Johns Hopkins nerve blocks

Tesoricx

hi, I'm meeting with an anestesia pain dr at Johns Hopkins -who specializes in oncology - to discuss nerve injections/blocks for mastectomy pain. It's been nearly a year since my surgery and I'm still having dibilitating constant burning and iron-bra type pain. I've been on every pain medication (I've also tried PT, accupuncture, yoga, etc) with no relief. Has anyone had any success with these injections/blocks for this type of pain (or any other pain). Thanks for your help. 

cinnamonsmiles

I have been living with permanent horrible pain from my BMX with node removal on 1/11/11. I have been seeing a  pain clinic since June or July 2011.

If you are talking about Stellate Ganglion Block (given in the neck), they are incredibly painful and dangerous. My pain relief only lasted about 2 weeks. This continued for awhile and finally my doctors and I decided that the pain relief was not enough to warrant more of those.

I switched to getting Lidocaine Infusions by IV. Simply, my doctor starts an IV Bag of Lidocaine straight to the vein. I am monitored closely and find that having it drip over 30 minutes gives me the best therapeutic relief.  I have been getting those for probably 3 years now. I can last about 8-9 weeks with pain relief. I haven't heard of many on here that have pain doctors that are willing to do those. I have had no problems with them. I feel a bit loopy for 2-3 days afterwards, and then loopiness is gone. I take that in combination of my daily meds, Gabapentin, Amitriptyline, muscle relaxer, and occasional vicodin.

In the summer of 2013, at my previous pain doctor's insistence, I had a trial of Neuorstimulaton Therapy. Basically, they put leads in the spine (it doesn't hurt) attached to a small transmitter that will send out what feel like tingles to the spine that reach out to the damaged nerves, blocking the pain signals from reaching the spine to the brain. There are many people that find this works wonder for their pain. It just didn't work for me. 

Always remember, just because one person has had one reaction to treatment whether it be positive or negative, does not mean you could or would have the same end results.

I literally feel your pain and hope you find some relief.

What medications and dosages have you tried?

P.S. Due to long term,  high dose Prednisone use for almost a year due to lung conditions unrelated to cancer, I have diabetes. I have found that the Lidocaine Infusion also helps with diabetic neuropathy in my feet that is just like chemo related neuropathy.

NatsFan

This is a non-b/c related case, but after wrist surgery last year, my husband suffered from Chronic Regional Pain Syndrome in his left arm - horrible, constant pain in his arm, wrist, and hand, with swelling, contracture of the fingers and other nasty complications.  Basically they said it was like a pain nerve got "stuck" in the full "on" position, and kept sending pain messages to the brain even though there was nothing physically painful really going on.  Fortunately the surgeon referred him to a Pain Clinic.  Along with physical therapy, gabapentin, and pain meds, he received three of the stellate ganglion nerve block shots in the neck.  They were done under light anesthesia - he was somewhat conscious through them and could respond to commands, but he felt very little pain.  He got immediate relief from each of them - they took the pain down from a 10 to about a 6 each time, and the effects persisted long enough to allow at least a few sessions of physical therapy to take place that helped restore function and calm the overactive pain nerve. Although the effects of the blocks lessened over time, each block gave him a longer period of relief than the one before, and the pain never got back to its previous levels.  It's been almost a year, and he's now pain free.  His hand is about 90% functional. But yes, these blocks must be done by a skilled professional as there is risk if they are done incorrectly.

We were given info about the neurostimulator - that would have been the next recommended step had the nerve blocks and meds been ineffective.  

As giantgarden says, everyone is different.  It sounds like you're at a good pain center (I had all my surgeries at Hopkins).  They should be able to review all your options, giving the pros and cons of each, and give you enough information so you can make an informed decision.  Giant - I'm glad you've finally found a therapy that gives you some relief.  Chronic pain is so very frightening and debilitating.  My dh was very lucky that the surgeon recognized his CRPS quickly and got him into a Pain Clinic promptly - from what we learned, the longer it goes without treatment, the more likely it is that the nerve will stay "stuck" in the full "on" position and full permanent relief becomes less likely.  Good luck!

Concernef1

tesoricx

You have a chronic regional pain syndrome that can be treated with pulsed radiofrequency or energy waves done under X-ray guidance. It is non destructive resetting of local nerves that is available in the Netherlands and American pain relief in Yankton South Dakota. You can read articles by dr Menno Sjluiter who trained Dr William Cohen. American Pain Relief Institute. 695-665-5225

Good luck

Concernef1

EileenKaye1

Tesoricx-Fatgrafting seems to have solved my problem with post-masrectomy pain. Let me know if you have additional issues. Eileen