[KathyUK]

Hi everyone

I thought I would try out this board in case any of you have any ideas. Rather than type the whole history out again, here is a link to the thread I posted in the spinal problems forum:

http://neurotalk.psychcentral.com/thread183880.html

That goes into depth about my history, including microdiscectomy at L5/S1 in Jan 2011, and bilateral facet joint injections in May 2011 (moderately successful) and November 2012 (very unsuccessful).

My symptoms, in order of how much they effect me are:

Chronic and constant high grade lower back pain, some focused on L5/S1 where my herniation is, but most slightly higher up, around L2/L3. When asked on a diagnostic level whether pain is worse in a morning on getting up or after exertion, the answer is both! It is at it's worst first thing in a morning and after "overdoing" it. However, it is also bad at rest, meaning I get very little sleep (on average 2 hours a night since September).

Radiculopathy 1 - constant high grade burning and loss of touch sensation in outer and front of both thighs, spreading into groin, lower back and top of buttocks. This pain is not covered by the level of my herniation. This and the pain cause me to fall a lot, I get weak legs a lot and am now walking with a rollator or elbow crutches. Because the numbness and tingling spread to my saddle area, I don't have much sexual sensation at the "front" (sorry, trying not to be graphic) and also have mild incontinence depending on levels of pain/numbness.

Painful and abnormally loud/strong clicking/crunching in a specific area in my back, which feels to be around the L2/L3 area. This happens mostly on sitting up from lying down, or on standing from sitting, both of which are always very painful for me anyway. I know clicking is fairly normal but this is to an extent where I can feel it in my teeth (!) and seems to freak out my family with how loud it is!

Radiculopathy 2 - Sciatica down right leg, the cause of that's covered (herniation). It's fairly high level but I'm used to it. It doesn't bother me nearly as much as the burning.

Problems with hot and cold temperatures when it comes to my hands, feet and pain levels. My feet and hands go "see through" and ache badly, then sometimes flush. The radiculopathy means my feet "burn" in warm water. My sister has Raynaud's and this might be a hint towards the cause, although I feel it's related to the other issues more.

Intermittent clunking movement in coccyx - upwards on sitting, downwards on getting up. Sometimes painful, sometimes just a bit touchy. It feels like the motion of clicking in a seatbelt.

Intermittent numbness in outside edge of hands (little finger side). Tested negative for carpal tunnel.

My back pain and nerve symptoms seem to be spreading upwards since my second set of facet joint injections (which were unsuccessful to the extreme and made my pain levels far worse). I get shooting pains in the back of my ribs now too.

I am on buprenorphine patches (35mcg a day over 3.5 days), Pregabalin (300mg a day) and nefopam (1 tablet 3 x a day). I am tolerant to the patches and have been waiting to see the pain clinic as an urgent case since last September because of my high unmanaged pain levels (bearing in mind I saw them in April 2012 and therefore am not waiting for a referral, just an appointment). The pain clinic have not been helpful at all and keep cancelling and rearranging appointments for further and further away. They also forgot to order my MRI last April and I only got it THIS February, and even then it wasn't the full spine one I was meant to have, only a lumbar one. My GP point blank refuses to change my meds without me seeing the pain clinic first, and has stopped my breakthrough pain meds (Oramorph) because he doesn't want me on two opiates. Therefore I have been "unmanaged" pain wise since last September.

My pain levels are currently around 7-8 as general everyday pain, with flares of 9s and even one or two 10s. I have had to go to Casualty on several occasions because of heightened levels of pain and therefore incontinence and saddle anaesthesia - obviously just for those embarrassing cauda equina tests which are always negative. I think they fancy me.

Anyway, I had pinned my hopes on the new MRI that was done in Feb. I completely expected it to show more than one herniation and/or other problems as my pain is far worse than when I had the first herniation. I got the results yesterday and other than a bulging disc at L5/S1 and foraminal narrowing at that level on the right side, it has shown NOTHING. The GP says that none of it explains my pain (other than the sciatica) and that my appointment with the neurosurgeon will be a waste of time - he congratulated me on the results as if I would throw my sticks away and profess to be cured! I am still going to the neurosurgeon but I am gutted that it's likely I will have to get another referral to another doctor and wait another year for more tests and no diagnosis in the meantime. I feel like people would be fair in thinking I was a faker based on all this with no proof.

