Happy ONB Day!

[Axel Slingerland]

Well, I had my Occipital Nerve Block shots this morning. It's now been over 8 hours and the Novocaine has worn off, and for the first time in three months, I am in about 80% less pain than I was in this morning. I'll never be 100% pain free until they cremate me (which I am in no hurry for), but I'll take a pain level of 3 over 9 any day. I've been looking for a new pain specialist Doctor since I found out the guy who has been doing my ONBs for two years is not a Doctor, he is a Physician's Assistant. What's the difference? Education and Experience.

To become a Doctor / Physician, you have to earn a 4 year Bachelor's Degree, a 4 year Doctor of Medicine Degree, and then do a Residency program lasting 3 to 7 years depending on the specialty. Pain Management falls under Neurology, which is one of the longer Residencies. Further training in a Fellowship for a subspecialty can add another 1 to 3 years. A Licensed MD can practice independently. A Physician Assistant (PA) requires 4 year Bachelor's Degree, a 2 to 3 year Master's Degree from an ARC-PA-accredited program and while they can do a lot of things a Doc can do, they must be under the supervision of a Licensed Doctor.

I have not had any luck finding a new Doc. There is one in Bakersfield (15 miles away from me) that is a DO, a Doctor of Osteopathic Medicine, but to get in I need chart notes from a Licensed MD, which I don't have. So I have to call his office and see if he will take a referral from my primary care Doc with a new MRI instead. I haven't had one in years anyway and based on what my DO in Eureka told me, I'm past due for one. My last one was in 2015.

So today I go to see the PA because he's "all I got" as the old saying goes, and it turns out he's on vacation. But his Attending Physician comes in and gives me the shots, immediately showing a night and day difference. He's Indian (as in he's from India, not a Native American) and as such I can barely understand a word he says. But his skill level is far beyond the PA, and he has an MD after his name...

 

[Marie Mallory]

Well, I had my Occipital Nerve Block shots this morning. It's now been over 8 hours and the Novocaine has worn off, and for the first time in three months, I am in about 80% less pain than I was in this morning. I'll never be 100% pain free until they cremate me (which I am in no hurry for), but I'll take a pain level of 3 over 9 any day. I've been looking for a new pain specialist Doctor since I found out the guy who has been doing my ONBs for two years is not a Doctor, he is a Physician's Assistant. What's the difference? Education and Experience.

To become a Doctor / Physician, you have to earn a 4 year Bachelor's Degree, a 4 year Doctor of Medicine Degree, and then do a Residency program lasting 3 to 7 years depending on the specialty. Pain Management falls under Neurology, which is one of the longer Residencies. Further training in a Fellowship for a subspecialty can add another 1 to 3 years. A Licensed MD can practice independently. A Physician Assistant (PA) requires 4 year Bachelor's Degree, a 2 to 3 year Master's Degree from an ARC-PA-accredited program and while they can do a lot of things a Doc can do, they must be under the supervision of a Licensed Doctor.

I have not had any luck finding a new Doc. There is one in Bakersfield (15 miles away from me) that is a DO, a Doctor of Osteopathic Medicine, but to get in I need chart notes from a Licensed MD, which I don't have. So I have to call his office and see if he will take a referral from my primary care Doc with a new MRI instead. I haven't had one in years anyway and based on what my DO in Eureka told me, I'm past due for one. My last one was in 2015.

So today I go to see the PA because he's "all I got" as the old saying goes, and it turns out he's on vacation. But his Attending Physician comes in and gives me the shots, immediately showing a night and day difference. He's Indian (as in he's from India, not a Native American) and as such I can barely understand a word he says. But his skill level is far beyond the PA, and he has an MD after his name...

I'm sorry you have to deal with the pain, I hope you can find a way to at least slow it down.

 

[Smithy]

Hope you get better soon @Axel Slingerland no pain no gain,

 

[Axel Slingerland]

I'm sorry you have to deal with the pain, I hope you can find a way to at least slow it down.

Well, like I always say, the pain is self-inflicted. It's a direct result of my career choice, and our ever increasing amount of gear that we had to unload, set up, test, play a usually 4 hour gig, take it all down and load it back in the truck, every day. We were very happy when our agent hooked us up with 30 week contracts in Casino Cabarets in Nevada. Our income went up (through less expenses), our workload went waaay down, we didn't have to travel as much, and we usually got free or lower cost rooms, and meals at the casinos that had buffets. (They wouldn't spring for the fancy restaurants.)

