Tag Archives for needles

Pain Clinic #9: Acupuncture Agony

I survived my first acupuncture treatment. I know that sounds dramatic, but I did have to sign a consent form and waive my right to sue the hospital and all staff if I had any negative reactions before my pain specialist started the treatment. Besides, once I outline what happened, that I characterize the outcome as survival might not sound far-fetched. After I signed the consent form, my pain specialist and the assisting nurse outlined all the possible known negative reactions I could experience during and after the treatment. The intention was to place ten acupuncture needles in my lower back close to my tailbone radiating outward to my hips, and more needles in other areas of my body. Because I can no longer lie comfortably on my stomach, we had to figure out the best position for me to lie down on the table to prevent me from moving during the treatment. The best position turned out to be lying on my left side with my right leg bent at the knee and supported by a pillow. I had another pillow placed under my head and both arms stretched in front of me – reading that back it sounds more complicated than it was. In anticipation of the bright lights of the treatment room, I brought a sleep mask with me that I put on to create a more relaxing mood.

With me lying steadily in place on the table, my pain specialist moved my clothes aside to get access to the bare skin of my lower back. She spoke to me as she started to insert the needles asking if they were causing too much pain as she placed them. Unfortunately, even though she didn’t insert them too deeply, the pain of each needle she put under the skin close to my tailbone was unbearable. After she inserted the fifth needle in the flesh close to my right hip, she decided not to put anymore into my back. I’m glad she stopped because I’m not sure I could have handled the pain of five more needles. My pain specialist placed the sixth and seventh needles on the backs of each of my hands in the soft pad between my thumbs and index fingers. The nurse set a timer for ten minutes, and then it was lights out.

During the first ten minutes, as I was lying on the table in the semi-darkness, I could feel an intense, tingling sensation radiating from each needle in my back and hands. It was uncomfortable and not at all like past soothing acupuncture treatments. When the timer went off the nurse came back to the treatment room to adjust, or as she said “twizzle” each needle. She set the timer for another ten minutes and left me alone in the dimmed room once more. The discomfort from the needles continued to grow. The familiar feeling I get at the beginning of a pain flare up started building in my legs, but there was still time left on the timer. While I waited for the time to run out, I hoped that the removal of the needles would ease the discomfort.

At the end of the twenty-minute treatment, my pain specialist returned to remove the needles. She delicately plucked each fine, silver sliver of metal from under my skin, and the nurse used cotton pads to dab blood away from some of the insertion points. My pain specialist told me to sit up slowly. As I sat up, a wave of nausea hit my stomach. I wanted to vomit. I sat still for a moment then tried to stand up. I felt dizzy. I had to sit back on the table. The nurse and my pain specialist were very concerned and made me lie back down for about 30 minutes. When I finally felt steady enough to stand up, the nurse said she could tell that I felt better because the colour had returned to my face. However, there was still concern that I might need more medical attention. She told me that if the nausea and dizziness continued or worsened that I should go to the emergency room.

As the day progressed, the nausea and dizziness started to fade slowly, but the pain flare up that followed was as unbelievable as it was unexpected. For the first week following that treatment, I had soreness in the areas where my doctor placed the needles; tingling in my hands and the soles of my feet; that tingling turned into fiery pain from the soles of both my feet all the way up to my pelvis and lower back, and I felt exhausted. I couldn’t sit comfortably and standing or moving around made the pain worse. I tried massaging the arches of my feet, my ankles and thighs but the added friction made the burning pain worse. Even my hands tingled, although I only had a single needle placed in each one. By the time I went back to the pain clinic for the second treatment a week later, I was so sore and stiff that my pain specialist decided against more acupuncture and had to increase the doses of my pain medications to help me cope with the pain. She also expressed surprise that I returned for another treatment and told me she hadn’t expected me to make it to the appointment because of the shape I was in after the first session, and how much pain I was still in while meeting with her. Even though I was still in so much pain, it never occurred to me to cancel the treatment.

It’s been a month since I had that acupuncture treatment and my pain is just getting back to a level where I can cope, even with the higher doses of pain medications. Because I had positive experiences with acupuncture in the past, this outcome came as a real shock to me. I knew that it was possible to feel some nausea and dizziness afterwards, but I wasn’t prepared for the intensity of what I experienced. Since going through this I found AcuTake, an online publication that provides information about acupuncture. According to an article on the site, “7 Acupuncture Side Effects That Are Normal”, one of the potential side effects is “worse symptoms” or what “is sometimes referred to as a healing crisis” because acupuncture “awakens your self-healing capabilities” and “can cause not only an exacerbation of current symptoms but also the recurrence of previous ailments that had been dormant.” The article further states, “The good news about this side effect is that it’s a sign that things are moving. In the case of acupuncture, this means that the primary objective is being met. That is, you are starting to transition on multiple levels from stuck to unstuck.”