My GP recently gave me blood tests for "the works", when I asked about other causes of chronic pain like RA and Fibro (which I don't think this sounds like). He didn't tell me which he did, he just said he was doing the lot (before anyone says, I know "the works" would include a hell of a lot of tests lol, but he meant the ones he considered appropriate). When he rang with the results he said I am not diabetic (I knew that), and that I can't have any autoimmune diseases as it would show up on the others which were normal. However, he rang back the day after saying one of my levels was abnormal and could I come back for another test. He said as I'd had flu the week after the test, he wanted to recheck it. Smooth muscle antibodies I think it was? I looked it up at the time and it doesn't seem to have anything to do with my problems, as I don't have liver problems. I have yet to have this done as I had flu for a month and have been fairly immobile since.

Possibly unrelated issues: IBS, diagnosis given after two hospital stays for gastritis and RUQ pain (agony). Gall bladder was suspected, but nothing showed up on tests. Still get bouts of RUQ pain very infrequently but now wondering if it's nerve related as the character of pain was similar to the pain in the back of my ribs after the facet joint injections. It burns and is stabbing.

Has anyone else had this sort of experience? Has anyone had an MRI not show a mechanical back problem up? Or does this ring a bell for any other conditions?

Does anyone have any ideas for suitable replacement painkillers as I am going to have to come off the Butrans and don't trust the GP to give me the appropriate level to cover my pain (he is really nice, but has a special interest in substance abuse and therefore has accidentally put me in withdrawal twice when I was a new patient). I need to find something that would go up to a similar coverage level as the Butrans or slightly above without the peaks and troughs of normal (non slow release for example) tablets, or with a way around them. My GP is unlikely to prescribe me any breakthrough pain relief so having proper coverage is essential. My pain clinic appointment is not until the end of May thanks to them cancelling it yet again because of doctor absence. They won't offer me any nurse appointments or even support group in the meantime as I asked (and I know they're available to others). My neurosurgeon appointment is on 30th of this month and I am hoping that this flare doesn't get any worse in the meantime, and that he will take over prescribing.

Sorry for the long post!

Many thanks

Kathy
xx

ps. I hope this posts because it's taken me 2 hours to type while laid on the bed waiting for any relief from the painkillers!

[Leesa]

Hi Kathy ~ Has he ever mentioned the Spinal Cord Stimulator since your pain is intractable? This is an implant and the stimulator gives the nerves an electrical type stimulation which masks the pain. It works very well with people who have peripheral pain, but doesn't work well for the back pain. You might mention it to him.

You also might have Fibromyalgia. Many people who have had pain for a long time end up with Fibro. The pain receptor go haywire and the nerves become effected and all of a sudden you have Fibro and the whole body is involved. It's terribly painful -- the trouble is, some doctors don't even BELIEVE in Fibro. They figure if you can't "see" it and can't really diagnose it, then it can't be real. Fibro IS hard to diagnose. If you look it up you'll see for yourself. But it is recognized by the American College of Medicine. I think more and more doctors are realiziing that it IS real.

I have the same problem as you in that my MRI doesn't look "bad." While I have had 3 surgeries, it always comes back as "post operative changes" but stable. There are never any more herniations or bulges; at one time there was a bunch of scar tissue but now they don't see it anymore. I wonder where it went??? I asked my doc just the other day -- I said that I KNEW how to read the MRI reports, and I knew it wasn't bad. So how come I'm in so much pain? Could I have Fibro?" And he said "Oh yeah, you have THAT!!" Well, darn it, why didn't he tell me that a long time ago!!! I just found out I have Fibro 3 days ago!! And i've been in horrible pain for more years than I can count!!! Good grief.

It sound to me like you need a long acting opiate -- I'm on OpanaER 40mg twice a day, along with Lyrica 75mg twice a day; Topamax 200mg twice a day for nerve burning; Cymbalta 60mg twice a day for depression And this stuff pretty much takes care of it. He did add Norco 10/300 for breakthru but it's not working well --- I'm VERY hard to medicate and it needs to be stronger. I'm supposed to call him tomorrow to let him know how it's working. But other than that these meds have worked quite well in keeping me "fairly" comfortable and I've been in awful pain for 27 years -- and I'm tired.

I don't know where you live, but I think it's terrible you have to wait until MAY to get into the pain clinic. That's just unacceptable!!! You should be able to see that doctor sooner than THAT!!! Good grief. Are you in Canada or England??? Jeepers, that's just too long.

