Sunday, September 23, 2012

Food and Pain.

Pizza, cheesy bread, cinamon rolls, cupcakes.  I might have well just given myself an I.V. of pain direct into my veins.  All those things I ate in one sitting at a birthday party for my husband's great niece at a pizza buffet place.  WTF was I thinking!!!! I'm in so much pain now I can't stand it and I know better.  I am really mad at myself right now.  So you may ask, "What's the connection with what you had for dinner and pain?"  GLUTEN is the reason.

Gluten is a protein found in wheat, rye, barley, and malt.  People with chronic pain often have an intollerance for gluten.  When the wheat protein enters your small intestine, your body treats it like a foreign object and the reaction you have to that foreign object is, guess what, PAIN.  So everything on the menu tonight was full of wheat, therefore, gluten, so I just basically overdosed myself with pain.

Other things that you ingest that cause pain are from preservatives and additives put in processed foods.  In particular Monosodium Glutamate (MSG), Aspartame, and Cystene. MSG is found in most processed boxed and canned foods.  Aspartame is used in almost all diet sodas, Cystene is found in some processed foods.  So read the labels before you put that yummy processed food in your mouth.  The preservatives and additives are put there to make food last longer than it should and to make bland foods taste better.  So if you look at it that way, why would you want to eat it anyway. Unfortunately the industrialization of foods is killing us.  If I felt better I'd protest, but I don't, so I just need to be vigilent about not eating this stuff as well as gluten.

05/08/13
I want to add to this post that since I have had my gallbladder out on February 25th, I am still having severe pain in my back, on the left side, around my kidney after I eat anything of significance.  My doctor has put me on an elimination diet to see if I can find out exactly what foods are causing the attacks.  I'll create a new post in this blog with details.

Saturday, September 22, 2012

Different Muscle Relaxer

I went to my pain doctor yesterday and we talked about meds and procedures.  He prescribed me a different muscle relaxer.  It's called Tizanidine to take every 6 hours as needed.  I took one last night and one this morning.  They did help me sleep/relax and I did not have any reactions to them. Here's the scoop on the rest of the conversation:

Meds: 
  • He did not want to add Wellbutrin because of possible seretonin overload.  He said that I should talk to a neurologist about that.  I need to call on Monday and make an appointment.
  • He recommended Naproxine for the anti-inflamatory, which I've already been taking.  He did mention to take it with meals at breakfast and dinner.  So I'll try that.
Procedures:
  • Pulse Radio Frequency therapy is where they go into the occipital nerve with a needle then pulse radio frequency for a couple minutes into the nerve to get the activity of the nerve to scramble and reset.  He used to do this a lot at John's Hopkins medical center but he did mention that insurance is not likely to approve it because it is still considered "experimental".  I went ahead and set up an appointment to get it done and they will query insurance in the meantime to see if it's covered.
  • Occipital Nerve Stimulator is a gadget they implant in your head that you can zap yourself with to reset the neurological rythym when you are in pain.  The problem with this procedure is that the gadget often moves because of the position where it's at in your head and the amount of movement you do with your head.
  • Nerve block/steriod injections.  I can continue to have these done whenever I want to or feel that I need them.  Since I only had 7 days of about 80 percent relief after the first set of shots, I'm not sure I want to go through that again or often.  He said there's no limit on how often you can have the shots.
So, I'm hoping the muscle relaxers help relieve some of the tension in my head/neck and that I'll get some relief from those while I wait to find out if the Pulse Radio Frequency is covered. 

I'm also still waiting on approval for social security disability.  They are waiting on the notes from yesterday's appointment to make a decision.

In the meantime, I'm trying to save up my energy from the mornings so I can be more functional for my family in the evenings.  This is quite a balancing act.

Thursday, September 20, 2012

Excrutiating Pain!!!!!

