Well, at least you have an appointment on Tuesday.

The lack of proper sleep is definitely adding to the problem and making it harder for you to cope. You should ask him short term solutions for this while your are trying to get your pain under control.

Have you ever tried Melatonin for sleep? Just make sure to ask/tell him about any you take or ask him to Rx you and whether they would interact with the nortriptyline...and the new med he starts (I'm being optimistic that he will ADD you on something else as well).