I hope your doctor will change your medication so that you get SOME level of comfort. You've suffered long enough. Being in this kind of pain not only effects YOU but effects the people around you too. But YOU are the most important, and you should NOT have to suffer. Being treated like we're in the dark ages is ridiculous and the DEA needs to keep their noses out of our care. God bless you and please take care. And let us know what happens, okay? Hugs, Lee

[KathyUK]

Hi Leesa

Thanks ever so much for your reply. It means a lot! This might take me a while to type as I can't sit to type today and also have RUQ pain today (and tummy problems) on top of my pain so might have to keep coming back to this.

Last time I got an appointment for the pain clinic was last April (not counting the facet joint injections as I didn't get a consultation with a doctor then), and as I was leaving the doctor asked me to consider whether I was ready to have more surgery. It was a passing comment and my answer was and still is a resounding yes if it will help. But I didn't know then they would keep me waiting over a year to see them again. The request for an urgent appointment went from my GP to them after I hadn't heard from the pain clinic by September last year, so it's not just from now til May that the wait entails - at the very least it's from September and to be fair I should've already seen them by then too. By October I was in such a bad "flare" (which has carried on since at the same and worse level without break) that I was begging them to see me, and their response was to send an appointment for the end of April (next month) which they since cancelled and postponed due to "doctor absence" til the end of May. It has been a total farce, especially considering the people who are meant to deal with me in between (ie. GP service and out of hours GP service) automatically assume I have cauda equina and send me to A&E every time I ask for help. Accident and Emergency can't help for pain, and rightly tell me it's the pain clinic's job, but won't let me go without a cauda equina test that is, well, degrading in the extreme lol.

I am not convinced I have Fibro (yet) as my pain is still fairly localised and to get a diagnosis here in the UK I would have to have at least 11 of the pressure points. There are some similarities that make me consider it, such as the sensitivity to touch in my lower back, but that doesn't tie in with the right places. Not yet anyway. I do think there is a neurological issue going on and I still am sure the lower back pain itself is from a problem there, even if it doesn't show up. That pain is different to my leg and feet nerve symptoms, it is hot and angry and grinding. When I flare up that specific part of my lower back is red hot to the touch and even someone gently stroking it is agony. With the buzzing, burning numbness in my thighs, it feels "wrong" having someone touch it - I can feel the pressure but not the sensitive nature of skin touch there. So that's not really a pressure point either. I do have IBS and migraine too though, but never really linked them to the pain other than in the cases where it was clear that medication had irritated either. Ginnie on the spinal problems board suggested RSD/CRPS but that doesn't quite fit either.

As for the SCS, that's where my thinking is headed too. Over here you have to fit certain guidelines though AND find a clinical trial. I know my pain clinic is part of the clinical trial but I just feel like I can't rely on them to do anything other than fob me off til the next appointment, so I daren't put any hope into that appointment. I do need to work out what a neurosurgeon can or can't offer me, as I have that appointment at the end of this month. At the time of referral though we all thought that the MRI would show something up that a neurosurgeon could operate on, and at the moment that's looking unlikely. I am trying not to get too depressed about that but it's hard when you've been waiting so long for even basic help. Each avenue is taking months or years, there's no "We'll do this test next month", it's all waiting lists and putting up with disabling unmanaged pain in between at a constant 8 or 9 level, with shooting pains of 9-10. I think they think because I've had to cope for so long, it can't be that bad, but the truth is it is that bad and it has been that long purely down to bureacratic mistakes on the doctors' parts, whether it's poor communication or forgetting to order an MRI. And each time something doesn't work, or tests don't show what it is, I have to wait another few months for a new referral or next test - why not get it all done at once lol.

My biggest worry, and it seems redundant and pointless now it's been so long and is so likely now, is that the nerve damage will be permanent. Everything I have been told from day one is that the sooner things are identified and treated, the less likely this will be. Well four years and counting, still waiting for a diagnosis, never mind the solution! It seems criminal and not just because it's me, I'd feel the same for anyone.

I am not sure if I've answered everything there, but my RUQ pain has got so bad I'm going to have to lie flat for a bit. I hope I'm not heading into hospital again with it, it's been 3 years since that happened last and I really don't need it!

