ED nurse with herniated disk needs advice in changing career...

Canadian Girl · Nov 12, 2009

Regarding the epidural: I was 23 weeks pregnant at the time, so I was not able to have an epidural placed under fluroscopy. I had to have one done without instead. I was in such agony before the epidural. I was taking 2 Percocet every 4 hours for a couple of days. I had the epidural done on an emergent basis by an anestheisiologist at our hospital. He was very good. I don't know the cost, as I'm fully insured. It took all my pain away for months. Epidural was in June 2008 and I was more or less pain free until December 2008 (the birth of my child was not even a problem). However Starting in Jan. 09 I began having pain again. It is a roller coaster ride for me. I have not been able to go back to my job in the ER. Some weeks I'm good and then I have bad weeks like right now (I sit here in pain).

I would recommend an epidural steroid injection (ESI). However, I would have it done by x-ray guidance to limit possibility of errors. I think the mistake I made was in doing too much housework after my ESI. I felt so good. However, I probably did more damage and didn't know it.

I love the ER but am not sure I'll ever be able to manage it again. It's the little things that bother me: the slight awkward movements more than the heavy lifting.

Take care!

Suzanne

zeppzepp2009 · Nov 12, 2009

Thank you for your response. I have L4 and L5 herniated and I am in agony, pain meds don't help so I am looking for other options. I don't have insurance so it limits my options.

wibobr · Nov 12, 2009

As the old song goes..."Welcome to my nightmare..." I too have had serious back issues both from my career as a paramedic and as an RN. I am currently on medical leave status post lumbar lam and per my surgeons advice, contemplating a "kinder, more gentle type of nursing. Most ER nurses I know can tell stories of at least one former co-worker who has faced the same decision making as you and I. Nurses by and large are taught that surgery should be the last option and it DOES apply here. Most folks I have known who treked down the OR pathway do one of two things......miraclously better or horribly worse. Right now in my case the vote is still pending but If I lefy you with any advice at all, try EVERYTHING else first. Look into advanced pain management procedures, physical therapy, yoga maybe even chiropracty (If your primary concurs) give all the alternatives a fair and fighting chance (I did them all multiple times) or had short term relief or some form of re-injury that placed me back on square one. So in short, we both share the same bucket of you know what.

Take a good hard look at your skills. I for one am actively trying to have an IV team in our facility and with the local nursing homes we service (Don't tell me you've never had the opportunity to be called to the floor for an IV restart or received a Nursing Home patient for nothing more than An IV start). Look into cardiology (You're ACLS, right?) Some recent opportunities here are for out patient stress testing, cardiac rehab etc etc. Look into your local clinics (I'm awaitng some word on a recent application to the veterans administration) as a clinic nurse, (same salary, no week-ends, no holidays, no on-call (WOO-HOO!))

Bottom line is this, good luck (seriously)and DO NOT sell yourself short! You might be able to take the ER nurse out of an ER ,but never take the ER out of an ER Nurse! Good Luck!

rbyrdrn · Nov 19, 2009

I was on a travel assignment when my L4-L5 herniated....I could not believe the pain- not only in the lowerback but in my right lower leg! I rested and medicated, watching the clock anxiously awaiting my next ibuprofen & Tylenol. After a few days of that I got physical therapy, and could not believe the difference p one treatment. I was able to complete my assignment, but I took 3months off before returning back to work. I continued c my back exercises, lost some weight and was able to return to the ER without incidence. Good Luck!

nuangel1, BSN, RN · Nov 19, 2009

i have neck and back issues.i have severe cervical stenosis in c4-5 and 5-6 neurologist wants me to have a fusion .i get pain in my shoulder down forearm with repetive motions.i have bonespurs in my thoracic spine with 2 bulging discs and a herniated l5 s1.over the years i have had sciatica twice severe pain .i have done PT chiropractic meds pain and relaxers tens etc.its all work related.but i continue to work ed.right now have been on nsaids for months some flexeril at noc prn and chiropractic.during severe episode i have take narcotics but i don't want to on aregular basis.i try not to let it alter my life.i don't give into it.i have also had steroid injections that helped somewhat.

