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Bartlett woman finds relief from hot flashes with a nerve block - BY SUSAN STEVENS - Daily Herald Health Writer - Posted Monday, April 30, 2007 It started with a twinge of anxiety. An instant later, Lori Lane felt like her blood was boiling, her face turned red and she became drenched in sweat. Then she'd be cold. Then she started to dread the next one. Hot flashes hit Lane a dozen times a day and five or six times a night. She never got more than four hours of sleep in a row. "You can imagine it's very wearing on you," said Lane, 55, of Bartlett. "It takes its toll." Lane tried to adapt her lifestyle. She collected an assortment of fans - hand-held, battery-operated, paper, electric. A yoga instructor, Lane tried breathing techniques and special postures to cool down. She dressed in layers. "My family would laugh at me," she said. "I'd be sitting there watching a TV show, and pretty soon my sweatshirt came off, then the long-sleeve T-shirt, then I'm sitting there in a tank top, and pretty soon I'd be putting back on the shirt and the sweatshirt, and pretty soon a blanket. Every half-hour I'd be doing this." Lori Lane of Bartlett had a spinal block to alleviate her menopause-related hot flashes. She is a yoga instructor at the Center for Spirituality in Bartlett. (Mark Welsh/Daily Herald) Lane tried black cohosh supplements, but they didn't help. She was frightened of hormone therapy, which had been linked to stroke and blood clots. Drug allergies made her hesitate to try other treatments. Then her son heard about a novel treatment offered by a pain medicine specialist in the Western suburbs. Dr. Eugene Lipov of Advanced Pain Centers injects marcaine - a drug commonly used in epidurals during labor - into a bundle of nerves in the neck. These nerves, the stellate ganglia, regulate blood flow and sweating and are connected to the brain regions that control the body's thermostat. Numbing the stellate ganglia can slow their activity. Lipov got the idea from his brother, Dr. Sergei Lipov, an internist in Elgin, who treated a woman with severe hot flashes. Sergei Lipov thought her symptoms resembled a disorder called complex regional pain syndrome, which is linked to the same part of the brain as hot flashes and can be treated with nerve blocks. Eugene Lipov tried a nerve block on the woman, and it worked. "Then my nurse started to develop severe hot flashes," Lipov said. "We did the injection, and she was the nicest person for three months." Lipov went on to perform the procedure in a total of 20 women. They've found varying levels of relief from hot flashes, with the positive effect lasting weeks or months. A second injection can extend the relief. The procedure itself takes about five minutes. Complications such as seizures are rare with new technology, including X-rays during the procedure to ensure correct placement of the injection. None of Lipov's patient's had those complications. Lipov recently published a case series of his treatment in the journal Medical Hypotheses. He's now recruiting patients for a new study of the technique in women with breast cancer who have severe hot flashes as a result of their medication. So far Lipov is the only doctor using nerve blocks to treat hot flashes. Dr. JoAnn Pinkerton, a professor of obstetrics and gynecology at the University of Virginia, said Lipov's early reports of the technique suggest it could help some women, but she urged caution. "It's a fairly invasive procedure, particularly if you can try deep breathing or relaxation techniques, or if you're a candidate for hormone therapy," she said. "I think it's very interesting, but we need data." Lane is satisfied with her treatment. After her first nerve block, Lane said her hot flashes declined 30 percent, and the ones she did get were less severe. After a second injection, she has three to six mild hot flashes a day. "Now there're not even hot flashes," she said. "I'm calling them warm flashes." |
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