I have been on two new meds for my gastroperisis. Relistor injections and Domperidone. The Relistor is to promote bowel movement (i.e. lower gi); the Domperidone is to promote stomach movement (i.e. upper gi). I'm getting some relief and can eat better, but I still get into a pain situation if I eat too much. At least I can eat a little more than before without setting off my pain. The Domperidone gives me lots of gas which can also set off the pain, i will bring that up with my gi doctor when I go back in a couple weeks. The Relistor gives me some energy and helps a lot with my general widespread pain. This is good news because I haven't felt this much relief from my Fibro pain since I got off of Cymbalta. The problem is, it doesn't really help in the bowel movement category like it's supposed to. So I need to bring that up to my gi doctor too. Relistor is not known to be effective after about four months use. What I wonder is, will it still be effective on m my widespread pain after four months? We'll see. Because it is so effective on my pain I want to keep taking it even if it's not helping with the lower gi issues.
Oh well, I know this post has TMI, but I wanted to document it anyway so I can come back and review at a later date. I'll post an update after I follow up with my Gi Dr.
Life and tips for living in the atypical world of Fibromyalgia, Trigeminal Neuralgia, and other chronic pain conditions.
Thursday, September 26, 2013
Thursday, June 20, 2013
Gastroperisis from Gallbladder Removal or Head/Neck Trauma?
Since my gallbladder was removed, I have felt like my stomach is stapled. I feel full after just a few bites, I have a hard time swallowing water/liquids, and I have referred pain to my back every time I eat. I went back to the surgeon a couple weeks after the surgery and she did a test to see if I had a bile leak. I did not so she sent me on my way telling me it was phantom gallbladder attacks that would/might eventually go away. I wasn't her problem any more.
I bought that theory for a while until I re-read a comment from one of my blog posts. This person recommended that I look into problems with the Vagus nerve. So I did and that brought me to a possible diagnosis of Gastroperisis. Basically, the stomach doesn't contract to digest the food. It is paralyzed. I read the associated symptoms and decided that this IS what is going on with me, not phantom gallbladder. I made an appointment with my GI doctor and he said that sometimes after the gallbladder is removed the bile cannot move through the system fast enough and backs up into the stomach causing this condition. He prescribed a medication that will take up to one month to work but said it should help. If this doesn't help then it may be that I have damage to the Vagus nerve which probably won't be reversible. The damage to this nerve could have been done during the gallbladder surgery. I think it might also have been damaged when my neck was hurt in 2011, but the symptoms are just more significant/apparent now that I'm not having other symptoms from my diseased gallbladder.
In the meantime, I'm back on the narcotics because I have to eat and eating causes me excruciating pain. I found that very small meals with no bulk (raw vegetables, fruit, whole wheat), no dairy, and no fat is tolerated the best. Yum, right? I've been drinking Ensure's twice a day to help get the vitamins and nutrition I need.
I've lost a total of 45 pounds since my head/face pain started in January, 2012. I lost 20 of those pounds during the year of 2012 and have lost 25 more pounds in the last 6 months. I'm continuing to lose 2-3 pounds per week because I can't eat. This isn't a problem yet, because I am overweight and can stand to lose about 30 more pounds, so this may be a blessing in disguise. I just need to make sure that I get enough nutrition.
I bought that theory for a while until I re-read a comment from one of my blog posts. This person recommended that I look into problems with the Vagus nerve. So I did and that brought me to a possible diagnosis of Gastroperisis. Basically, the stomach doesn't contract to digest the food. It is paralyzed. I read the associated symptoms and decided that this IS what is going on with me, not phantom gallbladder. I made an appointment with my GI doctor and he said that sometimes after the gallbladder is removed the bile cannot move through the system fast enough and backs up into the stomach causing this condition. He prescribed a medication that will take up to one month to work but said it should help. If this doesn't help then it may be that I have damage to the Vagus nerve which probably won't be reversible. The damage to this nerve could have been done during the gallbladder surgery. I think it might also have been damaged when my neck was hurt in 2011, but the symptoms are just more significant/apparent now that I'm not having other symptoms from my diseased gallbladder.
In the meantime, I'm back on the narcotics because I have to eat and eating causes me excruciating pain. I found that very small meals with no bulk (raw vegetables, fruit, whole wheat), no dairy, and no fat is tolerated the best. Yum, right? I've been drinking Ensure's twice a day to help get the vitamins and nutrition I need.
