Nerve Block Life Block Mental Block Blocky Block

My adventures with nerve blocks:

7:30 AM Bathe and dress.

8:05 AM Drive son to school so he doesn’t scuff up his dress shoes (worn for an orchestra performance. He plays cello.)

8:48 AM Sign in at my headache specialist’s office too early for my 9:30 appointment.

8:50 AM Realize I have panicked text messages from my son saying he forgot his Santa hat for his concert. Reply with sympathy but no assistance. I am on the other side of town.

9:20 AM Cathy, my doctor’s nurse, sarcastically but pleasantly says long time no see. She calls me by my first name like all doctors and professors and bankers always will and we talk about our lack of preparation for Christmas. We never say the word Christmas. Neither of us will break the delicate politically correct film that coats every surface of the room.

9:22 AM Nurse Cathy drops the C-bomb and suddenly every other word is Christmas. My blood pressure is good. My light sensitivity is not. She gets me a pillow and turns out the light. I stare up at the tile ceiling and listen to the air circulation system blow.

9:35 AM Dr. H. comes into my darkened exam room an calls me by my middle name like every friend and loved one always will and she asks me what happened. I tell her that yesterday… was a good day. Today… not so much. She asks if I’m flying solo or if my husband is waiting. I explain that since the appointment was made on such short notice I couldn’t ask him to miss work.

9:37 AM Dr. H. asks me where the instructions are. I tell her that the Jefferson Headache Center should have faxed them the prior week, and that I had called to confirm on Monday. I tell her that the gal I talked to said that there was a 20 or so page fax from Jefferson scanned in recently. Dr. H. wanders off in search of the paperwork because it is not properly attached to my records.

9:47 AM Dr. H. returns with a stack of very illegible copies, complaining that the girl I talked to doesn’t care about anyone but herself an isn’t exactly respectful. Dr. H. says, “I wonder how she’d feel if someone in her family was trying to get a helpful procedure done at the last minute before Christmas.” I am here for a nerve block and my doctor, whom is trying to replicate some success I had at Jefferson, wants to do things just right.

9:55 AM The paperwork has all of my progress notes, but no procedural notes from Dr. M. at Jefferson. Dr. H. says she can just do the major occipital nerve block and guess. She asks me about needles and medications. I explain that it was a big needle, and that I had definite needle marks and bruises after the nerve block Dr. M. performed back at Jefferson. I recall it was the same needle for my occipital nerve and supraorbital nerve, the nerve behind my eyebrow. Dr. H. teeters indecisively then decides to call Dr. M. and try to get the details. She’s dealt with me enough to know that I’m very good at recounting names of medications and procedures and the order in which they were administered, but she wants to be sure. She leaves me in the dark examining room to make the call.

10:15 AM Nurse Cathy pokes her head into the room and offers me a cup of water. I refuse.

10:32 AM I look at my phone and wonder how my son’s concert is going.

10:37 AM Nurse Cathy again. This time she wants to give me a donut. I refuse. She tells me that Dr. H. is seeing her 10 AM patient while we wait for Dr. M. to call back. She turns off the computer in the room so it is pitch black.

11:03 AM Dr. H. pops in to offer me ice packs, apologies, and to enthusiastically tell me that they are installing dimmer switches because so many patients wear sunglasses to appointments. She says I started a trend.

11:30 AM Nurse Cathy is back. Dr. M. called back! She tells me I should go grab something to eat and come back about 12-12:15 PM when Dr. H. is on lunch and we’ll get everything taken care of. She apologizes and thanks me for my patience. I tell her it’s no problem… that I have a pillow and a dark room. I decide to drive to Starbucks and eat a little something. OOO! They have chestnut coffee now!

11:56 AM I wander back into the doctor’s office. First I totter around the waiting room in my sunglasses. There’s this cool bug thing for kids to play with that I always want to look at but am too embarrassed to look at. My theory is that near-lunchtime will be slower and the waiting room will be empty. No such luck. I walk over to the DOOR. You know the DOOR… that barrier between the waiting and the doctoring. It’s not locked or anything. I just walk through and find my examination room once more. At first I sit in the chair with the lights on. I put my headphones in and listen to acoustic Christmas music. Then I decide that I want the room dark again and I want to sit on the examining table. It’s just more comfortable.

12:24 PM Dr. H. comes in with a flustered smile on her face and claps her hands. She starts moving furniture loudly as she tells me about Dr. M. calling her cell phone directly (I’m pretty certain that Dr. M. has a weird crush on my Dr. H.) with all kinds of details and news. She says he wants to see me soon and that I should increase my Mexiletine (used in the treatment of refractory pain) dose to 600 mg daily. She says it’s good that noise doesn’t bother my head as a chair squeals across the floor. She helps me down and moves the examination table and we proceed. She says that he did use a big needle, but she is going to try a Botox needle with the bupivacaine and steroids to minimize bruising. It seems to work, and she has me on my back as she does a few injections into my eyebrow. It hurts like a mother fucker. It’s not the sting of Botox. It’s a pressure, then burn, then bigger burn, then eventual numbing that isn’t so bad… but it’s over and over until the numbing fully kicks in. She finishes with my forehead, then moves on to my left temple. It feels like she’s pouring acid into my skull. I remember all of this vaguely from Jefferson… but I remember the 3 pain-free days that happened after that nerve block more.

12 Something PM She has me come off of the exam table to sit in a chair so I can lean forward with my forehead on my forearms. Her phone makes a Tinkerbell sound and she complains that her boyfriend doesn’t understand that she is having a busy day at work. She says she told him that poor *insert my middle name here* has been waiting around all day to get needles in her face. He is having trouble deciding what to get his mother for Christmas. Dr. H. can’t fathom how that is in any way her problem. She starts injecting the back of my head many times with the bupivacaine and steroids. It doesn’t take her nearly as long to do the back of my head because she’s done this procedure many times. She says she wants me to track my progress with this so we can repeat it as necessary. She tells me I could suffer some hair loss at the injection sites.

1:04 PM Dr. H. tells me to have a Merry Christmas with no qualms and gives me a gentle pat on the shoulder. I am to see her in a month. I have received 3 times as much bupivacaine in the left side of my head, but the right side of my head is completely numb. I can still feel pain in the left side of my head, but some numbness in places. I have to keep my head down for 10 minutes so the medication doesn’t migrate.

1:15 PM Nurse Cathy comes to set me free and walk me to the check-out desk. Dr. H. catches me in the hall again and says she really hopes it helps. I tell her I hope so too.

1:24 PM A text message from my son saying they didn’t need the Santa hats after all.



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