Quote:
Originally Posted by Neurochic
Cymbalta is not a tricyclic antidepressant - it is an SNRI. The tricyclic anti-depressants are an older class of antidepressants and have been around a long time but they can have significant benefits in reducing neuropathic pain. The thing is this, you can't assume that because one anti-depressant in a particular 'class' or type doesn't work for you, they will all have the same effect. You need to work your way through all or at least a number of them to know whether any of them will or won't work. Just because Cymbalta didn't help you, doesn't mean that a different type of antidepressant won't help. It can be a long, slow and tedious chore to work your way through different drugs but if you find one that helps and has acceptable see-effects then it is worth the effort.
I'm not surprised your doctor wants to put you back on the Nucynta given the excellent results you seem to have had. Are the periodic problems the Nucynta gives you with anxiety and your skin worth putting up with for the amount of pain reduction you get? If they are worth it TO YOU and ONLY YOU, then just get on with it and take it if the tramadol and kratom don't work sufficiently well for you. Its your decision in conjunction with your doctor, not anyone else's decision.
I so often read or hear about people with crippling CRPS whose biggest concern is how they will get off the drugs their doctor is wanting to prescribe for them to try. Lots of people won't even consider taking certain drugs just in case they might have issues stopping them in the future. I can't understand that. They would rather live with excruciating pain and poor quality of life than risk just trying something that, in fact, they may well have no/few issues coming back off. Its really important to give yourself the very best chance of getting the pain from this condition under control as much as possible. Like I said, the chances are high that you are going to have this pain for the rest of your days so its far more important to find medication that works and gives you a decent quality of life now on the basis that you are unlikely to be coming off it. Deal with the problems you have got now so you can have a good quality of life and can use your hand/arm thus, ironically, giving yourself the best chance of ridding yourself of the underlying CRPS. Don't fixate on the issues you might or might not have one day in the distant future. If you have to come off it one day then yes - it might be difficult - but deal with that problem if and when it arises in the future.
You are 45 years old - why do you let these relatives bully you and push you around? Its none of their business what medication you take. Why do you even tell them what medication you are being prescribed? Its got absolutely nothing to do with them. Ignore all this crap they are saying and the garbage articles they are sending you - throw them straight in the trash. They can only pressure you, upset you and make you feel angry if you let them. Personally I would pity them - I pity their ignorance and lack of intelligence. They clearly know nothing about CRPS, know nothing about modern thinking in chronic pain treatment and opiod medication. Oh and they obviously don't understand the difference between addiction and physical dependance - that's one of my personal 'pet irritations"! You absolutely CAN take your pain medication forever if you need to - that's just another indicator of their lack of intelligence. I fully expect to be taking mine for the rest of my life and I'm the same age as you.
How your father in law chooses to deal with his back pain is his business but its an entirely different medical condition and entirely different pain. No two people with back pain arising from the same underlying damage would have the same type or level of pain, nor would they cope with their equally well. Its not a competition to demonstrate how big your balls are based on how good you are at suffering!!
Have confidence in yourself and your decisions about the ways you choose to manage your own pain, including the drugs you choose to use based on your doctor's advice. Ignore your idiot relatives and be more assertive if they try to pressure you. What you do is none of their business and its a massive invasion of your privacy for them to keep interfering. You don't need to be horrible or destroy family relations but be absolutely firm, have the courage of your convictions and don't let them mess you around any longer.
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Is it worth it to go to a respected Neurologist or similar doc who knows CRPS well? I met women on a plane recently, sat next to me and had CRPS/RSD! Go figure. She flies up from Florida to Philadelphia for treatment - pain pump. I forget where she goes. Ugh..
I heard Drexel Univ. Med Cntr.
Thanks for encouragement. I lacked confidence and self worth as a child for reasons I won't get into, but it still impacts my actions and decisions.
I have always had issues standing up and defensing myself and hat confrontations. However, it is something I work on and am getting better.
I never trusted my decisions growing up and that is part of why I almost instinctually look for approval. I will say my mother can be rather shallow at times. Appearance is key with her at times!
Finding people to believe me when I first became ill, was tough. My team of doctors I first saw, along with my primary all said, just stop thinking about it, and it will go away. It is just in your head she said (Primary doc) and her partner said that I never seemed crazy or loony in the past, so it is most likely not in my head. Really? I got angry with them, voiced my opinion and my opinion of them and never went back! Even my father in law says anyone suffering from chronic pain, personality disorders, bipolar, are just crazy and need a good talking to. Really? Ugh! My step father has had back surgery, has a bad back and is the one who said that you can't stay on pain meds for life. He took them for a while - years for his back. He was also addicted to crack for years. He is clean now and I think views me in a similar light. Not fair!
If one more person in the family tells me to stop exaggerating and man up - I am going to scream!
My parents care but they are misguided and worry about stupid things.
For example, my mom always tells me my current doctor is not that good since he continued to prescribe Nucynta even after my skin broke out. I have a slight allergic reaction with higher doses. Then I pick and it becomes aczema.
Today I told my parents that if I decide to go back on Nucynta, it will be my decision with my doctor, period!
One thing that bothers me is that they are not all convinced that I am suffering from CRPS, and might be something else. They thought Lyme disease and I was treated but never got better. I have MGUS so they thought it may be that.
CRPS makes the most sense. Even my doctor is not convinced it is CRPS because he says you arm is not sensitive or swollen and if it were CRPS, I wouldn't also have pain in my right foot and sometimes both feet. They don't understand it can and often spreads. I try to explain this in medical terms, etc.
Many people also assume you need to have every symptom on the list to be CRPS and that everyone goes through the stages. I tend to grasp complicated processes, theories, ideas and things related to the human body and mind.
It is easy for me to understand connections and how things work and I am very in tune with my body. They lack a lot of this sense.
I have to educate this doctor about CRPS.
I read all the time that some people stay in stage 1!
My pain and tingling started within a week after my ulnar entrapment surgery, and continued to get worse, and then sort of evened out.
When symptoms started, they also began in my feet too - mostly the right foot.
Not always, but sometimes I will see my foot or hand turn blue, patches of blue, mottled skin, some swelling at the surgery site and in the hand. I also periodically get a temperature drop in my bad foot and hand/arm, can be very cold! I even experienced body temp dropping a lot.
Lately with flare ups, I can hardly touch my effected limb.
The person who I feel should know what meds/herbs I take is my wife. Nobody else needs to know. She did express that she wouldn't be able to live with me if I continued to have the side effects like anxiety, and being a bit hyper. I think taking the long acting and lowering the dose could help.