What is Nerve Block?

[DanaG]

Can anyone please share what exactly a nerve block is? What does it entail? What is it supposed to help to do?

Thanks.

Dana

[**Angie**]

I am having a sympathetic nerve block done on Nov 14th. I have a pamphlet here that says: It is a special test. It helps the Dr find the cause of your symptoms. Medication is injected near your spine. This blks the sympathetic nerves in that region. If these nerves are causing your problem, the injection will relieve your symptoms for a while.
I guess we'll see if it works. I'm real nervous. It does not sound like a pleasent expeirence!!! I'm willing to try it to see if it relieves me of some pain if not "all". Wouldn't that be wonderful!!!

[DanaG]

When you say 'problem,' are you referring to pain, frequency,urgency or all of the above? Does it last forever or eventually wears off? What kind of medication is it? It sounds like it is just an injection (which can defiitely be uncomfortable), but some are referring to it as a 'procedure.' Is it just the injection? Are you awake or under anesthesia?

Thanks again!

Dana

[**Angie**]

The Dr said he will numb the area first then give me injections into my tailbone to hit those nerves. The nerve blk is supposed to blk "pain" from transferring to my brain. Frequency/Urgency isn't too bad for me. So I'm not sure if Nerve Blks work for that as we didn't discuss it. Since I wasn't sure I was going to do it at my visit I really didn't ask enough questions. I did talk to my Uro about having it done and he felt it would really help me--so I scheduled it. We'll see!!

[ad8123]

The blocks I had done had to be done with me under (alseep) becuase it involved using a catheder to get to the right plexus of nerves, you can not be awake it is too painful-that is my understadninng for what i had. I know some people are just getting injections with a needle and they do not have to be asleep although are sometimes given a sedative and lidocane gel. I think this is more like an epidural vs the procedure type. ???

[aprilchen]

Can anyone please share what exactly a nerve block is? What does it entail? What is it supposed to help to do?

Hi Dana,

I have been getting Lumbar and Thoracic epidural nerve blocks for several years now since 2004. For me, they have been very helpful and have reduced the number of narcotic painkillers I have to take.

Oh, and after a series of three, at least in my case, they last for about eight months to a year. They usually spread the three out between 2 weeks to a month...so the whole process of getting all three injections takes at most three months. IF this is what you're considering, I would choose a physician who specializes in this such as a pain specialist with an Anesthesia background. Also, you won't see immediate results from this, but that you should feel better within a couple weeks if it's going to work for you. Make sure you can handle steroids because most pain specialists that do the epidurals for pain management use a long-acting steroid like Depo-Medrol and Fentanyl I.V....the same thing in Duragesic patches, but different when it is given into the spine.

In relationship to the back, the Psoas Muscle that runs along the spine can be affected by pain from IC. At the interventional pain clinic I attend, my physician does three in a series of eight months to a year. I am getting ready to have my third one on the 28th of February.

As for what the procedure is like, it varies for a lot of people. We may be even talking about two different things. Are yours for back pain? I get mine for IC pain related to that muscle (Psoas-attached to the spine) in the back, because a few years ago I had an abscess that formed there from Staph infection following surgery and caused a great deal of inflammation and scar tissue. It's really painful, IC even aggravates it. However, the epidurals and trigger point injections help tremendously.

The procedure itself, is not bad. Make sure you have it at an outpatient surgery center, then they will sedate you with I.V. sedation and you won't care if it hurts...which they deaden it with lidocaine. It feels like a bee sting and you're usually sore for the next three days. Use ice packs instead of heat and then the inflammation goes down. MAKE SURE that you have an emergency number for the physician who does this. You may need it your first time. My first time, my left leg was dead for two daysl It was a weird sensation, but they say this is normal as long as you can move all your extremities and your fever does not get above 101.

I'm not saying these work for you or that you are even referring to the same thing that I have, but if you are and would like to talk in more detail about Lumbar, Cervical or Thoracic Epidurals, PM me and I can tell you more.

Good Luck!
April

[DanaG]

Thanks April for all the info. I do not have any pain (I am very fortunate in that regard) so I am not sure if this is even for me. I have terrible frequency, especially at night, and I am desperate for sleep. In some regards, not sleeping is ruining my life. I am convinced it is a nerve related thing and have been down the Interstim road, so I was curious what this nerve block thing was all about. I have an appt with my doc next week, so I'll ask her her thoughts.

