Left Diagnostic 2-Medial Branch Block

 Had my 2nd Facete Joint Nerve block of the left side a few hours ago.   

We're ramping up to have the RFA on the left side.  

Those unaware, for years I have had limited mobility due to debilitating pain.  I was unable to stand or walk for more than a few minutes before the debilitating pain would begin. I would would not be able to stand without sitting or leaning against something to help alleviate pain.

When the pandemic hit & I began working from home, this made matters even worse. I was not walking to and from my car to the building, I was not going out often and sitting at my desk I would not leave it or move around as often as I might at work.

Weight gain was minimal, but I was unable to lose much because of my lack of movement. I already had pain associated with the Fibromyalgia, but adding the back pain made matters worse.

Living with chronic pain - describing it to anyone who has not had debilitating or severe chronic pain --they will never understand.  It takes over your whole being.   I was miserable and depressed and so exhausted of wanting to do things, but not having the physical capacity to do it. 

You feel judged.  When you tell people you can't join them on a walk or you need to sit when you've been standing in a line for only a few minutes.  Real or imagined, it weighs on you.   Do they think I am lying? Do they think I am lazy? Do they think I am fat because I want to be? The list goes on.  You internalize and the guilt and depression just build.

When I finally pushed and pushed to get to the point where I met my Pain Management doctor who told me I was a possible candidate for procedure that could reduce or eliminate my pain...I held out cautious hope.

Insurance requires 2 Lumbar Facet Joint Block diagnostic procedures to determine if an RFA would work.    

For the Lumbar Facet Joint Block, the doctor, using local anesthetic, injects a temporary nerve block into the joints.   The injection lasts up to 8 hours.    

As a patient, you keep a diary of your pain and are told to "go out and get busy". You are supposed to do what you can and would do that would normally elicit pain.

They follow up and you report your pain levels and % of pain reduction. If the procedures work, you are then scheduled to have the RFA.   

The RFA is a procedure to heat the medial nerve by damaging it to stop or greatly reduce pain signals to the brain.  For some patients the pain goes away, for others there is a significant reduction.    Unfortunately, it is NOT permanent.  Further RFAs are needed as the nerve regenerates.

I had the right side done in August and it was life changing.  I am walking and standing and have more range of movement than I have had in YEARS!!!

I can tell the nerve is regenerating as I am having some pain creep.  However it is nowhere near the level it was before the procedure, so I have time. 

With all my walking, I found my left side acting up.  The left is NO WHERE near the pain of the right, but it still hurts.  

So my next step is a follow appointment with the doctor in the next 4 weeks and we will schedule the RFA for the left. Plus I would like to discuss the Right side for future follow up.

How much has my life changed?   Here's some news.... I'm down 40+ lbs since July.  I walk regularly and I walk my dogs.   I have NOT been able to walk my dogs in more than 5+ years.   

I want everyone to know about this wonderful life changing option and will post about it every chance I get.   
Sharing some videos that provide more details ...

11.23.22 update

 Nov 23 2022

I don't know if it is because of the nerve block or my eating food that triggers inflammation, but my lower back has been bothering me something fierce since last Friday.

I'm still walking, just cutting it short due to the pain. ..

Facet Nerve Block

 This morning I had the first of my Facet Nerve Blocks on the left side (1 of 2 diagnostic procedures). 

There was a Fellow assisting the doc who did my block.  I don't know if it's because it's a different side or if it's because he was not as skilled as Dr Girgis...but my god. 

Earlier, I was walking around with no issues. Hubby said it looked like I was doing pretty good movement wise. 

However, the injection side HURTS.   Now, 6 hours later my lower back is irritating me.  I am so sore.  The site still hurts and the nerve block seems to have worn off.  I feel like it's swollen down on my lower back.     

I'm going to take some pain meds in a bit, since I can't use my pain cream.   It did NOT hurt like this at all when i had the first 2 facet nerve blocks.   UGH.  I go through this again in a month.

Just needed to vent......

Oct 21, 2022

Hey! 

Thanks for checking back.

