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Screaming Eagle - question (& others w/cervical epidurals)

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Posted 6/29/2015 5:20 PM (GMT 0)
Good morning

Did a search for cervical epidural & found your posting from 4/2012 re: your cervical epidural with sedation vs your previous one withOUT.. (thnx for posting that btw!)

My one & only previous CE was without. I will NEVER do another one w/out. The pain was incredible.
Your point of making sure a qualified professional is administrating & monitoring is a great reminder!

That PM advised me to never have another CE because my blood pressure went very high - I felt as if my head was going to explode.. I was afraid to move. Staff was preparing to call ambulance as my bp was at 'stroke level'. Fortunately it started to come down.

Also I immediately developed extreme sensitivity to light (causes migraines) which, though diminished a lot, has lasted for several years (wear sunglasses to minimize- add hat for very bright days).
And, if I looked to the side, or turned head, while walking, I became so dizzy I would stagger. Sometimes, not every time. That lasted about 9 months, slowly diminishing, thankfully.

A couple of years later, had procedure to aspirate a cyst - was unsuccessful & despite me telling everyone, including that dr + having it written down - "no steroids", ii was injected Kenalog. light sensitivity worsened. (And I barely slept for weeks)

The next PM did some trigger point injections using only lidocaine per my request.

My new PM is talking to me about doing steroid injections, saying steroids are natural & my reaction must have been to an additive. I don't believe everything i am told: i know some dr see $$$ when looking at patients.
I HAVE been on high dosage pain meds for several years (& know there are health consequences)

last dr had discussed possibly adding MM & reducing current pain med dosage but he changed practices & I cannot follow him.
This new dr started 'pushing' CE the moment he met me.

So I am researching steroids & CE.

My question for you is two fold
1) did you get relief - long lasting relief?
2) do you know what/which steroid was used?

Oh, 3rd question.. did you have side effects?

Thank you!
Posted 6/29/2015 11:54 PM (GMT 0)
Hi Diane I have had numerous cervical epidural injections over the years, never had one with sedation though. For me usually the longest period of relief from pain that I have gotten with the injections is around three weeks, sometimes less. I was told by one neurosurgeon that he likes a patient to have them as they are a good indicator that if the patient gets any pain relief from them, that the area of the injection is definitely where the problem usually is. So it is a good diagnostic tool. I have never had any major side affects from getting the injections, but also only limited short term relief.

For me personally the only thing that relieved my arm pain from the nerve impingement caused by the cervical disc was surgery. And the relief was immediate! But surgery isn't for everyone and it does, or can have its own set of problems! My PM always used fluoroscopy and numbed the area first, never had much of a problem with pain while getting them, just a bit uncomfortable.

I wish you well on this! Good luck!

White Beard
Posted 6/30/2015 1:56 AM (GMT 0)
Thank you White Beard! I've continued searching on this site & been finding/ reading a lot..

I had surgery, A couple of years ago (repairs & clean up).. no pain relief, just ever increasing pain + less & less range of motion.

Currently gathering info to figure out what to do next. I'm only guessing but, based on his comments, believe injections are step 1 in this docs' plan of eliminating me from his list of opiod pain med patients: I also know his reputation from other patients who are at my therapy facility When I am there.
Posted 6/30/2015 3:33 AM (GMT 0)
I've had several cervical facet joint injections, which are partly a test to see if ablations will work, and I've also had ablations there. Some worked and some didn't seem to do much.

I think the ones that didn't help were maybe in the wrong spot or were where there was so much damage from crushed vertebrae or the surgery that the steroid didn't go where it was needed or the ablation didn't hit the exact right spot because of all the damaged, changed anatomy.

I've had a few trigger point injections, but they did nothing.

I've never had sedation for any of my injections or ablations anywhere on my spine, and I've had a LOT of procedures. Sedation isn't even discussed. Yes, they hurt. The injections hurt moderately in the neck, minimally in the lumbar spine.

Ablations hurt a LOT in the neck, but you have to be awake to feel what's happening. The doctor needs feedback from the patient to know if he's in the right spot! It's not nearly so painful in the lumbar spine. It's worse for the first one, but after that not bad at all.

There's lidocaine for the skin and with the steroid injections and after the testing for the ablations, so the pain is brief. Seconds, really. But maybe my doctor is just really good. I don't really tolerate pain too well, so it's not me. I actually find the first lidocaine injections to be the worst part. He injects it for the surface and a couple of times deeper, which aren't bad at all. But yes, they do hurt.
Posted 6/30/2015 3:59 AM (GMT 0)
Diane, SE has not been active here at HW in a very long time.
Posted 7/1/2015 6:02 AM (GMT 0)
Thank you Susie
Posted 7/1/2015 2:27 PM (GMT 0)
I've had to CEs.

The first one, around 2010, did nothing. The doctor injected around C4/C5.

