Tag Archives: Interventional Pain Management

My Second Steroidal Epidural Procedure!

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A Patient’s Journey to Pain Relief with OSC Orthopedic Associates

After my initial epidural procedure failed to give me as much pain relief as I was hoping for, Dr Mark McFarland recommended I try a second cortisone procedure before moving to the surgical option to remove the herniated disk.

I head into to see Dr. Raj Sureja for my second cervical epidural – cue dramatic drum rolll please :)

I found this great Youtube video by Dr Sureja explaining the process of injecting cortisone into the spine and why this helps relieve pain:

This time, I am much less anxious about what my experience will be. Knowledge is power, right? I know that I might get dizzy or feel faint, but I also know that the epidural really doesn’t hurt and that it will be over soon.

Dr. Sureja comes in and is his usual gentle and wonderful self.  He decides to do my epidural at a level below the last one, to see if this time, I get some relief from the medication.

I lay down on my stomach on the table and again, during the procedure, I being to feel faint.  I hate the fact that I just get so faint whenever I am scared or feel pain.  Dr. Sureja says it is the Vagus Nerve Reflex that causes this and that it happens to other people as well.  Luckily, this time, I recover from my faintness very quickly and my blood pressure does not drop as low.  After a short waiting period after the procedure, I am released into the care of my long-suffering in-laws, who have again volunteered to pick me up and take me home.

 Pain management specialists Dr Raj Sureja and Dr Jenny Andrus

Dr Raj Sureja with orthopedic colleague, Dr Jenny Andrus of OSC

When I arrive home, I quickly get my ice pack and head for the bed, to lay flat and to ice the injection site.  I pray that I will not get the severe headache that I got last time, so I try to lie still, watch TV and nap.  After a few hours, my husband comes home from work and fixes me dinner.  I am just fine to get up and eat at the table.  Later that evening, I do experience some leg jitters and insomnia. However, these side-effects are nothing compared to those that I experienced after the first epidural.  Hallelujah, no headache, no flushing and no other problems!    The whole experience seemed to go much more smoothly, in large part, because I wasn’t so afraid and I didn’t work myself up before I went to have the injection.  Now, the fun part begins…waiting to see if I feel better.

Next time…..Second Time is a Charm!

After my Cervical Epidural Injection

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What Happened After my Cervical Epidural Steroid Injection

I went home after my epidural and continued to experience light-headedness, so I went and got in bed, laid flat and watched TV.  OSC’s Dr Sureja gave me an instruction sheet  to help after the procedure, and I immediately followed the instruction to ice the injection site, so I did.

My instruction sheet also gave a list of potential side-effects and complications to watch for and what to do should those occur.  Infection, nerve damage, bleeding, and a dural puncture were all discussed as rare, but possible complications.  More commonly, the side-effects possible were dizziness, pain at the injection site, flushing, leg pain, headache, high blood pressure, elevated blood sugar, anxiety or irritability, weight gain.

Dr Jenny Andrus

Dr Jenny Andrus

Unfortunately, I experience several of the side-effects, starting with leg pain and heaviness.  I also experienced a lot of flushing and feeling hot.  However, armed with the knowledge that these side-effects were common and although uncomfortable, not life-threatening, I dealt with them.  I took a long hot bath as I was having leg pain and I could not sleep.  I continued to ice my neck throughout the night, on-and-off.  I started getting a headache early in the morning and by 9:00 AM, it was very bad.  I did not go in to work.

So I called the practice and Dr. Sureja’s partner, Dr. Jenny Andrus at OSC, phoned in a mild pain prescription for me.  She said to let her know if I did not get relief in a few hours.  I took the medication and quickly started to feel better.  I felt pretty much back to normal in about 24 hours after the epidural.  After that time, I did not experience any more or continued side-effects.  Dr. Sureja told me that the epidural might work well within a few days, might take a while to feel better or might not work at all.  I certainly wanted it to work and I was willing to wait a few days to see if I began to feel relief from my chronic neck and shoulder pain.

Next time….Pain Relief…YES or NO????

 

Preparing for my Cervical Epidural Steroid Injection

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Interventional Pain Management with OSC’s Dr Raj Sureja

Okay, I think that I have told you in my previous blog posts that I am a BIG CHICKEN and TERRIFIED of needles.  So, it should come as no surprise to you that I was facing the prospect of having an epidural injection into the space surrounding my spinal column with great fear and trepidation.  I could lie to you and tell you I had no fear, because I work for OSC and have faith in the physicians here.  But, no matter how much I trust them and their skill level, I was still scared to death.

A needle, not only in my back, but in my spinal canal???

Am I crazy???

pain relief with epidural
Schematic of Epidural Injection

When the pain becomes so bad, that your life is affected everyday by your plans to manage your pain and how many activities you can complete during the day before your pain gets too bad, and how much time do you have to spend in the tub or lying on the heating pad before your muscles relax enough so that you can get some sleep, you become willing to do things that you never thought you would or could do to get relief.  Hence, I made an appointment with Dr. Raj Sureja, Interventional Pain Management Specialist at OSC, to perform my cervical epidural.

Dr Raj Sureja
Dr Raj Sureja with OSC’s Dr Jenny Andrus

In preparation for the epidural, you are given a sheet of instructions that are easy to read and follow.  Mostly, you are warned against taking anti-inflammatory medications of any kind for several days before your procedure (this includes Advil and Aleve).  They are concerned about the effect that the medications will have on bleeding and any complications that could arise from having the procedure done while on these drugs.  The OSC personnel also asked if I had any known allergies to drugs or if I had ever had a reaction to dye during a radiologic procedure.  They also checked to see if I could possibly be pregnant or have any other condition that might make having an epidural dangerous.

Given the go-ahead, I stopped taking my anti-inflammatory medications, switched to Tylenol and waited for my appointment!  Next time….E-Day!

Interventional Pain Management Providing Innovative Pain Relief

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More than 75 million Americans suffer from chronic, debilitating pain, according to the National Pain Foundation. In 2003, Research America released the results of a survey of 1,000 people in the United States that showed that 57% of all adults have had chronic or recurrent pain in the last year and that 75% of people currently in pain had to make adjustments to their lifestyle due to their pain. Chronic pain also accounts for more than 80% of all physician visits and leads to time off work and billions of dollars in lost productivity. With the prevalence and the exorbitant cost involved, it would seem only natural that health care workers would be clambering to find better ways to treat this epidemic problem. Unfortunately, this is not the case, and thus pain remains poorly understood and grossly under-treated. The complex mechanisms of pain transmission coupled with its inherent subjective nature creates an intimidating battle and requires physicians who are both comfortable with its diagnosis and more importantly who have an appreciation for the art of treating those in pain.

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