As far as slowing the pain down, that is what Occipital Nerve Blocks are all about. Pain relief with as little pain medication as possible. But I can only get them every three months, and the pain relief doesn't last that long. However, I learned recently that the three month limit only applies to one type of procedure per day. When I was talking to the Doc (the actual Doc) yesterday I asked about this because ONBs aren't working like they did before. He said the reason ONBs aren't working as well as they did in 2012 when I first started getting them is I'm older now. At about 65 to 70 they start to get less effective. They were working fine in 2022, when I was 66. But then I got Covid... You probably know that story, as I've talked about it before. Since I got out of the 96 day, three hospital stay, the effectiveness has dropped to about half of what it was in Eureka. In other words, I'm in serious pain half of the time.

However, the Doc said that Steroid Injections in your shoulders, effectively do the same thing as ONBs, with the same three month limit between injections. But I can get them in different months, such as a month and a half after an ONB, if both procedures are considered to be medically necessary and appropriate. Which he said is easily accomplished with good chart notes, and Medicare would generally cover both procedures, administered a month and a half apart, as each would them comply with the three month limit. They just have to be 90 days apart and can't be in the same area.

So I am hopeful about that. I might get to be almost pain free if I'm lucky...

As if it was like a bonus, the ONB also made my sprained knee pain go down!

 

[Axel Slingerland]

Hope you get better soon @Axel Slingerland no pain no gain,

There's no cure. So the best I can do is steroids. Which beats the stuffin' out of taking Percocet, which makes me Stoopid. I hate those things, but I have to have them IF I ever need them.

 

[Marie Mallory]

Well, like I always say, the pain is self-inflicted. It's a direct result of my career choice, and our ever increasing amount of gear that we had to unload, set up, test, play a usually 4 hour gig, take it all down and load it back in the truck, every day. We were very happy when our agent hooked us up with 30 week contracts in Casino Cabarets in Nevada. Our income went up (through less expenses), our workload went waaay down, we didn't have to travel as much, and we usually got free or lower cost rooms, and meals at the casinos that had buffets. (They wouldn't spring for the fancy restaurants.)

As far as slowing the pain down, that is what Occipital Nerve Blocks are all about. Pain relief with as little pain medication as possible. But I can only get them every three months, and the pain relief doesn't last that long. However, I learned recently that the three month limit only applies to one type of procedure per day. When I was talking to the Doc (the actual Doc) yesterday I asked about this because ONBs aren't working like they did before. He said the reason ONBs aren't working as well as they did in 2012 when I first started getting them is I'm older now. At about 65 to 70 they start to get less effective. They were working fine in 2022, when I was 66. But then I got Covid... You probably know that story, as I've talked about it before. Since I got out of the 96 day, three hospital stay, the effectiveness has dropped to about half of what it was in Eureka. In other words, I'm in serious pain half of the time.

However, the Doc said that Steroid Injections in your shoulders, effectively do the same thing as ONBs, with the same three month limit between injections. But I can get them in different months, such as a month and a half after an ONB, if both procedures are considered to be medically necessary and appropriate. Which he said is easily accomplished with good chart notes, and Medicare would generally cover both procedures, administered a month and a half apart, as each would them comply with the three month limit. They just have to be 90 days apart and can't be in the same area.

So I am hopeful about that. I might get to be almost pain free if I'm lucky...

As if it was like a bonus, the ONB also made my sprained knee pain go down!

Have you heard of ablation surgery? My friend is having it done to her neck ,it burns the nerve and cuts off pain, said son, sister had it done years ago.

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[Axel Slingerland]

Yeah, I've heard of it. But while medical technology has greatly improved in recent years, the risks far outweigh the benefits. My Neurologist in Eureka was a Doctor since the 1970s. He retired in 2015 at 72 years old. He told me not to even consider any kind of spinal surgery until I lose control over my bowels and bladder, the risks are far too high. Fortunately, I'm not there yet. And since I am already in a wheelchair, I'm not going to push my luck.

 

[Axel Slingerland]

I went to see my new Doc today and he gave me the results of my blood tests.

My last A1c, six months ago: 7.5%. He said that was on the border, but still good. The medical establishment today says if you're in the 7% range that good. I said I didn't think so, and I would rather be in the "Coveted 5% Club." He just smiled and said "Guess what? You are. Your current A1c is 5.6%." I was quite happy about that, considering the only exercise I get is pushing myself down the hallways in reverse, which I do twice a day. That's the equivalent of going over a Football field twice.

He also tested me for several types of Cancers that can be detected with specific blood tests, and a CBC Panel for things like Anemia, Leukemia and Lymphoma, etc. All results were Negative.
I don't know if I am as happy as this guy... But I gots happy feet!