My pain is so intense this evening I'm beside myself.  It originates behind my ears and radiates to the front of my head and temples.  I took prescription strength Naproxin and arthritis strength Tylenol at 7:00pm.  No relief.  I managed to get through until time to put Jamie (my 7 year old daughter) to bed at 9:00pm, then took my standard bedtime meds of Skelaxin, Nortriptaline, and Ambien.  I'm beginning to feel like a junky.  But even an hour after taking those meds I'm still in pain and not asleep yet.  I moved my pain doctor appointment up to tomorrow at 3:30pm.  I am desparate to see him.  I studied the medicine information I got from the Fibromyalgia Network and compared it to what I have been going through.  I found a major connection that is quite scary but I may be onto something.  Here it goes:

Dopamine, or lack of neuropathic transmission of, causes Parkinson's Disease.  When I took Baclefen, I started having jerking movements as though I had Parkinson's.  Baclefen reduces dopamine transmission, so my normal levels of dopamine and/or transmission of dopamine must be very low for one dose of this medication to put me into tremors.  The anti-seasure medications also suppress dopamine and when I tried to take them, I literally felt like I just wanted to die.  Low levels of dopamine cause major depression.  My fear now is that maybe Parkinson's disease is on the horizon for me.  It tends to show itself in people over 50 unless it is genetic. I'll be 52 next month. 

So another drug, Wellbutrin, increases dopamine levels and also increases seratonin and norepinephrine levels which relieve pain and depression.  Cymbalta stops the destruction of seratonin and norepinephrine at the nerve junction so it allows your body to maintain the levels it has.  By adding Wellbutrin, levels of all three neurological chemicals are increased which should help with pain and depression.  I'll go over this tomorrow with the doctor to verify that my understanding is correct.

Right now, I am just praying that I'll be able to fall asleep soon because I don't feel the pain when I'm asleep and I usually feel better in the mornings.  It's pretty bad to just want to wait for bedtime all day long.  I'm trying to stay halfway functional in the evenings for my family but it's getting harder every day. 

Wednesday, September 19, 2012

Dental Work Sets Off Facial/Head Pain

Well, my dentist visit went pretty well.  I had a lot of periodontal (pockets).  Most level 5 with a couple of 7s.  Normal is 3 I think.  They said it was because of the medicine I'm taking is making my mouth dry so I don't have enought saliva to combat bacteria that causes gingivitis.  They cleaned my teeth and then did a deep cleaning with a laser.  That was amazing because it didn't hurt at all.  I had a little pain in my gums/teeth during the cleaning. 

The dentist said that all my teeth looked good, no need for concern anywhere.  I talked to him about my facial pain and the incident with the back tooth during the first root canal about six years ago.  He explained to me that the initial root canal endodontist breached the barrier at the end of the root and the mixture they use to clean out the root (basically bleach water) got into the facial tissue and permanently damaged the nerves in my face.  Once the nerves calmed down from that episode, I didn't really have any problems but when I had the subsequent root canal done, the damaged nerves became inflamed and have not calmed back down.  This theory makes sense to me for part of my facial pain problem.  I still think that several of the cranial nerves got compressed during the second root canal or it's just a coincidence that the compression caused by the artery was excaserbated at the same time as the root canal.  I'm being referred to a new neurologist at Wash U and I'm going to present my theories to her and see what she thinks.  I'm also going to ask her to look at the MRA I had last April and see if she can see other nerves compressed. I STILL think my best option is a microvascular decompression surgery, but now I think more nerves are compressed than just the trigeminal nerve. 

Don't I sound like a neurologist?  Wow, who would have thought.  Anyway, I'm glad I went to the dentist but my facial/head pain has gotten significantly worse since then.  I went to rehab today but was very uncomfortable.  Everytime I touched my face I had radiating pain out in every direction from where I touched it.  I came home and went to bed.  I fell asleep for about an hour, but that didn't help the pain, just gave me some rest.  I didn't put two+two together until today, but the night of the dental cleaning I was in such pain I was yelling at my daughter and my dogs.  I threatened to take the dogs to the pound the next day and told my daughter to quit getting on the bed, because everytime the bed moved it caused me pain.  My husband got her and made her stay in the other room and I shut the dogs out of my room and curled up under the covers in the dark to avoid contact with anyone.  I just wanted to die I was in so much misery.

