I take epidural steroid injections in between my steroid muscle injections.   It is a hard choice for me.   I have weird bones; in some places they grow too thick. in other places my bones are way too thin.   I try to limit the spine ones until I cannot stand the pain and must do it because they are so painful.  I have had to have three in the last 4 months.   This time was the most painful epidural I have ever had.  It was the first time I have ever cried out on the table.  I was struggling so hard not to move despite the pain.  Remember I take 2 kinds of morphine and muscle relaxers at the maximum dose allowed by the state of Florida, along with 800 milligrams of Ibuprofen.  I used to take stronger ones before state legislators felt they knew more than my doctors.  

First I waited more than an hour and a half before the doctor actually came into the room.  They are horribly understaffed, and the state of Florida makes providing pain relief care as impossible as possible.  Everything from restricting medication to requiring frequent visits, which means more costs for the poor people needing the service.  I used to go every three months, get my medications prescriptions.  I now must go every two months and my medications are restricted causing me to be in even more pain.   Since the next pain medication level for me is Fentanyl and I talked to my doctor again today and told him I am very scared of it.  I need more pain relief, but he understood.   He thought there might be one kind of muscle relaxer that might help me more.   I am already on maybe the most powerful one that the state will let them give me at the max dosage.  I was on one that worked great and helped me a lot but again the state legislatures make it illegal for doctors to prescribe it in their attempt by republicans to look tough on drug crime. So he changed that medication after he gave me the shots.

Back to today’s procedure.   I got there and checked in.  I have been going there so long I am very friendly with the check in and check out people.  I talked at length with (name redacted … out of respect for others, I won’t use their names.) the check in woman.  Because I really genuinely care about people, I often get in to conversations and become very friendly with people I interact with.  I noticed she seemed tired and bothered, so asked her if she was OK, was she sleeping Ok.  She told me no.  She had another death in her friendship circle.   She has suffered that a lot over the last year with many deaths of close friends and family.  A friend of the hers had been walking at night, got hit by a car that did not stop to check what they hit and simply called the police to say they thought they hit something.   An ambulance crew found the man just in time, he had to be resuscitated and returned to life, but he is in critical care.  She, her husband, and some friends went out and found some of his stuff but by the locations of his things including parts of his bracelets he was hit hard and maybe dragged.   She couldn’t sleep because her mind wouldn’t disengage and let her sleep.   Boy do I know that.  So I let her talk and express her fears.  I expressed my deep well hopes and well wishes.  It doesn’t take being religious to care or empathize with others.  

After being in the waiting room for a while which I think was not too long, I read some news, posted a few news stories, read some of my books on my tablet I was called in.  

I was not given the normal check in where they do your weight and your medications, so I had to make sure that my restricted medications were reapproved.  As I talked with the woman doing this I complimented her on her purple colored hair.  It was clear she struggled to grow hair and she tried to make the hair she had stand out, so she was delighted to talk to me about the color.  I told her I thought it was great, that I loved the color, which was the truth. I enjoy people exploring being different.  It shows personality and style.  She was delighted and happy.    I waited in that room a bit over an hour.  

Now many might be upset with the time I waited, and it is not right to make patients do that.   But the truth is, it is not the doctors and providers making us wait.  It is the constant need for more profit by corporations.   It was not like this before my doctors were forced to sell to a large health company in California.  They are always pushed to do more, see more patients, and always short on staff.   While I understand that people who work cannot tolerate such waits, most of those in my condition don’t work so our time is our own, so we can give it when we need to.  The only problem I had was the sitting in their chairs was painful, so I had to stand, sit, readjust, and so forth to deal with it.  

Short side note.  One time I was there I waited more than an hour.  My normal provider I love and have followed to every office she moved to was covering for three providers.  She was running an hour behind because of this.   This is the same woman who is the only doctor who gives me a hug both when coming in and when leaving.  She knows the most I have ever told any doctor of my abuse, and I needed to because she noticed the self-abuse on my arms.  When she opened the door to my exam room, I heard a woman come out into the hallway and yell at her / everyone that she had been there almost an hour and shouted abusive language demanding to be seen.  My favored normal provider is elderly, she had already gone to semi retirement of only part-time, she stays simply because she is like me, she cares. She had returned to full time to cover for a fellow ARNP who had gone out on pregnancy leave.  She told the woman the situation yet when she came into my room she was visibly shaken and stressed.  I told her immediately to take a few minutes to decompress and relax, as I was not in a hurry.  She smiled, relaxed and we hugged.  That is what it means to see others as people, as humans like yourself, to accept and acknowledge their needs.

