Should I repeat failed RF nerve ablation?

I'm new, but really hope y'all can offer some advice. I'm suffering from chronic pain in the side of the ribs, due to cancer.

Early last month, the doctor did a test block of three intercostal nerves, and it was amazing! Suddenly I was 90% pain free, but it only lasted 18 hours till the temporary anesthesia wore off, as planned. However, he and I thought I was a perfect candidate for a longer lasting radio frequency intercostal nerve ablation.

So he performed one, and it was an utter failure. The pain in the side of the ribs actually steadily increased over the next four weeks. The doctor started me on neurontin a week ago, and the pain is still terrible but no longer increasing. Where he inserted the needles, in the back, barely hurt and went away in a day.

The doctor wants to try the RF nerve ablation again. He said they rarely fail and he doesn't know why mine did, but is confident it will work the second time. He's the most experienced doctor in the area, and one of the few that do these.

Has anyone had a failed RF nerve ablation? Did you repeat it? Did it work the second time like it was supposed to? I really hate taking drugs and would rather have a nerve ablation every 6-12 months, but I'm worried it will fail again and put me in worse pain.

Thanks in advance for any advice or insight!

Welcome to the forum James. Please understand that none of us are drs here, we simply speak from our experiences. I have to disagree with your dr about the RF rarely failing, that is not true. I had this done to my neck & low back. I had great results on my neck, nothing on my back. Yes, I responded to the temp blocks, but that is no guarantee they will work. My dr told me this too. He did not recommend doing the low back again either.

Obviously this is your choice, but this was my experience with RF. Keep us posted on how you are doing.

Thanks for your replies. Guess I should give an update, though it's not really good news. Last week, while still trying to decide what to do about the RF block, I had a huge spike in pain. Level 10, in a new area just below my ribs but near where the tumors are, and it wouldn't go down.

By coincidence the social worker called my wife about a mundane thing.

She said, "Help! what do I do?" Because I was lying on the couch moaning and couldn't do anything.

He said, "I think it's time for hospice, because they can manage pain better."

He got me hooked up within hours with a local hospice program. But rather than come to my home as hospice normally does, they said I was so bad they wanted me in the hospital before they increased my medicines by the massive amount they knew they'd have to.

So I wound up in the hospice room at the hospital, with a morphine IV five times the dose I was getting, but within a day or so, they had me almost out of pain (good enough at least), almost no brain fog which has now faded to no problem at all, no nausea, just a little dizziness which continues to improve--great combination of control with minimal side effects. They switched it over to pills so I don't even need to carry around a pump, and I'm back home and pretty happy--as happy as someone dying of cancer can be, I guess, LOL.

But no decision now about an intercostal nerve ablation being repeated because I'm so much worse overall. That's not even an option anymore.

They're handling that old pain with 900 mg neurontin, which seems to work with minimal side effects--the potential neurontin side effects were what had scared me off from taking it before--and that old pain is the least of my worries now.

We all think I might not be close enough to actually dying to need hospice yet--maybe six months to a year rather than six months or less--but I'm on the borderline. Still, it's just good to have that new horrible level 10 pain controlled, and they may have a palliative care program that works better for me until I get closer.

Not great news, but every day that I get to spend another day alive and reasonably pain-controlled is another good day, so it's better than bad news, I guess. At least that's how I'm looking at it.

Post Edited (JamesBW) : 11/3/2014 9:00:27 PM (GMT-7)

Yes I agree, not great news but not as bad as it could be. I'm so very thankful you now have enough relief to LIVE whatever time you have. Since the stress of that pain is gone perhaps it will be a much longer time than expected. Thanks for letting us know. Blessings on you and your family.