I had another a month ago, injecting at C7/T1, as well as left facets.

No left shoulder pain since; 80% reduction in arm pain; no more tingling in outer fingers.

BTW, they gave me versed, but I was still conscious. No pain during the procedure but my neck was tender for a couple of days after.

The first doctor, I think, just didn't know where to inject so merely put some in, hoping it might trickle across all the areas indicated on the MRI. The second doctor spoke at length with me, had me move around, talked over my x-ray and MRI for quite a while, etc.. He went over each cervical level to determine the most effective spot and I think made the right choice.

Days 1-2, pain from injections; days 2-3 no pain, felt great, over did it; days 4-6 recovered from doing too much; days 7-10, dizziness from other issue, acute pain on right side of neck; days 11-present, 80%-100% reduction in pain in left shoulder & arm. I still have pain in neck plus down back. But the C7/T1 based pain is nearly gone.
Posted 7/1/2015 6:23 PM (GMT 0)
You can have a reaction to steroids, They also have steroids without dyes/coloring. I can only tolerate a certain brand name steriod, I've also had a reaction to the medrol dose packs...If this new pm of yours is injection crazy seek out another doctor, immediately...I had lower back injections done long time ago without sedation, never ever again, I have ptsd from that as I remember everything and it also brought on an asthma flair for which they did not know how to deal with and I was on my own without help if my husband had not handed me my inhaler things could've gone down hill...I would not recommend injections ever without sedation because if you move and they are injecting your neck it could do harm...if you don't trust this new doctor then you need to find another doctor, there has to be trust between patient and doctor otherwise things could go bad...
Posted 7/2/2015 1:36 AM (GMT 0)
Thnx Chartreux

You got it ! I am definitely traumatized by the cervical epidural.. the dr told me not to move or make a sound or he might slip.. AFTER he had already started !!

Prior to starting he had told me that the first bit of injection was numbing med.

Not !! Most awful pain ever !!

My long list of sensitivities /allergies includes artifical dyes & flavorings, most OTC anti inflammatories, a dozen or so meds that doctors have tried, including first small dose of Lyrica. Quite possible my body rebelled against additives.

I've not yet researched allergy testing.. is there a standard one I could request (demand!) ?
Posted 7/2/2015 3:49 AM (GMT 0)
They do have dye free steroid, you could ask about that, I'm not sure there is allergy testing for steroids, but you can get allergy testing to the "caines", lidocaine., novicaine, ect as I did get that testing done, if you can tolerate dental injections than your probably not allergic to the "caine" family of meds...other than that I'm not sure...your allergy doctor would need your pain management doctor to send over the exact meds he'd use so you could get the allergy testing done, its complicated and you'll have to wait but it can be done if both doctors agree...also, not sure if your insurance will pay for this, so you need to ask your allergy doctor...
They pin pricked my back and arms for this allergy testing, hope this helps..
Posted 7/3/2015 12:25 AM (GMT 0)
Yes
It helps a lot Chartreux..
Thnx!
Posted 7/24/2015 2:05 AM (GMT 0)
Chartreux

Thanks to your posts, when I had my appointment earlier this week,
I had my PM doctor write down the names of the steroids he would be using, after (again) telling him of my concerns
re: possible reaction. (Oh I have had several lidocaine trigger point injections in the past with no adverse reactions).

When I was making appointment for follow up visit,
it was made clear he will not be seeing me again unless I agree to epidural.
He Tried to pass me on to brand new pa but my insurance will not pay for appointments with PA so
I will be seeing the doctor who is newest, least experienced one. Their choice.

Have been asking around for recommendations for a new PM dr. Hopefully I can interview a few soon.

The cost of seeing an allergist will be coming out of my pocket ... but I do not want to risk my health.

Thanks to every one for your input.
Posted 7/24/2015 12:33 PM (GMT 0)
Bless Your Heart Hun!!! I had the same light issues and migraines after an epidural in 2010, I was vomiting alot, many many visits to the hospital with a trash can attached to my face. I was told usually this is because spinal fluid leaks out and even a small amnt can cause this to happen. I had to have a blood patch once to patch the hole. I am so sorry you have had difficulty and hope you get relief and help in the future!!!
1- some times helped, i've had A LOT of them. but its a 50/50 chance with me.
2-yes steroids were used, caused me to have lady issues with my periods
3-yes side effects were lady issues.
Posted 7/24/2015 2:17 PM (GMT 0)
When you find the name of the drug injected you can look up the list or known reactions and the list of excipients (additives), and a lot of other stuff.

I react to many types of injections, notably immunizations, not from the drug but the preservatives. Multi-dose vials are the worst. Single-dose vials are often clean.

