Already having had several cortisone injections in my hip joints, I was not prepared for yesterday's experience.
I had been somewhat anxious about the appointment because it was at a different hospital than I had received my other shots so I was not quite sure what to expect. (The doctor at the original hospital was a true sweetheart, and a really nice guy too!)
Anyway, to start with, the other hospital had always been quite insistent that one must not take blood thinning medication, aspirin or any anti-inflammatory meds for one week before the procedure. In fact, I had witnessed patients being sent home with instructions to rebook their procedures because they had taken an aspirin "three days earlier." (A good friend of mine, who also gets shots at the same hospital, has been instructed to stop using a topical anti-inflammatory for a week before her procedure.)
But this hospital? No such instruction was issued. They had asked, at the time of booking, if I was on blood thinner meds. That was it. No discussion of aspirin or anti-inflammatories.
So when the intake nurse started the questions and only confirmed that I was not on a blood thinner, I broached to topic of aspirin and other anti-inflammatory meds. Told her about my previous experience and my knowledge of the other hospital's procedure. (Of course, it isn't an issue for me since I can't take any of them.)
"That's a bit of overkill," she said. "We don't care if you take aspirin, or even if you take Celebrex. At worst, you might get a bit of a bruise. But that's all. We're only concerned if you're on Coumadin or Warfarin -- an actual blood thinner. Then we can't proceed."
Wow. You'd think if it was dangerous at one hospital, it would be dangerous at another. Or, if it wasn't dangerous at one hospital, it wouldn't be dangerous at another. I mean, both hospitals are within the environs of the City of Ottawa!
Methinks the policy should not be that different from institution to institution.
This "aspirin and anti-inflammatory" policy is significant for the patient. People are going for these shots because they have osteoarthritis. If they have to stop their pain medication for fully a week before the injection, they are being rendered almost cripple by the time they arrive for their procedure. Craziness, if you ask me!
Then we got on the topic of Synvisc injections. She told me that the hospital is no longer allowed to administer them. Not covered by OHIP. Cortisone injections are covered, but not Synvisc. It seems that the province has decided that there is no demonstrated benefit for Synvisc over Cortisone treatment so, since April 1 of this year, they're not covering the administration of Synvisc injections. Yet, I just had the shots administered by my doctor in June of this year. (Have to check with my doctor about how that works!)
You learn something new every day.
But the real surprise came with the administration of the cortisone injection itself. It was a totally different experience from the injections I had received at the other hospital.
The procedure was much the same.
Cleanse the area.
Freeze the area.
Find the way into the joint.
Inject Cortisone -- and Bob's your uncle.
But the comfort level was so much better.
The doctor cleaned the area.
He administered the freezing. ("You doing OK?" he asked.)
I barely felt it. (Previously, this part of the procedure was mildly painful.)
He inserted the syringe into my hip, finding his way into the joint. As I felt the slight sensation of pressure, I steeled myself for the barrage of pain (intense pressure) that I knew was to follow.
"You doing OK?" the doctor asked again.
"Mmhmmm," I replied.
"Why are you so tense?" he asked.
"Because I felt the pressure and I know what's coming next," I replied.
"The worse part is over," he said. "I'm in the joint."
And then it was done.
No more pressure.
Just like that it was over.
"Wow," I said, "you're much better at this than the doctor at the other hospital!"
And I meant it!