Wednesday, February 1st, 2006 04:56 pm

"First 24 hours of what?", you're probably wondering.  Well, yeah, this is a little lacking in context.  For that, I plead acute intestinal distress ... which is to say, I've spent much of the time between waking up on Monday and this morning not daring to get more than about 10 seconds staggering distance from a bathroom.  By Tuesday morning I'd lost almost 10% of my body mass in fluids.  (Thankfully, it seems to have ... er ... run its course, so to speak.)

So, anyway, about this "first 24 hours".  The one thing I have made it out of the house for since Monday morning is for a trip up to York, Maine, an hour or so away, to see one Chris Delorie1, chronic pain specialist, for a procedure to perform a temporary nerve block on my left sciatic nerve2.  Why do such a thing?  Well, after a prior consultation, it seemed likely that a lot of the neuropathic pain in my foot might be bleedover into the sympathetic nervous system.  (The sympathetic nervous system isn't supposed to carry pain signals.  But, for reasons which aren't yet understood, in many chronic pain cases, it does start carrying pain signals as well as, or instead of, doing its proper job.)

Well, to cut a long story short, over the past 24 -- well, about 28, now -- hours, most of that neuropathic pain has been gone, poof, like turning off a light.  I had one brief twinge of pain across my toes about an hour ago now, at a much reduced intensity compared to what I've come to expect as normal.

This doesn't mean my foot has been pain-free.  Far from it.  The underlying ache that's there all the time is still there, and there's still additional aches and pains when I walk on it; all of the "structural" pain is still there.  But all the burning, shocking, crunching, crushing, slicing, stabbing pains that come out of nowhere with no warning, all the kinds of pain that we euphemistically put down to a little invisible sadistic gremlin whom we nicknamed Mack the Knife, have been notable by their absence, except for that one twinge, which so far has not recurred.

It looks like maybe we finally have a bullet with Mack the Knife's name on it.


[1] Yes, fellow geeks, brother of DJ Delorie.  Small world, isn't it?

[2] During the course of which his office staff also generously pushed two liters of IV fluids into me, much helping with the dehydration from the aforementioned intestinal distress.

Tags:
Wednesday, February 1st, 2006 02:12 pm (UTC)
my thoughts are with you
Wednesday, February 1st, 2006 03:53 pm (UTC)
Glad to hear you've found some relief.
Wednesday, February 1st, 2006 08:40 pm (UTC)
How long is the nerve block supposed to last?
Wednesday, February 1st, 2006 10:07 pm (UTC)
Not too long. It's a single steroid shot into the nerve sheath, primarily as a diagnostic. The first 48 hours are the most important to monitor. I don't know how far beyond that the effects are typically expected to persist. But once we know that it does have a significant effect on the pain, there are longer-term approaches we can take, some of which are permanent.
Thursday, February 2nd, 2006 03:27 am (UTC)
Nice reference to Three Penny Opera.
But will your Mack follow that of the Opera?
Imprisioned, escape, imprisioned again await execution, but then with a final pardon from the Queen and baronetcy to boot?

P.S. Your second endnote is unattached.
Thursday, February 2nd, 2006 05:22 am (UTC)
Huh. So it is. How'd that happen? Fixed.

And in answer to your question, I hope not .... I've never actually read Three Penny Opera (or seen it performed).
Thursday, February 2nd, 2006 10:29 am (UTC)
This is great news! Enjoy the respite, and here's to the death of Mack the Knife!
Thursday, February 2nd, 2006 03:16 pm (UTC)
What's the next step if this is diagnostic? Sounds like you got a positive response from initial therapy.
Thursday, February 2nd, 2006 11:33 pm (UTC)
The next step, since the results have been positive even if short-lived, would be a more permanent block, which could take the form of (among other options) an implanted (and user-adjustable) TENS unit, a cryogenic block, or even cauterization.
Thursday, February 2nd, 2006 06:07 pm (UTC)
woot! g'luck!