Thanks

Kathy
xxx

[Leesa]

Dear Kathy ~ I know exactly what you've dealt with. Even here in the US, I've had an AWFUL time getting treated. In the beginning I was looked at as a drug seeker even tho I'd had 3 surgeries under my belt. And when the SCS didn't work, they continued to treat me as a drug seeker.

I too went to the hospital but only ONCE -- because at that visit I was treated SO SHABBILY and was embarrassed and ashamed -- even tho I shouldn't have been -- that I vowed never to go back unless I was bleeding to death.

It has taken 27 YEARS to get medication that gives me some semblance of comfort -- and even at that I still have flares where I have to go to bed. Can you believe that? 27 years of agonizing pain, and that's in a country that's supposed to be so advanced. MY FOOT. The DEA has their nose in doctor's practices that they're afraid to prescribe! The DEA doesn't have any business in doctor's practices and this has got to stop! But I doubt it ever will.

I wish to blazes that you could get the treatment that you SO DESERVE. It's ridiculous for you to have to wait so long! I don't see how they justify this. How do people stay alive over there, while waiting for treatment? Boy, I'll bet the Queen doesn't have to wait like everyone else! lol

I wish there was someone you could talk to or write to, to plead your case! Here, we can talk to our Congressman and he/she will try to help us. They usually do too because they want our vote next election. lol I wish you had someone like that who could pressure someone to get you in sooner!!!! It takes about 18 months of "no care" for damage to become permanent for nerves. So you may have already passed that mark, I'm afraid to say.

Please keep me posted, will you ? I'd like to know what they decide on your care and what they put you on etc. I hope they put you on a long-acting Opiate and/or implant the SCS. You NEED some changes! God bless. Hugs, Lee

[finz]

Hi Kathy,

I'm sorry to hear that you are having such a tough time of things. I can't imagine the frustraion of having to wait that long for an appointment while dealing with such pain.

As Ginny mentioned in the other thread, some of your issues, especially the burning pain (without another explanation for it) and allodynia (the sensitivity to touch) do sound RSD-ish.

Regarding the fibro......How many tender points, if any, do you have ? Do you understand that it doesn't hurt all the time from those spots, just that they are more tender when palpated during an exam. While waiting for your appointment, a relaxing trip to a masseuse might reveal that you do have tender points, that need some extra work, that you were not aware of. Also, if you weren't aware, the IBS can be a sign of fibro. I think your doc is a bit "off". Some blood tests could indicate that fibro or lupus MIGHT be an issue, but negative results on a blood test don't rule them out.

I'm glad they have ruled out cauda equina. Geez, you'd think after so many emergency evaluations for that, SOMEONE would prioritize figuring out what your dx is !

[KathyUK]

Hi you two, thanks for your replies! Better tell you what happened last night before I answer your questions.

Yesterday the pain got increasingly worse and it was hurting to breathe. The sciatica was worse (which doesn't scare me as I know the cause of that) but I also had an awful lot of pain all the way up my back, across my shoulders and into my right ribs. The burning and pins and needles in my thighs and intimate parts were indescribable! In the UK we have out of hours GP services for emergencies that don't quite warrant going to Accident and Emergency at the hospital. I rang them for advice as I couldn't find any position that relieved even some of the pain and I had fainted. They sent transport for me (I will be eternally grateful for that) and an on call GP saw me at about 9.30pm.

I AM tolerant to the buprenorphine and when I asked if it was possible this had extended to hyperalgesia, she agreed it was possible. My entire back was in spasm too, that was a first for me. My choice was to go onto the Acute Pain ward at the hospital last night for a morphine drip, or to try some Oramorph and diazepam at home. My pain levels justified the first option big time (and that was the option the GP preferred too), but I couldn't leave my husband without asking my family for support for him as he's blind. He had a different opinion but I wanted to try at home first. So I was sent home with diazepam tablets (4 x 2mg tablets, to take 1 up to eight hourly) and some Oramorph to take.

The GP was amazing, wish she was my normal GP. She said my GP should ring the pain clinic to get me seen this week, and if it gets worse again I should be admitted. She said I need my buprenorphine replacing immediately, she was not able to do that because of pharmacies being shut and them only having limited supplies at the office, also she felt it was important that my GP carried out this part, or the pain clinic, as they know my case and can draw on more history.

