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kyadog115kkyadog115 Posts: 266
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Hi All..
Just 1 quick question please.I have a scheduled injection in the L-5 area due to herniation and S-1 impingement. ITs being done in the or by the Neurosurgeon. Will I need somebody home with me after words and for any length of time...like a few days, or will i be ok right after?


  • I think most people are pretty much OK afterward. You will need someone to drive you home...but you probably could do it if you had no other choice. I assume since it is being done in the OR that you will be given twilight sedation. They will keep on eye on you for a period of time afterward -- I think I was about an hour or so...can't really remember because I don't have them with sedation any longer.

    One word of caution: if at all possible, arrange your schedule so you can take it easy for 72 hours after the injection. Most doctors will not tell you to do this. But you will get the most from the medication if you can lay low for at least the first two days, and hopefully three.

    The injection just goes into a generalized area. If you are on your feet, the heart pumps harder and the blood circulates more than if you were sitting or lying quietly. This activity causes the medication to dissipate more quickly. Thus it will have a shorter period of time in which to work. After 72 hours, it has pretty much been used up, so then you can resume normal activities.

    Most doctors will tell you to just take it easy the rest of the day. I was first told this by a chiropractor whose husband has bad back problems...and then my new PM who is from Vietnam (which is irrelevant!)requires all his patients to follow the 72-hour restrictions. You don't have to go to bed. You just need to sit quietly, read, watch TV, work on computer...but nothing that will get your rate rate up or cause you to be "active."

    I figure, as long as you're going through all the trouble and expense of having the injection, you might as well give it the best chance of working.

    Good luck. I hope this will help you out.

  • HI
    Thanks for that info. I thought I heard somewhere about rest for like 3 days afterwards.Is the Inj painful? Will I feel it? I believe I am going to be given mild sedation...i hate needles and am nervous about this.....I,like any1 do not like Pain !!!

  • That's great you're getting twilight sedation that'll help with any pain or pressure you may feel. I never had twilight sedation for the injections but I do take half a pill of my own before hand. I last had my epi on March 3rd and I was able to walk around the block today without my cane though my leg is a bit sore after. But I can move better since getting that injection. I hope you have success with yours too. Take care and deep breathe it's always worrisome for something new. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Paul, you should rest for a few days in order to have the medicine give you the full effect, if you are up and about all day and getting your blood pumping it will move the medicine elsewhere in your body. If you have to go back to work the next day you will be ok, but its best to take it easy for a few days if you can.

    All the ESI's I have had they made sure I had a driver prior to them even doing the procedure, I would say this is a must. Once you are home you should be fine with nobody around, you will probably just want to take it easy and sleep most of the day.

    As far as the procedure, you will be fine with a sedative, let them know how much you fear needles and maybe they can give you a slight higher dose. Put your head down and go for it and you will be fine, lets hope this gives you some long term relief!
  • Your back might feel really sore after the ESI because the meds they give you during sedation wears off and then it will hit you. I relied on an ice pack on my back fore the pain and heat pad on my leg for the spasms. What happened to me was the ESI aggravated my pain and gave me nerve pain and spasms from hell. It lasted 2 weeks and I'd go back to the doctor telling them please no more. I'm not trying to scare you, it's just my experience but I also believe in telling it how it is (or might be, hopefully you don't have the same experience).

    So, keep the ice packs and heat pad ready. Take it real easy because you don't want a spinal headache either. They will go over this stuff with you where you're having the ESI done. It may take up to 5 days for the full effects of the injection to kick in. If it doesn't by then, it's probably a bust.

    I hope the ESI helps, take care. :H
  • I don't know, meydey, when I got my ESI, I did not feel any benefit to it until the 3rd day. By the 7th day, it had fully resolved my problem.

    For mine, I drove myself in and we did the procedure.
    The doctor did only local anesthetic and advanced it just ahead of the needle every step of the way. I only felt the initial injection for a second or two at most.
    My leg went numb and stayed that way until about 2 hours after the procedure. It woke up and I was good to go.
    Drove on home and took it easy. I felt totally ok tho.

    Goodluck kya and don't worry too much.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • There was a strick order that you must not drive after the block at my hospital. There are a couple of good reasons; one, that you possibly are sedated with a very potent anesthetic, and your motor skills are depressed with these drugs. You could kill or be killed on the road. Of course, if you have no one available that day, they can usually call you a cab for you.

    And before someone asks...it is propofol that is usually given for most sedation cases like a lumbar block. But I see a recurring theme of how cognizant the patient
    really is...these patients may seeem fine, carry on conversations, but within 5 mins, they are repeating themselves...this occurs over and over again for about 30-60mins after the block. This is a great indication that they should not be driving.

