injection by radiologist vs. anesthesiologist
Posted: Sun May 24, 2015 5:50 am
Is there any extra risk to having a CT-guided S2 block performed by an experienced diagnostic radiologist instead of under fluoro by a pain mgmt anesthesiologist? This is for my sacral/rectal pain, not the PN which is still much improved - separate issues. After many blind PN blocks, my first CT-guided PN blocks were performed at St. Joseph's by a radiologist as part of Dr. Hibner's initial eval in 2007. One of the most effective I've ever had.
I was having a shoulder arthrogram last week and the radiologist inquired why I'd requested extra padding under my sacrum. Explained about the sacral pain from the SCS and intolerance of hard X-ray/MRI tables. She asked if I'd heard about a radiologist at another facility who performs spinal injections under CT guidance. I met with him a few days later, discussed my case, and he requested a referral for ease of insurance payment. My pain anesthesiologist offered to perform such a block (under fluoro) 2 years ago, but I had to cancel due to illness. Since then he's not interested in doing one, though I'm still in pain from the SCS implant HE performed. Says I'd only get 1-2 day's benefit, no point since we know where the problem is. The radiologist told me he's heard similar complaints from patients about other local pain anesthesiologists, who aren't willing to try an injection unless it's for diagnostic purposes. He doesn't understand this attitude and is trying to help patients improve pain.
My anesthesiologist is now mostly at UCSF and only at my practice occasionally. His partner, who does my meds, refused a referral. Said that because this doc is a diagnostic radiologist he could inject me incorrectly and make things worse. She offered to refer me to another pain practice. They're basically refusing to provide what was once offered, and instead keep pushing for a pain pump trial. Not interested in another implanted device, at least not from this doctor.
So many patients on this forum have complained about anesthesiologists causing much worse pain after nerve blocks. Is this just a rivalry between specialties, or should I avoid the radiologist?
I need rotator cuff repair soon (full tear with separation), which will even further limit my sleeping position for 6+ weeks. Lying supine, even with padding, hurts the sacrum due to the SCS lead damage. I'd like to at least try a block. If it doesn't work or helps only briefly, at least I'll know and cross it off the options list. Would appreciate your opinions and experiences! Thanks!
I was having a shoulder arthrogram last week and the radiologist inquired why I'd requested extra padding under my sacrum. Explained about the sacral pain from the SCS and intolerance of hard X-ray/MRI tables. She asked if I'd heard about a radiologist at another facility who performs spinal injections under CT guidance. I met with him a few days later, discussed my case, and he requested a referral for ease of insurance payment. My pain anesthesiologist offered to perform such a block (under fluoro) 2 years ago, but I had to cancel due to illness. Since then he's not interested in doing one, though I'm still in pain from the SCS implant HE performed. Says I'd only get 1-2 day's benefit, no point since we know where the problem is. The radiologist told me he's heard similar complaints from patients about other local pain anesthesiologists, who aren't willing to try an injection unless it's for diagnostic purposes. He doesn't understand this attitude and is trying to help patients improve pain.
My anesthesiologist is now mostly at UCSF and only at my practice occasionally. His partner, who does my meds, refused a referral. Said that because this doc is a diagnostic radiologist he could inject me incorrectly and make things worse. She offered to refer me to another pain practice. They're basically refusing to provide what was once offered, and instead keep pushing for a pain pump trial. Not interested in another implanted device, at least not from this doctor.
So many patients on this forum have complained about anesthesiologists causing much worse pain after nerve blocks. Is this just a rivalry between specialties, or should I avoid the radiologist?
I need rotator cuff repair soon (full tear with separation), which will even further limit my sleeping position for 6+ weeks. Lying supine, even with padding, hurts the sacrum due to the SCS lead damage. I'd like to at least try a block. If it doesn't work or helps only briefly, at least I'll know and cross it off the options list. Would appreciate your opinions and experiences! Thanks!