The Procedure

I arrived about half an hour early for my 0830 appointment. The first thing that happens after the receptionist checks your name off a list is she hands you this big, blue, cumbersome pager that she tells you will buzz you when they're ready for you to sign paperwork and check in for the scheduled procedure. Mine was number 13, which just happens to be my lucky number. Things were already looking up and it was only about five minutes after 0800. The next half hour I spent trying to get comfortable in the chair despite the increased waves of pain in my lower back, radiating down my left leg that had gotten worse since the Day at the Park on Saturday when I bit off more than I could chew in the way of moving things from one spot to another and grilling 160 hamburgers.

When the pager went off, I went back to the receptionist to fill out information for insurance and put my signature on receipts of medically necessary information and policies on HIPPA and my rights to privacy. The receptionist told me that when my pager went off next, it meant that the nurse would be ready for me and I was to hand the pager over to Mom who would be buzzed after the procedure was complete.

I'd barely gotten back to my seat when I was buzzed the second time and walked to meet my nurse, Emily, who took me to the back and had me sign off for everything that was coming next. She asked me the routine questions about negative reactions to medications, problems with eggs, allergic reactions to shellfish, and dermatological issues with adhesives and latex. I do nursing assessments for a living, so I was already familiar with the need for her collection of my data. Emily asked if I'd ever had an injection before, so I took the cue to tell her that I was an epidural virgin and extremely nervous. She took me back to a curtained area and had me remove everything down to my undies and replace it all with a flimsy hospital gown that opened at the back. After this, I settled on the bed and covered myself with a blanket that felt like it had been microwaved or run through an industrial strength dryer for about half a minute before it was given to me....warm and inviting.

Next, I was asked about my current rate of pain which I've basically been living with for over a year, a pain which has steadily increased to intolerable levels over the past two semesters. I gave my level a four, explained its origins and radiations, and she explained that the injection would be to the left of my spinal cord, and that I need not be nervous as another nurse would be coming to give me "some relaxin' medicine".

As if on cue, another nurse named Janice came in with all the tools to start an IV. I have to say that I was very impressed with the speed and efficiency of the whole staff; however, I am particularly indebted to both Janice and Emily for taking their time in explaining the procedure, taking me through all the upcoming steps in the process, and having generally amiable and caring demeanors. I'd read up about degenerative disc disease and epidural steroid injections online, researching the causes and risks and potential complications, even watching video of procedures and taking their accompanying tutorials as if I were applying for CE credits. It's always nice to be well-informed.

Janice took her time with both arms, thumping and carressing several areas before finding the best option to poke. She started the IV on the first attempt and I barely felt the gauged needle sliding into my vein. I hope I'll always take that kind of time with a patient. I hope I'll always be able to make the insertion on the first attempt.

After the line was set up and taped to my arm, I looked down and saw that it was going to hurt when that tape came off, but I wouldn't worry about that until the time came. Next, I was greeted by Dr. Majors, an attractive and soft-spoken blonde who alleviated any further fears that I had, telling me that I would be drinking juice before I knew it. She was correct.

I was wheeled into another room, clearly a more sterile environment for which I had to don the dreaded shower cap before tranferring from my gurney onto a harder table that had a specially placed hole for my face to poke through... not unlike a massage table. Just as one of the nurses (a hottie, I think his name was Kyle) began pulling my gown open at the back and slathering something cold all over my back (very nice, Kyle), another nurse named Ginger appeared with a syringe that she told me was Versed. As she pushed the medication into my IV, the last thing I remember was thinking that I was awfully alert if they were about to begin. I vaguely remember something of a sting at some point and have some fogged recollection of eating some crackers and drinking pineapple-orange juice cocktail before riding in the car with Mom on my way home.

Now that it's over, and I've spent the day sleeping, there are a few things that stand at the forefront of my mind from the literature I received and the articles I researched online. One is that the medication takes anywhere from 12 to 24 hours to begin working on the inflammation, with maximum relief not beginning until approximately 72 hours following the procedure (that's Thursday morning at approximately 0900/0930). Also, the information I've received re-iterates that symptoms typically worsen before they improve (I'm about thirteen hours out now...pain is right at a three, a four/five when I move around). Finally, the results can go one of two ways. Either the injection will work and keep working for several months, or the symptoms will simply continue, perhaps worse, and I will have to contact the staff to schedule another injection.

For now, it's just a wait. I'll take the medicine as prescribed and hope that the epidural steroid will do what it was intended to. I have too much going on to let anything like this get me down anyway.

I'm a very busy guy.