Back to this morning.  When the young man … so many people in professions are to me these days.   Young I mean.  I followed him.  I had to remind him I couldn’t walk fast as he raced into the room, but he came out and apologized and told me to take my time.  As it happened, I had a lot of time.  He got stuff ready; I took the stuff out of my pants pockets along with taking off my glasses, put my hair in a ponytail, and he told me I could get up on the table.  Damn if I knew it was going to be another thirty minutes I would have waited as the table is painful for me.  He went out twice to check on the doctor and said the person the doctor was seeing must have lots of questions.  I told him that was OK as I appreciate it when the doctors / providers take their time with me.  There is simply no way to do the 10 minute visits the corporations demand to increase profits and give decent care to those in need.  

Side note.  After this doctor sold his practice which was required because a large hospital system screwed them out of 8 months of billing hours, the new company required him to see non-spine shot patients between each shot patient, plus do all the medications needing physician sign offs that day.  He seriously almost runs from room to room.  Yet once in the room he gives his all to the patient.  It is what drew me to his practice in the first place, he is like me, we truly and really care about people.  

And in true fashion, that same doctor gave me the time and attention to address my needs.  But this is the first time I ever cried out when given the spine shot.  I have had a lot of these, I knew the drill.  Plus, I am used to pain.  First from childhood abuse and in later years with my body failing, which my first orthopedic surgeon blamed on the trauma done to my body / bones from that abuse.  I never told him of my abuse but by my scans he already knew.  I am paying every day for what was done to me so long ago.

So when the doctor put the numbing agent in, I was prepared for the pain, the sharp sting.   But what followed next was more than I was used to.  My injections seem to be in three parts but that maybe just how I feel them.   First is the sting of the needle to inject a numbing agent.  Then the second needle to drive the guide needle into the spot.  Those are painful on an increasing scale, the stinging needle I handle easily, the guide channel is really painful but I bear it without moving, I have had a lot of experience doing that in my life.  Then comes the largest syringe of medications.  I get to see them draw it up, it is a mixture of at least two different stuff.  

This time when he put the guide in it was really painful, but I took it.  As I said I have known pain all my life.  He is the kind of doctor that seems to feel your pain and discomfort and talks you through it.   I told him I understood how important it was to remain still and not tense up. Like I said, I get these a lot.  He told me the nerves were really inflamed.    But when he went to put the medication in … The pain was horribly crashing over me and increasing.  For the first time I cried out, saying “flocks” as I desperately tried to stay still.  Every part of my body demanded I move and it took all the will power I had to stay there and let it happen instead of trying to run away.    The doctor was talking to me trying to explain why this time was so much worse than the others, but I was struggling to hear / understand him.  I again cried out “Oh good golly miss Molly” Seems the nerves in that spot were extremely frayed / inflamed.  It felt like he had inserted a golf ball into my spine.  When I said that the Doctor agreed with me and offered me comfort. 

As to the choice of words to cry out.  I am not normally a vulgar person, I had enough of that growing up.  While I don’t believe in bad words per say I know others do.  Even in great pain I tend to use the words I like to express it.   After all that is what curse words are, our expressions.  

Being the great caring doctor he is he did not rush out of the room to his next patient.   He talked to me, made sure I was OK, we returned to the conversation I had with him the last time he gave me shots.  We had been talking about my muscle issues and he even took the time to go back into my chart to find a new medication that might help me.  When I told him how painful the two muscles along the side of my spine would get and then told him they were not so painful today as normal, he kept asking me about it.  I described how they can get as raised as my fists and as hard.  What I did not realize is like the last time he gave me spine shots he mentioned how swollen they were, they were also swollen this morning.  I just get so use to the pain I don’t realize how mind numbing bad it is.   As I said he took the time to go through my chart and look at my medications and prescribed the only one left he thinks will help. 

I was in so much pain I could hardly drive home.  I had to have Ron help me into the house.  This morning, Tuesday, my leg muscles are so sore from me tensing on the table during the procedure that I can hardly walk.   I will take it easy today.  Ron just took the bandage off my back and he says that the needle mark / hole is really big.  Hugs.  Scottie