Sending many thoughts and I hope today you get some answers and direction. I am not sure about the meds but it sounds like either you are in more of a flare up of pain or the dose is now too low or maybe something else needs to be done. As for the patch I can't tolerate them but I know Mrs D says how key placement is and it is not on the area always where you have the pain it is where it originates so you may want to ask her. The sleep/anxiety/pain I can really relate to as I go on very little sleep from the cycle. I am on meds to help but they do nothing. I am not sure what my point is other then I can relate. Sending many better thoughts