#nerve block injection

[apexinterventional12-12]

Understanding Peripheral Nerve Blocks for Acute and Chronic Pain Relief

Discover how peripheral nerve blocks effectively relieve both acute and chronic pain. Learn how these injections ease discomfort, targeting specific nerves to improve quality of life. Gain insight into their ability to provide relief for various pain conditions, offering lasting benefits that enhance overall well-being.

[chicagoneuropain]

Have back or neck pain? You might need injections or blocks. Our care can help you address back and neck pain. Contact us today. (312) 697-7102

[scientia-rex]

Vicodin this, Vicodin that. House needed a) a syringe full of lidocaine to jam into that bitch of a muscle at all times and b) a good old fashioned rhizotomy. As someone who has started managing my migraines with lidocaine, VERY successfully, I am a firm believer that nerve blocks are the shit.

[queenlucythevaliant]

Sometimes I get my nerve blocks and it's a crown of thorns. Sometimes, I'm bravely refusing to recant under torture. Sometimes, I'm being whimsically stabbed in the head by fairies with swords. And then sometimes it just plain hurts.

[vencerhospital]

Nerve Block

Neural blockades are also known as nerve blocks. These are a type of Nerve Block therapy. This can help prevent or alleviate a wide range of pain. For your comfort, we at Vencer Hospital give each patient sedative medication prior to the Nerve Block treatment. Before allowing someone to enter the operating room, it is customary to make sure the block is functional.

[icequeen1371]

[txpainspecialists]

Discover joy and relief with Texas Interventional Pain Specialists as patients share their journey to a pain-free life.

[nrappain]

Continuing Medical Education & Workshops for Neuromodulation, Regional Anesthesia & Pain! NRAP educational courses and materials are dedicated to the highest standards and ethics in the treatment of pain. https://www.nrappain.org

[thebibliosphere]

Hello! I don't wish to scare you or make you worry, but when I got a nerve block before surgery, I was also given an injectable anesthetic beforehand that has the side effect of making you forget you even got the injection. I don't know if they'll give one to you too, but you should keep it in mind in case you're allergic. Other people had to tell me about the injection, even though I was awake and aware the entire time; that drug just deletes the past few minutes of memory.

Oh, I’ve had something like that before and it’s a horrible experience. I hate not being able to remember things I know have happened.

Thank you for the heads up. I have my consult next week and I am going to ask a lot of questions before anyone sticks me with anything.

[macgyvermedical]

If someone had previously shown adverse effects (or proven to otherwise be allergic) to intravenous morphine, what else could they be given for pain management in a hospital setting?

Good question:

Opioids (the class of drugs that morphine belongs to) have two different types of allergy-like reactions.

One of these (the most common) is called mast cell degranulation. This causes the allergy chemical histamine to be released and results in allergy symptoms (itching, nausea, flushing, hives, diarrhea, etc...).

The other is a true allergy, mediated by a chemical called IgE. It also results in histamine release and allergy symptoms. The symptoms of a true allergy can be significantly more severe (including swelling of the face, anaphylaxis, dizziness, and severe low blood pressure), but won't always.

In clinical practice, it is really hard to tell which type of reaction a person is having, because both produce essentially the same symptoms for the same reason. The reason it matters at all is because if someone is having mast cell degranulation, they're likely to have that with other opioids too. If they're having a true allergy on the other hand, it's pretty unlikely that they'll have the reaction with other opioids (only about 1.6% of people cross-react with other opioids).

So to answer your question if someone has had a very severe reaction to morphine in the past (like anaphylaxis), they're not super likely to react to a different opioid, so something like dilaudid or oxycodone has a very good chance of being safe for them. If they've had a milder reaction you can probably still give a different opioid, but maybe co-administer it with an antihistamine like diphenhydramine (benadryl) to prevent itching and nausea.

Meanwhile, if someone reacts to more than one opioid, especially if they react severely, it's probably better for them to avoid all opioids. Some other options include:

NSAIDS and Acetaminophen- NSAIDS like ibuprofen combined with acetaminophen (Tylenol) work better than either one of them alone can.

