May 23, 2008

Pain in the Ass: CT-Guided Pudendal Nerve Block

On Wednesday I had a CT-guided pudendal nerve block.  I hadn't anticipated it would be such an ordeal.  2 days before the appointment I received a call from the office saying that I had to come over an hour before the procedure, I couldn't eat or drink after 6:00 am that day.  I'm under a ridiculous amount of stress at work and unfortunately, I have my fair share at home as well.  I began to have some misgivings.

My mom was kind enough to go with me for the block.  I had to get completely undressed and wear gown.  I got an IV on the top of my left hand.  I was hungry, but cool as a cucumber.  One of the nurses even said, "I've never seen a woman this calm before this procedure!"  

I guess she jinxed me.  I finally got to meet the doctor who was performing the block.  He was very nice, but I think I got a little more information than I needed.  He told me that I needed to be awake enough to tell him if he punctured the nerve.  

That sent me into a bit of a panic.  I was all ready to be knocked out.  I thought all I had to do was lie there and look pretty.  I didn't want to be awake and in pain!  What if he did puncture the nerve!?!  What if this little procedure only made me worse?!?  

I started to feel hot and nauseous.  My mom got one of the nurses and I told her that I didn't want to do it, that I had changed my mind.  She was very surprised.  I was no longer her super cool patient.  I was a hot mess.  I was ready to rip the IV out of my hand myself.  

My mom suggested that I speak to the doctor and see if he could put my mind at ease.  I have to say, everyone on staff that day was just wonderful.  They were patient, understanding and kind.  The doctor and the nurse administering the anesthesia assured me that the risks were minimal and I would be well cared for.  

I decided to go for it.  I had to lie on my stomach with my arms stretched out in front of me.  My ass as in a tube for the CT.  Once they had everything lined up, I was given a local numbing injection in each butt cheek.  It hurt.  Then the big needle was placed on the left side.  "OW!"  Then another big needle was placed on the right side.  "OW!"  I'm not gonna lie.  It hurt.  Those needles were long!

After that second "ow" I was out.  I woke up feeling very happy and very relaxed some time later.  That was a wonderful sleep.  I felt so relieved about everything when I woke up.  Apparently, every time I said "ow" the nurse gave me another dose of twilight.  Good deal!  

I'm not nearly as numb as I have been with the previous nerve blocks.  Unfortunately, I have another raging yeast infection from a course of antibiotics.  And let me tell you, I can feel that!  I wish I couldn't.  

My butt is still very sore from the injections.  I feel like I got a tetanus shot in both cheeks.  

The steroid in the injection is not supposed to take effect for about a week, so I'll keep you posted on if I see some improvement.  I really need to nix this yeast infection first.  It's completely tainting my results and ruining my day!

I have a followup with my doctor some time in the next two weeks where we'll discuss surgery.   The CT-guided nerve block is supposed to be a good indicator of whether or not you should have surgery because it is so much more accurate.  The needle is in the potentially compressed canal.  

Hopefully, I'll have a clear indication of where to go from here.    


lora said...

I'm excited to hear the results! Good for you for being so brave!

Talk to your doc about twice weekly Diflucan. I've been doing it for two months and my whole life has changed. I'm not 100% by any means, but I'm not crying every morning when I put on my pants.

I have almost always tested negative for yeast cultures, but apparently there is more to the treatment than just that.

I promise to get a post up soon!

Big love to you from me!

Amelia T said...

I'm concerned to hear your additional problems with yeast again. I guess it is a bit of a personal crusade because I had the run around with the drugs approach to yeast and it became a ever decreasing cycle of effectiveness. In fact I only got to the end of the road with yeast problems when I really grasped the 'lifestyle change' approach and persisted! I wrote a recent article about this on hub pages if any interest:
I hope your treatment keeps progressing positively and will keep an eye on the 'blog'! Good luck

Fighting Fatigue said...

Hi! I wanted to see if you wanted to exchange links with me to another chronic illness blog I have. It is called IC Disease and the link is at I will go ahead and add you over there.

a woman in pain said...

Dear Fighting Fatigue,

Thank you so much for the add. I will include your site in my links.