Thanks!

Dana

[curlycue]

DanaG Hi ....................... Can you take a sleeping aid at night to help you sleep. I take ambien CR and it really helps. Good Luck.

[aprilchen]

Hey Dana and Curlycue,

Ok. Here's the lowdown on nerve blocks. What I am talking about that I get are thoracic and lumbar epidurals given in my spinal column by an anesthesiologist who is a pain specialist, trained in a special residency that deals with pain control. The theory is that the blocks given with a long-acting steroid act on nerves outside the back and ones that supply the bladder with pain also. I have thought about Interstim, but I am scared of another surgery because I already have had a pulmonary embolism and really, most doctors won't even consider elective surgery for me because of that.

Now, my IC pain is OUT OF CONTROL right now. I am on Methadone twice daily 10mg with Percocet 10mg twice daily in between, if needed. And, let me tell you, there have been days when I have taken everything I could and was allowed. Today, I just got my catheter pulled out and I have had in and out catheters ever since my hydrodistention on January 18th. So, IC is my biggest problem right now. Currently, ONLY Pyridium Plus and the narcotics help with THAT pain....BUT I am being told by my doctor and others on this board that the Pyridium could be causing me to retain my urine. That is why I have been catheterized so much since last month.

This has been a nightmare. As for sleep, I do two things: I used to be on Lunesta, 3mg and that worked for a while...then after a while your body gets "accustomed" to the sleep meds and you usually need to change. My physician (primary care) just changed my Lunesta to Ambien 10mg (not CR). I asked about CR and she really doesn't support it because it lowers your blood pressure SO MUCH MORE when you're on pain medications.

I was in the hospital a week ago and with my high blood pressure medication, sleep medication AND two different pain medications, my blood pressure was 55/40 and they transferred me to ICU because I bottomed out SO fast.

Anyway, I hope this information helps. Be extremely careful combining these meds because they can cause blood pressure drops and other extreme side effects. See: http://www.drugdigest.org/DD/Interaction/ChooseDrugs and put in everything you take to check for interactions.

Please let me know if you have anymore questions or if I have left anything else out.

April

[DanaG]

Thanks Ruth. Believe me, I wish it was as simple as taking a sleeping pill. I have suffered with this for 15 years, so I have been there done that. I am convinced it's a nerve thing. When I am knocked out under anesthesia, I wake up having to urinate so unbelievably badly, it is excrutiating. The need to urinate is SO strong and painful that no sleeping pill prevents me from waking. I have to look into something more than a sleeping pill and I've tried meds that are supposed to lessen your urine production, but that hasn't worked either. Onward and upward I suppose...

Thanks!

Dana

[ihurttoo]

Dana,

Hi!! I had 2 nerve blocks that were done by my Pain Dr. He is board certified in pain mgmt and anesthesiology. They were performed at the surgery that he owns, which is attached to his office bldg.

I had the Superior Hypogastric plexus nerve block done twice. They were done 2 weeks apart. I had them for pain. They gave me versed in my IV. I had to have someone drive me there and home. He also gave me local injections in my back to numb me. I was awake during the procedure. Of course I felt the shots of Lidocaine to numb me, but after that, I primarily felt pressure. He used Fluroscopic Xray to guide him to the nerves. They put a steroid in there, along with the Lidocaine, and if there was anything else, I cant remember. It took about 10 min from the time he started until he was finished. (Of course the prep before, with the IV and stuff was longer....about 20 min.) Then, they took me to recovery, where I stayed for about an hour.

I got immediate pain relief. (From an 8 without pain meds or a 5 with them down to a 2.) I was initially very pleased. However, after about 3 days, I went into SEVERE retention and couldnt urinate at all. I had to go to the ER to get caths because I went to see the Pain Dr and told him I couldnt pee, and he denied that it was from the nerve block. He said he had NEVER heard of that before, and I needed to see my IC Dr. I knew how to self cath, but didnt have any caths, and he wouldnt even write me a script. His office was 5 hours round trip from my house, and I hadnt urinated in over 14 hrs!!! My reg IC was back in my home town and I couldnt wait any longer to get home to get caths. So I had to go to the ER in Nashville to be cathed. I was furious, when he could have written me an order for some caths, but refused to do so saying "This is obviously just an IC problem". (I had never had retention before, except one other time, (while in the hospital) and that time wasnt IC related either!!