This morning I had my pain management appointment.   A few things of note from this appointment. 

First, I was incorrect in my assumptions about the 2 diagnostic procedures that I had.   They were not for the Left side and then the Right side.  They were both for the right side.  I have to have 2 diagnostic on each side.   I will be contacted to schedule the first of those.

Second, the RFA I did have is considered a success so no more diagnostic procedures required.  If & when my nerve regenerates, I can automatically get the RFA scheduled without them.     

The N.P also noticed me when I walked in & immediately recognized my weight loss.    She was extremely happy for me that I am walking --which is all I wanted.  

I am down about 30-35#s.   I've plateaued. I've lost maybe 2#s in 3 weeks.  That is all on me.  I have been eating a bit more "richer" foods.  My BC is staying within range, but I'm not doing enough to continue with the quicker weight loss.

I would have been seeing my primary next week, but she's out for an unknown time period.  I don't think that will stop me from being able to get labs put in for my bloodwork, but I do want to see her about some things.

Rich is concerned, and frankly I am as well, about a large "lump/bump" on my left back near my shoulder blade. It hasn't shrunk & it is tender when pushed on.   It's been there for about 3 weeks now.   I will have it looked at next week by the NP to determine who I should see (Dermatology?) about what it is.

Walking--still walking a minimum of 3 days a week.    yesterday I actually had 2 walks.  One after dropping my car off at the shop and walking home. Then the next on the way back to pick my car up.   

With my trip to TN in 1.5 weeks, I took it in to get an inspection & tune up.  That cost me big.   Next I need to take it back in on Thur for $1500 more work.   YIKES.   Considering I haven't had any major work on it in years (besides a battery & cosmetic work) you figure that's $500/yr of work.   
He did indicate I will need rear brakes when I get back from TN.   UGH.   

Unfortunately this is cheaper than a monthly car payment for 5 years.     Still ....

Overall the only health issue i have had lately is my sleep.  I have been waking exhausted. I haven't had this happen in ages. 

Otherwise--doing well....  Blood pressure has been down.   BG has been within normal range. Weight down.   In fact, today I wore a jacket that I had not been able to comfortably wear for the past few years!!!

Yay

Since my last update

•  RFA was a success. 
• I am walking regularly now (3-4 times a week) about a mile. 
• I am down 30 lbs. 
• My blood pressure yesterday was NORMAL for the first time in years. 
• Feeling a lot better. "Flare ups" reduced considerably

Sept 16

 Anyone still reading?

So...RFA worked.   My pain has decreased to nearly non-existent.  I have gone on several walks since and am doing well.

Still eating well...better.    Had an appointment with my rheumatologist today. My first "official clinic" visit since all this started. My official medical record weight loss is currently 29# down. 

Some items are looser than others. But overall, I'm more comfortable in my clothes. 

Other things of note:  the swelling of my left ankle has disappeared. This is something that has been going on for YEARS!    MANY MANY YEARS.   It was especially evident when working from home & i was not wearing shoes.     

I've been wearing compression socks to help ward off some of the swelling for a few years now.    
I've had no swelling in a very long while.  My flare ups from FM are gone.  I only have issues with dealing with high temps & humidity. rain (weather changes), & just joint pain in my knees.

When I sleep, I sleep deeper. I sleep in on the weekends...

When i did the walk with R yesterday, we took 2 of the dogs. I actually walked Peryn for a majority of the walk. Do you know how long it's been since I've been able to hold a leash when walking?   
I'm debating about taking both boys for a walk when i get off work in a bit.  Thing is, V won't walk long--it's not his nature.   So do I risk it...try?  Maybe do a short walk around the neighborhood?
 i'll let you know.....

September 1- So Far

 Yes! Another post!  3 in 4 months time? What is going on?    A lot actually.   I think most is positive in the long run.   

I have struggled with my A1C & cholesterol #s for the past few years.   I do good and they drop and then I eat the wrong stuff and it rises.    I was considered pre-diabetes & then diabetic but "diet controlled" for so long.    This year my #'s jumped. My doctor gave me a stern talking to and gave me 3 more months to get in shape.   

