very tolerable. I just say ouch a few times.
Alcie
 
 

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 3/15/2011 10:10 AM (GMT -6)   
First off I would like to say I think you were treated horribly and wrongly. You are, since you are hearing impaired, a special needs patient and extra time and/or resources should have been brought to bear for you to make sure that you were comfortable, knowledgeable about what was going on/going to happen, etc. There is absolutely no call for the way you were treated and if I were you I would find out who is in charge of that treatment facility and write them a very detailed letter of your experience.

In the future I suggest you do a few things. The first is to write a letter stating your special needs, what you can do, what you need, etc. Something like "I am deaf. I can communicate by reading lips and American Sign Language. If I am unable to see your mouth or hands or if you talk to fast I am unable to understand what it is you are asking or wanting from me.........(so on and so forth)." Then I would make copies of this letter. Keep a few copies on you to present to nurses, etc when in the hospital, undergoing tests, procedures, etc. Also make sure any and all doctors that you deal with have this.

2nd, who ever goes with you to appointments, procedures, whatever needs to be knowledgeable and assertive enough to stand up for you, make your wishes known, etc. If need be you should be able to get a patient advocate through either the state department of human resources, the area hospitals, etc.

As far as the physical issues you have and are experiencing I honestly don't know. I have been through several injections in my low back and have never experienced anything like that. I have had both general sedatives and local anesthetics. When only the locals were used I was able to walk myself from the procedure room to the recovery area and when I was given sedatives I was fine as soon as I woke up enough to know which way was up. The only issues I ever had was the expected increase in pain for a time between when the numbing meds wore off and the nerves settled down from being irritated by the medicines, and since I am diabetic I also had radical increases in my blood sugar for quite a while afterwards.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 3/15/2011 10:12 AM (GMT -6)   
First off I would like to say I think you were treated horribly and wrongly. You are, since you are hearing impaired, a special needs patient and extra time and/or resources should have been brought to bear for you to make sure that you were comfortable, knowledgeable about what was going on/going to happen, etc. There is absolutely no call for the way you were treated and if I were you I would find out who is in charge of that treatment facility and write them a very detailed letter of your experience.

In the future I suggest you do a few things. The first is to write a letter stating your special needs, what you can do, what you need, etc. Something like "I am deaf. I can communicate by reading lips and American Sign Language. If I am unable to see your mouth or hands or if you talk to fast I am unable to understand what it is you are asking or wanting from me.........(so on and so forth)." Then I would make copies of this letter. Keep a few copies on you to present to nurses, etc when in the hospital, undergoing tests, procedures, etc. Also make sure any and all doctors that you deal with have this.

2nd, who ever goes with you to appointments, procedures, whatever needs to be knowledgeable and assertive enough to stand up for you, make your wishes known, etc. If need be you should be able to get a patient advocate through either the state department of human resources, the area hospitals, etc.

As far as the physical issues you have and are experiencing I honestly don't know. I have been through several injections in my low back and have never experienced anything like that. I have had both general sedatives and local anesthetics. When only the locals were used I was able to walk myself from the procedure room to the recovery area and when I was given sedatives I was fine as soon as I woke up enough to know which way was up. The only issues I ever had was the expected increase in pain for a time between when the numbing meds wore off and the nerves settled down from being irritated by the medicines, and since I am diabetic I also had radical increases in my blood sugar for quite a while afterwards.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3695
   Posted 3/15/2011 11:25 AM (GMT -6)   
 nvrthesame98
 
