first nerve block with Dr. Antalok

Diagnosis, nerve blocks, transgluteal decompression surgery
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Karyn
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Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: first nerve block with Dr. Antalok

Post by Karyn »

Hi Ellie!
No, I've never tried fentnayl. I'm not on any meds at all anymore. They just weren't effective for pain and I couldn't tolerate the side effects. I'm sincerely hoping that as time goes on, they'll come up with a better method for diagnostics. I was hoping you'd at least get a little relief for a little while. I've heard good things about Dr. Antalok. Yes, Dr. Shobeiri trained under him and Dr. Conway is planning on training under him some time in the future.
So, you're going for round 2 next month? If you don't mind me asking, why are you keeping your appointment with Hibner?
Hoping for less pain for you,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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Violet M
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Re: first nerve block with Dr. Antalok

Post by Violet M »

river133 wrote:After having the nerve blocks yesterdayt. I saw Dr. Antalok two hours after the block... He wanted to see how I reacted to them.. He did the pin test and said I was responding when I shouldn't have .. Does that make sense to you..
After the nerve blocks Dr. Antolak presses in certain places with a pin to see if the block numbed you up adequately. All I can think is that maybe the block did not numb up the nerve adequately. I wonder if he is thinking you have a variation in anatomy where the rectal nerve does not branch off in the typical place -- this happens with some people. You say your pain is primarily rectal. After the nerve block did you have any numbness or relief of pain in that area?

Some people have what is called a Morestin's rectal nerve. I have no idea if that is the case with you or if this is what Dr. Antolak meant. I would ask him.

[The inferior rectal nerve. Anatomical bases of perineal pain]

[Article in French]

Leclair F, Robert R, Faure A, Armstrong O, Rogez JM, Lardoux MC, Leborgne J.

Laboratoire d'Anatomie, Faculté de Médecine 44035-Nantes-France.
Abstract

MATERIAL: 4 corpses (1 fresh, 3 formoled) without preliminary injection; age: 84 to 90.

METHOD: a front access enabled us to show the origin of the inferior rectal nerve from the pudendal plexus, its course across the Alcook canal and the ischiorectal fossa. Then a posterior transgluteal access showed the short intragluteal course across the "biligamentary tunnel" (between sacrospinal and sacrotuberal ligaments) of nerves and vessels related to the anus, in particular the inconstant Morestin's nerve.

RESULTS AND CONCLUSION: the compression of nerves causing perineal pain can occur at different places. Depending on the localisation of the origin and the course of the inferior rectal nerve (which change) in relation to the place of that compression, and also the existence or not of Morestin's nerve, the changing topography of these pains can be explained.

PMID: 11434115 [PubMed - indexed for MEDLINE]
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
river133
Posts: 260
Joined: Sun Sep 19, 2010 9:29 pm
Location: Melrose. Mn.

Re: first nerve block with Dr. Antalok

Post by river133 »

That first nerve block really did me in... I know it isn't going to be any better for the second and 3rd, but I am willing to go through them just to get myself to surgery with Dr. A. I got really depressed ,crying sobbing, hurting so bad and didn't care if I didn't wake up in the am. I finally told myself that I have to hang on for a few more months. I asked my husband if he gets depressed over all of this and he said yes... I said , "because you feel helpless"? and he said yes...No one except the people we live with can know what we go through.. I hide it most of the time, have done that for the last 3 years.... I am tired of riding around in the back seat lying down... I could go on and on, but you all know what I mean..... Went over to walmart today and got a toilet seat, $10.00 cushion . have had 5 0r 6 of other kinds of sittinbg apparatus's. I should paint it or some thing.,.. have any good ideas? :D Ellie
Surgery Jan.05 2011 TG with Dr Antalok. Dr.Chambi May of 2012 showed injury from a fall on back, 11 years ago. My piriformis muscle caused a large amount of fibrosis .My sciatic nerve was growing through the piriformis muscle which caused a bifid p.muscle. . Dr Chambi decompressed the sciatic,pudendal,pfcn ,and peroneal nerves. I hope to have a nuerostimulator put in to help with the sciatic pain that never goes away. Most days are better with the pudendal if I do not sit at all.
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Violet M
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Re: first nerve block with Dr. Antalok

Post by Violet M »

I'm sorry Ellie -- I understand. Sometimes the steroid can cause depression but also I'm sure the additional pain does too. Use lots of ice and if you need more pain meds don't be afraid to ask for them. Sometimes it takes some extra help to get through the flare-ups after nerve blocks.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
vickinmn
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Re: first nerve block with Dr. Antalok

Post by vickinmn »

Hi Ellie! (or River) makes me think that you are a flower child or something, but I know better now! Hope you are doing okay.
I had my 3rd injection last Friday. It was the one done by the radiologist. It didn't seem to hurt at all and was done very quickly. The radiologist was young, but very competent. I asked him if when he is doing these if he would also be able to see if there is anything like a tumor in this area. He said, "Yes, he could". He's always looking and figures that sometime it will happen that he will see something else that is causing someone a problem like a tumor or something. He said I was the first person to ask him that and he's been surprised that others haven't asked him that before. He said if I was interested, he's be glad to show me my CT scan. He was able to show me where different things were and where the pudendal nerve is, etc. It was very interesting.

This injection seemed to hit better where my problem is. I've tried sitting the last couple days and I'm not feeling the pain I usually experience. I never really got any relief from the other two at all. I asked Dr. Antolak what I will do if the injections and the rx's don't do anything for me and he said I had 3 choices, I can have a 4th injection next month, and I can have more injections after 4 months, I can live with it and practice the self-care measures or if I am in excruciating, 24/7 pain, not able to get off the couch, then he'd suggest surgery. I was kind of surprised that it sounded like he thought surgery should be only a last ditch effort for the very worst of cases. If I were you, I'd keep that appt. with Dr. Hibner. You never know when Dr. Antolak might retire again. And you really need to get some lasting relief from what you are going through, sooner than later. ------ Vicki
river133
Posts: 260
Joined: Sun Sep 19, 2010 9:29 pm
Location: Melrose. Mn.

Re: first nerve block with Dr. Antalok

Post by river133 »

I got the call today.. surgery will be on the 24th of Jan. with Dr. Antalok.. YES!!! I am almost afraid to hope . He said he will do both sides..... I don't know a lot of the terms you use out there..... I know many of you have had this for a lot longer than I ... It is 3 years this month... I am 74, the same age as Dr. A. He so wants to retire, but keeps on plugging away.... A great Xmas to you all... Ellie
Surgery Jan.05 2011 TG with Dr Antalok. Dr.Chambi May of 2012 showed injury from a fall on back, 11 years ago. My piriformis muscle caused a large amount of fibrosis .My sciatic nerve was growing through the piriformis muscle which caused a bifid p.muscle. . Dr Chambi decompressed the sciatic,pudendal,pfcn ,and peroneal nerves. I hope to have a nuerostimulator put in to help with the sciatic pain that never goes away. Most days are better with the pudendal if I do not sit at all.
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Karyn
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Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: first nerve block with Dr. Antalok

Post by Karyn »

Congrats on your surgery date, Ellie!
I'll be keeping you in my thoughts for a positive outcome and full recovery!
Hugs,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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