  • Thanks everybody for the input. "Propofol" as in Michael Jackson? Oh boy!! I'm gunna have someone drive me there and then home its just that I live alone and really dont have anybody to help me afterwards, that was my concern,if I'd be able to take care of myself when home. I'm gunna grin and bear it and go for it. I need some relief, I truly hope this works, I dont wanna have to do it twice and I really do not want surgery again...
    Thanks everybody !

  • Yes, you will need someone to drive you home after your injection. You will probably feel tired when you get home and a little bit sore at the injection site. When I got home, I slept for about 4 hours straight. I had slight discomfort at the injection sites and the ice packs worked very well. You should have no problems functioning when you get home.

    I just had my first set of nerve blocks done a couple of weeks ago, so I understand being nervous about having these done.

    I was given Versed for light sedation and it worked very well. There are a couple of other members who also received Versed for their injections. It doesn't knock you out...but you will feel nice and relaxed.

    I hope your injection goes well and provides you great pain relief. Mine worked wonders and I will have them done again, if need be.

  • Tammy,
    Thank you for that info. Much appreciated indeed. I am nervous , i hate needles. Since u said you'd have it done again,I assume you feel as though it's not too bad a proceedure. That helps me feel a bit better about it all. I have some anxiety issues anyway and this has surely compounded those. Since I do have a herniation, I'm thinkin eventually I'll need another surgery.... I hope not but sometimes my mind always thinks the worst..

    Thanks again & good luck to you...
  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    Hope that your fears have lessened somewhat because of the good info everyone has given. I had my first cervical ESI on March 12 and I was very anxious about it. I didn't think they were going to use sedation but they did. They gave me Versed and it wasn't bad at all. I did feel the first needle when they numbed it but it was just a matter of seconds. I'm having another one April 9 and I'm not dreading it now that I know what happens. Just thought I'd let you know that it's not bad at all. It's all over before you know it.

    Good luck
  • As you can tell, I didn't have great experiences with ESI's. I had 3 without sedation and was only given nerf balls to squeeze. My doctor said I was a trooper because he's done grown men who screamed. Sorry about that. Take it from me, sedation is better and you have to have a ride home- it's worth it.

    I was given Versed and Fentanyl citrate? on my last 2 ESI's and I don't remember one thing except being awakened in the recovery room. I was sleepy for the rest of the day and that's fine compared to laying on your stomach squeezing 2 nerf balls while your doctor is playing Poke A Nerve with a giant needle. Sorry, I couldn't help that :D

    You'll do just fine. If I did it, you KNOW it's a piece a cake for you. Take care
  • It's not that big of a deal, so don't get yourself nervous. It's a minor procedure. You feel a pinch from the local anesthetic, then it is just a little bit of pressure. When the medicine is injected, you will feel a slight pain down one or both legs.

    They did tell me I needed a ride, but sometimes my "ride" was in the "cafeteria" :) I also wasn't sedated, so I never saw the point in dragging someone along with me.

    I used to get 3 a year for around 8 years, so trust me, it's a cake-walk compared to a discogram ;)
  • Thanks Debbie..Yes, I do feel somewhat better about it. I do want the sedation though.


  • MeyDey,,'
    You had to throw in the part about the "Giant Needle" didnt you?..lol. I hate needles !!!
    Thanks for the input, appreciate it.

  • Thanks for the comment bro...Never had a discogram, dont want one either...
    Take Care & Thanks
  • Please bear in mind that each person's comments are a reflection of his or her own experiences with injections and nerve blocks. Different doctors have different ways of doing these procedures...so you won't really know what your doctor is going to do until you have it done.

    Since your doctor offers the option of sedation, you should take it. And trust me, you will not be aware of the size of the needle. I used to be given versed but then I switched doctors and this current one does not believe in sedation. Given your acknowledged anxiety around needles, I think you'll be more comfortable with sedation. You do need a ride home...but I think you'll be able to manage just fine on your own, once home. You'll be able to get up and move around as needed. The restrictions I mentioned in an earlier post are just to keep the medication from dispersing quickly. They are not because you physically will not be able to do the usual activities.

    I don't know if anyone else has this reaction, but I get wired on whatever steroid medication my doctor uses. I typically do not sleep for the first 24 hour period after I get home. I may feel physically tired, but my brain races. Oh, that's another good reason to have the sedation! I think that must counter-act the stimulating effect of the steroid so the two kind of balance each other out. I do recall sleeping a lot after injections with my previous doctor who used sedation.

