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.

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.

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.

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.

A Little of This and a Little of That

I know I said I wasn't going to enter any more posts for this blog but I've had some time now since I saw the last neurologist and I'm doing some experimenting/self evaluation to try to find relief from some of my symptoms.  I have determined the following:

1. The pain behind my ears, in my temples, and causing general scalp tenderness seems to be lessened substantially when I go off of all drugs that have to do with Seratonin.  I was taking 90mg of Cymbalta, a Seratonin Norepinephrin Reuptake Inhibitor (SNRI) for Fibromyalgia.  I slowly reduced the dose and those symptoms mentioned above improved.  I stopped Cymbalta all together and those symptoms all but went away.  I believe these symptoms are now due to a condition called Seratonin Syndrome, which, by the way, can be FATAL.  While off of Cymbalta, my Fibromyalgia pain (primarily in my back) came back with a vengence, so I talked with my doctor about switching to Savella.  It is also an SNRI but has a threefold affect on Norepinephrine to Seratonin so I thought it might be able to address the Fibromyalgia without terribly affecting my head.  Unfortunately that is not the case.  The head pain is back and the Seratonin affect on the Fibromyalgia is not significant enough to help.  So now I am up tonight with head pain, back pain, and my trigeminal nerve is also acting up. I've taken Oxycodone, Tylenol, and Tizanidine (muscle relaxer), and Ambien.  Hopefully I'll be able to fall asleep soon and feel better in the morning.  I need to make an appointment with my primary care doctor and talk about what other options I have for treating Fibromyalgia without using Seratonin altering drugs.
2. Menopause/hormone imbalance.  I have been having hot flashes gallour and then am chilled episodes.  I keep telling my husband and daughter that my thermostat is broken.  I've been using Progesterone cream to help with the hot flashes, but it doesn't seem to do much. With the Progesterone cream, I do have a little more energy though and labido is returning.  My husband is happy about that :).   When the hot flashes occur it sets off the Trigeminal Nerve pain and the overall head tenderness and pain behind my ears.  Ice packs seem to help if it gets too bad.  I also need to ask my doctor to see if she can test my hormone levels and make any recommendations for treatment.  I've tried natural supplements for increasing Estrogen and that makes my head symptoms really bad, so that's why I tried the Progesterone.  I was reading that even if Estrogen levels are lowering, if there's no Progesterone (as is what happens when you stop ovulating), Estrogen dominance occurs causing the head aches, etc. so you need to supplement the Progesterone vs. the Estrogen.  I hope my cousin was right when she said hormone imbalance calms down around 56 or 57.  Only 4 or so years to go.
3. I'm starting some supplement therapy with a general whole food multivitamin for women (but it doesn't contain soy so it doesn't cause headaches), and another supplement that is supposed to be good for relieving inflamation.  I'm not sure if they are helping, but I know they are not hurting me, so I'm going to complete the 30 day supply and see if I feel any general health/well being improvements.
4. Physical fitness.  After the first of the year I'm going to start looking for a Tai Chi program.  I need to strengthen my core without setting off the Fibromyalgia everytime I work out.  From what I've read, Tai Chi is the best exercise program for that. 

So for the next year, I hope to strengthen my core muscles, increase my intake of nutrients via supplements and eating a more nutrient dense diet, go off of Seratonin altering drugs and find other options for treating my Fibromyalgia.  As for the head pain and trigeminal nerve pain there's not much I can do about that other than take opiod pain relievers and muscle relaxants.  I'm just praying that I can be more functional and a little happier to be around for my family's sake.  After all, who wants a Debbie Downer around all the time.  If there's anything I have learned from all this, it's to try to enjoy life through the pain because if I keep waiting for it to go away, I'm going to waste my life away and be a burden to my family.

Fibromyalgia Has Gone to my Head

I saw a second neuroogist today.  She was kind and listened and asked me why I came to her.  I said I wanted to know if there were any other tests to do to see if nerves were damaged or if there were any conditions left to rule out.  She said no.  My MRI of my brain from April looked good, in fact, not remarkable enough to warrant surgery of any kind.  My pain is too atypical and therefore there is nothing they can do for me since I cannot tollerate the anticonvulsant medications they use to treat this type of pain.  She mentioned that she believes the condition going on in my head is Fibromyalgia, so to me that means chronic, neverending, misery.  I'm very sad at that thought but guess I have to accept it.  I told my husband I'm done with doctors now.  I'm not going to chase this any more. I'll just take the drugs that I can tollerate and maybe eventually I'll get some relief on my own.  He thought that was a good idea.  I can't really afford to pay these doctors anyway, so I might as well just stick with my primary care physician and let her prescribe the pain maintenance meds. 

This will be the last post in this blog.  I guess the only thing I have left to say is that I'm too young to feel this damn old :(

It's Been Quiet from the Doctor Front.

The radio frequency (rf) treatment was not approved by the insurance company, so I'm waiting until my appointment with the new neurologist on November 7th before I schedule any more treatments from the pain management center.  I think the rf treatment was a shot in the dark anyway and I don't really have many, if any, other options. 

In the meantime, I got my thyroid checked to see if the nodules have grown since last year, that's a negative.  One less thing for me to think about :)  Well woman visit went well, gotta go for an annual mamogram. 

My head pain is unchanged; still there daily and unrelenting at night, thank goodness for drugs that knock me out and ice packs to lay my head on. 

On a better note, my social security disability was approved so there's some financial help on the way. 

Sorry this sounds so down in the dumps. My primary care doctor added Wellbutrin and took away Nortriptaline to see if it helps with my mood.  Maybe I'll be in better spirits next time.