Is it worth traveling to have specialists do the blocks?

[Pudendalite]

Hello, I have been bedridden for 6 years due to pudendal neuralgia after a car accident. I just recently had a MRN that proves my nerves are inflamed, edema is clearly shown. My question is: is it worth traveling out of state to have the nerve blocks done by specialists or is it safe/effective for any pain doctor to do the injections? I am considering flying to Phoenix to have nerve blocks by Dr. Hibner's team but would be much more affordable to have it done where I live. Unfortunately my current pain doctor says he has not done very many pudendal blocks which makes me nervous. Any advice or input would be appreciated, thanks.

[stephanies]

In my opinion, it is worth traveling to one of the specialists if you can. They are more familiar with where/how to do the injections and you can be confident in the results. I had one set of blocks done semi-locally by a relatively new doctor and it was a not a good experience.

Sincerely,
Stephanies

[Pudendalite]

Thank you for the input. Unfortunately I just called Dr. Hibner's office and they refuse to accept me as a patient because I am self pay. I don't know what my options are now for specialists. I live on west coast and am in too much pain to travel very far. Seems like Dr. Filler is the only option. Dr. Attaman is the closest to me but I have not seen many reviews about him on this board and he is a general pain doctor not specializing in pudendal neuralgia. I may have my own doctor do the nerve block and if it doesn't go well I will travel to see Filler or Attaman.

[stephanies]

That is interesting about them refusing you for being self-pay. Maybe someone with expertise on medical insurance knows why -- is it against his contract with the insurance companies? I would think a doctor would get more money from a self-pay patient than one with insurance. I haven't seen his name recently on the forum, but Dr. Sheldon Jordan in CA did pudendal nerve blocks. I had Botox with him in 2006. Maybe others on the west coast know other doctors to consider.

My best to you,
Stephanies

[Pudendalite]

I went ahead and scheduled with my local doctor, we'll see how it goes. He uses ultrasound and fluoroscopy. It's an injection directly into alcock's canal because he said that's where the problem shows up on the MRN. I had no idea, I thought these injections were always done at the ischial spine.

[Violet M]

Nerve blocks can be given at the ischial spine or the alcock's canal.

If there are any PT's who are from your area who are on our list of PT's' they might be able to direct you to a doctor in your area who is experienced with nerve blocks.

Violet

[Pudendalite]

I was given the wrong information, Dr. Hibner's office called me back today to schedule. They do accept self pay and give a 50% discount! My consultation is scheduled for October. Now I can't decide if I should have the nerve blocks where I live before the the consultation, or wait and schedule them with Hibner's team. I am supposed to have a physical therapy evaluation in Phoenix, if it's right after a nerve block and I'm having less pain I'm concerned they might not get an accurate picture of how bad my pain normally is. On the other hand it would save time and perhaps could speed up the scheduling of surgery (if Dr. Hibner agrees on it).

[stephanies]

In my experience, Dr. Hibner's office will do the MRI, then you meet with his PT, then you consult with him. Any procedures (including nerve blocks) that he decides to do would be after the PT eval, resukts of the MRI, etc. I remember when I had my first MRI/MRN with PN issues they told me to wait until at least 8 weeks after a block to have the imaging because it can skew the images. I forget exactly how or why or if that was just this one doctor's opinion, but you may want to check with Hibner's office before doing the block locally.

[stephanies]

I thought about it and it was Dr. Filler's office and they told me the block could cause inflammation in or around the nerve that might show up on the MRN and not accurately reflect the state of the nerve or surrounding structures.