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ESI Question

kyadog115kkyadog115 Posts: 266
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
HI All...
I know a bit about these injections as I had them in my cervical area in 08 however, My neuro said we he'd do them in the O.R. under mild sedation for me as I bug out over this and those needles. Anyway, I called his office today and they are trying to refer me to another Dr. to do them. I curious as to if you all out there think it matters....in the Op Rm. or being administered by another Dr in his office.

I also know that they are really a temp fix, if at at all.........buut I suppose at this point, short of actual surgery, I gotta give em a try....thoughts please?



  • I have never had these injections but my feeling is thta if you are gonna get that close to my spine I want the conditions to be right. Today these are often done by pain management docs which is what he may be referring you to. Did you call the other office to see what they do?
  • HI Kris..
    No, i didnt ask the Neuro's secretary...I just mentioned to her that the doctor had told me HE would do them under sedation in the OR.....She said she'd check with him and get to me.
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  • I have had several of these injections. The first time I seen my PM doctor was at a hospital and to get the injection there it was going to cost $200 for my copay. He said if I would have them at his office there would be no copay. His office has several rooms that are set up for procedures and have fluro in each room. They are similar to surgery suites only smaller. I have never been sedated for these injections and they are not that bad.

    Give em a try.
  • Paul, the PM doctorsa I have seen have their own OR in their office. The ESI requires flouroscopy (x-ray guidance). I also have sedsation with my injections. The sedation is a combination of versed and fentanyl. I am relaxed for the injection and hardly remember it afterward (a side effect of the sedation).

    PM me and I will provide more info.........Paul
  • You do not want to have an injection unless the doctor is doing it under fluoroscopy. Depending on the set-up, the doctor will have what look like small operating room suites, or sometimes you will go to one of those day surgery places. The important thing to ask is that it is done under fluoroscopy so the doctor can see where he is sticking the needle...and more importantly, where he is NOT sticking it.

    Often surgeons do not do these procedures. They usually work with or refer you to a pain management doctor or a physiatrist.

    I don't have sedation any longer. It takes so much longer and you have to have someone drive you. I decided I could put up with the pain for a minute or two when I started having them fairly often.

    Good luck. Do your homework so you know where you are being sent and what will happen once you get there.
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  • HI
    Thanks for all the replies. I would assume all use fluroscopy machines.........( i would hope anyway) I do agree with the other poster Re: OR costs.
    The neuro's office did not call me back today.. but I will call them Mon. Either way..O R, or this other Dr,,I;ll give the Epidurials a shot & See...
    Thanks for all the input..
  • I think it's good that you'll have sedation with your ESI. I've had it without and was given a pair of Nerf balls to squeeze instead. My doctor said I was a trooper because he's seen grown big men scream. ESI's never helped me and all it did was aggravate my pain and have me suffer for 2 weeks. They are not pushed on me anymore thank goodness. But if it helps you for a month,3 months, or even 6 then it's very well worth it. Gwennie is right about the importance of the doctors using a fluoroscope- it makes a big difference. You also want it done by a doctor with plenty of experience too. Take care
  • SpineAZSpineAZ WiscPosts: 1,084
    I have had these done under OR type conditions but not a true OR. There are many surgical facilities, outpatient centers, etc that have full suites to do just ESI. In all cases these have been done by PM doctors. Although my prior surgeon did do injections, he was fine with me having them done by my PM doctor instead.

    Currently I have any injections done by my new PM doctor. They have a treatment area in their suite complete with a dedicated treatment room with oxygen, machines to monitor pulse, fluoroscope, etc. And they do sedation if requested, they just require you bring a driver. The great part of this is by having them done in the PM's own suite I'm only paying my specialty co-pay - no additional facility or anesthesia costs. And in their practice they have one doctor who specializes in the nerve ablation and discogram type procedures so I had not yet met him when he first worked on me but as long a he was the one in the practice who specialized in those things I was happy.

    Sedation for injections should be light using something like versed. You can get off the table yourself and go sit in a chair. They require me to remain for 30 minutes, give me some juice or water, and let me close my eyes. The versed both sedates you and leaves you conscious but unaware. Great stuff. I then go home and often end up with a good nap.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Thanks for that info. IN retrospect, I most likely should go to whom the Neuro is directing me to as I dont need to incurr OR costs...noe anesthesia


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