I tried. I thought I was doing good--but my A1C jumped and here I am clearly in the diabetic category-Diabetes controlled with medication. Yes I am now on meds to regulate my blood glucose.    This probably was a good thing as I've seen the results of people with unregulated blood glucose.  I started eating healthy, took my meds, & really started watching my choices

Additionally in June I used the free membership to the Rec Center & began using their therapy pool.  It was suggested that I start water therapy in prep for the RFA procedure.

Between all that I've maintained my blood glucose in normal range, built up my core with walking in the pool, eaten better & log all my meals and have lost approx 20# in just over a month's time.

Very proud of that.    
I also had my 1st RFA on the 24th.  Did my first walk outside with the hub & pups this weekend.  I walked a significant (my small) part of the trail (includes a big hill) and survived without any excruciating pain.  Hoping temps start to drop so i can do more.

my membership is coming to an end next week.  I have to decide if I want to pay $40/mo to keep it or just go to paying $8/visit.  I really do love the water therapy/walking in the water.  I don't like the whole showering & chlorine smell afterwards--but It is my favorite form of exercise.     
I may not be super active, but compared to before June, I'm rocking it. 

Just how well the RFA was successful is still "in process" as it may take up to a few weeks for the nerve to 'die'.   

to be continued......

Part 2-Did she just post?

 I'm breaking this up into 2 different posts to give you a break in reading everything. Besides I think this is the best place to break it up.  Everything leading up to the visit and the visit and aftermath.

So I had some glimmer of hope before seeing the Pain Mgmt doctor.  I have A LOT of self-hatred. I have a lot of embarrassment & guilt over my weight.   I also feel like no one believes me.  Fibromyalgia has taken a lot from me.   I have lost A LOT of mobility, energy, strength, & normalcy. I lost a lot of my feeling of self-worth. I have lots of depression. 

Besides my mental health struggles that I had prior to FM, it has brought a lot of other issues to the table. Being social is PHYSICALLY DRAINING. It is equally mentally draining. This is also a lot of the reason I tend to self-isolate.   Throw in I am so dang sensitive to heat, light, noises, & smell--Covid to boot, WHY WOULD I want to be out & about?

When I went to the chiropractor the first time, he asked what I hoped to achieve? The pain management doctor asked the same?? Can you guess what my answer was? To be able to walk again.  I want to be able to go on a walk without debilitating pain. Not much of an ask. If I can walk without debilitating pain, I can walk to gain some of my health back.   

SO I met with my new Dr.  He had me do a number of movements. Then he felt along my spine, asking "does this hurt?"  When he got to my lower back, I reacted.  Reacted significantly because he had pushed right on the spot.  

He tells me to sit & says "It is arthritis."  I almost cried because to date, other than some medicine & injections , nothing helps.  However he took it a step further. Brought out his spinal vertebrae display and explained in detail what was happening.

This meant a lot as just being told you have arthritis & the detailed explanation of what is happening and why helped ME understand.

My L4 & L5 and S1     vertebrae, where the pain originates, the joints get inflamed when stress is put on them. Stress of walking, standing, & sitting.  When they get inflamed the nerve radiating out sends the pain signals.   This is specifically located at L4-5 and L5-S1. 

The better news was that there is a procedure that can help significantly reduce or even eliminate the pain.   However in order to determine whether or not this would work, I was required to undergo TWO diagnostic procedures. 

The diagnostic procedure, Medial Branch Nerve blocks, involved injections that would temporarily block nerve pain in the lower back (one side for each procedure. Depending on my results would determine if the treatment would be best for me.

My first diagnostic test was April 13.  We would definitely call that a success.  This has given me hope that it would work for the right side.  After which would be the treatment-RFA Ablation.

was set to have diagnostic procedure 2 on May 18. It was cancelled last minute.  I am severely disappointed.  The reschedule is June 15.  This means I have to wait a month to have the second diagnostic--which is required before we can even talk treatment.  This means another month of pain. Another month of waiting for relief. Another month of waiting.