I've lost a total of 45 pounds since my head/face pain started in January, 2012. I lost 20 of those pounds during the year of 2012 and have lost 25 more pounds in the last 6 months. I'm continuing to lose 2-3 pounds per week because I can't eat. This isn't a problem yet, because I am overweight and can stand to lose about 30 more pounds, so this may be a blessing in disguise. I just need to make sure that I get enough nutrition.
Friday, June 7, 2013
Herniated Discs in the Cervical Spine
After my gallbladder was removed, I noticed that my arms were falling asleep when I layed on my back. I'm normally a side-sleeper but while the incisions were healing I had to lay on my back. I mentioned my arms falling asleep to my chiropractor and he ordered an MRI of my cervical spine. I have two herniated discs in my neck. This could be causing a lot of my problems with "right sided" pain, head and neck pain, and back pain. My chiropractor wants to do a regimin of decompression therapy along with some exercises and traction-like poses with a support device. He says that the decompression will allow the discs to rejuvinate with fluid and move the herniation back into the center, thus "healing" the situation. I was very excited until he told me the program would cost $5500. Of which I was promptly approved for credit through Care Credit. While I want to be "healed", I'm skeptical of the treatment program and cost. He reassured me that there would be before and after x-rays, etc. and that he guarantees improvement. I just can't afford another monthly payment. I already owe way more than I can afford in doctor bills.
I asked my primary care physician about all of this and she suggested that I talk with my pain management doctor about it. I did, and he recommends an epidural steriod injection into the discs. At least this is covered by insurance. I'm not clear on what to expect from this treatment and I know results vary from patient to patient so I'm going to go ahead and give it a try to see if I can get any relief from any of my symptoms. At least this is a "firm" diagnosis that has specific treatments which may lead to surgery. I have a feeling that I have other herniated discs along my spine that no doctor has considered. I guess I'll just start on my neck and see what happens from there.
Wouldn't it be great if I actually got to feeling well enough to go back to work? Who knows. I'll keep you posted.
I asked my primary care physician about all of this and she suggested that I talk with my pain management doctor about it. I did, and he recommends an epidural steriod injection into the discs. At least this is covered by insurance. I'm not clear on what to expect from this treatment and I know results vary from patient to patient so I'm going to go ahead and give it a try to see if I can get any relief from any of my symptoms. At least this is a "firm" diagnosis that has specific treatments which may lead to surgery. I have a feeling that I have other herniated discs along my spine that no doctor has considered. I guess I'll just start on my neck and see what happens from there.
Wouldn't it be great if I actually got to feeling well enough to go back to work? Who knows. I'll keep you posted.
Wednesday, May 8, 2013
Wake up and get off the narcotics!
I've been doing some more research on alternative treatments to help with my Fibromyalgia pain since I can no longer take the SNRI's like Cymbalta or Savella. I've been on a trial of low dose Naltrexone (4.5 mg) per day. It acts by blocking opiod receptors and reducing cytokines that cause Fibromyalgia-like symptoms according to the President of Alabama Society of Rheumatic Diseases, David McLain, M.D. as quoted in the Fibromyalgia Network article Sublte Signs of Immune System Breakdown in Fibro. The on-label use for Naltrexone is to assist people getting off of narcotic or alcohol addiction so people taking this drug cannot take narcotics or drink alcohol. So for me, although not addicted, I needed to quit taking narcotic pain meds for seven days prior to taking the Naltrexone and haven't taken them since.
After being on Naltrexone for one month, I did not feel any significant improvement in my pain symptoms, however, I have been more alert and feeling alive since I'm off of the narcotics. I didn't realize what a zombie I was and how regularly I was using the narcotics until I went off of them. It was enlightening but when I have my severe pain episodes it's really hard not to reach for the Oxycodone. Instead I've been using ice or heat, taking a hot jacuzzi bath, or just resting until the pain subsides. It's difficult to get through. I still take OTC pain meds such as Ibuprofen and Acetaminophen.
I visited my doctor last week and discussed all of this with her. She doubled the dose of the Naltrexone to see if a higher dose would be more beneficial with the pain. Unfortunately, the side effects of the higher dose of medication kicked off my scalp sensitivity and the pain behind my ears and temples just like the SNRIs did. I quit taking the Naltrexone for a few days and am now back on the 4.5mg dose until my doctor instructs me otherwise. A medium dose of 6mg may be beneficial to try. This dosage will need to be compounded at the pharmacy so I'll have to make a special trip to the hospital pharmacy to pick it up.
