Blog > Thoughts > Sean's Thoughts > Daydreams, and femoral nerve questioning
Daydreams, and femoral nerve questioning
Written by Sean on Sunday, March 25, 2007
Thinking of a simple surgery, really. Anesthetic, open the thigh, cut the femoral nerve, close up, done. Geee, put it in those terms, and you wonder how difficult could this be? One would think anyone with a modicum of surgical experience should be able to do this (well, aside from putting you under that is). A very simple surgery.
Femoral nerve: a tidy snip at the
hip joint, and there you go!
Daydreaming about being able to get such a surgery. There’s a surgeon in Asia who is doing elective amputations at a high cost. He won’t do a spinal cord transection. Would he reconsider and do a bilateral femoral nerve transection? It seems like the biggest argument disappears if you attack the femoral nerve rather than the spinal cord. Bowel/bladder/genitalia: Intact. Long term issues of pressure sores: Greatly reduced due to retaining feeling in one’s butt.
Not like I have several thousand dollars spare for such a surgery, and for getting myself to Thailand, or wherever such a surgeon operates.
I know someone who is both transabled and a surgeon. He declined helping. He claimed that his specialty was completely different, and that he hadn’t been practicing "general" surgeries in such a long time that he couldn’t do it. Surely it doesn’t take such a high level of skills and practice, does it? So what if you cut into the muscle, or botch the job? It’s not like the muscles will be used ever again, is it? I’m bitter about his response, actually. Because I don’t buy it. Had he told me "Sean, I’m sorry, the liability is just too high", I would have accepted it. I wouldn’t have liked it, but I would have accepted it. Or whichever other reasons. Just don’t take me for a fool. Play straight with me, and I’ll be straight with you.
And I’m thinking, would I be accepted into a rehab programme if I became a para as a result of such a surgery? Would I *need* rehab? Probably not, but I would like to go through it. It seems like rehab is an integral part of paraplegia. I’ve heard a lot about it. I’d like to experience it. Not mission critical, no. But it would be nice. Perhaps a moot point.
But going back to this femoral nerve thing, it would be ideal, wouldn’t it? Best of all worlds, really. Have one’s cake and eat it too. But of course, can’t eat that cake, because nobody will do it. And it’s not like you can do it to yourself. Obviously, there’s the pain factor, but then, there’s the femoral artery right next to the nerve. Wouldn’t want to cut *that*, would you?
Bah! Perhaps it’s time I send another batch of letters, like last year. Didn’t yield any results, but perhaps this time it might? Dunno. Dunno.
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12 Comments
2 On 23 March, 2007, Claire said:
And wouldn’t you have to hit the sciatic as well to parallyze the whole leg? That one is buried pretty deep, no way to get to it yourself.
My surgery to relieve some back pain/nerve issues included cutting small nerves leading to the femoral nerve and to alleviate some of the sciatic pain I was constantly having. The result, some numbness but not the constant nerve pain I had, a significant drop foot on my right side, and atrophy along the inside of my thigh and calf. I can get away with using a chair when I want, I do when needing long distances or long days. Most days I will use a cane or forearm crutch.
4 On 25 March, 2007, Sean said:
Welcome back Darci, long time no hear. :) I’m glad to see you.
I have only been lurking here before, but now that you bring up my favorite topic of amateur home surgery, I have to comment. A basic principle of “real” surgery is that the surgeon has to have a DEEP understanding of the area to operate on. That may explain why surgeons are unwilling to work on unfamiliar areas. It takes just a little bit of study , like Gray´s anatomy on the net, to find out about a structure called the Femoral sheath. That is a hose-like tube bundling together the Femoral nerve, vein, and artery.
Both those vessels are finger-thick.
Cutting blindly in that area at home could easily cause some very unwanted effects.
But you could ask your surgeon friends if they could perform a Femoral block on you, using a local anestetic (preferably long-acting) to give you an idea what a loss of femoral function is like. I think that is fairly commonly done for knee surgery. Maybe not exactly what you want, but maybe something you can actually have?
Btw, the Femoral nerve running “close to the skin” was some 4 cm deep when I once located it on myself in a sitting position. Used the better part of a 50mm cannula to poke it, just for practice.
6 On 26 March, 2007, Sean said:
Hello Jay, Thank you for coming out of the shadows and commenting on this post.
I should point out that I do NOT recommend anyone attempt DYI surgery. Never have, and never will.
I’ve often wondered if a doctor would be willing to do either an epidural or a femoral nerve block, but there again, the problem lays with finding a willing surgeon/anesthetist. Might be easier to find the proverbial needle in the proverbial haystack…
7 On 27 March, 2007, Claire said:
Whoops, no, I wasn’t advocating home surgery either, I had something entirely different in mind. Sorry, that was totally unclear. (And no, if you don’t already know what I’m talking about, don’t ask).
Jay, how did you know that you had actually located the femoral nerve? Pain?
Oh, that´s rather obvious. Whenever a nerve is touched like that, it makes a kinda unpleasant tingling, in this case down along the thigh. I expect that pushing the cannula into the nerve would be outright painful, but I never tried that.
A \”DIY\” sciatic block is actually quite easy if are adequately equipped. A femoral nerve block is far more difficult and dangerous. Either, performed by a competent if unethical doctor/surgeon would be of very little risk. (healthy patient)
I know of a practitioner in Europe who has performed both on a permanent basis. The cost? about $ 100,000 for both!
10 On 25 August, 2010, Sean said:
well, adequately equipped is tricky to start with. And do it yourself, involving sticking needles in specific places in your own back is… very tricky, not “easy” at all. Unless you’re a contortionist.
As for $100,000 for surgery, that’s extortion. A surgeon demanding that kind of cost to help is not in the business of helping people.
He is there to make money and put the Hipocratic oath aside, but is an expert surgeon and orthopaedic specialist. Note thet no nerver surgery by a competent surgeon is cheap even when legally done. Any surgeon who operates to sever the sciatic or other nerve is taking a risk to his career, hence the high price.
The equipment is fairly expensive,PNS machine and needles and of course the know how, but it is not difficult to use. A sterile bed cover; a big mirror, etc etc. No need to be a contortionist but the ability to relax and be calm is very helpful.
Not in your back, study anatomy if you want to know how you work! Buttochs/ Groin for the sciatic and femoral nerves. Anything higher will destroy erectile function, cause bladder retention. do you want a supra-pubic catheter or a urostomy as well? I will not go into detail unles anyone is really interested.
Jeremy H
PS I am not transabled, I came across your site by chance and find myself intrigued by anyone who wishes to be disabled. I hope that you do not mind me being here.
Jeremy, welcome. You’ll find that most people who are here, who stick around, know a great deal more about their anatomy than lay folk do. Our knowledge may not extend into the depth a surgeon’s might, but we’ve done our research.
We know from our own experience or the experience of others that self-injury or attempting DIY surgery is a dangerous area best left alone.
Thus, Sean’s search for a surgeon.
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1 On 23 March, 2007, Claire said:
Do it!! Send out that batch of letters. It’s worth another try. Find a surgeon, and you’ll figure out the money. If you don’t try, you’ll never know.
And if they refuse…FWIW, at that junction, the femoral nerve is very close to the skin. If you are very careful, it can’t be any more difficult or dangerous or painful than the methods that the successful amp wannabes have used, can it?