Pain Really Hurts - Round 2
“I’m getting too old for this shit” - Alan Brewington. February 14th, 2023, a few minutes after the doctor had finished round two of diagnostic injections into my neck. (First round of diagnostic injections - https://www.alanbrewington.com/blog/2023/1/16/pain-hurts)
By most medical definitions, the difference between acute and chronic pain is time. Depending on whose definition you use, chronic pain is defined as pain that lasts longer than 3 or 6 months. Basically, if you break your arm that is acute pain because it will hopefully subside within days or maybe weeks. However, rheumatoid arthritis pain lasts a lifetime since there is no cure for this autoimmune disease. The best patients like me can hope for is pain management, we are still in pain but its at levels that still hopefully allows us an acceptable quality of life.
What we don’t discuss is pain caused by medical treatment. Many treatment options that chronic pain patients have can best be described as having a “fight fire with fire” methodology. My diagnostic injections are a perfect example. In order to obtain the best possible evidence for a successful radio frequency ablation, the doctor can’t use anesthesia on my skin before giving me the injections. The doctor, along with much of the literature, state that I will feel a small pinch or mild discomfort. I’m here to tell you that is bullshit, the injections fucking hurt.
So what exactly happened. With the aid of a ultrasound, the doctor directs a hollow needle through the skin and into my C2, C3, and C4 region on both sides of my neck. The ultrasound allows the doctor to watch the needle in real-time on the monitor to make sure that the needle goes to the desired location. Contrast material is then injected to confirm that the needle is in the correct location. Once the doctor is happy with the location, the “medicine” is then injected.
It’s time for a little debate. Both the contrast material and medicine go through the hollow needle. The question is does that count as 1 shot with 3 parts, or 3 separate shots. I will attest that since I can very much feel the contrast material and medicine being injected that they should could as their own separate shot. In that case, I received 18 diagnostic injections into my neck on Valentine’s Day. If you are less generous or sympathetic, I received 6 shots into my neck on Valentine’s Day.
This is not for debate. The initial puncture of the skin doesn’t hurt much. Its when the needle reaches the affected nerve is when the awful pain begins. My doctor is good at placing the needle, however, being good does not mean he doesn’t have to move or completely pull the hollow needle out in order to replace into the correct position. When he moves the needle I can feel it scrape along my vertebrae. Believe me when I saw that feeling is mentally traumatic. While placing the hollow needle at C3 on the left side of my neck, the pain went shooting down my left arm and through my fingers. Not only does this hurt but it is also mentally startling. Finally, at C2 and C3 on the right side, the pain was so bad I thought I was going to relive my junior high nickname of Puke Brewington (short story - I went to school one day sick as a dog and proceeded to get sick all over the junior high). In this case medical textbooks are so wrong, I felt real pain on Tuesday, not mild discomfort or pressure. Mild discomfort or pressure would be a win, I wish I could live a life with only mild discomfort or pressure.
The good news. When I left the clinic about 20 minutes after the procedure was over with I was not in much pain. Something felt weird on my right side, still does. Not sure how to describe it except to say that I think the needle did some damage this time. Stay tuned. However, the mental pain was strong.
I’m so tired! I’m tired of being in pain, I’m tired of not being able to sleep for more than a couple of hours before the pain wakes me up, I’m tired of having issues while eating because of my neck pain, I’m just tired of it all. No, you do not need to be worried about my mental well-being, ok maybe a little worried but no more than usual. This isn’t a cry for help. My goal and purpose with this post is to show the power of having opportunities for a better quality of life. Opportunity is as powerful of medicine as anything else healthcare can provide to chronic pain patients like me.
In my case, the opportunity I’m referring too is a radio frequency ablation for my neck. That is the only reason I’m jumping through these diagnostic injection hoops. For those of you that are not familiar with this procedure, my pain management doctor uses what looks like a torture device from a Rambo film to burn the nerves leading to my spine. The hope is to reduce the ability of my central nervous system to register the near constant pain I’m in at the C2, C3, and C4 level. I’ve had this procedure before at several other locations on my spine with some success. Nerves do regrow and regenerate at roughly a half inch per year so at some point in the future I could be in pain again, this is not a cure. It is an opportunity to raise my current quality of life to a level that I can successfully work full-time at a career and still have enough energy to go hiking with my camera. I’m not ready or willing to give up this definition of what quality of life means to me.
My follow up appointment for these latest injections in on the 23rd of February. I’m going to guess that the doctor will be happy with the results of these injections and will recommend the radio frequency ablation. Assuming he does, it will then be up to my insurance company to approve. If they approve, then I can begin the final step towards hopefully keeping my definition of what quality of life means to me.
Stay tuned, I will post another update as soon as I know more. In the meantime, please feel free to ask any questions about the procedure or my conditions. I’m here to help.