If the Naltrexone 6mg is not an option or does not work, then my next suggestion to my doctor is Plaquenil which is also a drug that tempers immune activation and my help with pain. I'll keep you posted.
After being on Naltrexone for one month, I did not feel any significant improvement in my pain symptoms, however, I have been more alert and feeling alive since I'm off of the narcotics. I didn't realize what a zombie I was and how regularly I was using the narcotics until I went off of them. It was enlightening but when I have my severe pain episodes it's really hard not to reach for the Oxycodone. Instead I've been using ice or heat, taking a hot jacuzzi bath, or just resting until the pain subsides. It's difficult to get through. I still take OTC pain meds such as Ibuprofen and Acetaminophen.
I visited my doctor last week and discussed all of this with her. She doubled the dose of the Naltrexone to see if a higher dose would be more beneficial with the pain. Unfortunately, the side effects of the higher dose of medication kicked off my scalp sensitivity and the pain behind my ears and temples just like the SNRIs did. I quit taking the Naltrexone for a few days and am now back on the 4.5mg dose until my doctor instructs me otherwise. A medium dose of 6mg may be beneficial to try. This dosage will need to be compounded at the pharmacy so I'll have to make a special trip to the hospital pharmacy to pick it up.
If the Naltrexone 6mg is not an option or does not work, then my next suggestion to my doctor is Plaquenil which is also a drug that tempers immune activation and my help with pain. I'll keep you posted.
Wednesday, March 13, 2013
Diseased Gallbladder Wrecks Havvoc
I had my gallbladder out on February 25, 2013. After taking two trips to the ER in January and having all tests come back normal, I finally saw my GI doctor on February 13th. I told him when they injected the nuclear medicine it set off my headaches and all my "right sided" gut and back pain. He said that was enough to warrant taking out the gallbladder and sent me to a surgeon. The surgeon said I was a "million dollar test" patient because when all the tests come back normal they have to go on symptoms, so she took out my gallbladder and I feel much better. My chronic daily headaches are gone. My gut and back pain from eating are gone. I'm still having my normal chronic back pain and I had a real bad widespread pain episode last Friday night after trying to do yoga earlier in the day, but I think all in all I'm doing better.
The pain behind my ears and in my temples I have found to be associated with high blood pressure and that is under control for the most part. Caffeine, chocolate, and seratonin related drugs, and cold medicines aggravate it. The problem is that those seratonin drugs used to really help with my chronic back pain so my back pain is out of control. So basically I am treating the greater of the two evils, the headache. I did get some trigger point injections in my back on February 14th, but they haven't been very effective.
When my widespread pain hit last Friday I took one Oxycodone, then a few hours later took two more and got in a hot bath. When that didn't help and I was still going out of my mind in pain, I took a Lyrica. That did help calm things down and I was able to go to sleep. My pain had resided by the time I woke up but I felt hung over and my body was limp, like a wet noodle. I continued to take Lyrica for several evenings but found that I cannot wake up in the morning when my alarm goes off. My daughter was late for school yesterday and today we just totally blew it off. I did not take the Lyrica before bed last night and I woke up at 2am and as of now, 4am, I am still awake. I can't win for losing. Oh well, at least I'm not in pain right now. I can live with a little lack of sleep if it's not caused by pain.
The pain behind my ears and in my temples I have found to be associated with high blood pressure and that is under control for the most part. Caffeine, chocolate, and seratonin related drugs, and cold medicines aggravate it. The problem is that those seratonin drugs used to really help with my chronic back pain so my back pain is out of control. So basically I am treating the greater of the two evils, the headache. I did get some trigger point injections in my back on February 14th, but they haven't been very effective.
When my widespread pain hit last Friday I took one Oxycodone, then a few hours later took two more and got in a hot bath. When that didn't help and I was still going out of my mind in pain, I took a Lyrica. That did help calm things down and I was able to go to sleep. My pain had resided by the time I woke up but I felt hung over and my body was limp, like a wet noodle. I continued to take Lyrica for several evenings but found that I cannot wake up in the morning when my alarm goes off. My daughter was late for school yesterday and today we just totally blew it off. I did not take the Lyrica before bed last night and I woke up at 2am and as of now, 4am, I am still awake. I can't win for losing. Oh well, at least I'm not in pain right now. I can live with a little lack of sleep if it's not caused by pain.
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