Discogram sedation

[tisury]

So, they finally sent me for a post op discogram on Wed. - 21 months since my 1 level ADR. Anyhow, my question is - are you supposed to remember at least parts of the discogram? I know the versed makes you forget things, but this is the second discogram I had that I do not remember a thing from the point they injected my IV with versed until I was in the recovery area. I have had a total of 3 discograms - 2 of them pre op. Only one do I remember anything about the procedure at all. I am afraid that they may be sedating me too much and not getting accurate responses. Am I crazy for worrying about this?

I can remember bits of pieces from the actual discogram - I remember getting onto the wierd chair thing (and being scared as I got on it that although I had real trouble moving I felt wide awake - I'd not had a discogram before and that scared me), the screaming agony when they hit the right disc and the anaesthetist offering me her hand to grab (I apologised later for any broken bones). I don't remember much else including what score I shouted (although I'd bet it was 5 of 5 from what I remember of the pain!). I do remember everything from being in the recovery area. My anaesthetist told me afterwards that the surgeon was very happy with the discogram but I can't remember what the surgeon told me because when he came in to see me it was just after I'd nearly fainted. I'd have thought that if they weren't happy they'd have said something at the time (and there's nothing to stop you asking them) but I'm sure there are plenty of people who've had more of them than me on here.

[spotty14]

I had one discogram only so far but I can remember everything that was being done to me. I was given Demoral (maybe versed also) which not only made me very ill it had the opposite effect and made me hyper alert and having other weird sensations. I couldn't have done anything functional while on those medications but I was awake and responding to the doctor questions and telling them how sick and scared I was.

If your not awake or able to converse then I don't know how the doctor would know what your pain level was as they injected each disc. The doctor could tell if the dye leaked without talking with you. I think you are correct in being concerned about being too sedated.

[Dale S]

I had 2 discograms, 1 with sedation, 1 without... and they had different results.

Two well renowned doctors were satisfied with the definitive results of the first sedated discogram, revealing 4 bad levels.

Circumstances forced me to go to Germany for my surgery and Dr. B insisted on his own, non-sedated discogram. With me fear level well beyond 10, I submitted to the test, which wasn't nearly as bad as my anxiety level and revealed only 3 bad levels. I was laying on the table, with a needle in my disc, wide awake, and absolutely no pain. My previous sedated discogram revealed this same disc to be a pain generator.

The two other well respected doctors were both satisfied with the first discogram and were both prepared to do a 4 level adr whereas Dr. B did a 3 level. I would have to say that the amount of sedation tremendously affects the outcome of a discogram.

This surgery is something you want to do right the first time. Despite any anticipated pain, which is over before you can even say it hurts, I would recommend a non-sedated discogram.

I wish you good luck, Dale

I feel the need to contribute to this discussion as I have a lot of concerns about my discograms (called, by the way, discography in the UK) and am hoping that one of you very knowledgeable people out there just might help me to put my anxieties to rest.

I had two discograms in the UK, by different doctors (pain specialists, not spine doctors) one under mild sedation and one not sedated. They were both deemed to be inconclusive although it was clear that the disc had a rupture as the leaking dye could be seen. In fact with the second one I ended up arguing with the doctor whilst lying on the table about how much it hurt. I told him it hurt like hell, he told me that as I didn't hit the roof, it couldn't have hurt that much. I was in tears with frustration.

In March this year (after 5 years of pain and no diagnosis in the UK) I went to the Alphaklinik in Germany with a wadge of papers including the 'inconclusive' discogram report and pictures. After an MRI at the AK, Dr Zeegers felt '99% certain' L5-S1 was the culprit.

We agreed I'd try a minimally invasive procedure before going the whole hog and having ADR. This was done by Dr Hoogland and he did a discogram immediately before the surgery. However I was so sedated that I don't remember a thing about it. I am assuming (I hope not naively) that he wouldn't have operated on the disc unless the discogram had indeed indicated it was a pain generator. After the surgery he told me it had 'multiple ruptures' which satisfied me, although I didn't see a discogram report. Crucially I didn't know then that it's possible to have a ruptured disc that doesn't cause pain.

Dr Hoogland's surgery was unfortunately unsuccessful and 10 weeks later I returned to Germany to see Dr Zeegers again to discuss ADR. He didn't feel the need to do another discogram (the torture, as he called it) but I actually asked hin to do one because I wanted to be certain, after the unsuccessful surgery, that the pain was coming from the disc and not from somewhere else.

So he did it, without sedation, and it was indeed a torture - 100 times more painful than the two in the UK! Zeegers' conclusion:- L5-S1 definitely the culprit.