Then, after I left the ER, I went to my IC Dr, told him what happened, and he said that HE has heard of nerve blocks causing retention and it is very common. I was furious that the Pain Dr. lied to me, just b/c he wanted me to do more so he could make more money.

But, at my next visit, even though I told him what happened, (I was in retention for 3 weeks from it!!!), and what my IC Dr said, he STILL stated that the nerve block couldnt cause retention and refused to give me any pain meds (or keep me as a patient of the pain clinic), unless I did another nerve block. I was over a barrel, so I had to do the second one. Sure enough, it caused me complete retention also! The pain Dr. acted like I was a freak, and STILL would not acknowledge that the nerve block caused it!!

The only way I got out of having to do MORE nerve blocks, was b/c my IC DR called him and told him that I never had this problem before and that he had seen and heard of several patients who had retention after nerve blocks and that he did NOT want me having anymore.

Then, a few weeks later, the Pain Dr. tried to drop me as a patient. He said they were going to change their practice to only practicing "interventional pain mgmt" and wouldnt be seeing chronic pain patients like me anymore. I cried and talked to him and he agreed to keep me "For now".

I am certain he was dropping me b/c I was not profitable enough to him. He made $1400 for 10 min worth of work doing the nerve block, and "only" made $80 for my monthly 8 min office visits for pain meds. I am convinced that he is solely in it for the money.

After he tried to drop me, I spoke to my Rhem the next month and told her what happened. I asked if she would write my r/x for pain meds for a month or 2 until I could find someone else if he decided to drop me again when I went back to my next appt. She said she would. So at my next appt at the pain clinic, I told the Dr. that I had someone else lined up now, so if he wanted to go ahead and drop me after all, that would be fine now. He asked who I had and what I told my other Dr. When I told him, he left the room and called my Rhem RIGHT THEN!! I heard the conversation thru the wall. (Well, his side!!) He totally, did a change of tune when talking to her, and said he wasnt going to drop me.

I saw this same on Mon of this week. I asked her what she told him that day, that he suddenly decided to keep me that day, when the month before he planned on dropping me. She said that she just told him that since she had so many chronic pain patients that she had been referring to him, that she was glad to know this, so that she could start sending her referrals elsewhere, so he would have plenty of room in his schedule as he wished for those in acute pain. :) :lmao: I LOVE This woman!!!!

Sorry to run on and on, but I just wanted to explain to you why I am personally wont do one EVER again! However, I realize that not all Drs are as unethical as mine, and also that nerve blocks really do actually help some ICers. I also realize that most dont go into retention as a result from them. (But is isnt unheard of, like my Dr. said, either!) One other notable difference in me and most others here is that I ordinarily dont have freq and urg as part of my IC (unless I have a UTI or am just in a bad flare.) My primary IC symptom is daily, constant, severe, unremitting pain. So, someone who DOES have freq and urg, may get relief from those symptoms....I just dont know.

Anyway, again, my apologies for going on for so long. But, as you can see, this subject (and the memory of my own horrific experiance and treatment) really fires me up!!!

I hope if you proceed with a nerve block, that it gives you alot of relief from your symptoms.

Hugs,
Amy

[aprilchen]

Amy,

I am SO sorry that you had SUCH a bad experience. My pain specialist is a Chinese guy (and relates SO well with ALL his patients). My husband is also half Chinese so we had something to relate at the beginning because my last name is 'Chen'. I am with you in that it's really SAD that there are SO MANY doctors out there who are in it for the money and NOT the patient, which to me, defies the very oath they take on--the Hippocratic Oath.

"To consider dear to me as my parents him who taught me this art; to live in common with him and if necessary to share my goods with him; To look upon his children as my own brothers, to teach them this art if they so desire without fee or written promise; to impart to my sons and the sons of the master who taught me and the disciples who have enrolled themselves and have agreed to the rules of the profession, but to these alone the precepts and the instruction.

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone."

This is obviously NOT the way this physician practiced. I would STILL be tempted to get another pain specialist if you could....