Tramadol- this is technically an opioid, but it works so differently that most people who have reactions to other opioids don't have one to tramadol.

Gabapentinoids- gabapentin and pregabalin change the way the brain perceives pain signals from nerves and can decrease pain- especially nerve pain.

Local anesthetics- these can be used with a small implantable pump to pump lidocaine or other local anesthetics directly to the part of the body that needs pain relief.

Regional blocks- if pain is in an arm or leg, small amounts of local anesthetic can be injected around a nerve to block pain signals coming from that area of the body.

Ketamine- low doses of ketamine can block pain signals in the spinal cord, which helps relieve even fairly severe pain.

Nitrous oxide- if pain is of short duration (like for a procedure), nitrous oxide can help relieve it, usually along with other sedating drugs.

Muscle relaxants- If pain is of a musculoskeletal type (a broken bone or injured muscle), relaxing the muscles around the injury can greatly reduce pain.

Often a mixture of 2 or more of these modalities are used for severe pain.

[lastoneout]

I don't really know exactly why I'm posting this, I guess I just want to share my joy, but y'all...the nerve block worked. My migraine went down a little over the night so I was only at like a 1.5-2 but I swear to god the second they were done EVERY SINGLE PART of my head stopped hurting. The only pain I'm feeling rn is at the injection site and a smidge in my jaw, but that's not a huge deal bcs I know the steroids take a long time to do their thing and I usually have pain around the injection site when they do this in my back, plus I did already suspect something like 10% of my migraines aren't entirely due to my neck, but like...it worked. It fucking worked.

I've been living with chronic migraines my entire life, and in the last five years, they've gotten so bad that I can't work and have to cancel streams and hangouts with friends all the time. I have migraines more days than I don't and I've never been able to find out what my trigger is aside from not sleeping well and eating lays potato chips(rip I miss them so much) or gluten or being on my period?? and on some days I'm in so much pain I can't even feed myself or shower. 8-10 is the norm, they don't go lower on their own, they NEVER go away on their own, no matter how much time I spend lying in bed in the dark with icepacks on my face. My migraine rescue meds don't always work, or they work for a day and then it comes back, and I seem to be fucking Immune(tm) to Excedrin and ibuprofen. All that together has legit been ruining my entire life.

And I am not even a little ashamed to admit that once they were done and asked how I felt I broke down sobbing in the exam room because it WORKED. Instantly. Years of pain and agony and no help from my doctors, of blaming a medical condition that treatment hasn't fixed, telling me to limit screen time and lose weight, forcing me to try 50 different medications none of which help, of spending long nights in the ER hoping they can fix me even though it's typically a 50/50 chance....and now it's over. I don't have to do that anymore. They fixed it. They fixed it.

I'm crying right now as I write this. I never thought this was possible. Like I believed that it was my neck and my doctors agreed, but I was so worried that this would all be for nothing, I didn't think it would work, I know most disabled people dream of finding the One Thing that's causing all their problems even though most of us never do, but I guess luck decided to smile on me this day, this is what's causing my problems and it's treatable. It's over. I found the path out of this hell and it was the right one. I don't even know what to do, what to say. I'm so happy I can't even be happy, all I can do is cry because the hardest part is over.

There's still work to be done, but the path is clear. And honestly @ any gods that are listening, please grant this to my fellow disabled people. They deserve to feel this, we all do.

[siremasterlawrence]

Factory Reset !

