SO. To recap...
I had my first (really the second, the 1st was in August) spine injection a week ago Wednesday.
It didn't work.
In fact, it made so hurt so much that for three days I woke up, suicidal thoughts in my head.
I have NEVER had a suicidal thought in my life. Not ever. It freaked me out.
Of course, my pain doc said he'd never heard of such reactions, and blahblahblah.
I had a follow-up with my primary care doc on Monday, to let him know I wanted to take a different direction with my treatment, and to go over the list of symptoms I'd written up covering major things from the last ten years or so. Especially troublesome to me were the new symptoms of the last week, many of which were brand-new things to me, including a huge loss of appetite, obsessive thoughts of using speed again, and suicidal thoughts. ALL things that are COMPLETELY out of character for me.
I told him I really didn't want any more shots, surgeries or medications, and that I wanted to start looking into alternative treatments, like acupuncture or cognitive behavioral therapy; ANYTHING to help end this increasingly hopeless state of mind I've been slipping into over the last ten months or so. And I told him I wanted to begin getting off so many medications.
Since this summer, I have been taking 4 aspirin, 8 ibuprofen, and 1-2 tramadol every day for pain. The tramadol has narcotic-like properties, and so I don't like to take it anymore than I have to, which is why I've been alternating it with the OTC's.
In addition to the pain meds, I also take a muscle relaxer called Soma, Zyrtec for allergies, and Xanax for anxiety (to help me sleep).
All in all, it's a shit-load of meds for a 37 year old man who by all outside accounts should be healthy. I don't drink, smoke or do any recreational drugs, I eat fairly healthy, I've been sober just short of 20 years, and I
ought to feel better. Even my CT scans, nerve conduction tests and MRI's have shown that, while I have some damage in my shoulders and some arthritis in my neck, nothing is outside the range of normal for someone my age.
So anyway, my doc is actually a pretty good good guy, and I like him, so I didn't argue when he threw three new prescriptions my way. First, he said the appetite and nausea problems were most likely due to stomach damage caused by all the NSAIDS (aspirin, advil) I was taking, and that I had to stop taking those immediately. He prescribed prilosec to fix the stomach ulcer, and absolutely NO NSAIDS, at all. He reiterated that the tramadol was not addictive, and that I should take it as prescribed, 1-2 every six hours. It wouldn't hurt my stomach, and it was not (as I had heard from another doctor) dangerous to my liver.
Then he prescribed a new arthritis cream called
Voltaren. It is supposed to help with the neck pain without the negative effects on my stomach. Finally, he prescribed me
Cymbalta. It is marketed as a panacea, a cure-ALL for multiple needs. Especially considering the depressive thoughts, he believed it would do wonders for me. In addition to being an antidepressant, it is a pain reliever, and it would allow me to drop my medication intake down to three (the cymbalta, Xanax, and the tramadol). He gave the the scrips and a sample of the cymbalta, and sent me on my way.
So, being desperate, I took a cymbalta when I got home, then I went to the pharmacy to fill the scrips.
Much to my surprise, however, the pharmacy wouldn't fill the cymbalta scrip. It turns out that cymbalta
is not safe to take with tramadol.
WTF?
I went home and started doing some research. Not only is there potential for seizures when the two are taken together, there is moderate danger when taken with Xanax (though I found out cymbalta is also an anti-anxiety).
Hello fucked-up night of little sleep and paranoia.
Shortly after going to bed, I heard loud ringing in my ears. Weird flashes of pain, twitchiness... not to mention countless other irregularities in thought and sensation.
I don't know if the drugs were causing me to react strangely, or if it was just my worrying about it, but either way it was a rough night.
So anyway, I woke up Tuesday and went to school. However, I didn't take
anything, because I was afraid of what might happen if I did.
And, it turns out, I made it through the day ok. Yes I hurt, but I realized that I'd been hurting for quite awhile while taking the meds anyway.
So I called my doc, who apologized for not knowing (it's not uncommon, and it is why we have pharmacists) and who told me to stop the tramadol and to wait at least 72 hours before resuming the cymbalta.
So here it is, five days since I've taken any pain killers (aside from the topical I rub into my neck) and I am feeling ok. My neck and shoulders still hurt, and I am still having trouble sleeping, but I haven't begun the cymbalta (I don't know if I will or not) and I've only been taking the xanax, which really does make a noteable (though small) difference in the amount of time I sleep.
I also went to an acupuncturist on Thursday, and it was pleasant. Whether or not it will really help, well... we'll have to wait and see.
My current plan is to stick with the acupuncture, play it a day at a time in regards to starting the cymbalta, and to begin exercising and working on stress relief techniques. I keep telling myself "baby steps, baby steps," and I am trying to get back to that old AA adage of
one day at a time. I believe that the root of my pain and health issues is repetitive strain injury in my neck, due to my poor sleep hygiene and heavy computer use, and my inability to deal with stress. So starting out small, I've been walking for 15 minutes every day during my morning prep at the park near my school, and I am planning on seeing a therapist to get some help with relaxation practices and stress management. I'm also looking around for a physical therapist that can help me learn how to sit and walk in a way that will help me regain healthy posture and will help relieve the muscle strain in my neck. Erin's sister sees a guy in NY who practices
The Feldenkrais Method. It is similar in philosophy to PT and chiropractic, but focuses on healthy movement instead of body parts like bones and muscles. Unfortunately, Las Vegas doesn't have any active practicioners, so I'll have to find something else, but approaches like that seem more like what I need than being filled with medicines that just interfere with the natural way my body is supposed to work.
The point is I am about finished with the traditional pills and surgery route, at least for now. I am not discounting the benefit of ALL medications, just the general idea that more is better where they are concerned. Simply put, I really think my problem is a holistic one, and I am trying some holistic approaches. At least for now.
And to end on a completely unrelated note, my friend Elaine found a little program which would count up the number of cuss words on your blog, with an assigned percentage. While I had no doubt I'd beat her out, I was surprised at how close our scores were, and that mine wasn't higher. My guess is that many of my profane utterances were obtuse enough to slip past the program's filter.