Very worried after nerve block

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Very worried after nerve block

Postby stevee620 » Sat Feb 04, 2017 12:28 am

Hello all,
Three weeks ago tomorrow, i had a guided nerve block done by my pain management doctor. The injection site was just below the tail bone. I don't know the exact medical name for the area.
He wrote down on my consent form that a flare up could be one the the side effects. But up until after the procedure, i'd only read general medical sites about treatments and what a nerve block consisted of.
24 hours after the block, the anaesthetic wore off, and since then the pain has been far worse than it was before. I expected at worst to be more sore for a few days, and then maybe no better than before. I did not expect this!
It is really depressing me, and i wish i'd left things as they were, as i was kind of coping with the limitations that the problem was putting on my life. There WHERE times when the pain wasn't that bad at all. If you were to ask me now, or if it were possible to wind the clock back 3 weeks, i wouldn't have had it done at all.
Each day when i get up and feel no difference, i get more and more frustrated and depressed. Will it be like this for ever? i ask myself. I'm finding it very hard to live with that prospect. I've no one to talk to about this as its very delicate. So i suppose i'm just looking for some kind of reassurance that it might settle down eventually.
I have a follow up appointment in April.
Thanks for reading.......
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Re: Very worried after nerve block

Postby Violet M » Sat Feb 04, 2017 6:30 am

Hi Steve,

I had a nerve block once that caused a major pain flare-up. Can't remember exactly how long the increased pain lasted but it was about 4-6 weeks. I guess my advice would be to let your physician know and see if they will prescribe some extra pain medication for you during this flare-up and also use whatever pain relieving therapies you can such as ice, heat, and local anesthetics such as lidocaine spray. Or if the pain is internal, use compounded pain relieving rectal suppositories containing medications like gabapentin, ketamine, baclofen, or valium. It might take a little trial and error to see what works. I would not be afraid to use some opioids but I am partial to the ones that last 4-6 hours rather than the time-released ones and just taking them part of the time so you aren't as likely to develop a tolerance or addiction.

Sorry, I don't know your exact issues so I'm just making general suggestions here. The goal is to keep yourself from getting into a cycle of pain that causes the pain signals to become more permanent in your brain and spinal cord.

Sorry you are experiencing this increased pain. I understand how scary it can be but most likely things will calm down given a little more time. Sometimes just having anxiety can cause you to clench up your pelvic floor muscles which just increases the pain so I think it's important to try to get this under control before it gets out of hand. Hopefully your doctor will be willing to prescribe something.

Violet
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.
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Re: Very worried after nerve block

Postby stevee620 » Sun Feb 05, 2017 5:36 am

Thank you for your advice Violet. I know its difficult to give anything but general advice when you don't know the issues i have. Much as i'd like to "get things off my chest", its difficult on an open forum. But your advice makes sense, and yes, i think that anxiety has a major role in how i'm feeling.
I had been working with a psychologist prior to having this procedure done, and we had made progress in breaking the pain cycle, (unfortunately, she's on long term sick leave at the moment.) Believe me, the neural pain pathways are well established in me after years of dealing with this, and we worked on changing and varying activities that caused flare ups, kind of muddying the picture in an attempt to confuse the mind/patterns of pain.
One thing is certain, i think he put the stuff in the right place. I know that because if i drew a line along which the pain was before, that is, from the rectal sphincter down past/through the prostate down into the perineum, that is where the pain has flared up since the block.
Like you say, its a case of controlling the pain/anxiety and not to get too despondent, and hope it will settle down given enough time. I do take opiate pain killers Violet, but i have to balance them as they can cause constipation which makes the problem worse.
If anyone would like to share their experiences privately, feel free to PM me.
Thanks again Violet,
Stephen.
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Re: Very worried after nerve block

Postby Violet M » Sun Feb 05, 2017 6:00 am

Hi Stephen,

Yes, constipation has been a problem for many of our forum members. The information at this link might be helpful. http://www.pudendalhope.info/node/32

You mentioned anxiety playing a role. I guess it can be difficult to determine whether the pain is causing the anxiety or whether anxiety is triggering the pain. I wonder if you would find Ezer's recent posts on the mindbody approach helpful. He has also recently posted under the username of nonsequitur. He had pretty serious pain for quite a few years but has had great success with the mindbody approach. You can do an advanced search in the search bar up on the right for posts made by Ezer or by Nonsequitur.

You might want to find out for sure what kind of block you had for future reference -- maybe a ganglion impar block? For anal sphincter pain you could try nitroglycerin ointment.