Anyway, God Bless!
April

[curlycue]

April........... My sister in law is a obgyn and she must have forgotten this oath cuz when I asked for help she said I am sorry you need to consult your dr. what a dissapointment of a human being.

[aprilchen]

Hey Ruth,

I am with you there...especially when the person you're family with doesn't care. That same scenario exists between my mother and me. She is a nurse and sometimes she can be so ugly when I call and ask her medical questions about my life. So I understand. If you ever need to talk, you're welcome to PM me.

G'nite
April

[curlycue]

April........... It makes me so sad. I would do anything and everything to help anyone. My parents always thought me to help anyone with what ever they needed for as long as they needed it. and god would always be there to help you. I really have to come to belive that.

[aprilchen]

Ruth,

Without God, I literally think Aaron and I would NOT be handling this as well as we are...and we're NOT handling it that well because of all the drugs, how they change my attitude and just ALL of it. Aaron made a comment (my husband) the other night that really worried me. He said he did not marry the Lortab and the Methadone or Percocet. I thought about that and he didn't...but we discussed it more because HE KNEW I was sick when I married and on my side, I KNEW he was Air Force and would be deployed at some time. Neither of us have dealt with the others' issues as well as we would like. I cried for an entire week this last time that Aaron was sent to Afghanistan and cried even more when he returned because he JUST had to tell me what happened (that a circle they drove through) was bombed six weeks before so it was common practice to SPEED through it because it was very dangerous. Anyway, before he had left he told me that he would be completely safe (that did NOT even calm my tears)...because I was scared so bad. And, he's not a front line soldier. He is an engineer...who reports to the field to restore critical communications that have somehow gotten interrupted.

On another note, does anyone on here know if it is safe to alternate use of Pyridium with UTA and take them alternating long term? I was told by several and then researched it that taking Pyridium for over a month as I had is dangerous and not recommended. So, what about alternating the combination...do you or anyone else know?

Thanks for letting me vent. God Bless.

April

[Kara29]

April,

This may be a great question to ask your doctors.

Each person is individual and a lot depends on your medical condition.

Good Luck to you!

Kara

[aprilchen]

Hey Kara,

It seems like EVERY doctor has something different to say about Urogesic Blue/Pyridium use all the time. Last night I had to go to the ER because now I am taking Methadone for pain and had an episode where I COULD NOT breathe and my oxygen saturations were in the low 80-percent range when they checked them so I had to have a lot of O2 in the ambulance and I went into Tachycardia and my BP was WAY TOO LOW...55/43. No one could believe I was even awake at that point.

Anyway, to get back to my Urogesic/UTA/Pyridium issue, my Urologist feels that it is okay to take it four times a day EVERYDAY. Well, every web site including the Physician's Desk Reference makes special note NOT to take this everyday because it can cause liver and renal failure...(because it builds up in toxic amounts in your body). I read this in more than one place. Since being on it so long, I have started swelling alot and retaining water. Also, I have had multiple urine retention episodes. I am now authorized to self-cath, but my Urologist does not feel comfortable letting me do instillations of heparin and lidocaine at home....part of me makes me wonder if he is doing that because he makes so much money on me coming every week for those instillations. That is REALLY all that has helped me more than a day. They usually help me about 5-7 days and then I need another one.

Also, the ER doctor last night told me she would NEVER use those for longer than 2-3 days. The RN also said the same thing. So, I am not inclined to trust my urologist right now because 1) he put me on Enablex and I still believe that caused my retention and 2) he put me on that WITH the Pyridium and Urogesic Blue and 3) Enablex, from what I read is for overactive bladder, which certainly was not my problem. So even though I got accused of being a drug addict before the ER doctor heard my whole story (I guess they automatically assume you are when you're on Methadone)...because after she heard it all, she changed her tune a lot.

Anyway, after hearing this what do you guys think?

April

[curlycue]

April I agree............. It sounds like you have a wonderful husband. My husband it really supportive,kind,gentle. I will keep Aaron in my prayers. I dont know how you do it,but I know with the lord on your side you can do anything.

Aaron you have a great lady walking on your side . Good Luck.