I had been kind of hoping to have it over so when I attend a concert next month, I could actually enjoy it. But alas...more waiting.
As I said, I'm severely disappointed at this time. I just want some relief.

WHAT IS RFA Ablation?

below info directly from _Radiofrequency ablation | North Texas Pain Institute (thentpi.com)

AN ELECTRICAL CURRENT PRODUCED BY A RADIO WAVE HEATS A SMALL AREA OF NERVE TISSUE AND THROUGHOUT THAT PROCESS, DECREASES PAIN SIGNALS FROM THAT AREA.

TYPICAL BENEFITS OF RADIOFREQUENCY ABLATION:

• Longer lasting pain relief in comparison to steroid injections
• Reduction or relief of pain
• Short recovery time
• Improved range of motion
• Reduction in pain medication
• Semi-permanent disturbance of the pain signals
• Targets nerves part of the spinal column sending pain signals to the brain
• Reduced need for anesthesia as this has a reduced degree of nerve damage.
• Decreases the pain from severe knee arthritis without needing a knee replacement
• Pain-free benefits of 6 to 12 months on average. Some patients claim pain relief for up to 2 years.
• 
  
  

TO BE CONTINUED

Holy Freaking Sh!t. Did she just post? What's going on.

 So obviously I have not posted in years.   A lot has happened during this time. 

A few months after the last post I lost my father.  This also happened to occur during a very stressful time of selling our home, building a new one, & moving in. This all happened in a 4 week time frame. The moving in had some major hiccups.  

The stress of witnessing his passing, the memorial, taking care of Mom, packing, moving, and all things that come with moving, I did not have time to deal with my grief.  I also had major anger building within me.  Anger at so many things.  

This was affecting me greatly.  I thought I was keeping this anger internalized, but apparently not as someone who dealt with me daily made the comment that they had witnessed a change in me overall. 

December threw another blow with the complete & unexpected loss of one of my beloved fur babies. Her illness came out of nowhere & was devastating.   

I ended up being put on additional anti-depressants (the Cymbalta I am currently on is mostly for fibromyalgia & depression stemming from that).  I also returned to therapy in order to deal with the trauma from witnessing my fathers passing & the passing itself.  

Enter 2020.  Starting the year off ill & by March we all know what happened. I began working from home & being isolated.   

I also found myself diving into my work.  No breaks. Becoming much more productive...and glued to my desk.   

Eventually, walking & standing became excruciating. The pain so intense that when I did force myself to walk more, I ended up vomiting because of the pain ( & overheating thanks to my Fibro). 

I had to stop walking, Having been glued to my chair 8+ hrs a day with less breaks than when i was in the office took its toll.   

I brought it up at Dr appointments, but it was attributed to my weight gain during this time. During 2021 I decided to try a different route & began seeing a Chiropractor.  Through visits with him & massages, upper back felt better, but the lower back was still painful.

Numerous masseuses have mentioned my lower back has felt inflamed.  The chiropractor also indicated the lower back was inflamed.  He wanted me to go for some Xray's.

I ended up catching Covid & was unable to go back to him or get that Xray before I ended up seeing my primary. I forced the issue and ended up getting some x-rays.

X-rays indicated "significant" arthritis in my lower back.  Shortly after I ended up seeing my rheumatologist and we discussed my back & the x-rays. She recommended me seeing a pain doctor.  Perhaps I would be able to get an injection (kind of like I did on my knees.)

 The thing is, even though most of my friends  are understanding of my issues, there are those people that you can tell think you're full of shit.  They are the ones who silently judge you, but you can see it in their face.   

They see an overweight individual that doesn't walk or do much exercise. They think LAZY. They think they eat too much.  It gets to you.  I hate being perceived in that light.   Even though I stretched in the mornings & eat very little--there are those that judge without knowing or UNDERSTANDING the pain I feel.

Being told I had significant arthritis in my lower back, being told by others that they "felt" the inflammation made me feel a little better. There are those in the medical field that were finding something physical related to my pain. 

If getting an injection like that in my knee were going to help--I was all on board.