Surviving my first FESI

I've been a bad blogger lately... mostly due to the monotony in my life: work, PT, back pain, work, PT, back pain... you get the picture. Anyway, yesterday was my first eventful happenstance of the new year, so I thought I would share. Ready? It's going to be fantabulously boring, I promise!

So I was referred to a spinal surgeon last month because PT has not been doing much for my back problems. The new doc gave me some pretty grim news.... There isn't much that can be done other than surgery (but he doesn't recommend that until I can absolutely no longer keep functioning without it because we're taking about a level 2 fusion, i.e removing my L4/5 and L5/S1 discs and fusing them with a bone graft) or just plain old pain management... which up until now has consisted of PT (not working) and drugs that tear up my stomach and/or can only be taken at night because they knock me out, yet leave me in oodles of pain all day at school/work. AWESOME.

He did however, mention one more thing we could try, a Fluoroscopic Epidural Steroid Injection (FESI). While not permanent fixes, these can sometimes provide a few weeks to months to years of pain relief IF they work. It's not a given that they will, but always worth a shot... especially when faced with my options. So we set up that appointment and off I went on my merry (or not so merry, depending on the day) way.

Yesterday was the day. I've had cortisone injections in my foot before and they were pretty unpleasant experiences... My back pain is of the nature that besides the radiating pain/numbness/burning down my right leg, I also have some REALLY sensitive spots that can barely be touched without me howling in pain. Guess where the big bad ESI needle was going to be placed? Oh yeah... at the trigger points of my L4/5 and L5/S1 discs. That combined with my prior knowledge of what my foot steroid injection felt like (it hurt... bad) well, let's just say I wasn't the calmest person in the prep-room. Sedation is recommended for this procedure but still the patient's choice, so when they said my heart rate (in the 140's) and BP ( I never saw) was really up they highly suggested that I let the doc give me some Versed. I happily said, "Yes please!" :)

They got me set up on my tummy, hooked me to a vitals machine, and then went back and forth for a few minutes about how to prep me (antiseptically) because I'm allergic to Iodine and Chlorhexidine, as discovered after each of my Endo surgeries. In the end they went with the Chlorhexidine because he was already going to inject me with Iodine contrast dye (for which I had been given Prednisone and Benadryl to take starting 13 hrs previously) and promised to wipe it all off with alcohol in the end. I was cool with that. Better a rash than an infection, in my book. So after I was washed and prepped, the lovely Versed was pushed through my IV port and within seconds I was happily drooling on my pillow and slurring my words. It did not knock me out though, I can remember everything. However, it mellowed me out just enough to where I could still answer questions (He had to make sure he was in the right spot and whether or not I felt pain was the indicator, so I had to be able to speak) but was not all tensed up. The worst part was the numbing, honestly. That burned like the dickens, but was over with rather quickly. I then felt a series of clicks and increasing pressure as he slowly inserted the needle while checking its placement with the dye on the Fluoroscope (Xray machine). Uncomfortable but not painful, per say. Once he was satisfied with the placement (that took a few minutes) he told me he would be injecting the steroid solution and asked me to confirm it I felt any pain going down my leg. I did. Bingo! Then he readjusted the needle and tried another spot. Pain? Yup! Bingo again! More steroid solution went in.  Then there was the sudden release of pressure and they were swabbing me down with alcohol, slapped a band-aid on and it was all over. Seriously? That was it? Yup, that was it. From start to finish the whole thing took about 10 minutes. Not bad. I was pleasantly surprised.

They then wheeled me out to the recovery room where they monitored my vitals for 30 minutes, made sure I wasn't having a reaction to the Iodine, gave me some Sprite and crackers and I was good to go! I was still quite unsteady from the Versed so Ben helped me get dressed, and they wheeled me out to the car and that was that! We got some food on the way home because I was starving since I'd been NPO (nothing to eat/drink) for the procedure, which wasn't over until about 3:30. By the time we got home though, the local was wearing off and I was starting to hurt. Things kinda went downhill after that and I got the shakes really bad for a few hours every time I stood up and tried to move. I guess that's normal but Ben was freaking out that I was maybe having seizures, LOL. In the end, because I was so uncomfortable on the couch (too low) and couldn't quite make it up the stairs, we decided to take up my mother-in-law's offer to come over and have me rest there for a few hours. Best decision ever, thanks Erlene & Mike! I was hurting so bad at that point (this was normal though, my doc warned me that the pain would get 10x's worse for a few days before it got better... same thing happened with my foot) that I went ahead and took my pain meds and muscle relaxant, though I was a bit worried about what that would do on top of all that Benadryl  and Versed in my system. The Nursing student in me kept freaking out about my heart rate  and respiration dropping too low, so as I lay on my lovely ice pack on Mike & Erlene's super comfy high bed, I kept taking my pulse every 30 minutes or so between brief catnaps. Obsessive, I know... but I do this at work with all my patients so it's just kind of ingrained. My normal resting HR is in the mid 80's to 90's. It got as low as 52, which isn't horribly bad but I kept checking  until it was back in the high 70's. At that point I let myself relax a bit more and finally fell asleep for a few hours. Paranoid? Absolutely. :)

Today I feel a bit better. I still hurt worse than normal, but not as bad as yesterday/last night... thank goodness! The shakes are gone, so that's nice too. Doc said to take it easy the next 2-3 days, take my pain meds on schedule, and ice ice baby! Oh how I  love my ice pack!!!

That's it I guess. What a way to start the new year, but hopefully it will prove to be helpful. I guess only time will tell. However, if I do need to have a 2nd or 3rd, at least I now know that it's not that bad. I guess it didn't help that on Thursday I spoke with someone who had just had this done and said it was the most excruciatingly painful 20 minutes of her life... she was not offered sedation. So yeah, I was totally freaked out. Thankfully, my experience was nothing like hers! So to all my readers (well... to all, what... like 3 of you? LOL) if you ever have to have this done, ask for sedation!!! Well, if you're a weenie like me ;)

PS> if you actually made it to the end, you deserve a medal... knuckles!