Nerve Block Question(s)

[ClareW]

I've just had a bilateral nerve block and unfortunately I went very wobbly afterwards, so was unable to talk to the doctor again to ask him questions.

What would happen if a 'normal' pain free person was injected with local anasthetic next to their pudendal nerve? Surely they would be numb in that area too and unable to feel pain, so what is the difference between this reaction and a 'successful nerve block' in a PN patient.

Has anyone experienced an improvement with steroid injections and if so, how long did it take and how much did it improve by?

Thanks
Clare

[Rosemary]

Hi Clare

My understanding is that the anesthetic numbs the area for a few hours and the steroid can alleviate your particular nerve pain for a while - so i guess a pain free person would just go numb for a few hours.

I had an unguided block done which numbed the area - like going to the dentist but did not take any nerve pain away - i feel that the needle missed the nerve.

Rosemary x

[helenlegs 11]

That must be correct Rosemary.

I suppose that best analogy would be an epidural during childbirth. I have no idea what goes into an epidural drug cocktail but I would guess some of it must be similar without the steroid content?? I think that is why some doctors are content to give an unguided nerve block as effective epidurals happen in their hundreds every day for childbirth. I would always want guided however.
Are you usually worried by needles, injections or even hospitals Clare?
I am not a fan of any (well who is?) and was famous for fainting on a school trip (yes it was a long, long time ago) to a local hospital and that was simply to look at the radiology equipment!
I'm much better now with regard to going wobbly or fainting, but wouldn't look at a needle going in for instance as I know I would be on the floor soon after!! If I do go all wobbly, and didn't actually faint, I would feel really bad for much, much longer (weirdly) if I hadn't actually passed out. This has happened a few times with various emergency and other hospital visits with my boys when you have to act, quickly and as normally as possible, trying to hold it all together.

Have you felt any good pain numbing effects from the block ?

Helen

[ClareW]

Hi,

Thanks for the replies both of you.

I know that steroid injections "are a long term therapeutic attempt and in some cases they will decrease the nerve inflammation. This can take days or weeks, and improvement may be temporary or permanent. This delay explains why physicians prefer a delay of several weeks between nerve blocks with steroids. If the nerve is not irritated, the steroids have no effect." Quote cunningly lifted from Pudendal Hope's information pages

It has only been a few days since I had the block, so perhaps too early to see a positive effect. I did have more pain for a couple of days after, including some new stabbing pains, but these seem to have gone away now and the pain is pretty much where it was before.

I don't mind hospitals, so long as I'm not a patient! I'm not a big fan of needles and quite often start to faint after an injection. I'd been studiously avoiding reading ANYTHING about nerve blocks before I went to hospital as I know it would have made me even more scared. Unfortunately, one of the blocks was very painful, which made me feel sick too My right leg had also gone completely numb, so I wasn't able to walk more that a few steps for hours and even then I kept falling over.

I'm still confused about the diagnostic local anesthetic part of the injections though. When I arrived at hospital, I was having a good day, so the pain levels weren't too bad. I don't remember feeling any PN type pain after the blocks, but as I was literally crawling round the hotel room floor, I had other things on my mind. I did manage to make it to Wetherspoons eventually though, by a combination of holding on to OH and clinging on to all available fences etc - they must of thought I was very drunk

I'm still confused about what nerve blocks would do to a non-PN person though. If local anesthetic is injected close to any nerve and it makes the area served by that nerve go numb, how could you feel any pain in that area??

[Rosemary]

Hi Helen

This is a thread i started about what was in my nerve block - Violet kindly answered that the steroid is similar to an epidural.

http://www.pudendalhope.info/forum/view ... f=5&t=4434


Hi Clare

I think the steroid is the diagnostic part of the block and not the anaesthethic - or maybe i am confused - probably.

Hope that you get some pain relief soon.

Rosemary x

[calluna]

Rosemary, I'm pretty sure you've got that the wrong way round - the anaesthetic is the diagnostic bit, that's the bit with the immediate response. The steroid is the bit which will is intended to have some longterm effects, hopefully good ones. The anaesthetic is not intended to have any longterm effects, it is just a local and it wears off within a few hours.

[Ray P.]

Who did your nerve block?

[Karyn]

I'm still confused about what nerve blocks would do to a non-PN person though. If local anesthetic is injected close to any nerve and it makes the area served by that nerve go numb, how could you feel any pain in that area??

I agree, Clare. Excellent question. I've been asking myself the same thing for years. With the PN blocks, I did experience temporary numbness. Then the steriod kicked in, evoking unspeakable pain flares which lasted for months. I had a block done a couple of years ago to the tarsal tunnel. I requested to leave the steriod component out, so it was just lidocaine. Result ... a completely numb foot. Not just the tibial nerve - the entire foot. So, no. I don't understand how indroducing a numbing agent to anyone is diagnostic for anything. The criteria for a "successful block" is pain relief for several hours. It's thought (by the medical community) if there's no change in symptoms, the block failed and whatever they injected isn't your problem. However, I know several people who didn't respond to the PN blocks at all, yet managed to proceed to surgery. Thick, dense scar tissue was discovered, suggesting the possibility that their scar tissue was so dense, the anesthetic wasn't able to penetrate it. Just a theory ...
Kind regards,
Karyn

[ClareW]

Hi Ray, I will PM you

Hi Karyn,

I guess 'further research is needed' on this one! I'll let you know if I can manage to find out

I've not yet had any particular pain relief from the steroid part of the block, but fingers crossed I might soon x

[helenlegs 11]

Thick, dense scar tissue was discovered, suggesting the possibility that their scar tissue was so dense, the anesthetic wasn't able to penetrate it. Just a theory ..

OOOooo that does make sense tho' Karyn. I like that theory, thanks Not something that I would have thought of but I'm sure it can be added to the list of strange and often perplexing 'arguments' and alternative theories we amass.

Thanks for that link too Rosemary

Helen x