Fast forward to today. I am exactly 10 weeks post ADR (with Zeegers) and I am not making the recovery that I had hoped for or expected. Things are slightly better but not much.

And finally I come to the point! I am haunted by the possibility that that disc was not the pain generator after all and that the reason it hurt so much when Zeegers did the discogram was that I had surgery on it 10 weeks earlier. Of course I have asked him the question (several times) but I haven't got a straight answer.

And he's getting fed up with me because I'm one of those awful patients who asks loads of questions and, although I know it isn't possible, would really like a guarantee that I'll be OK.

So if anyone has any comments on my discogram saga - I'd be delighted to hear them.

Thanks

Vicky

[Laura C]

TISURY,

I would speak to my doctor about the fact that you do not remember anything. You need to be lucid in order to be able to feel the test and then communicate. I do not believe however, that light sedation would make a huge difference.

For my discogram, I was put out with Verset (for only a few minutes), when I woke up, I was completely awake and aware of what was going on. I had 3 levels tested and they were extremely painful. There is no doubt that these 3 discs are the pain generators.

I find that whenever I have the least doubt about anything, I ask my doctor and get a second opinion. I had 4 opinions for my case and they were ALL the same.

[Dale S]

Vicki,

First and foremost, I am no expert. We are just talking here and I don't want you to take anything I say as gospal.

You say you are 10 weeks out and not making the recovery you had hoped for. I too, am 7 weeks out and not making the recovery I had hoped for... but, I am moving forward. I don't see it everyday but it's in little things. I'm still in so much pain that I just bagan seeing a pain managment doctor. After 7 weeks, I still have no life and my poor husband is a nervous wreck watching over me.

10 weeks is still pretty new and you have to give it a chance. I'm currently looking for a PT in my area and perhaps you should do the same. And most of all, don't be afraid to ask questions.

I wish you the best outcome and hope it all comes together for you.

Dale

[annapurna]

One more question to ask about discograms is whether or not they used an amnesiac drug in the sedation mix. It may be that you were lucid at the time the actual procedure was performed but the amnesiac drug added took care of that memory. The doctor who did the second discogram on my wife (this is Annapurna's husband) said that everyone in the city block knew that she had a positive discogram. To this day, she doesn't remember it clearly.

[tisury]

Thanks for all the responses. I am not sure what type of sedation was used. I will have to ask my doctor when I see him on the 13th. I know with the first discogram I had, they used versed, and I felt like I was kind of in and out of it. But I definitely remember feeling pain and talking to the doctor. The last two discograms, I don't remember a thing from the point they injected my IV with the sedation. Not only that, it pretty much knocked me out for the rest of the day. I remember getting in the car and an hour down the road, I woke up briefly and thought we had just left. That's how the majority of that day went.

Another thing I am going to have to discuss with the doctor is the huge increase in pain (especially the back, but the legs too) and the increase in muscle spasms since this last discogram. Just what I needed with Xmas and trying to get my EA credits before the end of the year. I expected some additional pain for a few days, but it has been 19 days now.

I wish I would have had my PM do the discogram, but the surgeon wanted it done by someone he knew. With the risks associated with this test, I don't think I could get her to repeat it.

Since the report is saying the discogram is negative, I am 99% sure my doctor will not do anything - even though the positional MRI is showing 2 pinched nerves. He may order the selective nerve root block that the report suggests. I don't get that either, if the nerve is swollen as it says, doesn't that tell you it is being irritated by something.

I really don't have the faith that he and many others have in discograms. Prior to surgery, I had 2 conflicting discograms, and here I am still in pain.

I was really hoping to get some answers before Xmas, but it doesn't look like that is going to happen. This is so frustrating and depressing.

Dale - I just want to tell you something that may be helpful, (and remember I only had one level).

I finally managed to speak to Dr Zeegers last week. He told me that not to be better at 10 weeks is unusual but not unheard of. He said some people just take longer than usual, some even 6 months or more, and I shouldn't give up hope.

I also got an email from Dan, who posts as 'djscal'. He is in a similar situation - had his surgery by Dr Regan a few weeks before me and is also no better. He went back to see Regan who told him exactly what Zeegers told me. In fact he told him he even had a patient who took a year to get better.

This certainly made me feel more hopeful, less despondent. And extraordinarily (or maybe not!) even a little less pain. I don't care how long it takes as long as it works - and I eventually get my life back.

I hope this is encouraging for you (and your husband!).

Take care and look after yourself. 3 levels is a very big deal. I had no distraction pain as my new disc is only 85mm.

Look forward to reading of your progress.

Vicky