That is what is hardest for me to cope with is the losses I have had in all the things that I loved to do.  Like working, teaching, taking care of my family, playing with my dogs.  I used to love all the attention I got from my daughter and my animals but now I can't tollerate any activity that is going to cause vibrations or movement of my face and head.  Including talkin, laughing, and smiling.  This disease has litterally stolen my joy and I have lost interest in just about everything and everyone.  In my rehab program, I'm going to mention that they should cover the stages of grief because all chronic pain suffers grieve the loss of their previous life and it's inevitable that they'll go through denial, anger, sadness, acceptance. 

I have a follow-up appointment with my pain doctor on Friday.  I want to check into other medications besides anti-convulsants that are used to manage pain.  I've got a list of them from the Fibrmyalgia Network and am going to get as informed as possible before I go.  I have definitely learned during this experience that I have to be my own advocate and be prepared to discuss medications, treatments, reactions, etc. when I go.  This blog is really helping because I can review it every so often and see what progress or digress has been made.

Saturday, September 15, 2012

Dental toxins?

I've been doing some reading on the chronic toxic symptoms from silver tooth fillings that contain mercury.  Some research is very strong about the side effects, mainly neurological disorders.  The ADA does not support this.  Why would they.  If they did,they would have a wide-spread panic on their hands and countless law suites.  The toxin information I read also suggested that the fillings they use in root canals is also toxic.  So I looked in my mouth and counted.  I have 5 teeth with silver fillings and I have 5 teeth with root canals and crowns.  So a total of 10 teeth that could possibly be leaking toxins into my system causing neurological problems.

So do I go have those 10 teeth removed?  What would I replace them with.  I think I also read that the material used to make dentures is toxic as well as the newer "tooth colored" fillings being used these days.  I am baffled.  So I posted a question on the Trigeminal Neuralgia Support Group Facebook page and asked if anyone had had their fillings/teeth removed and did it help.  I got a mixed set of responses.  Some had and it helped.  Some had and it didn't help. One person said her dental surgeon said that there are so many nerves in the head that there is no way to really know if removing the teeth is going to help until its done.  I know I had one tooth pulled and the pain just transfered to the tooth in front of it, so that tells me to keep my teeth in my head and not go down the path of possible dental toxicity.  I just cant help but think that there is a connection though. 

The people on the support site have all stated that they wished there were more dentists and neurologist partnerships.  Because these are two separate practices neither one takes ownership of the issue of painful facial and head nerve pain and the patient ends up frustrated and on medications that have severe side effects and don't necessarily help. 

Oh well, I'll get off my soapbox now.  But to let everyone know, I am going to join the facialpain.org facial research organization and start supporting the medical research in this area so an effective cure can be found.  I'll keep you all posted once I decide how active I can be and what fundraisers I can chair.

For now, that's all what's been on my mind.  I needed to get it out so I can sleep.  Good night.

Getting into a pattern with pain and meds

I've noticed lately that I'm getting into a pattern of feeling pretty good in the morning then the pain rushes in between 3:30pm and 4:30pm every day.  So I think maybe that my Cymbalta, although it is a delayed release med, is dropping off in the late afternoon.  There is another drug similar to Cymbalta but it is given twice per day and is not a delayed release drug.  It's called Savella.  I'm going to contact my pain doctor and see about switching.  Taking that medicine twice per day might be what I need to get through the day.  I've also switched to taking prescription strength naproxin (Aleve) instead of ibuprofen.  It works better/longer at reducing the inflamation in my head without taking as much medicine.  I was taking 800 mg. of ibuprofen 2 to 3 times a day for a total of 12 pills.  The ibuprofen works better at onset but does not last as long. For instance, I was taking 800 mgs. of ibuprofen and it was wearing off after 4 hours and I couldn't take the next dose for 2 more hours.  With prescription naproxin, if I keep on top of it, it will last around 10 hours so if I take one in the morning when I get up, it relieves the inflamation for the day.  Then I take one before bed. I also tried Tramadol today for the pain when it set in this afternoon and it was pretty affective for keeping the pain from escalating.  So I think I will take it now instead of tylenol which doesn't help much.  Tramadol is a low level opiod (narcotic) pain med.  There is less chance of getting addicted to it than some of the other stronger narcotics like oxycodone and endocet.  So just to have it documented somewhere this is my medication list and when I take what.

