Wednesday, March 23, 2011

More cortisone, please.

You know things aren't going well when you count the days or hours until the next time you can get a 14 gauge needled shoved into your abdominal muscles.  Well, ever since I had my first round of injections 2.5 weeks ago, that's what I've been doing.  To refresh your memory--2.5 weeks ago I had three injections.  Two in the middle of my right rectus abdominis muscle, and one in the middle of my left.  When I had those done, he asked me to point to the most painful spots.  It is VERY difficult for me to pinpoint the pain.  It hurts all over my abdomen.  So I had him inject right in the middle of the muscles.  Those injections helped, but they also made me realize that the majority of my pain was actually coming from the border of the rectus muscles...not the middle of them.

So, today, I was bound and determined to have him inject the correct areas.  And that's why I ran without the TENS yesterday.  So I was ready today when he asked me where to go with the needle.  The can feel them.  They feel like really thick guitar strings that you can almost pluck.  It's the lateral side of my rectus muscles.  So, again, he had me rate the most painful spots.  Only this time we'd do 6 injections instead of 3...allowing us to cover a larger area.  So I pointed to them.  The worst spot is mid-way down on the right side.  The second worst is just above that, very close to my ribs.  Third is mid-way on the left, and fourth is the lower right side.  The last two were on the left.  He marked me all up.  I pretty much had mirror images on both sides.  We had to be careful (or, rather, HE had to be careful) with the high ones, as a slip of the needle could cause a pneumothorax (collapsed lung).  He promised that wouldn't happen.  But you never know with me.

He had me sit up this time.  The nurse sprayed the completely ineffective cold spray on the first spot.  I don't know why they even do that.  Part of the ritual, I guess...but it does NOT work.  Then he stabbed the first part with the needle, and moved it around in the usual fashion.  That actually felt kind of good.  I think maybe the mechanical disruption of the muscle with the needle gives me some relief.  Anyway--he moved on to spot number two, three, and so on.  The pain did not bother me too much...except for in those two up by the ribs.  OUCH.  Those killed.  But, alas, I made it through all six.  Tim even took pictures.  What a guy.

He actually injects me with cortisone AND lidocaine.  The lidocaine numbs me temporarily (less than four hours), and the cortisone should decrease the inflammation (though this can take up to 7 days).  So, as soon as we were done...I strummed those guitar strings and it didn't hurt.  Totally numb.  Oh, that's another thing--he thinks I need to stop poking myself.  Whenever they hurt, I just automatically press on them.  He thinks this is keeping them aggravated.  So I have to consciously not press on them.

So, as soon as he finished, I felt a lot better.  But I could tell something else was still hurting a little.  Sort of on my right side, and sort of below the injections on both sides.  I can't pinpoint it exactly, but there's still something there.  I think it may actually be from the TENS unit (it can make your muscles sore), but I'm not sure.  That's frustrating on one hand, but I'm learning to expect it.  It's trial and error.  I'm only aware of the parts which hurt the MOST...until those are numb.  Then all the surrounding "hurts" begin to show up.  If only I could have more cortisone...then I'd just have him inject EVERYTHING.  Alas, that's not the deal.

So I go back in two weeks, and then again April 20.  Those are my last two injections prior to May 1st (marathon day).  Hopefully I'll have sustained relief by that day.  I'm hopeful, but I'm also realistic.  The last time I was injected, I was hoping to be completely pain free.  It didn't happen.  I don't want to disappoint myself again.  My condition is very complex, and thus so is the treatment.  Most of the time, people have two or three trigger points that give them grief.  The doctor injects them, and they're pain free.  But my abdominals are full of them.  He even described the right side of my abdomen as being "one big trigger point."  It may take a few more visits with Dr. L to find ALL the spots.

The numbness is beginning to wear off already.  And, from last time, I know that I'm going to be EXTREMELY sore tomorrow and probably into Friday.  I have 14 on the schedule tomorrow.  Kathy's joining me and I have every intention of finishing the run.  I might strap the TENS on but leave the power off.  That way I have it just in case.  I know one thing:  I'm taking a gel with me!

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