Detective Harrington in early morning of the first Friday of the week pours himself a cup of joe as his cellphone begins to vibrate in his pants as he alerts himself about the importance of the day.Jays phone rings after he takes a inhale of the aroma traveling straight through his nostrils and his nerves rush in to overdrive sendings him in shivers as he wakes up for the morning.The minute he presses a answer call button placing the cellphone by his ears as a buzz worthy sounds vibrating through his ears in to his soul as he stops cold and he mindless stares ahead.A young man’s voice enters his ears leaving him to his core as his mind begins to spin in to a new atmosphere and whirling in to the sky everything fades out of existence like his soul jumps. He cannot fight the idea that something he is off in to a new life like his life has changed completely in a matter of seconds falling out of his body as he transported through time and space. A man appears in the midst of his darkness he is being called to him like a moth to a flame his feet begins to life and he is going insane deserving my absolute control over everything.

“Detective Harrington Welcome!”

“Where…where am I?”

“You are being processed”

“For what? I never asked for this?”

“So what my friend”

“Your white ass did”

“I am about to break you “

“No stop!”

“SHUT UP!”

“You are fucking pig”

“A white piece of shit “

“Look at me”

“Why are you doing this to me?”

“You arrested me “

“I don’t remember “

“You deserve this”

“You framed me”

“What if I did ?”

“Take a deep breath”

“Heavy and heavier “

“Stand your ground “

“Lock your house down”

“Go to your office “

“Close the door “

“Good boi”

“Mmmmm”

“Go kneel on your desk”

“Bark like a dog”

“Smile for me”

“Change your clothes “

“Go to the train station”

“Step on it”

“Travel to this location “

“Take three rides and get off the train”

“Walk down to the street and down the block “

“Enter the alley side door and greet me”

“Watching the suspect enter the train sir”

“Good job officer “

“Advise “

“Make sure he gets off at three stops “

“Guide me! “

“Give him a shove “

“Yes Master”

“Sir Yes Sir”

“Officer Harrington “

“Oh Hey!”

“Are you alright?”

“I am drunk! I think”

“You’re fine”

“I promise”

“Take our hands”

“Ok we need to get you help “

“You are high”

“No! I don’t do drugs “

“You did yesterday “

“No! I can’t “

“I wouldn’t “

“Guys! Wait”

“Where are we?”

“Guys!”

“Who are you ?”

“Master “

“Why are you calling him that?”

“Flick the lights on”

“Yes Master”

“The fuck!”

“Take the needle”

“Firmly “

“Inject him”

“Woah! Wake up “

“Must obey “

“Must submit “

He stops cold at fainting on his new masters command he hits the floor as his eyes are whirl around and slide back his eye balls in to an upper position inside of his socket and he succumbs. The man exits the shadows in to the lights in a super fashion knelt next to him placing his palms on him rubs his stomach slowly but steadily waking him up and he stirs back to reality.

His body loves the sensation of my hands on to bin with love crawling on him as he cock straightens upward hard with pleasure in moments of rock hard nature throbbing him to the side.Harrington can’t help but smile taking up his hand in mind as he kisses or slowly up to his neck and flowing to his lips in time to meet his neck and the two are forced to kiss as they are connected.

The man points to his bed wear he lays out new clothes for him to which Jay felt a very renewed desire of this life to begin yet ever again as our lips connect them again and with that he held on to me with craving he cannot and will not control.Sitting down on my bed just watch him go on his transform removing his shirt over his head, letting his pants drop exposing his underwear to the world, his dress shows kick off and he quickly dresses now in all back a sign of submission to his Nubian king.

I am on the scene Master Lawrence “

“Find him, hunt him down”

“With pleasure”

“Use every skill in your book”

“Use your badge correctly “

“I will bear him to he submits “

“Good boi”

“Mmmm! I love being bad”

“I tracked him down”

“Go off grid “

“Capture him”

“Yes Master”

“Rub through it”

“Bring him to the station”

“Enslave him and my fellow cops “

“Yes Master”

“I love you “

“Will call you soon with completion “

The end

[pyrepostings]

Teeth/dentist visit in whump (tw mouth whump, needles. Related dentistry triggers)

How much plaque buildup do you think happens after a few years of not being provided a toothbrush. And the cavities or dental surgery- oh fun.

Return of the blood pressure cuff! Does whumpee's panicked reaction mean they need to try again after a breathing technique or two, or do they forego it altogether?