Morning:
90 mg. of Cymbalta (anti-depressant/pain med)
25 mg. of Triemptarene (diuretic)
375 mg. of Naproxin (anti-inflamatory)
25 mg. of Prevacid (antiacid)

Afternoon:
50 mg. of Tramadol (narcotic pain med)

Bedtime:
30 mg. of Nortriptaline (antidepressant/pain med)
800 mg. of Skelaxin (muscle relaxer)
20 mg. of Ambien (sleeping pill)
375 mg. of Naproxin (anti-inflamatory)
7.5/325 mg of Endocet (narcotic pain med) Only if pain is too much that I can't get comfortable to sleep.

This combination seems to be the best for me at this time.  I'll see what the doctor says about switching the Cymbalta for the Savella.

Tuesday, September 11, 2012

Pain is Returning :-(

Over the past few days the pain in my head from the Occipital Neuralgia is coming back.  I'm realizing how effective the nerve blocks were now.  I'm feeling very depressed over this.  The doctor said the nerve blocks last anywhere from two weeks to six months.  I was hoping they would last longer.  I guess I'm a two-weeker :-(  They were awful painful to have to go through every couple weeks.  I don't even know how often they will give them.  I'm sure there's a limit.  I have an appointment on October 17th with the pain doctor for a follow-up appointment, but I'll think about moving it up.  I've been reading on the Trigeminal Neuralgia website that if you can get through a couple weeks of the bad side effects of the anti-convulsant drugs that they subside and the drugs help.  I may need to do that.  Ugh... There's no positive news here.

In other bad news, we hit a really big whole crossing a railroad track on Sunday and I flew up in my seat and back down hard.  My back has been hurting ever since.  I've been icing it and taking Ibuprofen which is helping.  I'm going to my chiropractor tomorrow.  I hope I didn't fracture any vertebrae.  I've got enough going on right now.  I don't need to add this to my list of chronic conditions.   We'll see, I'll keep you posted.

Sorry for all the negativity.  It's just been a really bad last few days.  Maybe tomorrow will be better.

Friday, September 7, 2012

What came first?

You've probably heard the question, "What came first, the chicken or the egg?"  Well another comparison for people with chronic pain is, "What came first, the pain or the depression?"  We talked about this in the pain management rehab this week.  For some they thought the pain came first, for others, including myself, I thought the depression came first. 

I have had a history of depression since I was a child.  Of course, back then, I don't think it was ever something that was openly discussed.  I remember when I was a teenager I ran away from home (for a whole day) and then my mom said maybe I needed to go to a counselor.  I proceeded to tell her I wasn't going to a f''n shrink and went to my room.  Hind sight is 20/20 though and that is exactly what I needed along with some anti-depressant meds. I got severly depressed in my late 20's when my husband (at the time) left me for someone else.  Our son was only 6 months old when I was asked for a divorce.  I tried everything to keep the marriage together, but after another six months he was gone.  The depression and stress was so significant I couldn't swallow.  I lost a lot of weight and looked anorexic.  My mom and dad came and brought me and my son to their house for a week.  I took off work.  I did go to my doctor and got some anti-depressant meds and went to counseling.

The counselor used a method known as "Cognitive Therapy".  It's basically recognizing your inner thoughts and learning to change them.  So, for instance, an overly negative person thinks negative thoughts most of the time and discounts any positive experiences or compliments. This is what I did.  The cognitive therapy was very helpful and I was able to basically rewire my self-talk.  They talked specifically about cognitive therapy in rehab as a means to help cope with chronic pain and depression.  I can see that this would be useful because I have noticed that I have a lot of guilty thoughts and feelings because of my chronic pain.  These lead to depression and the cycle begins. 

We also talked about medications for depression and pain.  I take 90mg of Cymbalta in the morning and 30mg of Nortryptaline at bedtime.  When I first started taking Cymbalta it was like turning my pain switch off, but that was several years ago and it's not as effective any more.  My pain doc says I'm taking as much as recommened so I might talk with him next visit about adding Welbutrin.  My sister takes that and is happy with the pain reducing effects it has.  It's crazy.  I never thought I would know as much as I do about pharmaceuticals.  They are a blessing though.  I can't image what it would be like without them.