Scooty Puff Jr · Nov 29, 2009

Have you considered NICU and save the action and adventure for outside of work? I went from NICU to ER and I can tell you I never had a back problem in the NICU.

kittykat8 · Dec 16, 2009

I injured my back at the end of May 2009. Herniated L4-S1 (3mm and 6mm) with linear tear in L4 and bilat nerve compression. Been through many meds and am having 2nd steriod shot. PT worsens symptoms now. Will have surgery if injection doesn't work. Tired of meds, pain, and lack of normal activity. Talked with other nurses who have had similar injuries and surgeries. One OR nurse is rock climbing after her surgery. Time for me to have my life back. Oh, I worked in a Spine Unit when I did this. Ironic, isn't it.

peacetou · Jan 11, 2011

Hi,

I agree with Wibobr. Try the PT, yoga, acupuncture. Go to gym and do weight training, no matter how exhausted you are. get a personal trainer who is a PT too. I have one and she is special. I also have osteoporosis, I just found out so I have to go. The crunches, elliptical (or walking) and weight training can save you even more pain. I was fine until I stopped for ONLY 1 WEEK! You have to do it for the rest of your life. Try everything before surgery or even shots. More than 3 shots is not going to benefit you.

The best to you,

Peace:heartbeat:redbeathe:redpinkhe

Canadian Girl · Jan 11, 2011

Thanks for your kind advice!!

bubbasmom · Mar 31, 2011

i was wondering if anyone knows at what point they will do emergency surgery for a herniated disk.i herniated l5-s1 a year ago and it is compressing my l5 nerve root.been taking 10 mg hydrocodone, muscle relaxers and neurontin.i was functional till 2 days ago. started having extreme pain and pressure in my lower back and down both my legs. i couldnt sit, stand or walk. went to er they did a mri and said nothing new had happened.then i went to my pain management dr. and he said it seems like all of the inside of the disk has came out and is herniated at .7 cm.he put me on steroids and percs and hydro's.my insurance is horrible...will they do emergency surgery if i am unable to walk?

bubbasmom · Mar 31, 2011

how do u survive nursing school with a herniated disk and compressed nerve without pain meds?

Canadian Girl · Mar 31, 2011

Hi there,

I can relate to your pain. Sorry you're having such grief! People who have never had severe nerve pain cannot relate. My injury was now 3 years ago, the disk has healed itself (is completely back where it is supposed to be) but I still have pain (5/10) every few weeks, but tolerable with the occaisional Vicodin. I guess I have some permanent nerve damage and collapsed disk space.

To answer your question, when will they do emergency surgery: well, they will if you have any bowel or bladder incontinence, or if it looks like you will have permanent nerve damage (severe leg weakness for example). I did have some leg weakness and was limping around, but went to the ER and they put me on oral prednisone for a week and that really helped.

Have you had an epidural steroid injection yet? I did and it took away all of my pain, for months. I was even pregnant at the time!

Have you seen a neurosurgeon yet? If your disk is not any worse, maybe ask about the Ligamentum Flavum (a little yellow ligament in the spine that can mimic disk injury pain by pressing on the nerve root: often not diagnosed properly, but usually only affect older people).

As far as taking pain meds. It's difficult not to take narcotics when suffering from nerve pain. Nothing else usually works well enough for that type of pain. I'm not sure how much muscle relaxants would help nerve pain. Maybe decrease that and increase your narcotic??? Just a thought. I just have to suffer at work, and then take narcotics when I get home. If your pain is so severe that you need to be taking narcotics during the day, every day, then you need to be doing something different, as obviously we can't practice while taking narcotics.

Feel better!!!

Sue