    Have you learned breathing exercises to help deal with your anxiety? If not, now would be a good time to to learn. There are also some very useful CDs available on relaxation and for chronic pain management. They teach techniques that I find very helpful as I go about my daily life -- they're great for having a MRI, getting injections, awaiting surgery when they take you into the holding area with no TV, books, magazines, etc. and then both your surgeon and anesthesiologist are delayed (in separate surgeries) and you're stuck there for three hours with nothing to do but think about the upcoming procedure...etc. I use breathing techniques and visualization techniques all the time to calm myself and slow my breathing and heartrate. I highly recommend you look into it, if you haven't done so already. I would think it would help with your anxiety issues.

    Anyway, good luck. You'll do just fine, and then realize it isn't really that big a deal!!

  • Gwennie..
    Thank You so much to trying to put my mind at ease. That is very thoughtful of you. At various points in my life, I have in fact done some breathing exercizes and listened to relaxation tapes and such.I'm fairly certain once its over,I'll look back on this apprehension and wonder why I expelled all this energy on nothing but, this is sorta my "make-up"

    Thanks again...
  • I, too, felt hyped up for a few days after my nerve blocks and injections. I had an elephant dose of steroids, though.

    I think some of us can be more sensitive to the steroids, than others. My doctor told me she will sometimes see this with people, but it isn't the "norm".

    You'll do great with the sedation. You won't see the needles at all. You will feel very relaxed and may even sleep a little bit. If a bomb would have went off in the operating room, it would not have phased me. That's how relaxed you will feel.

    Your doctor will make you very comfortable, particularly when you express your anxieties. Be sure to tell everyone you talk to, what you have told us here. They want this to be a pleasant experience for you, in the event you need to have more done.

    When do you go in to have these done?


  • hey paul
    i have had several over the yrs and each pain mang doc is different..
    so something you better discuss ahead of time..
    i explained very clearly this last time to the doc i wanted to be out..
    had one doc said she give me mild sedation and it did nothing for me..and i discused with her also..so every doc is different..
    i had 3 facet injections and done by my ortho with numbing injection first and i felt some pressure..
    but were every i had done when they scd me i always had a rn call me and explain everything...
    instuctions for before and after care..
    good luck hope it helps
    and remember ice pks help alot later that day and day after
    go slow..
    neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
    good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
    daily goal do good thing for someone.
  • Hi
    Thanks for writing. The surgeon is aware of my apprehensions. He in fact did a Micro'd on my L-5 Back in April 09. I fell this January, slammed my back down very hard on steps and re-herniated this disc...so he "knows Me"..lol

    Inj's are scheduled for 4-14 in the operating room..


  • SpineAZSpineAZ WiscPosts: 1,084
    I have had a ton of ESI both cervical and lumbar. I've always been given the choice as to whether I want sedation or not and I choose the sedation. My current Pain Management doctor has a single procedure room where they can do ESI, nerve ablations, discograms, etc. They have 4 lazy-boy type chairs for the patient to sit in right after. My prior PM doc required that I eat nothing after midnight the night before, but my current PM says a light breakfast is fine. Another benefit of my new PM is I only pay my co-pay when having an ESI or discogram, etc, since they do it in their suite. Previously I had to pay my co-pay and then got a facility bill as the ESI was done in a surgical center.

    When twilight sedation is used the primary medication given via IV is versed. It's sort of like valium. Versed allows you to be semi-conscious while in the procedure room and then you wake up quite quickly after but will be very lethargic. Often they can also give you pain medicine via the IV, most frequently demerol or fentanyl. Versed is also used in procedures like colonoscopies and dental procedures where minor sedation is needed. While in the procedure room or OR you are able to respond to questions, to some degree, but you will have no memory of this and often you remember versed starting and the next thing you remember you are getting released. Most facilities keep you 30 minutes or so to see you wake up a bit more.

    If you have sedation you will be required to have someone drive you home. You'll get a really good nap, usually, after coming home as there is some versed left in your system. If you don't have the twilight sedation you will not be required to have a ride home.

    You'll want to take it easy for the first 24 hours both due to the sedation wearing off and the after affects of the ESI (if you have any increased pain). But they will tell you that you can return to normal activities at 24 hours. Some people have no increase in pain post-ESI and can return to normal activities and others need a day to rest. When I was working, if I had the shot, I was able to return to work the next day in most cases. I've always tried to have the ESI on a Friday so I could take it easy.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • HI,
    Thanks for that reply..
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