Does Hibner require CT guided block?

Nerve blocks using many techniques, and medications - options discussed in detail
Faith
Posts: 697
Joined: Fri Oct 15, 2010 5:15 pm

Re: Does Hibner require CT guided block?

Post by Faith »

Celeste wrote:
Faith wrote:That's very encouraging about the use of the On-Q and Botox to avoid surgery in some patinets. Thanks for posting!
Sadly, none of the people who post here have had anywhere near those kind of results.
I have wondered where those people are too Celeste. But I think there are a lot of people with PN that we don't know about. I know a lady in my small hometown that also has PN, but she doesn't get online and read much because it freaks her out too much. Her first block helped her greatly and she didn't flare (but you don't read about that much on here). I think a lot of people don't want to post on forums because 1) they feel uncomfortable talking about their private areas online 2) it's depressing to read all these horror stories and see that so many people never get better. If I ever get a lot better I probably won't hang out on the forums because I have found I actually do better emotionally and sometimes even physically when I am not dwelling on my pain and reading about everyone elses on here. I'll be out making up for lost time with my daughter! I mostly use the forum because I am a nurse and am interested in helping others as well as researching as much as I can about my condition. I do appreciate the mods and everyone like you, Celeste, who has greatly improved and shares their experiences because it is encouraging. But just because we don't see people like pianogal mentioned on here doesn't mean they don't exist.
-11/08 vulvodynia began around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
paulette
Posts: 184
Joined: Sun Sep 19, 2010 6:13 pm

Re: Does Hibner require CT guided block?

Post by paulette »

Who on this website has had the On-Q? I still don't understand what it is. Where can I find more information?

Something that might be of interest to someone is an article, "Acupuncture and Cold Laser Therapy For Pudendal Nerve Pain," by Craig Amrine L.Ac. He illustrates where he does the acupuncture and the cold laser. He claims to have had good results.
RJR
Posts: 155
Joined: Mon Nov 15, 2010 11:26 pm
Location: Northern VA

Re: Does Hibner require CT guided block?

Post by RJR »

Paulette,
I was Dr Hibner's second (?) On-Q Pain Pump patient last Spring.

Procedure: Using CT guidance, an interventional radiologist will insert catheter next to nerve. The tip of catheter permeated with small holes that diffuse the Marcain over nerve for 2 or so weeks. Purpose is to test and hopefully reverse Central Sensitization and lead to possible pain reduction w/o surgery.

My Result was not successful. The report stated: “…additional contrast injected, demonstrating no opacification of the more anterior Alcock’s canal” …failed attempt to access Alcock’s Canal, impeded by loss of the normal tissue planes…” Per Hibner: “Scar tissue”. And when I had surgery in November, Dr Hibner found lots of scarring on my STL.

Google On-Q and you can download the manual. On-Q is used in various surgeries and recoveries as an alternative to oral opiates, etc.
Hope that helps,
RR
Cyclist till perineal pain onset R side (Apr'08). Dx with PN (Aug'09). Lyrica gave 30% pain reduction. Potter MRI (Oct'10) validated at surgery with Dr Hibner (Nov'10) - found nerve attached to scarred STL. Now sitting 10 hrs/day vs 1 hr/day pre-op. Occasional MRI-guided steroid injections by Dr. Jan Fritz at Johns Hopkins. Surgery video = http://www.youtube.com/watch?v=6FDwana6SQU

Deep neuropathic burning pain flares have been gone since surgery...Grateful to Dr Hibner.
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Celeste
Posts: 574
Joined: Sat Sep 18, 2010 2:24 am
Location: central Ohio

Re: Does Hibner require CT guided block?

Post by Celeste »

Faith wrote:
Celeste wrote:
Faith wrote:That's very encouraging about the use of the On-Q and Botox to avoid surgery in some patinets. Thanks for posting!
Sadly, none of the people who post here have had anywhere near those kind of results.
I have wondered where those people are too Celeste. But I think there are a lot of people with PN that we don't know about. I know a lady in my small hometown that also has PN, but she doesn't get online and read much because it freaks her out too much. Her first block helped her greatly and she didn't flare (but you don't read about that much on here). I think a lot of people don't want to post on forums because 1) they feel uncomfortable talking about their private areas online 2) it's depressing to read all these horror stories and see that so many people never get better. If I ever get a lot better I probably won't hang out on the forums because I have found I actually do better emotionally and sometimes even physically when I am not dwelling on my pain and reading about everyone elses on here. I'll be out making up for lost time with my daughter! I mostly use the forum because I am a nurse and am interested in helping others as well as researching as much as I can about my condition. I do appreciate the mods and everyone like you, Celeste, who has greatly improved and shares their experiences because it is encouraging. But just because we don't see people like pianogal mentioned on here doesn't mean they don't exist.
Everyone who has been treated for PNE exists, with some kind of result. Many never post on the forums because they only want to find a doctor and deal with the doctor. I know quite a few TG surgery cures who have never once posted on the forums; it just isn't for them, period. Not everyone needs community, I think.

I was just remarking that every time somebody from this forum hears of the encouraging news of non-surgical cures in Phoenix and tries it, they are always disappointed. You really would think just one would have good results. Maybe that day is coming. Maybe it will be you?
PNE as a result of childbirth, 2002. Treatment by the Houston team, with neurosurgery by Dr. Ansell in 2004. My left side ST and SS ligaments were found to be grown together, encasing the pudendal nerve.

I am cured. I hope you will be, too.

There are no medical answers on the forum. Your only hope is to go to a doctor. I was very happy with the Houston team, which has treated the most PNE patients (well over 400), more than any other US provider.

http://www.tipna.org
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Violet M
Posts: 6610
Joined: Mon Sep 06, 2010 6:04 am
Location: United States
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Re: Does Hibner require CT guided block?

Post by Violet M »

Faith wrote:Those of you who are Hibner's patients. Does he require a CT guided block in Alcock's canal before considering you a surgery candidate or will he take other blocks you've received elsewhere that were done under fluroscopy? Or does he make you have a block by his radiologist or pain management doc or whatever he uses first?

I read in his article in The Journal of Mimimally Invasive Gynecology that he does 3 CT guided injections at Alcock's canal. Anyone know why he doesn't do any at the ischial spine level at the sacrospinous ligament?

From what I've heard, Dr. Hibner will require at least one block from his team but otherwise will accept previous blocks. My understanding is that they don't do separate ischial spine/alcock's canal blocks but rather they inject a larger volume of solution so that it permeates both areas since the two areas are so close together.

These are the answers I've heard to these questions but I'm sure Dr. Hibner could always change the protocol so it would be best to check with his office.
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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