(no subject)
Ah back to the somewhat more sedate pace of the Live Journal. Live has picked me up like a dog with a rag toy and shaken me about, but I seem to be coming through in one piece, though perhaps a bit dizzy.
Where was I in my tale of healing and recovery? The knees have settled down a bit thanks to application of Advil and the end of faire. The wet and damp season here in the City is beginning to ramp up though and I’m not looking forward to that… I’ve brought in a heating pad to work though which should help a great deal. I’ve also ordered some custom orthotics from my chiro which should arrive in the next week or two and help to brace everything up in the right way… yay arch support!
The biggest news in my life is finally getting into the USFC Pain Clinic. They called saying that I had to go in for my evaluation appointment… after 3-4 months trying to get in, they wanted to see if they actually wanted to treat me. I was terrified. What if I wasn’t in *enough* pain? What if they didn’t believe me? What if they turned me away with no answers and nothing to show for all the waiting and patience?
But the appointment was amazing… The person who took my history and gave me my initial exam was a doctor, not an intern, nurse, or surly assistant. She listened attentively and generally put me at ease. We talked a great deal about my shoulder and the injury, and how my life revolves around it now… Can I reach over my head? When does the numbness kick in? What makes it feel better? What makes it feel worse? We talked briefly about my knees and hips.
She took my basic vitals, and damn near gave me a heart attack when the blood pressure machine gave an initial false reading of very very bad (aka, OMG you’re going to die). But after re-taking my BP everything was fine. The most peculiar thing she did was stick two topical thermometers on the backs of my hands - those stickers that change colors? She was looking for them to be symmetrical, and lo and behold they weren’t - the left, injured arm was colder by several degrees. Poked, prodded, bent, and questioned.
Then she left. I was left to sit for a long time. What felt like a very long time.
But then back she came with the presiding doctor, a trim woman who spoke fast but clearly, and who was relaxed and at ease. She slouched back comfortably in a chair and started in on what kinds of treatment options were available to me - no questions about whether I needed it or questioning my need, just what needed to be done to help solve what was going on.
She started with great detail about what we can do if things deteriorate - “You’re not there yet, but if things get worse we can…” Some of those things are kind of scary intense, but I find it oddly comforting to know they are out there, that no matter what happens, my life doesn’t have to have pain in it forever. One option is to do an epidural to the spine or the shoulder, a steroid block right to the nerves where the damage is assessed to be, to ease the pain… there’s risk of nerve damage, but since things are already horked up it’s sort of low risk in some ways. If things get really bad, they can implant this really crazy thing to my spinal column that is essentially electric wires that will feed low current to my nerves, an internal tens unit, with the wires going down my spine to a battery pack in my ass that I charge through induction via a belt thing. That’s if things get so out of hand I can’t work etc, but it’s there for me.
But for now, we’re taking a much more non-invasive approach. First off, I’m to see a physical therapist who is a pain rehabilitation specialist. I need to call and schedule an appointment actually… She’ll hook me up with a normal external tens unit and get me exercising to strengthen and what not. Also, though there are some insurance issues, I’ll be seeing a pain psychiatrist to look at psychological factors of pain and relaxation things I can do to ease things up.
The more western medicine angle we’re taking is still pretty relaxed… I’m going to be taking topiramate (the brand name is Topamax), which is technically an anticonvulsant but that does a great job of shutting up nerve pain. The idea is that my nerves are stuck in a feedback loop where they keep screaming, “YOU’RE HURT, YOU’RE HURT, YOU’RE HURT” which is something I’ve known fairly intimately for the last five years or so… but once they’re stuck in that pattern they tend to stay in it even though it’s not longer useful. If we can quiet them for a while and essentially reset them to a zero point, then I can move forward from there. The nice thing about this is that if this script works for me, I need only be on it for about six months - long enough for the pain to stop, to get things to settle, then wean off once they’ve been shushed. Hopefully at that point, they’ll have been reset to normal and no more screaming nerves…
I’m also taking amitriptyline at night which is an antidepressant, though at the dosage I’m taking it, that affect is pretty weak. An off-label use for it is in treatment of chronic pain, and as a sleep aid, and it’s been prescribed to me foremost to help me sleep, and secondarily to help the pain. Currently, I get woken up at night from pain either in my shoulder or in my hips and knees, either from sleeping in a position that is awkward or from the fog rolling in at night / barometric pressure changes, and the idea is that if I sleep the night through, my body will be more capable of a) handling pain and b) healing itself.
The final new script is my new best friend - lidocaine patches. Lidocaine is basically a numbing agent, and the patches basically transmit a dose through the skin to the area you put it on. There are no side effects, and it’s localized to the area so it’s not systemic. I can cut them up so that they target just the area that hurts, and can have a max of three on at a time, for 12 of 24 hours in a day. In other words, if my AC joint hurts, I can slap half of one of those bad boys on it and it doesn’t hurt no-mo.
They also like the tramadol, and think it’s a fine pain killer for systemic dosing, so hurray for that. They seemed to think that things like Percocet and Darvocet were “mild” opiates, which I don’t agree with, so I’m pretty ok with sticking to my tramadol.
