Two weeks have barely passed and the effects of the nerve block are wearing off. I’m having a pain flare accompanied by swollen feet and ankles, and a burn down both my legs. I also have pain in my right hip. I spent the day lying on my couch with my legs elevated by a stack of pillows because they hurt so much. I was able to escape the pain for a few hours here and there when I would doze off.
The mild relief I’ve felt over the past couple of weeks is leaving. I called the pain clinic earlier this evening and left a message for my pain specialist letting her know that things seem to be returning to my usual high pain levels. I asked for an appointment so I could go in for an assessment. I don’t know what else to do.
On Tuesday morning I had a nerve block. According to the pain specialist who performed it, the procedure couldn’t have been more perfect. The needle was easily passed through my tailbone to deliver the anesthetics to my nerves – this may be the one thing about my condition that has played out as described in a medical textbook. Because they inserted the needle into my tailbone, the area has been incredibly sore so the only way I’ve been able to sit is straight upright as if I have a plank in my back.
Ganglion Impar Block
For the past 48 hours, I’ve been dutifully keeping a log of my pain improvement progress every two hours. Overall, I’m not pain free but I have less pain than before the procedure. I still have my right-side oriented pain in my lower abdomen, back and leg but I’m experiencing what I’ll characterize as a constant low level of pain on the pain scale. This probably means that combined with the nerve block, I’m feeling the benefits of my pain medications for the first time in a long time. My hope is to lower the level of pain medications I take over the next few months so when I have surgery the doctors will have room to treat me before reaching the maximum limits of pain medication doses during my recovery. The pain specialists have told me that my case is very complicated and the possibility exists that my pain will be difficult to treat post-surgery. This nerve block will be a good indicator of what they can expect.
I’m also hoping to go for a few walks before the effects of the nerve block wear off. Walking for a significant distance is something that I have a lot of difficulty with these days. With the weather being as wonderful as it is, it would be nice to pack a lunch, walk to the park, and sit in the sun for a while. That’s such a simple thing to wish for, but it’s something I badly want to do. However, I know I’ll have to take things slow because I just came back from an appointment and the car drive there and back has affected me negatively and increased my pain. I’ll dream about the walk to the park while I rest my body.
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
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.
My Small Surrenders 