For this particular reply, I did a quick search of "injected steroids excipients" and found lists for several drugs.
The page for Kenalog shows:
"6.1 List of excipients
Benzyl alcohol
Polysorbate 80
Sodium carboxymethylcellulose
Sodium chloride
Water."
from /www.medicines.org.uk/emc/medicine/11366

A simpler review of excipients and drug reactions to Kenalog may be found at
www.drugs.com/pro/kenalog-10.html

Another article on preservatives in anesthetics for neck injections, although I won't vouch for the validity of this one, /www.spinalinjection.org/?page=LACFF

Besides the anesthetic and the steroid is the dye used to check the placement of the needle. The contrast dye contains iodine and 5 - 10% of people react to this dye. www.mayfieldclinic.com/PE-MYEL.htm#.VbJI1KRVhBc
"What are the risks?
A CT scan is safe for most people, though pregnant women shouldn’t have one.

Be sure to tell the doctor if you are pregnant or have a history of allergies (to medications, previous iodine injections, or shellfish), diabetes, asthma, a heart condition, kidney problems, or thyroid conditions. Also tell them if you take any blood thinning medication such as aspirin, Plavix, or Coumadin.

about 5% to 10% of patients experience side effects caused by the dye that include headache, nausea, and vomiting. However, these side effects should not be severe."


There are other articles on the placement of the injection needle. The complications mentioned by some of the above posters could have been caused by hitting the subdural area instead of the epidural space that was the intended target.

This is all so complicated that most people should rely on their doctors for information and whether to get the injections. For my part, I intend to continue to get them, as my pain seriously impacts my quality of life,
Posted 7/25/2015 4:37 PM (GMT 0)
Thnx BunnyG & Alcie !
BunnyGirl - you've had some awful effects -i am so so sorry you had all those things in addiiton to pain!

Alcie - That info is useful -Going to research the steroids by name..

Very Glad that some people do get relief from injections.. the one I did have offered minimal relief for a matter of days. The pain during procedure was intense.. I kinda flickered on edge of blacking out.

Everyone's body is unique.

Re:doctors
I depend on medical people to be educated & to give me the benefit of their expertise.
That said, they are 'only human' & may make mistakes.. I require several opinions in cases of possible serious procedures.
Almost 40 yr ago my first exposure to med to put me to sleep for surgery - came close to being my last..
(severe reaction - not a medical mistake)

The statement made by my new PM dr - "you cannot be allergic to a steroid because they are natural' -
set my internal alarms bells off: even I knew the steroid was not only substance used during my previous procedure.
Perhaps only a poor choice of words on his part but, at that moment, I knew I would be looking for a new p m dr !

Was so so satisfied w/previous dr.. wish he could have stayed.

Thanks again
Posted 7/26/2015 1:32 PM (GMT 0)
Hi Diane,

Didn't have time to read all of every other post (feel kinda rude of me to not do that) but I have had cervical epidural injections w/ steroids and WITH sedation--2 this year. I'm sure others have said already, but blood pressure increase was likely due to the pain response. Pain has some weird affects on the body. I know for me, I get increased BP, severe anxiety, rapid heart rate, migraines, and sort of feel paralyzed--my whole body stiffens up.

I always get the sedation, even if the pain might not be horrible, it helps me to avoid all the other possible side effects (and the pain). I never remember things after and am up and moving around within a half hour or so.

Can't help you about the steroid reactions. I certainly hope you find answers for that.

As for the doctor, make sure you tell him about your past reactions and that you are uncomfortable having injections again. Obviously they are not the only treatment for pain and any doc who isn't flexible about treatment options is one to be wary of. I have actually been doing biofeedback and dry needling for my neck problems and migraines, might not help you, but just wanted to remind you that there are other options. Don't give in to something you know will cause horrible side effects for you.

I'm sure i just told you everything you already know, but I can't help myself sometimes! Sorry.

Good luck and take care.
Posted 7/27/2015 10:34 PM (GMT 0)
Thank you Sunny !
I would rather be told soomething twice than to have folks assume I know something that I don't..

I did tell this dr about the side effect.. 2x.

I agree re: pain can cause high bp. That was some crazy terrible pain.

Extreme sensitivity to light & dizzyness lasted for many months.

Original dr & current dr will not sedate in any way.

This dr has not offered any other treatment.

Acupuncture helped one particular area many many years ago & have been considering doing that again.

Thnx again
Posted 7/28/2015 1:12 AM (GMT 0)
At this point getting a new doctor would be your best bet, start that search engine.
A lot of PM Doctors are injection crazy and to just do injections without a mri to pin point the possible pain cause is just bad. and it also sounds like you have lost your trust in this doctor so it's time for another doctor and I hope your next one will not be injection crazy. My very first pm doctor was injection crazy and didn't do any x-rays or mri's and when he did do a ct scan he called me straight away at home and said I had moderate canal stenosis, plus other stuff and he sounded shocked, like I came to him only for pain meds...I Left that doctor shortly after that. If you have an RA doctor for your arthritis it is possible to ask him or her to take on your pain control...some RA's will or you might get referred out...
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