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Pain Management Message Board


Pain Management Board Index


Hey Bilbo, Without any actual trauma, It would be unlikely that things fell aprt in a few days after the branch block. More than likely, while you felt beter/numb, your over idd thngs testing out the result of the blocks, too much turning and twisting of your head to see how well it worked. This would also agrivate as spinal fluid leak if the dura was nicked during the procedure

Ideally the RFA would do the trick, but untill then, using something proportional in strength to your base dose would work as a BT med. 5mgs of vicodin is maybe 3% of your total daily opiate intake, I wouldn't expect it to help. Purdues formula is take the total daily dose of OxyC, devide into 2 doses, 60 mgs BID, use 20%-30% of that dose as a BT med, 15 mgs of oxy IR, Roxicodone, or OxyFast wold be 25% and significant enough to actually help, something equal in strenght to that, like 2-4 mgs of dialudid, 15-30 mgs of MSIR, even 2 Norco would double what your taking.

As far as imediate MRI or Xrays, When they do the RFA you would be under Flouroscopy, which wold more than likely show any major problem like hardware snapping, vertabrea shifting, "spondyliosis", or arthritic spurs impinging nerves. Flouro is a good diagnostic tool because you can see things in motion.

If they see anything that abnormal, they would likely stop the procedure to speak to you about addressng any new problems. A branch block that succsfull, would mean the RFA is the next step, likely your going to need something stronger than Vicodin after RFA untill the nerve completely dies and settles down. 15mg Roxicodone or generic 15 mg oxycodone tabs would be about twice the strength your taking now and doubling a dose of anything is about the most you want to do in one step.

Sorry Billbo, sounds pretty miserable and being able to take a 2 hour trip isn't an unrealistic expectation. The headache, may also be from nicking the dura and causing a spinal fluid leak, [B]which would explain everything[/B]. Does layng down help the headache/nausea and standing up make it 10X worse, if that's the case, you likely have a spinal fluid leak causing a spinal headache,The brain sets down on your skull from loss of fluid and would cause every symptom you describe.

A blood patch can be done if you have a good anesthesiologist? If the headache continues and your vomitting, call your PM doc asap, or go to the ER because you could also pick up bacterial menningitis from a spinal procedure like this. They may be able to do a blood patch there, or may simply leave it to your PM doc to fix and tell you to remain flat on your back untill he can. Either treatment is consideed exceptable. Whoever did the MBB should have a protocol for spinal fluid leaks and be available to treat the problem. It is unreasonable for a doc to leave town with nobody on call the day after any spinal prcocedure.
Good luck, Dave

I'm leaning more towards a spinal fluid leak, if I had to guess. Been there and done that several times from ESI's and the pump trial.





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