Thursday, February 9, 2012

Nerve Block Redux

About 18 months ago, I had an intercostal nerve block, which I wrote about here. In short, an intercostal nerve block is a method of injecting a numbing agent and cortisone, under x-ray guidance, right into the nerve root between a particular rib with the hope of reducing pain and inflammation. The original block I had done was at the wrong rib, so, naturally, it didn’t work. The experience was awful and I was reluctant to repeat the procedure. However, the cortisone injections I had late last year offered temporary relief and my rib pain has been escalating over the last month even with time off and reduced training; a nerve block was the next step in pain management.

I called the doctor’s office on Tuesday and had the following conversation:

     JZ: I would like to make an appointment with Dr. Tobey.

     Assistant: Have you been here before?

     JZ: Oh yes. I am a frequent flyer.

I explained my problem and she said she would confer with Dr. Tobey. An hour later she called back.

     Assistant: Dr. Tobey wants to do an intercostal nerve block at ribs 11 and 12. Can you come in Thursday?

     JZ:  Sounds good. Can you ask him if he has punch cards? You know, have 6 procedures and get the 7th free? Or, maybe I can purchase a deal on Groupon?

     Assistant: Ummm….

    JZ: I’m just kidding.

It would be an understatement to say that I experienced some anxiety about having the nerve block done.

Here is how it all went down.

I had to put on a very oversized gown that barely tied in the back. The room was freezing. How did they expect me to stay warm with a flimsy piece of cotton?

The x-ray technician came into the room. As I mentioned, this procedure is done with x-ray guidance to make sure the needle is in the right spot. We had some banal banter. I asked her to turn off the soothing music, it was making me agitated. I requested some AC/DC, but apparently that agitates the doctor.

The doctor came in and examined my ribs. He poked and prodded – yes, it all hurt.

My back was swabbed with iodine and then draped with a sterile sheet. Tobey injected a local anesthetic and then he went in for the kill. Basically, he took a gigantic needle and touched the rib with it and then came off the rib into the nerve root and injected the cortisone. Since he was doing two ribs, I endured this twice. He told me to expect a little pressure. Excuse me, but a little pressure is a Swedish massage. This felt like the massage therapist was doing jumping jacks on my back! And, the dizziness. It was overwhelming. Kind of like the bed spins when you drink too much (oh, come on, you know you’ve been there).

Tobey was making polite conversation during the procedure, presumably to keep me distracted. He asked me when I was racing again. He probably expected me to say in a few weeks. I sheepishly told him I was getting on a plane tomorrow to go to St. Louis. He was somewhat relieved when I told him it was only 8K and not a marathon.

And then it was done. I requested a photo of the x-ray for posterity and I was on my way.

Here is my souvenir! Those are some big ass needles.

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