Yesterday I had a right stellate ganglion nerve block, the first of two experimental procedures to hopefully reduce my POTS symptoms. Again, this procedure is done for a variety of reasons including relieving pain and has been done on other people with arrhythmias but has not been done on someone with POTS alone. The sympathetic nerves, such as the stellate ganglion, are part of the autonomic nervous system. A stellate ganglion nerve block involves injecting medicine around the sympathetic nerves in the cervical (neck) area. The theory is that by doing this, the system is temporarily blocked in hopes of reducing my POTS symptoms. If my body reacts well to the nerve block, the doctors believe a more permanent fix such as cutting of the nerves, may be the ultimate solution to my POTS problem.
Before the nerve block yesterday, I had a series of autonomic tests done to test my autonomic nervous system and its dysfunction at baseline. This included tests of blood pressure, breathing rate and heart rate at baseline, laying, sitting, during a hand grip test, and during a math test(mental stress). The nerve block is usually done under conscious sedation but we opted not to use sedation as we had to do a post test and because it usually doesn’t work on me anyways. I was laid on the OR table, draped and prepped. The doctor inject local anesthesia in the front of my neck(throat area) and proceeded to inject the anesthesia to block my nerves with a needle placed in my throat area and positioned all the way back to my spine. I was completely awake and it was extremely painful. I could feel the needle on my spinal area.
Afterwards I completed the post test of the autonomic testing.
One of the indicators that the block worked correctly is Horner’s Syndrome, which affects only one side of your face. Typical symptoms of Horner syndrome include a drooping eyelid, decreased pupil size and decreased sweating on the affected side of your face. Well I had Horner’s Syndrome(see picture). It is only supposed to last a couple of hours after the procedure and if it lasts longer, there is a problem. Mine lasted all night last night. I was afraid it would be permanent. I prayed that these side effects would be resolved when I woke up this morning and I am thanking God they did! My face is normal today! Unfortunately, my POTS symptoms have not improved at all and I am having other side effects(pain, swelling, hoarseness, and more) and issues from the block today and I am not feeling well at all. Not what was supposed to happen.
According to my team of doctors, doing the left block(they can’t do both blocks at the same time due to swelling) should improve my symptoms because those nerve control the heart rate variability more. The left block is schedule for next Wednesday, June 5. I need to decide if this is something I want to proceed with, if I want to let the doctors experiment on me some more. If I want to put myself through this again for a chance of relief. I need to decide if I want to take this risk. We’ll see……stay tuned……