[aprilchen]

Hey Ruth,

Aaron says 'thank you' and he knows and values me as a great wife. He says I contribute MUCH more to our marriage than I give myself credit for. I guess I need to NOT focus on how much I lean on him with this IC...maybe that would help if I looked at how much I take care of him at home (clean clothes, laying out his military uniform, organization of our bills and other important things, cooking meals, etc.). Thanks for the upper, really.

[curlycue]

Your Welcome. I am glad that you are around to do all that stuff for him. It sounds like you are a very supportive wife and you contribute quite alot to the household. You go Girl.

[aprilchen]

Thanks, Ruth. You know, some days are better than others and when we can be well...we have to just be. Take Care.

[Babs RN]

April,
I take quite a few of the same meds you do, and have had alot of the same "quirky" emergencies happen too. I also have experience with the meds vs. the military vs. compassionate and consistent medical care. I understand and empathize with your fears. Deployments are scary too, and Chris was gone for a year to Iraq. I don't want to barge in on your life, but I would be glad to share my experiences with you. let me know, ok ?


Hugs,
Barb:hi:

[aprilchen]

Hey Jilly,

I went to a specialized pharmacy this evening because we went to pick up the meds and materials for bladder instillations. Anyway, I talked with the pharmacist about it and he does not agree that you should take it long term either. He also employs a nurse at the pharmacy and she does not agree w/ taking it long term because of what it can do to your liver and kidneys. Howver, he said most drugs can do that...and also to watch out (which I am sure you know) with pain medications and that issue.

Hope you have nice evening.

[curlycue]

Ladies be careful out there, I remeber once the Uro in Tijuana Mexico adviced me the same thing he said no longer than 10 days were good.

[marysxx]

:help: HI I TOO HAVE IC/ FIBROMYALGA/ ETC. THE NERVE PAIN I EXPERIENCE IN MY VAGINAL AREA IS HORRIBLE. ESPECIALLY RIGHT BEFORE MY PERIOD. AND IT GIVES ME THE SENSATION OF HAVING TO PEE CONSTANTLY! I DO TAKE ELMIRON/ CYMBALTA/ ELAVIL/ETC. PLEASE IS THERE A NERVE BLOCKER FOR THIS PAIN? IT FEELS LIKE ONE INFLAMED NERVE THAT IS REALLY DRIVING ME INSANE. SHOULD MY URO KNOW ABOUT THESE NERVE BLOCKERS? DOES IT HURT? AND CAN I BE ASLEEP? PLEASE I WOULD LOVE SOMEONE TO HELP ME.:help: MARYSXX

[curlycue]

Hi ladies how is everyone................. I hope grrrrrrrrrrrrreeeeeeeeeeeaaat and having a wonderful summer.

[aprilchen]

:help: HI I TOO HAVE IC/ FIBROMYALGA/ ETC. THE NERVE PAIN I EXPERIENCE IN MY VAGINAL AREA IS HORRIBLE. ESPECIALLY RIGHT BEFORE MY PERIOD. AND IT GIVES ME THE SENSATION OF HAVING TO PEE CONSTANTLY! I DO TAKE ELMIRON/ CYMBALTA/ ELAVIL/ETC. PLEASE IS THERE A NERVE BLOCKER FOR THIS PAIN? IT FEELS LIKE ONE INFLAMED NERVE THAT IS REALLY DRIVING ME INSANE. SHOULD MY URO KNOW ABOUT THESE NERVE BLOCKERS? DOES IT HURT? AND CAN I BE ASLEEP? PLEASE I WOULD LOVE SOMEONE TO HELP ME.:help: MARYSXX

Hi Mary,

I do not think there is a nerve block for vaginal pain? However, there are lidocaine based creams and something I think called MSM gel, however I am not familiar enough with them. I think someone else on here would know about them. But I have had over thirty nerve blocks and none addressed those areas. However, you might could try like a lidocaine/heparin injection with a 60cc syringe if you could get a Urologist to write an RX for it. Try asking Jill, the creator of the site, because she knows I think about it. I think her ID is icnmgrjill. I hope this helps.

April

[aprilchen]

April,
I take quite a few of the same meds you do, and have had alot of the same "quirky" emergencies happen too. I also have experience with the meds vs. the military vs. compassionate and consistent medical care. I understand and empathize with your fears. Deployments are scary too, and Chris was gone for a year to Iraq. I don't want to barge in on your life, but I would be glad to share my experiences with you. let me know, ok ?


