Nerve Ablations and SCS Revision

I've been away and unable to really write much for quite a while. I was getting a nerve ablation, and in order to explain more of the need for that I'd kind of like to go into some stuff about my spinal cord stimulator surgeries. Especially I'd like to emphasize some stuff about the revision, for people getting this surgery or considering this option to keep in mind and prepare/look out for(for the record I still highly recommend this treatment, every option comes with risks and surgeries have more risks than non-invasive options, I was aware of the risks when I opted for this and am not regretful at all, it's ended up being totally worth everything I've gone through).

A problem I experienced after my two surgeries(the spinal cord stimulator implant surgery and the SCS revision surgery), a problem which I am pretty sure I mentioned before, is that the muscles in my back have atrophied from the lack of use. I'm not 100% sure if I've mentioned it, medication brain-fog making me fuzzy on everything I've talked about on here already, and I'm too lazy to go back and check right now. :/ You see, after the spinal cord stimulator implant surgery, they tell you to be extremely careful, no bending or twisting at the waist, no lifting over 5 pounds, you can walk but be very cautious about physical activity for 6-8 WEEKS to avoid dislodging leads until scar tissue can form and anchor them. Now, I was overly cautious because I wanted this thing to WORK. That, and I was in paaaaaain after the surgery, so there wasn't much accidental movement anyway. You aren't gonna move in excess and not notice it after this surgery, trust me, the tissues they tunnel away and separate to fit those wires in will certainly let you know if you're moving too much, and if they don't the incision sites will. So for three months I was hardly using my back and not really moving it. However, I have scoliosis to the left so mild we didn't even know about it until after the surgery, which means the midline of my spine shifts slightly to the left. My RSD pain is severely in the right leg, slightly in the left but the majority of the pain and the most severe pain is in the right leg. This ended up being a problem for me because the leads of the spinal cord stimulator shifted with my midline after the surgery, simply millimeters to the left but it was enough that it was hardly covering the intense pain on my right leg after only a couple weeks of recovery. So the doctors all decided we needed to go back in and fix it, which meant another 6-8 week recovery of no back use what-so-ever, literally right after I was able to start moving normally after the last recovery period. Knowing the problem with my spine this time around my surgeon put the leads almost entirely to the right side and it worked perfectly, however my chiropractor determined that the muscles in my back atrophied from such a long recovery time without being able to be used. It's caused problems when I sit or stand too long because my spine has a hard time supporting my body weight up without the help of those muscles, it's really painful and makes classes even harder than they were with just the RSD. Even sitting through dinner with my family was nearly impossible, my mom would catch me trying to hold back tears when I'd have really rough nights. I've been doing a LOT of physical therapy, but no progress has been seen in the couple of months I've been doing it yet.

So my pain doctor suggested we try a facet joint nerve ablation to help with some of that pain. This is an interesting process, my step-dad had one done before actually but he didn't really remember what it was like so he was no help in mentally preparing me. :P I had to go in for two sets of facet joint nerve blocks before the ablations were even scheduled because the block is like a trial run, if you get even an hour of relief from the block it's an indication the ablation will be successful and they go ahead with it. Since the ablation is essentially them chemically burning your nerves it makes sense they want to make sure it's going to offer some relief before jumping in with it, or even making sure they've got the right nerves before burning them. Kinda like the spinal cord stimulator trial. Anyway, I've been really stressed for money lately because I have no income and endless medical expenses, and getting these procedures without sedation is half the copay cost. My pain doctor told me EVERYONE gets the facet joint block without sedation, and hardly ANYONE feels ANY pain, it's NO big deal. Hahaha, it's such a simple procedure, like a tickle really...(she didn't really say that part, just my sarcastic help) Do NOT get this procedure without sedation if you don't normally go without sedation for your procedures. Whatever you do, DO NOT SKIP THE SEDATION. They injected the local anesthetic, which hurt because even just the skin and muscles over the spine there were so messed up, and my doctor that performs all my procedures put the needles in that the medicine goes in. And I Screamed. Oops.... He decided to administer another round of local anesthetic, waited a minute to let it take affect, then warned me he was administering the medicine to the nerves and it was probably going to burn a little. Big understatement, my mom heard my reaction from the "little burning" from the waiting room.... I apologized for screaming, I think that's probably bad patient etiquette or something, but I did feel better and less like a wimp when he sounded really sympathetic and said "Don't apologize, your nerves are really badly damaged" I was exhausted from all the freaking OW and after the 5 minutes in the post-op area(I even skipped my apple juice!) got in the car with mom, and promptly slept the rest of the day. I decided I would tell them before my next block that decided to opt for sedation, though apparently someone made that decision for me because when they called to see how I was doing after the procedure, the guy on the phone said this "And I see here on your chart you have another block next week? It says you're getting sedation, is that correct?" I thought it was pretty hilarious someone there recognized my mistake.

Now, finally, onto the ablation. This they definitely don't recommend without sedation, and I understand why after getting it. Even with sedation this one hurts. It hurts during, it hurts after, it hurts all the way home and makes sure you remember it a while. And not just achy pain, oh no. When they say they're going to burn the nerves, it sure as hell feels like they just burned the nerves. I mean, not the same firey pain as RSD but it's definitely a burning pain all it's own. Holy crap, I was tearing up like a baby all the way home after both ablations, I don't even know why. It just huuuuuuurt and you can't get comfortable. I think with the second one it sucked more because the needle injections were right by my hip incision from the surgery, which is still a little tender with that big battery inside there so laying down even a week later it's kinda tender on that left side. I will say it was worth it though... because yesterday, in class, I sat through both my morning and my night class without having that severe my-spine-feels-like-it's-snapping-in-two pain. :) Still had pain, but not nearly the same thing, and I made it through both classes entirely which I haven't done in weeks. I even managed to concentrate fairly well through the whole thing, which I usually struggle with because my brain is focused on the pain too much to even hear what they're saying.

Basically, yesterday was good. Yay for ablations and small wins.