Pain management follow up appointment

Monday morning, I trekked back to Bone and Joint to meet with the pain management doctor.  We discussed the relief I experienced after the first and second sets of injections.  After that conversation, she believes that going forward with the nerve ablation would be the most beneficial for me.  She said she was hopeful.  She asked me if I was hopeful.  I told her I was desperate.  I don’t think that is the same as hopeful.

We went over the procedure.  I will report to the surgery center just like I did for the injections.  Nothing to eat or drink before.  This time, I will get an IV.  This procedure can be more painful, so the IV offers easy access for medications.

She will start by injecting a local anesthesia then inserting the needles into the nerves in my back (L3-L5).  I’ll be awake for the entire procedure, lying on my stomach.  She will use xray guidance to make sure the needles are properly positioned.  Then comes the testing phase.  This is the most time consuming part.  She needs to make sure that the needles are in the sensory nerves and nowhere near the motor nerves.  Sensory nerves transmit pain impulses.  Motor nerves allow me to walk.  If she gets too close to the motor nerve during the testing phase, my leg will start twitching like crazy.  It is good to know this prior to burning off the nerve.  She assures me she has never been to close to the motor nerve.


Once the needles are in the right spots, the actual burning procedure takes about 6 minutes.  There are four 90 second ‘burns’ that travel a set length up the nerve.

After the procedure, they will keep an eye on me for 30-60 minutes.  I’ll need a driver to take me home.  And, in the words of the doctor, I get to be a queen for the rest of the day!  No lifting, no cooking dinner, no bending or working.  Just relaxing.  She said she would make sure to tell my husband!

I may experience some increased pain for the first day or two after the procedure from the area being irritated and swollen (from the needles going in).  Or, the relief might come right away.  Each patient is different.

After talking about the procedure, we discussed what happens after.  I will have a follow up about 3 weeks after the procedure.  She typically likes to do a 2 week follow up, but her schedule was pretty full.  If I’m feeling good at that point, she will get me started with physical therapy.  If I’m still a little sore, I’ll wait until the 6 week follow up.  Everyone starts therapy after the 6 week follow up.

I asked her about activity restrictions after the procedure.  I remembered that I couldn’t do anything strenuous the day of the procedure.  But I wondered about the next day or two.  Would I be able to go swimming or walking?  She said: “You can run.”

And I cried.

Even writing about it now, I’m crying.

The doctor put her hand on my knee and offered me a tissue and gave me a minute to collect myself.  She told me that this was what we were working toward.  She wanted me to get my life back and running is an integral part of my life.  I felt like such an idiot crying, but those three simple words were something I have been waiting to hear for almost 6 months.

Once I had regained my composure, she went on to clarify the conditions of me being able to run.  I can run no more than half a mile, at a very slow pace, no more frequently than every other day.  Until I see her at the follow up appointment.

She went on to talk about how much she enjoys working with athletes.  They are typically very healthy, meaning that they have the potential to heal more quickly.  But, that they often push themselves further and faster than is recommended during their recovery.  A lot of times, she needs to pull back the reins on the athletes so that they don’t overwork themselves and slow their recovery time. 

Message received.

I am optimistically looking forward to the procedure on August 4th.

Please pray that everything goes as planned and that I get some pain relief quickly.


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