Hugs,
Barb:hi:

Barb,

You are actually NOT barging in on my life. I just found out that Aaron is being deployed freakin' again! This time hopefully ONLY 45 days because we are set to PCS to Wright-Patterson in OH on Oct. 31st...and I don't know the first thing about picking a house for us. And now, I am starting a new thread.....about what is going on now...so look for one called medical stabilization.

AC

[ad8123]

I have had mny nerve blocks for the pelvic region and yes they help with that horrible deep pain in the vaginal area. Also if your period makes it worse have you thought about back to back birth control so you do not have as many periods to cut down on the symptoms. My old pain docs did the nerve blocks and my gynocologist prescribed the birthcontrol. I also use heat and lidoderm patches on the pelvic area deoending on the type of pain. When my flares are very bad I will use heat or ice between my legs as well so Iunderstand sometimes it is just terrible. I am going to be trying a vaginal electrode for my tens unit also, they say it will help even more for the reall bad flares we will see. Good luck.
Angela:angel:

[Vonnie]

After multiple nerve blocks I have begun to notice side effects from the steroids. Will the side effects completely reverse once they have worn off?

[Vicki]

Hey Dana and Curlycue,

Ok. Here's the lowdown on nerve blocks. What I am talking about that I get are thoracic and lumbar epidurals given in my spinal column by an anesthesiologist who is a pain specialist, trained in a special residency that deals with pain control. The theory is that the blocks given with a long-acting steroid act on nerves outside the back and ones that supply the bladder with pain also. I have thought about Interstim, but I am scared of another surgery because I already have had a pulmonary embolism and really, most doctors won't even consider elective surgery for me because of that.

April

April-
I am curious to know if the embolism was caused from the nerve block. I am thinking about doing one of these. The reason is because I have had 3 pelvic surgeries due to endo. I used an epidural for pain after the first two abdominal lapartomies because Morphine really upsets my bladder. I had remissions after both surgeries that lasted around ten weeks. I was in heaven! Well, I just had a third surgery to remove an ovarian remnant. The doctor wanted to use Lovanox injections daily while I was in the hospital to prevent blood clots. He said that epidurals and lovanox cannot be used together because their is a higher chance of blood clot. Interestingly enough, I had not remission and I am convinced it is because I decided to use morphine, instead of the epidural, for pain control because the whole blood clot thing scared me since I am on hormones now. I had forgotten all about the epidurals until my husband reminded me. So, now I am back thinking that this would be a good wasy to control my pain. The Interstim only helps frequency and urgency, not pain. I did a trial it I was not helped at all by it. My doc reminded me it was only indicated for frequency and urgency, not pain. So, I said all of that to see you are still doing the nerve blocks or not. THanks, vicki

[aprilchen]

Hey Vicki,

I AM NOT still having epidurals because after a year and something later, they never helped my IC. See, they only made me gain ALOT of weight...like from 140 to 180. I am now down to 148-150, but with lots of dieting and some exercise. Anyway, I never saw benefit from them. BUT that is not how I got my pulmonary embolism. Mine happened in 2004 because of some surgeries I had and subsequently ended up with a staph infection (which formed a perinephric abcess on my left kidney). They did not tell me to get up and walk much so I didn't because I was in SO SO much pain on the left flank...so I basically laid in bed 24/7 for about 12-14 weeks. PLUS, I was on the birth control patch (which carries its own risks for clots, strokes, etc.) And, then after I got out of the hospital and was on Coumadin therapy, they did some hematology testing and I have a heterozygous gene for two different blood clotting disorders, one of which is MTHFR. I don't know the name of the other one because it has a number and no abbreviation so I just always tell medical professionals that I am at an increased risk of clots.

Now, about Lovenox...I take it when we drive longer than 4 hours; fly; am in the hospital, etc. I have never heard anything about having Lovenox be a problem with epidurals....for CAUSING or CONTRIBUTING to clots. Actually, to the contrary, I had always been told to get off ANY and all blood thinners three days before epidurals, including Aspirin and Ibuprofen therapies.

If you have anymore questions, I'd be glad to answer them. :-)