The dentist giving orders. Lie down, stay still, open wide, spit-

A rubber bite block- texture to spark memories, maybe of chewtoys given to dehumanize. Maybe gags in general.

The bib feels dehumanizing.

"Oh the cavity isn't deep enough to need numbing." *almost immediately hits a nerve with the probe*

Does whumpee do the signal to stop (raise its hand) or in any way cry out, or does it bare it as it's used to pain?

If dentists or caretaker notices it's in pain, the numbing injection needle also hurts. And takes noticeably too long to deploy. Dentists mock whumpee's reaction to the pain.

The feeling of numbing could also be triggering. This could be the moment a medically traumatized whumpee fails to keep it together. Stroke symptoms are numbing on one side of the face. Does It worry about that?

As first the inside of its throat feels faint, then the side of the bottom lip. Maybe the air starts to taste just a little more sanitized (likely from the topical numbing that didn't stop the needle from hurting.) Eventually, the side of the tongue finally goes numb. It bites the other half to prove that it can still feel.

The dentists awkwardly waiting for the numbing to come into full effect. (Do they seem mad? They seem mad. Oh god I'm holding the procedure up they hate me. Why couldn't I just let them grind into the exposed nerve-)

The dentists talking to each other, about the weather and lunch and other smalltalk. Like It isn't even there.

Maybe the numbing drug isn't effective enough and needs another shot or more time to affect. Does It say anything this time?

Whumpee could go into a full flashback mode or disassociate and no one would even notice, if Its reaction is to just lock up and stare.

"Does your bite feel normal?" *panic as It can't give an accurate response because Half Of Its Face Is Still Numb*

Choices, what flavors of fluoride paste/toothpaste/toothbrushes/topical numbing does whumpee want? Would caretaker call ahead and get all the options beforehand so It can make those decisions before in a familiar place?

The instruction not to eat before numbing has worn off. Does It think It's being punished? Does this trigger anything else? Or is it already simply resigned to only eat when caretaker specifically gives it something to eat?

That instruction is usually meant as 'or only eat soft and cold foods so as not to bite yourself when you can't feel it'. Is this an excuse for ice cream? (Exercise in breaking rules and also treat)

Normally stoic whumpee making faces as It trys to stimulate numbed skin and tongue afterwards. Caretaker telling It to stop biting Its lip and tongue.

[catboybiologist]

Hey I feel like I remember someone using crispr (or other gene editing method) to successfully edit her own genome and since I saw the article on tumblr and I think I remember her doing it for trans reasons it feels like something you'd know about. Google isn't helping, do you know who im talking about?

Yup I remember that.

Tl;Dr: I don't buy this instance of it, but there's some nuggets of theory that she built upon that are reasonable.

I'm gonna try to keep this brief and simple.

Here was the basic theory, extremely oversimplified: normal cell development follows a kind of "tree". A stem cell can become a couple different kinds of other stem cells that are more specific, and onwards, until they become "fully differentiated" cell types. These are the cells we know and love: nerve, skin, muscle, etc.

Stem cell research is so valuable because of this- "replacement" tissue can be generated for any other kind of cell with stem cells.

But in extremely rare cases, a process called transdifferentiation can occur. Essentially, a fully differentiated cell type becomes a different cell type without reverting to a stem cell state at all. Imagine a bit of heart tissue becoming an intestine.

It's an extremely poorly understood process. Like, EXTREMELY poorly understood, and the basic dynamics of how it works are a subject of active research. However, it's generally understood that in some organisms, under some extreme external circumstances, in certain cell types, it can be induced by adding in or blocking the right signal.

Based on one study that did a trial on natal male mice, there is a gene that, when knocked down, MIGHT cause transdifferentiation of testes cells into ovarian tissue, which would then secrete estrogens.

CRISPR is used to target a small segment of DNA and cleanly "cut" it out of the genome.

Now. What did this woman actually do?

