Necessary Evil: Steroid Epidurals

After we realized how badly herniated my back was, the first thing suggested was that I have a steroid epidural. The hope is that these will reduce the inflammation in the back and sciatic nerve, therefore eliminating or reducing the pain and nerve issues like tingling and numbness. So hopefully if I had one (or two) of these, I wouldn't need surgery.

It is amazing to me how many of these things they dole out. (Watch a video of one here.) Mine was administered at a "surgery center," which was just a doctor's office where they wore scrubs. I was surprised they could do that there. This surgery center was next door to the awful rehab place that I went to, and was run just as horribly and with just as uninterested staff.

First of all, you can't eat or drink for many hours beforehand, presumably so that you won't barf everywhere. They told me no food or water after midnight, and my appointment was at 2 p.m. the next day. I made it to the appointment, and the waiting room was overcrowded, standing room only ... this didn't look good. Turns out they were "running late" ... 3.5 hours late. I didn't get my epidural until almost 6 p.m. I was starving! The nurses were in such a hurry that I immediately felt panicked about my care there. It didn't help that when I was called, a nurse in scrubs threw me a gown with a "here, hurry!" Oh great. This was going to be but another wonderful experience with these people.

I put on a gown, socks and a hairnet. It felt very strange for someone who had never had any medical problems, ever, and was a little scary. I felt like I was in a Lifetime movie--As the Epidural Turns. Sadly, my nurse didn't have time to deal with things like comforting me. I sat on a wheeled gurney and they quickly jammed a needle into my arm, with a "sedative." I was never knocked out for my epidural, in fact, I didn't really feel too different, just a little more relaxed. But I was awake and aware of everything, even if random things did start seeming funnier than usual. I met the guy who would be my doctor for the procedure. I think they crank these things out all day, to the tune of nearly $10K per injection. Nice.

When it was time they wheeled me into this room with a big operating table, huge screens and lights. I rolled onto the table onto my stomach, as they compared my MRI to what they saw on the x-ray screen. "My god," one of the doctors said loudly. "Look how big this herniation is! Can you even sit down? How do you work?" They had put a towel over my head by this point and strapped down my arms. "I can't work!" I said through the terrycloth. "What?" the doctor asked. "What did she say?" "I said, I can't work!" "What did she say?" "She says she's not working, doctor." "Oh."

While the pain was not excruciating, I was surprised that my back wasn't that deadened. I felt it, buddy. There was definitely discomfort, but compared to the pain I'd been feeling, it was bearable. What they do is put a small hollow needle down into the spine, between the discs (called the "epidural space") and then insert the injection needle into that. Dye injected in helps them see the herniation and they do the procedure with the aid of an x-ray. This first one was just inserted into my back right over the disc. It was surprisingly quick, less than five minutes. Then wheeled off to "recovery" for 30 minutes, which was annoying because I didn't feel I needed to "recover" for 30 minutes. I walked out and went and got dinner. Overall I felt fine, somewhat dull achy and sore in my lower back the rest of the night.

It took 4 to 5 weeks before I felt any significant relief from the pain and sciatica, which was disappointing. So about 4 weeks later I got a second one. This one was a caudal epidural, basically into the tail bone. This one hurt! But like I've said, at this point it didn't even matter how much these things hurt, I was already in so much pain there wasn't much else they could do to me it seemed. Again, not the miracle cure that I had hoped for, although from what I understand they do wonders to some with lesser herniations.

I knew that it is suggested that you only have three of these a year, but didn't hear too much about why. There are definitely side effects. I felt that these steroids messed my body up for a good three or so months. My periods went haywire almost immediately and stayed that way for months. I suppose there was a hormonal issue going on because I would get nauseated often and without warning. I started carrying ginger candy in my purse to help. My face was flushed for weeks.

The only good news is that I realized that epidurals are not really that big of a deal. No, they don't feel great, but they're nothing to fear (like I'd heard) either. They work for some people, just not me.