My last post was just over a week ago. It was one day after my diagnostic facet injections and I was confident that the short acting anesthetic provided a positive result. The injections substantially reduced my pain for the duration of the anesthetic, then my pain returned, big time. A couple of days later it was clear that the steroid component of the injections was kicking in. I experienced some " better than ever" time. I believe that I moderated my activities up and generated similar pain levels, but these were based on higher activity. Also, the pains were relatively short lived and not as severe as a normal.
The entire week has been better than any week during the last couple of months. I believe this is because of the steroids on board and also because of increased medications. (I waited until I was certain about the injections before I upped the meds so there would be no confusion.) I met with my pain management Dr. on Thursday. I like this guy. He doesn't seem to be interested in selling me a bunch of injections or rhizotomies.
I have a tough time believing it’s my facets (even with the positive injections) because:
1. The onset of problems, going from zero to 3 months of disability does not seem to be consistent with a degenerative problem. There is no episodic nature to my pain. The doc agrees this is unusual.
2. My facets are CLEAN on MRI. I have 2 thoracic studies this year with NO MENTION of facets. The doc agrees this is unusual
3. I can arch back and forward and bend to both sides with no distress. Again... the doc agrees that this is unusual for facet problems.
4. I perceive that the problem is related to axial loading and that the pain is much like my lumbar disc pain memory that gives me this perception. The doc does not agree that pain on axial loading implies ‘not facets’ as they are a component of the weight bearing system.
The doctor suggests that because of the unusual presentation, it’s prudent to reconfirm with another round of injections. I suggested doing only one level and he’s willing to do that, but recommends doing both. (Experience tells him that doing fewer injections as often as not, provides more confusion than clarity.) I’m inclined to go along with him and he has submitted request for another round.
I finally listened to Diane and the docs about being undermedicated and agreed to up my Oxy from 3 x 10 to 3 x 20mg/day. This is a tough pill for me to swallow... this was the highest prescribed dose from my lumbar years, but things are that bad. It’s been 4 days now on the increased dose (plus the steriods on board)... what a difference! While I’m not great and am still quite limited... this is WAY better. I’m way more functional and when I do get into pain, it’s not as severe and I recover much more quickly.
I still have some decisions to make, but at least the good news is continuing.
More as it happens...
Mark
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