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Sucker Punch

16 Wednesday Nov 2011

Posted by Ed Mahoney in Medical Files, Running

≈ 3 Comments

Tags

betadine, Boulder Surgery Center, cortisone, Kindle, steroids, symphysis

I wasn’t totally certain what to expect from this steroid shot.  I took off a half day of work since they said it would take 3 hours.  Still somehow I’ve logged in a 10 hour work day.  That’s what they call an IBM vacation.  I could have easily spent 2 hours simply finding a parking spot.  Boulder parking sucks.

True to the expectations set by Nurse Heather, prep took an hour.  A few forms and questions to answer, but mostly waiting.  I read a few chapters from the Steve Jobs biography on my iPhone Kindle app.  Should have brought my Kindle but the sweet thing is how what you are reading on the Kindle synch’s wirelessly to your iPhone.  I was able to get some of my questions answered from Dr. Stilp.  She said it is indeed possible that this treatment will last a lifetime.  She performs this treatment for the same condition every 2 or 3 years.  Typically to runners over 30.  It is possible though I might need a second shot after a few weeks.  I should know based on how the pain recedes and that I should followup with Dr. WW.  It might be that I’ll need some rehab therapy rather than a second shot.  I can run this weekend but should not expect noticeable results for a few more days after that.

The door to the surgery room had a sign reading, “Pain Free Area”.  I asked the nurse if that was some sick humor.  She responded in a serious manner that perhaps so for me since it only applies to patients who receive anesthesia – which I had declined.  Hmm.  She instructed me to lie supine on the surgical bed and she proceeded to prep my lower abdomen with betadine and sterile towels.  Because I expected this as well, I trimmed my belly hair.  I simply trimmed it with clippers.  I didn’t want to shave it with a razor because I think that’s a bit weird.  I don’t want too prepubescent a look lest I suddenly get hit on by football coaches.  Which reminds me, have you heard what high school athletes are saying in the locker room now?  “You can stick it in coach, I’m ready to play.”

Anyway, I’m glad I trimmed because the betadine would have been a hairy mess otherwise.  I suspect they would have shaved me if necessary, but they didn’t so I think my efforts were smart.  The nurse wrapped a blood pressure monitor around my right arm and attached a heart rate monitor to a finger on my left hand.  She then had me fold my arms up over my chest.  A second nurse handed me two squeeze balls, sort of like little stress relievers.  She said I would want them.  Dr. Stilp came in and was quite efficient about things.  She adjusted the towels leaving me embarrassingly exposed.  I now know where the needle’s point of entry will be.  Less than an inch north of my Johnson.

Dr. Stilp applied some topical analgesic to minimize the pain of the needle breaking my skin.  It still hurt a tad bit more than a flu shot, but nothing to cry home about.  That is until she went deep.  After entering the needle, she paused in order to adjust her fluoroscope.  This is an xray image on a monitor directly over my abdomen.  She then looked at the monitor as she pushed the needle further into the joint.  I wasn’t expecting this type of pain.  It honestly felt as if she had punched me in the gut with all her strength.  The nurses on both sides of me then applied moderate pressure to my arms to ensure I didn’t whack anything and exhorted me to take deep breaths.  The scene was not unlike a woman delivering a baby.

Dr. Stilp then told me that she’ll need to do this again and it will hurt the same amount, and that I should try to relax and let her know when I’m ready.  “Are you fucking kidding me?”  I’m not certain I said those exact words.  I might have, I was in a highly emotional and reactive state.  I couldn’t believe she would ask me to relaunch the needle.  It’s like asking someone to commit hari-kari.  I took a couple of deep breaths and told her to go ahead.  I didn’t want time to think about it.  She was right, it hurt just as much the second time.

And before I knew it they were helping me to my feet and escorting me out of the pain free area.  A nurse monitored my vitals for about 5 minutes and then sent me home.  Despite feeling like I was sucker punched twice in the abdomen, I’m glad I declined the anesthesia.  I’ve seen people take that stuff and I’m confident the side effects would not have been worth the pain avoidance in this scenario.  Not feeling any pain now – a few hours later.  We’ll soon see how effective the steroids are when I try out my treated pubic symphysis on a run.

40.137598 -105.107652

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Shot of Steroids

12 Saturday Nov 2011

Posted by Ed Mahoney in Medical Files, Running

≈ 1 Comment

Tags

Boulder Surgery Center, cortisone, fluoroscopy, MRI, orthopedic, symphysis

Dr. WW called back again to let me know he’d reviewed my MRI with Dr. Stilp – an Orthopedic Surgeon across the street at the Boulder Surgery Center.  She concurs with the radiology diagnosis of arthritis in my symphysis pubis and wants me to call her to schedule myself to receive a fluoroscopic-guided shot of cortisone.  Dr. WW actually let me agree first that I was interested in receiving the shot.  He might have been following some ethics protocol.  He seemed happy with my decision though.  And he related to me that I’m only the second case of symphysis pubis arthritis he’s treated.  The other guy was a few years ago.  That guy was in his 30s which makes me feel better about this not simply being about my age.  Dr. WW ended the call by giving me the phone number to Dr. Stilp’s nurse Heather, to setup the procedure.

Nurse Heather penciled me in for this coming Wednesday afternoon.  I’ll take a half day vacation as this will suck up too much time to simply squeeze it in between conference calls.  Heather briefed me on what to expect.  The shot itself will take just a few minutes, but I’ll need an hour for prep and another hour post-op.  Apparently this isn’t a simple flu shot.  The doctor will use fluoroscopy to guide the needle into the area of my hip bone.  Heather surveyed my medical history over the phone so I won’t have to spend time filling out forms once I arrive.  I declined the anesthesia so I’ll be able to drive myself home afterward.  I’ve never had anesthesia before but have seen others receive it and can say that it doesn’t appeal to me.  Heather answered most of my questions.  I’ll have to wait to talk with Dr. Stilp to answer other questions such as ongoing expectations.  I neglected to ask just exactly where the point of entry will be for the needle.  My buddy Dave suggested I should expect it to be where I least want it, and that stirrups might be involved.  Ouch.

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Ed Mahoney is a runner, author, and cybersecurity product director who writes about endurance, travel, and life’s small ironies. His blog A Runner’s Story captures the rhythm between motion, meaning, and memory.

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