Hi I am so sorry that you were treated the way you were! I personally would file a formal complaint with them about it! There is absolutely no excuse for the treatment you recieved, did they not know that you had a hearing impairment? Surely, your Doctors knows that you do, doesn't he?  He should of notified everyone involve  in your treatment about it, and they should have treated you accordingly! It is an absolute outrage that you  were treated that way! Not to mention the injection! I do not understand why some Doctors choose to sedate their patients when doing the spinal injections, my PM Doctor does offer you the choice of taking or not taking, Xanax  prior to getting an injection, ( I have only taken it once and it was not effective till well after the injection was over with) So I don't ever take it anymore! My Doctor does do lidocaine injections to numb up the  surface skin and muscles before doing the actual epidurals. Those actually hurt the worst, but are not bad, and he always waits a few minutes for the lidocaine to work before proceeding with the epidural injections! Anyway I have had these steroid injection in just about every place imaginable in the spine, (from having nerve blocks in the base of my skull, to regular epidural spinal injections every where in the spine, including the thoracic area!) and I just had a steroid injection into my hip joint last week, and I have never ever been put out, or sedated or drugged up ( other than that one time with xanax) during any of these injections!  I will admit they  have not been overly comfortable, they have not been absolutely unbearable either! I think the worst ones I have ever had was  number of years ago at a small rural hospital I worked at and the anesthesiologist was trying to give me a steroid injection at T-12 and he just could not get the needle placed correctly and after trying 4 times he ended up putting it in at L1/2! That was a terrible experience, and he never  did another injection again to me! 
 
Honestly though I think I would be scared to have an epidural spinal injection done while being sedated, if they hit the spinal cord or a nerve root, you would not know it till after the proceedure was over with,and the damage had be already done!  But if you are awake and the needle is getting in the wrong area you would immediately know it and you would be letting the doctor know it too!. That guided flouroscopic immagery is only good to a certain point, and also the Doctors skill that is doing it.
 
Anyway nvrthesame98 I would be thinking about it really hard before I ever went back to him to have another injection done! Your treatment was just plain unacceptable!  I do hope you are feeling better now!  Good Luck to YOU..............White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

Post Edited (White Beard) : 3/15/2011 11:34:02 AM (GMT-6)


nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 3/16/2011 1:15 AM (GMT -6)   

Thanks all! I am doing better today alittle sore alot dehydrated and agitated probably due to stress and the general anesthesia. That is another thing, I didnt ask to be put to sleep,was never given a choice at all. Now mind you this is my first injection of this kind to my back but have had numerous ones to my knees and also might add had 3 of my  kids with an epi which looks to me to be close in nature and was NOT sedated other then the local.

It says right on the front of my chart that I am deaf and yes my Doc is well aware as I always have my son or daughter with me at my appts. My son tried to get back to recovery with me after they had to take me back in when I fell at the car and he was told no one was allowed back there and I could hear him out there giving her hadies. He also complained about her to the office manager and the Doc for her rudeness to me in triage about my B/P which was extremely high and I was trying to tell her I had not taken my meds that a.m since they instructed me not to, I was told to sit back and be quiet so she could take it again and she did in the same arm never releasing the cuff no more then 60 secs after the first reading and said see its better.

I am writting a letter to send to the group that owns this center and if I thought I could get away with having medicare not pay for that kind of treatment I would.

Whitebeard I thought that hitting a nerve was exactly what they had done leaving me paralized for who knew how long or maybe forever,it happens I am sure and most likely at those times they use general.

Like most CPers I have a very high tolerance to pain and am sure I would have survived without being put all the way under,this is dangerous for me when your not using a vent as I have COPD and had thru a bad EKG that had NOT been checked over by cardio at that time. I probably should have even postponed the thing altogether until I got the abnormal sinus rythm and the atrial abnormality checked out 1st. I take lots of excedrin which I was honest about and due to the asa in those amts I have always been required to have a pt and ptt done pre-op to make sure I was clotting correctly,had no labs done prior at all.

I take xanax up to 3 xs a day and could have just taken my dose and got by relaxed enough on that.

I will know better next time and I did have a very long discussion with my Doc about it all as well as my son did and he was very sorry but I dont think I will do this again or at least without alot more info.


nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 3/16/2011 1:50 AM (GMT -6)   

Thank you Paula. It was a very trying experience and one I hope never to have repeated. I learned at least not to assume they have your best interest at heart even if it is a medical facility! It will not happen again thats for certain.

Thanks again and believe me I am going to get the word to the right people here so maybe someone else wont have to bear this hummiliation and fear I did.

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