Sometimes, my body has a strong opinion with which I disagree.
Here’s a good recent example: My body doesn’t like getting stuck with hypodermic syringes. When I refuse to allow my body to leave the doctor’s office and when I allow my body to get jabbed with a hypodermic needle, it retaliates by fainting. It’s one of those things that I completely forget about until I’m sitting in a doctor’s office overly aware that I’m about to be stuck again. At such moments, my body reacts in a way that embarrasses and annoys me.
Here’s a bit of context. For the past few months, I’ve had some nagging back and arm pain. On a lark, I signed up for some acupuncture administered by a chiropractor. Getting stuck with those little acupuncture needles didn’t give me big problems—not that I enjoyed the sensation of those tiny needles being pushed into my back. After three treatments, I gave up on the acupuncture because it didn’t offer any long-term effect (although each treatment relieved my symptoms a bit, for a few hours).
My next step was to see my family physician, who arranged for x-rays. He told me that I had “arthritis” and suggested some physical therapy. [Before going any further, anyone reading this should probably email me a HIPPA form].
I was hoping for more of a pinpoint diagnosis, though, so I visited a doctor who specialized in Physical Medicine & Rehabilitation. He arranged for an MRI, resulting in some fascinating pictures that suggested that I had noticeable deformities in several cervical vertebrae and in the discs that separate those vertebrae. It is not an unusual condition for someone in his 50s, but for me it has been quite painful because it’s pushing on a nerve root. It’s distressing to see such clear pictures of my body’s insides deteriorating.
The physical medicine doctor suggested that I might eventually want to consider some surgical options. Therefore, I visited a surgeon who confidently assured me that the pain I am suffering is due to the spinal deformities evident on the x-rays and the MRI. It was delightful and refreshing to hear this surgeon discourage surgery, at least for the time being.
[As many of you might have experienced, many doctors are over-eager to provide you with what they offer. For example, the chiropractor I visited, a pleasant fellow, appeared content to keep administering acupuncture, with no diagnostic images to inspire a more accurate diagnosis. Because it is appearing that my problem is a pinched nerve caused by deteriorating bones, additional acupuncture would have been an essentially worthless investment.]
This brings me to the topic of needles. The surgeon suggested that I consider special injections by a pain management doctor (as well as continued physical therapy). All I had to do was get a few “injections” of a cortisone-like slow-acting drug that would be placed near the nerve root that is currently being irritated by the deteriorating cervical disks. I set up an appointment with the pain management doctor.
The pain management doctor was an affable fellow who described the technique he would be using in great detail. It turned out to be more than simply injecting me with steroids. The procedure was called a Cervical Epidural Steroid Injection. The procedure involved a preliminary injunction to numb part of my back, which allowed a blunt-ended catheter to be pushed several inches through the inside of my body toward the affected nerve root. The procedure is done under a fluoroscope, which allows the doctor see where the catheter is going. Nonetheless, the insertion needs to be done while the patient is awake so that the doctors can learn if they get too close to a nerve root (I would feel unpleasant sensations in my arms if that were to occur).

[Above is a fluoroscope image of my cervical epidural steroid injection.]
As my friendly pain management doctor described this procedure (in much more detail than I’m describing for you) I was sitting in a chair across from him, taking some notes. I found it all interesting, in fact too interesting. My visual field started to get cloudy as he spoke to me and I started to feel clammy. I started falling forward out of my chair. He jumped up to get my legs raised and he called for the nurse to bring in the monitoring equipment. I was told that my blood pressure dropped from 110/60 down to something like 50/30 (I was at 80/40 for 15 minutes). I recovered slowly over the next 30 minutes, quite embarrassed. You see, the doctor was not administering any treatment at the time. We were not yet even in the x-ray room where the treatment was going to occur. He was merely talking with me.
Before we had even started talking, had warned him that I was sometimes not good about getting jabbed with needles, and this was proof that I wasn’t exaggerating. As this fainting episode proved, I’m not even good at discussing syringes. (more…)