I also had an EMG today to test the nerves in my left arm again, and the test came back normal which is great news… but that’s a whole different storey. This has gone on long enough :)
Where was I in my tale of healing and recovery? The knees have settled down a bit thanks to application of Advil and the end of faire. The wet and damp season here in the City is beginning to ramp up though and I’m not looking forward to that… I’ve brought in a heating pad to work though which should help a great deal. I’ve also ordered some custom orthotics from my chiro which should arrive in the next week or two and help to brace everything up in the right way… yay arch support!
The biggest news in my life is finally getting into the USFC Pain Clinic. They called saying that I had to go in for my evaluation appointment… after 3-4 months trying to get in, they wanted to see if they actually wanted to treat me. I was terrified. What if I wasn’t in *enough* pain? What if they didn’t believe me? What if they turned me away with no answers and nothing to show for all the waiting and patience?
But the appointment was amazing… The person who took my history and gave me my initial exam was a doctor, not an intern, nurse, or surly assistant. She listened attentively and generally put me at ease. We talked a great deal about my shoulder and the injury, and how my life revolves around it now… Can I reach over my head? When does the numbness kick in? What makes it feel better? What makes it feel worse? We talked briefly about my knees and hips.
She took my basic vitals, and damn near gave me a heart attack when the blood pressure machine gave an initial false reading of very very bad (aka, OMG you’re going to die). But after re-taking my BP everything was fine. The most peculiar thing she did was stick two topical thermometers on the backs of my hands - those stickers that change colors? She was looking for them to be symmetrical, and lo and behold they weren’t - the left, injured arm was colder by several degrees. Poked, prodded, bent, and questioned.
Then she left. I was left to sit for a long time. What felt like a very long time.
But then back she came with the presiding doctor, a trim woman who spoke fast but clearly, and who was relaxed and at ease. She slouched back comfortably in a chair and started in on what kinds of treatment options were available to me - no questions about whether I needed it or questioning my need, just what needed to be done to help solve what was going on.
She started with great detail about what we can do if things deteriorate - “You’re not there yet, but if things get worse we can…” Some of those things are kind of scary intense, but I find it oddly comforting to know they are out there, that no matter what happens, my life doesn’t have to have pain in it forever. One option is to do an epidural to the spine or the shoulder, a steroid block right to the nerves where the damage is assessed to be, to ease the pain… there’s risk of nerve damage, but since things are already horked up it’s sort of low risk in some ways. If things get really bad, they can implant this really crazy thing to my spinal column that is essentially electric wires that will feed low current to my nerves, an internal tens unit, with the wires going down my spine to a battery pack in my ass that I charge through induction via a belt thing. That’s if things get so out of hand I can’t work etc, but it’s there for me.
But for now, we’re taking a much more non-invasive approach. First off, I’m to see a physical therapist who is a pain rehabilitation specialist. I need to call and schedule an appointment actually… She’ll hook me up with a normal external tens unit and get me exercising to strengthen and what not. Also, though there are some insurance issues, I’ll be seeing a pain psychiatrist to look at psychological factors of pain and relaxation things I can do to ease things up.
The more western medicine angle we’re taking is still pretty relaxed… I’m going to be taking topiramate (the brand name is Topamax), which is technically an anticonvulsant but that does a great job of shutting up nerve pain. The idea is that my nerves are stuck in a feedback loop where they keep screaming, “YOU’RE HURT, YOU’RE HURT, YOU’RE HURT” which is something I’ve known fairly intimately for the last five years or so… but once they’re stuck in that pattern they tend to stay in it even though it’s not longer useful. If we can quiet them for a while and essentially reset them to a zero point, then I can move forward from there. The nice thing about this is that if this script works for me, I need only be on it for about six months - long enough for the pain to stop, to get things to settle, then wean off once they’ve been shushed. Hopefully at that point, they’ll have been reset to normal and no more screaming nerves…
I’m also taking amitriptyline at night which is an antidepressant, though at the dosage I’m taking it, that affect is pretty weak. An off-label use for it is in treatment of chronic pain, and as a sleep aid, and it’s been prescribed to me foremost to help me sleep, and secondarily to help the pain. Currently, I get woken up at night from pain either in my shoulder or in my hips and knees, either from sleeping in a position that is awkward or from the fog rolling in at night / barometric pressure changes, and the idea is that if I sleep the night through, my body will be more capable of a) handling pain and b) healing itself.
The final new script is my new best friend - lidocaine patches. Lidocaine is basically a numbing agent, and the patches basically transmit a dose through the skin to the area you put it on. There are no side effects, and it’s localized to the area so it’s not systemic. I can cut them up so that they target just the area that hurts, and can have a max of three on at a time, for 12 of 24 hours in a day. In other words, if my AC joint hurts, I can slap half of one of those bad boys on it and it doesn’t hurt no-mo.
They also like the tramadol, and think it’s a fine pain killer for systemic dosing, so hurray for that. They seemed to think that things like Percocet and Darvocet were “mild” opiates, which I don’t agree with, so I’m pretty ok with sticking to my tramadol.
I also had an EMG today to test the nerves in my left arm again, and the test came back normal which is great news… but that’s a whole different storey. This has gone on long enough :)