Best,

Violet
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.
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Re: Very worried after nerve block

Postby stevee620 » Sun Feb 05, 2017 6:21 am

Hi Violet,
Great deduction! Yes, ganglion impar block is exactly what it was. I will re read your suggestions tomorrow as its quite late/early here in the UK. Thank you.
Stephen.
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Re: Very worried after nerve block

Postby Violet M » Tue Feb 07, 2017 5:46 am

Other options would be compounded creams that have ketamine, gabapentin, or baclofen. You could also try valium suppositories or some people even insert oral valium pills because they are much cheaper.

Violet
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.
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Re: Very worried after nerve block

Postby stevee620 » Sat Feb 18, 2017 1:00 am

Hi Violet,
Sorry about the delay in getting back to you.
Yes i had some success with a kind of mind body approach, it was by reading Dr Sarno's book about TMS. It worked for my RSI injury, but i've never been able to make any progress with the pelvic pain. However, i had made a lot of progress with my psychologist using a combination of mindfulness and CBT.
Its 5 weeks tomorrow since the block and i can't say that i've noticed any reduction in the increased pain. I've noticed with this condition, that it can flare up really quickly (through whatever activity, or through none) but it settles back down so slowly that i hardly notice it. I'm hoping this is the case with this. With you saying that your flare up lasted 4 to 6 weeks, i imagine it didn't settle down for you overnight either, was that the case? If you can remember. I'm trying to keep positive, and also to break the pain cycle, using painkillers. Thats all i can do at the moment, but my mind inevitably returns to the pain, i can't help it.
Thank you,
Stephen.
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Re: Very worried after nerve block

Postby nonsequitur » Sat Feb 18, 2017 6:41 am

stevee,

I recovered via mindbody healing after 12 years of pudendal pain. It took me 2 years of 100% strict adherence to the mindbody technique to recover. It wasn't quick or easy but it is possible. Patience and perseverance are key. Pelvic pain is probably as hard to heal as fibromyalgia.
“Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways.”
S.Freud
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Re: Very worried after nerve block

Postby Violet M » Sun Feb 19, 2017 5:08 am

stevee620 wrote: Its 5 weeks tomorrow since the block and i can't say that i've noticed any reduction in the increased pain. I've noticed with this condition, that it can flare up really quickly (through whatever activity, or through none) but it settles back down so slowly that i hardly notice it. I'm hoping this is the case with this. With you saying that your flare up lasted 4 to 6 weeks, i imagine it didn't settle down for you overnight either, was that the case? If you can remember.


You are right, It settled down slowly.

Violet
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.
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Re: Very worried after nerve block

Postby stevee620 » Tue Feb 21, 2017 8:08 pm

Thank you Nonsequitur for your input. I've kind of got more interested in mind body relationships during the past year, as i believe, that a lot of my pains, including this one, DO have a psychosomatic base. I'm susceptible to anxiety, and therefore worry alot about things and that manifests itself in all kinds of ways, pain being one of them.
My main worry at the moment, is that in this case, a third party has been introduced to the equation, an actual Physical intervention, the Nerve Block itself! AND, as of having that procedure, my symptoms are twice as bad. And still are over 5 weeks later. I know the way i think could be prolonging the recovery period. But i can't be sure that its only that. Thats the problem, the uncertainty. And the same question i keep asking myself, "is this it for the rest of my life?" I just want some sign that its settling down, but i think its like the old saying, a watched kettle never boils.
Violet, i have been taking clonazepam for a while now which as you probably know is used as a muscle relaxant. I was using it even before the block. What you say about clenching the muscles when in pain is very true. And the importance of breaking the pain cycle as you say is massive. I've had to convince myself that having to take more painkillers isn't a negative sign. So thats what i'm doing. I take co-codamol 30/500 and naproxen.
A little bit more about the actual procedure i had. It was a ganglion impar block of the pudendal nerve, guided by x ray i think. When i was on the table, the doctor asked me which side gave me the most pain. I told him that sometimes it was on the left sometimes the right, and sometimes both sides at the same time. So he said that he would do both sides. So maybe i've had like two for the price of one, more cortisone? more side effects? maybe i'm just clutching at straws, but it crossed my mind anyway. Actually when i went for the block, the pain was quite low, around 1 or 2 i'd say, which makes me even more frustrated that i even had it done in the first place! These are the sort of negative thought patterns that i'm trying to avoid.
I'm glad at least there are forums like this though, as with a condition like this, its proximity, its nature, makes it difficult to discuss with even the closest of friends.
Thanks again,
Stephen.
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