So "What came first, pain or depression?"  I think it's as complicated as the chicken or the egg.  No straight forward black or white answer, just an understanding that they co-exist and both need to be treated.

Tuesday, September 4, 2012

Improvement, Causes, and Life in General

Improvement
I have had a steady decrease in scalp/head inflamation over the past couple of days.  I guess the steriod is doing its job.  So I was pretty functional today.  I swept the floors and did some laundry. Other than a mild headache late in the day, I felt better than I have for a while.  I did not get any TN shocks today.  So I'm calling it a good day.

Causes
I was at a birthday party for my 90 year old Aunt last Sunday and I was talking with one of my cousins about this pain that I have been having.  She mentioned that she thinks it's primarily caused by menopause.  She told me that she suffered with extreme nerve related pain for about 6 to 7 years when she was going through menopause.  She said the pain calmed down when she was around 56/57.  I'm 52 now and am post menapausal so if this is true, I've got a few more years of this to deal with.  I have read somewhere that lowering levels of estrogen effects nerve endings and can cause acute nerve pain.  So I'm thinkin that I am probably case in point because the fibromyalgia has caused my nerves to already be overloaded with pain signals .  I was kinda happy to think that this could eventually work itself out, but then depressed to think it might be another 5 or 6 years.  I would probably loose touch with my IT career in that timeframe, but I could probably get back to teaching part-time.  For now, I'm trying not to worry too much about the future because when I do, I start feeling guilty about not working and then that just makes matters worse.

Life in General
Getting these neurological problems with my head has made me rethink my future.  Before I was always trying to prove myself to myself and others.  I always felt like I had to one-up whatever I did last.  I longed for recognition from my supervisors, co-workers, family, and friends.  Now I realize that isn't necessary.  I've always done exceptional work, I've studied hard and do well at teaching others. I'm one of the most requested professors at the University.  So I'm moving on from my my proving myself mode and moving to a new taking care of myself and counting my blessings mode.

Taking care of myself is going to benefit both myself and my family.  In order to do that, I need to learn how to cope with the pain better. These episodes of pain can drain me to the bottom of the barrel and at times, I admit, I haven't cared if my life was over, I just wanted to end the pain.  I didn't want to live if I was going to be brining my family down all the time by either complaining or externally suffering from pain.  I didn't want my little girl to see me in pain all the time.  I didn't want to miss out of outings to visit with family or friends because I'm in pain.  I didn't want to miss out on being there for my husband because the drugs have me too spacy/sleepy all the time.

This type of pain steals your joy because it escalates when you interact with others. So lately I've been hiding in my home, trying not to get too worked up, doing relaxation techniques to calm down my face at night so I can sleep, and praying it doesn't come back worse in the morning. Going to the weekly pain management rehab is important because I am learning other coping techniques there.  I'm also learning alot from the Facebook Trigeminal Neuralgia Support Group. 

I need to start looking at my life in chunks of time now vs. days.  I'm no longer pain free for a day, but I have pain free periods throughout the day.  So I do a little work each day. I rest a little each day.  I try to eat healthy foods and take my prescribed medications along with Ibuprofen.  I try to count my blessing everday and I do pray for God to intervene and take my pain away when it's more than I think I can handle. I also pray for those I love that they have blessings in there lives and that they are given the gift to deal with me. 

When, at times, I'm feeling out of control and frustrated, I keep in mind what my husband has taught me.  He says "Worry is worthless, Prayer is priceless." So I get off my pitty pot and flush it and start couning my blessings again.  Oh yeah, and occasionally I reach for the narcotic pain meds to break the cycle of pain or take me out of it for a while so I can regroup. 

So little by little I do think I'm better, but doubt that I'll ever be well. I have too many separate nervous system disorders for them all to misteriously go away.  So I'll just take the bits and pieces of peace as they come my may throughout the day.

With accepting that I'm diabled over this I ponder the question, "What's Next". This is where I try to find ways to add value to society with whatever stamina I have left on any given day.  There are endless possibilites, I just need to find the right (ones).