Rachel,

A muscle relaxer to help release some of the tension in the neck area wd be one thing to ask your Dr about - most of us are on some kind such as Zanaflex or even Valium (I take generic for Zanaflex twice daily, have Valium to use as needed at night - save it for flares when NOTHING else will help a cervical headache brought on by neck muscle spasms). Ask also about the off-label use of epilepsy meds for neuropathy (best to just say someone mentioned this unless you know your Dr is receptive to Internet research).
These may take trial and error to find what works best for YOU with the least side effects, but they do make your regular pain meds more effective.

And, my friend, please consider asking about an antidepressant. Now that the pain is becomiing progressively severe, and "good days" are rare or vanished, the "feel-good" (seretonin) chemicals in the brain are decreased. Sleep usually restores them, but disturbed and scant amounts of sleep prevents this from happening. The antidepressant will restore the balance, and you will see a very REAL difference mentally and emotionally. Your moods won't swing so drastically and you will cope better - we've all been there, see, you're not alone! Also, Cymbalta, a relatively new antidepressant, has a neuropathic pain-relieving effect as well. It has worked wonders for ME. You might ask your Dr about it.

None of us made the decision to take meds easily or lightly, I believe. I know initially after my injury I was given rx's for increasingly heavier meds, but after 6 weeks or so I quit them all ( cold turkey - ) because I was still working, and a parent and wife, and couldn't function in a perpetual fog.

But 9 months later after beaucoup tests, therapies, treatments and tortures, it was obvious the pain was here to stay, and I wasn't functioning well without meds either. And in fact the first anti-depressant I was on really wasn't effective, although no one caught it til I was pretty desparate and reached out for help. A pain counselor is a REALLY good tool to have in your bag - someone to let it all out to - the rage, the despair, the sorrow, how family and friends just don't "get it".

Lately I find myself going through guilt over not being able to help my mother with health issues she and my stepfather are facing - they live 2 hours away, and I can't BE there like I want, can barely manage my own family. But I'm the only daughter, and my brothers (3) are out-of-state except the youngest, and wouldn't be of much help even if they were close. I hate to feel so useless when she's done so much for me - it's my turn to give back, only I'm not capable of doing it. Fodder for my next session, obviously.

Anyway, I hope your visit is productive, generally a Dr will only start one rx at a time, then wait a few weeks to see how you respond before adding another. Oh, be sure to let him know the PT exercises that have made you flare badly, and ask about possibly trying ultrasound and massage along with nerve glides/stretching to open up/ loosen the upper chest/pec minor area.
Or, if he's really that unknowledgeable, why not ask for a referral to a neurologist who will be able to answer your questions more effectively and arrange tests that may give you added information?

Best wishes,
beth