So here's another quickie update.
Last Thursday I finally stopped taking Nortryptlene for the first time since last September. The expert doctor I have been seeing, Dr Jain, had lowered the Lyrica I was on, down to 200mg/day. To juxtapose the decline in Lyrica, from 300mg/day, he increased the amount of Nortryp up by 25mg. Unfortunately this placed me on the hard side of taking 50mg BID. While my body tolerated 25mg AM and 75mg PM (at bedtime), the switch to 50 in the AM relaxed me too much and forced focus issues upon me. Not unyielding focus issues, just wanted to nap. With that I decided it was time, and Spring-time is in full flourish as well, to omit the medication. Doc is going to kill me when I see him, especially if I have any rebound issues, though none experienced to date. Coming up on a week now.
One of the associated benefits to not being on Nortryp, for me, is that my libido is through the roof, off the charts almost. I haven't felt this way in almost 12 years, since first encountering Rheuma Arth.
With this I'm down to 2 meds, Lyrica and Celebrex. I'm hoping to be brought down to 150 mg/day Lyrica in May. Then 100 in June. 75 in July and off as of Jul 30th. I anticipate taking long-term Celebrex for the foreseeable future to keep the Rheuma in check.
The other great benefit, I'm starting my regular life back up again. I'm walking long distances. Doing heavy work around the house. Have lost about 20lbs so far in 3 weeks through the high activity. Going to start Mountain Biking again shortly with a goal to become competitive again by summer 2010.
I hope that these are all great and sustained signs of the future life. Time will though tell.
Tuesday, April 28, 2009
Tuesday, January 13, 2009
long time needed update
Okay, so I've heard from a few of you and its time for another update.
Its as if I'm a new person.
First, Rheuma Arth, I believe its Celebrex that has changed me the most. My desire to be more active consumes my every day. I'm challenged, for the most part, to restrain myself and not over do it. I've pushed myself back towards a normal life, life without RA (again, for the most part.) As I get toward excess, my body begins to rebel a biot and I am tuned to listen to my bod and then begin curtailing activities. I am though up to about 400% more activities than I was prior to Celebrex, prior to my perceived PN issues.
Second, The combination of Lyrica, Nortryptilene and now Methocarbamol has me feeling no pain whatsoever. Maybe I'll occassionally feel some achyness, but only after some long term physical activity or prolonged sitting (>6hrs.)
The pain management dr, Dr Jain, os by far the doctor with the greatest impact in my life. His mannerisms, ability to listen through the fog of everyday description, the ability to care for his patients and be actually concerned, is by far the best qualities I've seen in ANY Dr. (That should say something since I've been to over 12 since July, personally, and then in my life have seen and spoken with thousands professionally.) I see the doctor monthly and we sit and speak at length, go through examinations and then discuss diagnostic approaches for over an hour each time. How many doctors out there spend an hour or more a month with their patients? I recommend him to me Justice friends, family around the country and anyone else who will listen. He's also good friends with the people over at CBS TV and 60 Minutes (if that makes any difference, which it shouldn't.)
Now, next steps. Obviously I can't be on these meds for the rest of my life. Well, I guess I could, but not advisable.) If we get to a point where the discomfort is gone and I begin withdrawing from meds and the pain reoccurs, then we have chosen to go with a tungsten seed implantation. The seed is benign in and of itself. I'd then go for sonogram treatments where the typical exam itself would heat up the seed which is implanted next to the nerve. The seed heats up and gently, covertly diminishes the irritant pain signals. This procedure will be undertaken after great diagnostic testing to isolate the specific nerve in question (illiogunial, genitofemoral or PN) since they're mostly contained within the same nerve channel.
So, that's my story through now. Don't know if I'm a fan of the methocarbamol (its compressed tablet form breaks up in the mouth very easily leaving a very bad taste for quite some time. I also can't quantify if its actually doing anything for me. But that will be left for time to tell.
I can though recommend Pain Management as a primary choice for anyone experiencing PN or any other type of aberrant pain. The knowledge in GOOD pain mgmt doctirs far outweighs most other specialties. It also helps to make decisions of urgent need or critical need and impact out from underneath the pall of constant invasive pain. Get on top of the pain first, before making critical decisions which can affect you for the rest of your life. Its makes sense.
Its as if I'm a new person.
First, Rheuma Arth, I believe its Celebrex that has changed me the most. My desire to be more active consumes my every day. I'm challenged, for the most part, to restrain myself and not over do it. I've pushed myself back towards a normal life, life without RA (again, for the most part.) As I get toward excess, my body begins to rebel a biot and I am tuned to listen to my bod and then begin curtailing activities. I am though up to about 400% more activities than I was prior to Celebrex, prior to my perceived PN issues.
Second, The combination of Lyrica, Nortryptilene and now Methocarbamol has me feeling no pain whatsoever. Maybe I'll occassionally feel some achyness, but only after some long term physical activity or prolonged sitting (>6hrs.)
The pain management dr, Dr Jain, os by far the doctor with the greatest impact in my life. His mannerisms, ability to listen through the fog of everyday description, the ability to care for his patients and be actually concerned, is by far the best qualities I've seen in ANY Dr. (That should say something since I've been to over 12 since July, personally, and then in my life have seen and spoken with thousands professionally.) I see the doctor monthly and we sit and speak at length, go through examinations and then discuss diagnostic approaches for over an hour each time. How many doctors out there spend an hour or more a month with their patients? I recommend him to me Justice friends, family around the country and anyone else who will listen. He's also good friends with the people over at CBS TV and 60 Minutes (if that makes any difference, which it shouldn't.)
Now, next steps. Obviously I can't be on these meds for the rest of my life. Well, I guess I could, but not advisable.) If we get to a point where the discomfort is gone and I begin withdrawing from meds and the pain reoccurs, then we have chosen to go with a tungsten seed implantation. The seed is benign in and of itself. I'd then go for sonogram treatments where the typical exam itself would heat up the seed which is implanted next to the nerve. The seed heats up and gently, covertly diminishes the irritant pain signals. This procedure will be undertaken after great diagnostic testing to isolate the specific nerve in question (illiogunial, genitofemoral or PN) since they're mostly contained within the same nerve channel.
So, that's my story through now. Don't know if I'm a fan of the methocarbamol (its compressed tablet form breaks up in the mouth very easily leaving a very bad taste for quite some time. I also can't quantify if its actually doing anything for me. But that will be left for time to tell.
I can though recommend Pain Management as a primary choice for anyone experiencing PN or any other type of aberrant pain. The knowledge in GOOD pain mgmt doctirs far outweighs most other specialties. It also helps to make decisions of urgent need or critical need and impact out from underneath the pall of constant invasive pain. Get on top of the pain first, before making critical decisions which can affect you for the rest of your life. Its makes sense.
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