I don’t know how true it is that I have to feel worse before I get better, but I have a follow-up appointment scheduled with my pain specialist in about two weeks and we’ll definitely have a conversation about whether the agony that comes with acupuncture will benefit me in the long run.

 

Stevie Wonder – Ordinary Pain

Nerve Block Nervousness

On Tuesday morning I’m getting a nerve block. A Ganglion Impar Block to be more specific. The pain specialist ordered it during my last visit to the pain clinic for hopefully better pain management. The closer I get to the appointment, the more nervous I become. I know the intention of the procedure is to reduce my pain – although temporarily – but the process that’s been described to me along with the odds that it may not work are starting to play on my nerves.

I have instructions to start fasting at midnight tomorrow night because I will receive full anesthesia as if having a big surgery. Then I will check into the Outpatient/Ambulatory Surgery department at the hospital at 8:30 AM on Tuesday. Once I strip down to nothing but a blue hospital gown and my vitals are recorded, an orderly will wheel me down sterile corridors while making small talk with me about the weather. The destination will be an even more sterile room with scrubbed, masked strangers who will be predictably cheerful as they organize trays of instruments and measure precise quantities of nerve-numbing medicines.

Ganglion Impar Block Instruments

Ganglion Impar Block Instruments

As described, the procedure will require me lie face down on my stomach “with a pillow under the pelvis to help flatten out the lower lumbar spine’s natural curvature. Your lower back and intergluteal cleft [that’s ‘butt crack’ in layman’s terms] will be prepped and draped in a sterile manner before local anesthesia is administered at the point of entry of the needle into your skin. When your skin is adequately anesthetized, the needle will be advanced under fluoroscopy guidance until correct needle placement is obtained. Its correct placement will also be confirmed by administration of contrast dye. Once position is confirmed either a diagnostic block (to determine if your perineal pain is visceral or somatic), or a therapeutic block will be preformed.”

I think the best part of all this will be my lack of consciousness as I lie on that table with my naked butt in the air when they penetrate my tailbone with the needle. With that wondrous image in my mind, my hope is that when I wake up I will have better pain relief. I hope I don’t experience a pain flare up before that relief arrives as the pain specialist has forewarned. I hope I can have a few months of better pain relief before the next wave of intense pain arrives when I have the big surgery at the end of the summer. I know I’m hoping for a lot.

 

Pat Benatar – Anxiety (Get Nervous)

Pain Clinic #5

Last Friday I returned to the pain clinic to discuss my options for more invasive pain management methods because surgery – or a definitive plan to restore my health and eliminate my pain – is now far into the distance. I met with a pain management specialist I hadn’t seen before. His style of interaction was not as comforting or as informative as the doctor I’ve grown quite comfortable with over the last year. At the beginning of our session I had to ask him to slow his speech because it was very clipped and difficult to understand because of what I thought was a fast-moving Australian accent. It turned out that he is a British northerner, which on a good day is a hard accent to understand but was doubly so because of my medication fog.

We spoke for a while. Since, of course, each time you meet with a different doctor or medical practitioner you have to repeat your history and your primary concern of the moment. I explained to him that because I have no idea when or how the surgeon will treat my condition, and because I have no desire to increase the amount of pain medications I take – it would be impossible to function – I believe I need to have my pain treated more aggressively with other methods. I told him my favourite pain specialist – I didn’t actually say that, at least I hope I didn’t – had described the procedures that might be available to me and after a lot of thought I’m ready to try one or both.

He reviewed my chart. He reiterated the possible benefits and risks of each procedure. And especially emphasised that because my case is so “unique” and “complicated” – when I get better I’m going to set up an online dating profile and use those descriptors to snag a prime partner – whichever procedure they use might not work and may actually cause me to have a terrible pain flare up. How’s that for setting someone’s expectations?

He left the examination room to consult with the head pain specialist of the clinic to decide what to do with me. When he returned to the room about 15 minutes later my fate was sealed. I will get the Ganglion Impar Block that “treat[s] chronic, neuropathic perineal pain from visceral and/or sympathetic pain syndromes”. That’s a fancy way of saying they’re going to try to numb my pelvic pain and the associated leg and back pain. It is a delicate procedure for which I will be heavily sedated so they will admit me to the hospital under day surgery. I will need someone to take me to the hospital and take me home. This is the third time in just under a year that I will be heavily sedated on top of the large quantity of pain medications I take.

I don’t have the date for this procedure yet. I will get my notice by phone from one of the pain clinic administrative clerks who are all very lovely; or in the mail with an official-looking, detailed letter about when, where and how it will take place and what I need to do to prepare for the day. I’m not sure it’s a good thing, but I’m getting used to waiting for these notices to arrive so I can transfer the information to my calendar then patiently count down the days to the next procedure, consultation, or examination.

 

Europe – The Final Countdown