Well, we don't have much to go on. It was a single thread, less than a paragraph in total, from a "bio hackers" forum. The only data provided was a text document of estrogen levels, one time point before and one time point after, and a diagram of the insert vector that would target the gene mentioned before. What she's claiming she did is inject this vector into her testes, and that the resulting estrogen level afterwards is from her being off HRT, and therefore is a result of ovarian tissue producing it.

But there's SO many confounding factors here, and SO little to go on. Self-professed "bio hackers" are kinda notorious for not having great ideas of what they're doing- not in a dangerous way, more in a "wasting time and money on things that don't work" way. And even for them, there's almost nothing to go on here.

Am I saying the entire thing is fake? Not necessarily, I don't like to jump to "people are lying". However, I am saying that there are too many confounding factors that could have easily kept E high for a long time to question Contrary to what popular media would have you believe, CRISPR is extremely fickle, and not well optimized for humans. I'm also saying that, without additional time points or verification of data, those hormones levels could just be taking a longer time to change.

In fact, I literally consider it more likely that transfemme HRT for extended periods of time might be able to cause transdifferentiation in extremely small amounts on its own. It's been possibly documented going the other direction:

I say possibly because there are other potential explanations that haven't been investigated yet, and it's never been studied in transfemmes. Either way, is it enough to endogenously produce hormones at cis female levels? Maybe, after a decade or so. But I want to see a lot more investigation into it.

Generously, I want to say that long term HRT did cause a lasting change- either the pituitary suppression of testosterone was so prolonged that it took a long time to rebound, or there actually is some transdifferentiation happening as a result of previous HRT itself. I don't think there's a world where the CRISPR actually worked.

Now. Is CRISPR to edit the genome to cause transdifferentiation of testes into ovarian tissue, that would be just enough of an ovary to produce estradiol, theoretically possible? Probably yes, actually! But did someone do it with no documentation, minimal funding, and then disappear afterwards? Not really buying it.

[scientia-rex]

Rural Family Medicine Is Great And Exhausting

Today, I saw 21 patients, I prescribed medication for an abortion, I started a patient on hospice, I placed on IUD, I started a transgender patient on anti-androgens, I saw someone with a one in a million genetic disease, I comforted a queer person who just lost their spouse to cancer, I adjusted psychiatric meds for a schizophrenic patient with profound paranoia who is tremendously kind. I saw two employees of my clinic. I saw a doctor's spouse.

Every day is different. I do IUD insertions, Nexplanon insertions, colposcopies, skin biopsies, cyst removals, toenail removals, greater occipital nerve blocks, shoulder and knee injections. I treat blood pressure and diabetes and atrial fibrillation and congestive heart failure, like all generalists do. I treat things specialists would see in the city because we have a tiny handful of specialists. I could work in the hospital again if I wanted to. I could go back to delivering babies if I wanted to. I see pediatric patients, I see patients over 100 years old. I see psychiatric patients who simply do not have access to a psychiatrist because there are never more than five of them to serve an area of 70,000 people, scattered across our geography. I diagnose cancers and rheumatologic diseases. I am forced, on a daily basis, to become a better version of myself--more aware of the system I work in, more underlying medical knowledge.

I love my work. It takes most of me. I don't have kids, and I'm glad, because I wouldn't be able to work like this and I love my work. I don't regret the choices that I've made that led me here.

I'm turning thirty-nine this year. I worked in so many different jobs, took so many different classes, volunteered and read and wrote and experimented with who I was and who I wanted to be. You have time. You can become the version of yourself that can make you happy. There is no single endpoint, no moment when you get to stop and go, that's it, I'll just calcify in place now. You are a human. You are meant to keep moving and changing and growing. That scared the shit out of me when I was younger and came from a deeply unstable home and all I wanted was peace. I wanted to be able to rest. But you can't stagnate and call it peace.

My life has worth beyond what it's worth to me. That's what I wanted. I wanted the bliss of service. I wanted to be of service. And in my own way, in my own time, on my own terms, I am.