Saturday, June 13, 2009

My discogram

Tuesday was the bid day. I arrived at the doctors office almost 35 minutes early. Better to be early than late, right? I did not have to wait long before I was called up. I was taken to an exam room where all the typical questions were asked. Then an IV was started and I was given a small amount of sedative and some antibiotics. The antibiotics are given because this procedure is technically a surgical procedure.

After the IV was started, I was taken to the procedure room. It is a big room with a table, different types of monitors, and a fluoroscope x-ray devise.

I lay, tummy down, on the table with my back exposed. I am hooked up to a pulse oxygen monitor and a blood pressure cuff. The doctor comes in, asks some questions, and then starts.

First he marks on me where he will be inserting the needles. Then he cleans the area with an antiseptic and places an incise drape on my back.

Lidocaine is then injected into different areas in my lower back. After a few minutes, the doctor begins to insert the spinal needles. 18 gauge needles were used as introducer needles and 22 gauge needles were used to advance into the center of the discs.

Because of the anesthetic, there is little pain when the needles are being inserted. That does not mean I did not feel anything. I can feel the doctor pushing on the needles as they go into my back.

As the needle gets closer to the disc and closer to the nerves, I can feel a sharp shooting pain run down my left leg. After the needles are inserted into the disks, a contrast dye is injected into them. This is done for two reasons. One, to make the disks more viewable on film, and two, to find which discs are injured.

In order to find the injured discs, the injected dye will create pressure and cause pain in that disc. The pain I felt was more like a large amount of pressure being placed on my back and not being taken off. It is not a good feeling.

The doctor tested three discs in my lower back. Here are two x-ray images. In these images, you can see the three needles in the three discs of my lower back

discogram 2 cens

ADDED 6-19-09 In the first disc you can see the dark dye stays in the middle. That is a normal disc. In the second disc you can see the dye moving towards the bottom. This is a bulging disc. In the third disc you can see how the dye is not concentrated in the middle like the first disc and a lot more is moving toward the bottom. This is the herniated disc.

discogram 1

After the dye was injected and the damaged disc located, the needles were removed, bandages were applied and I was taken to a recovery room. When I first got off the table and started walking, I noticed that my legs felt weak and wobbly. I sat down for a while, had some apple juice to drink and had my blood pressure taken.

After a few minutes of resting I was able to leave and go to an imaging center to get a CT scan. After the CT scan was completed, I went home and rested for the remainder of the day.

It has been 4 days and I am still a bit sore where the needles were placed. I have an appointment on Tuesday the 16th to get the results of my CT scan. The procedure was done by my pain specialist doctor so I will probably have to take the results to my neurosurgeon and see what the next step is.

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