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Anesthesiology/Chronic pain since epidural

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Expert: - 9/10/2009


Question

my back
I had my son almost two years ago.  Ever since I have had chronic pain in my spine and back.  It is like a knife stabbing morse code into my back or bugs with razor blades for feet crawling around. At times it even feels like my spine is going to rip out of my body.  I get headaches and nausea all the time.  I have tried Vicodin, Tizanidine, Tramadol, Neurontin, Indomethacin, physical therapy and massage, and an EMS machine.  Nothing works. I was in labor for over 20 hours, and tried to have a natural birth. When I finally decided to go with the epidural, he placed the intrathecal epidural with success and i was pain free. He said that usually he would wait two hours and see how I was doing but that he had a c-section to attend to and would be back in 45 minutes.  He came back and started to try to get the catheter in. He sat there for over 45 minutes and just kept sticking the needle in and out over and over.  My mother was there and asked him why he was doing it so many times. He seemed very nervous and anxious.  It was like he wanted to get it in so bad that he didnt even think about what he was doing. At one point he actually left, I thought he was going to get help.  But he came back and kept poking in the same spot about 5 more times. There was blood dripping down my back, and he was dipping the needle into sterilization fluid with blood in it.  The only reason I know for a fact that he made over 25 attempts is because that is how many hole marks were in my back the next day.  I am sure it was much more than that, as he kept trying in the same spots as well.  Finally, after all of this, he moved up my back about 5 inches, made about 5 attempts there and put it in. It was one of the worse experiences of my life.  And now I have been in chronic back pain ever since, with numbness, tingling, knife like stabbing pains, and many more pain symptoms. I dont know where to go for help, as the doctors i have been to so far seem leary to even help me. Have you ever heard of an anesthesiologist doing something like this?  What kind of damage could have been done? Don't they teach you in med school that something like this could be dangerous?  Thank you so much for your help or any information you can give me.  My life has changed for the worse since this incident.

Answer
Yes, I have heard of anesthesiologists and other doctors not "knowing when to quit" or being given a mandate by patients or senior doctors or whoever to "do it no matter what", etc.......but the answer to that question won't help you now.  As far as damage goes, repeated tries at [failed] epidurals and spinals usually involve only bruises on bone, cartilage or maybe ligamentous structures--usually not involved with longstanding pain syndromes---clearly what is 'usual or typical' won't apply to your two year pain syndrome.  

"Don't they teach you in med school that something like this could be dangerous?" :  Yes, most of us learned to first "do no harm".

Please note that if an intrathecal catheter was placed it was not an epidural but an intrathecal analgesic or anesthetic.  
Any number of issues could be causing your problem that has been reported with the use of these devices:  inflammatory epidural or spinal masses, retained catheter tips and subacute infections with or without spinal compression, etc...... the list is rather long.

You should have your pain syndrome evaluated by a BOARD-CERTIFIED anesthesiologist specializing in pain management. Find one near you at the American Board of Medical Specialists website:   http://www.abms.org/  

JM Starkman, MD

Experience

Over twenty-five years of adult and pediatric, inpatient and outpatient clinical anesthesia practice--some private, some group.

Organizations
American Association of Physicians and Surgeons. My county medical society.

Publications
[not a researcher]

Education/Credentials
American medical school graduate. Board Certified. Fellowship trained Cardiovascular and Pediatric anesthesia subspecialist.

Past/Present Clients
Over 20,000 anesthetics, the majority of which have been personally managed, with less than 5% consisting of supervising nurse anesthetists or in-training resident physicians.

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