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Posted 2/2/2016 4:48 AM (GMT 0)
I'm a 38 year old male and here's a little history on myself. In both knees( 3 surgeries on right knee) I have tears and just about bone on bone. I've had ulnar nerve transposition in both elbows( 2 surgeries each elbow). Severe pain in both shoulders and possible tears again.( 4 left shoulder surgeries and 3 right side surgeries) Surgery each foot to put in stents for flat foot. C1, C3-C6 are all dried up. L2-S1 are dried up as well. They want to do surgeries on my neck, back, and both knees, but I told them I'm tired of surgeries and need a break. I also have CRPS in the right hand/wrist and I'm right handed. Besides the surgeries, I've had 4 nerve block injections( 1 lower back and 3 in the neck area), and numerous cortisone injections. The problem is anytime I get any kind of injections It makes everything 3 times as worse for 1-2 months and then after that it stays permanently slightly worse. My questions are has anyone experienced this and does anyone know why things stay worse after then injections? I usually hear that people either feel better or at least stay the same. I just can't figure out why I feel worse after steroid and nerve block injections? It makes me afraid to get either of these type of injections, due to this. Any ideas?
Posted 2/2/2016 11:44 AM (GMT 0)
Hi rob. Welcome to the forum. I totally hear you on needing a break from surgeries and healing from surgeries. I'm not a doctor, but I am concerned about the amount of cortisone you've had. Considering the body makes cortisol in reaction to 'stress' and you've had a lot of stress...perhaps the injections have put you in overload. Maybe ask the doctor to do some testing on your cortisol levels.

My daughter had problems with too much cortisol. It caused general lethargy, joint pain, etc. It's worth checking out.
Posted 2/2/2016 12:26 PM (GMT 0)
I get tested for those levels, kidney's, liver, thyroid, and everything else about every 1-2 years at max. I know I was just tested extensively about 6 months ago and the only thing that was found through the urine test and blood work was my vitamin D was low, which does happen from time to time with me, so I take the extra vitamin D they ask me to. In the last 5 years I've had somewhere between 5-7 cortisone shots. I know I've never had more then 2 in a year, but can't understand why nerve block injections and the cortisone shots make things worse if all my levels are fine. It just frustrates me, because I'm tired of surgeries that only help for so long, tired of the pain, and everything else. Pain Management was talking about the possible next step is burning the nerves since the blocks haven't worked. They want to try the lower back first, but I'm just not sure since it would another needle in the back messing with the nerves. Just not sure what to do
Posted 2/2/2016 1:51 PM (GMT 0)
A complete metabolic panel (CMP) and complete blood count (CBC) do NOT test for the body's cortisol levels.

That you have had numerous steroid injections does leave you at higher risk for developing secondary adrenal insufficiency. It is not a disease on the radar of most MDs.

Secondary adrenal insufficiency is serious and quite debilitating. The use of steroid injections suppresses the pituitary gland in producing ACTH, the hormone that instructs the adrenal glands to produce cortisol. Cortisol is life essential.

Ask your MD specifically for a morning baseline cortisol level and morning baseline ACTH level. Blood sample should be taken before 8 am, as your level will be compared to an expected average for 8 am (the body's production of cortisol follows a biphasic pattern).

If your morning cortisol and/or ACTH levels are low/low normal, seeing an experienced endocrinologist would be strongly advised.

I have Addison's disease (primary adrenal insufficiency) and, believe me, low cortisol impacts my total self and being.

Early symptoms: Unrelenting fatigue, not relieved by rest; persistent nausea and or vomiting, GI unease, queasy stomach; diffuse muscle and joint pain, moderate to severe; low blood pressure, especially with change of position from sit to stand; difficulty with higher level thinking/executive thinking, general "brain fog;" gravitating toward salty foods.

Again, your cortisol level and ACTH level would require a specific laboratory request from your MD. Cortisol and ACTH are not measured on routine blood tests normally ordered on routine/follow-up visits. You want your MD to order: "Early morning baseline cortisol level and morning baseline ACTH level, 8 am, fasting."

Cortisol below 5 ug/ml and ACTH below 9 ug/ml would be worthy of endocrinologist evaluation.
- Karen -
Posted 2/2/2016 4:12 PM (GMT 0)
Hey rob.A Doctor is gonna have to do some good convincing to stick me in the back again.

I've had 3 in my Lumbar.Didn't help.The 3rd one they stuck my Sciatic Nerve and put me in He!! for 49 days.I quit him.

I'll have no more injections.

Had a Rt knee Replacement November 9th.85 days ago.I walk 1/2 mile a day.Have full flexibility.

But it feels like they did exactly what they did.Cut my knee out and replaced it with a mechanical device.

Doesn't feel good.But it works.It didn't used to.

Take care and God Bless.

Rick
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