The meds helped ease my back for a couple of hours which was enough for me to sigh in relief. The pain came back in the night without the spasms, so I used more Oramorph and I'm here now. My GP will not be happy when I speak to him, he thinks morphine will put me into withdrawal from the buprenorphine and will up my pain levels, despite me having used both together successfully for 2 years before I got him as my GP. He's not in today so I am going to continue with the meds I was given and speak to him tomorrow. I hope I don't need admitting to hospital as I will have to find another doctor to sort that.

This morning the spasms are coming back so I will have to use the diazepam again soon, I don't want to risk having to go into hospital if I can help it but I also know that docs from the pain clinic work that ward. Not my specific consultant but still. Ow. Ow.

Leesa I read your post to my husband, hope you don't mind, just I thought it was pretty amazing how you have survived through that. I could write to my MP (member of parliament) but we have to expect a wait of weeks for a response and that response will be to contact the PALS service (Patient Advice and Liaison Service) or the local NHS patient experience manager, the latter of which I have done. They are not happy with the treatment I've had and want me to make a formal complaint, but I have to live with these doctors and going that far would make things worse I think. I *hope* what the GP said last night will work in pushing my GP to get me sorted ASAP. Thank you so much for your reply, I think you sound amazingly strong considering everything you've been through and even though I feel terrible about how much pain you must've had to endure, your post was a bit of an inspiration. Thanks.

Finz - most of my "proper" pain is in my lower back. I have nerve symptoms that radiate further out - thighs, buttocks, groin, calves, feet, ribs, hands, and as of last night very painful muscle spasms that are my entire back, shoulders and neck (and bum!), all of which are just as "bad". If I were to rate the issues, the back pain, muscle spasms and burning thighs/groin/buttocks/lower back would come tops. It always frustrates me when the neurosurgeons or pain clinic ask which is my priority, my back or my wobbly legs - the answer is both lol.

I really don't know much about where the Fibro pressure points are, I've seen a picture when googling, but it was contradicted by an information sheet I found. My sister is a qualified massage therapist but her guidelines say not to touch someone in a flareup. I'm sure she would if pushed to for me, but it made her uncomfortable when I asked. It's not an intimacy issue, she's massaged me before, a long time ago when I wasn't flared up.

As for RSD, I thought although people can have varying symptoms, that the changes in skin were pretty important for a diagnosis? I can't think of the right words to phrase that, my head is fuzzy from meds. You know what I mean?

Thank you both so so much for replying to me, it makes a huge difference when you find someone who is able to listen (ok read) and who understands. I see you both give great advice to others here and I hope everyone knows how lucky they are to have that support! Many thanks xx

[KathyUK]

Just received another letter from the pain clinic. My May appointment has been cancelled and put back to the end of July. I can't do this any more.

[Leesa]

OMG Kathy! How do they expect you to live like this??? This is UNREASONABLE! They can't expect you to wait this long! It's inhuman! It's cruel and inhuman punishment! Prisoners aren't treated this badly!

I just don't understand. You'd be better off if you were in prison. It might be a good idea to fly over here and see someone at the Mayo Clinic or one of the hospitals here. There are PLENTY to choose from. I'm sure they could get you in in a day or two. Yes, it would be expensive to fly over, but my gosh, you can't wait!

I'm praying Kathy. I'm saying LOADS of prayers. PLEASE keep me posted, will you? I really really care. Love, Lee

[KathyUK]

I'm just soo tired lee, the diazapam got me 2.5 hours sleep last night but i am only allowed today on that. I lost my job because of this so can't afford private treatment or to go abroad. I also care for my husband whos blind. he cares for me too and that's not fair on him with his problems. I think only thing i can do it ring back the GP practice and get another GP to admit me to the acute pain ward. Only way I'k going to get seen isnt it. I didn't want this, they're going to think i'm a drug seeker and i'm not, only thing i;m addicted to is relief and i'm not getting my fix of that am i. sorry about ypos, really tired and medicate.d

[KathyUK]

Hi everyone

Thought I'd update you all on what happened after my last post.

Well, I rang the GP practice to get admitted to hospital and a GP rang me back. I'm not entirely sure how to judge what he said, because I know there are some that would agree with him, but it came across as really unfair and unkind. He said I should just learn to put up with the pain and stop putting on them. He said he wouldn't come out for a home visit (which I didn't ask for) but would see me at the practice if I could get up there, however he would not be prescribing anything (again I hadn't asked for that, I needed admitting). I was really upset after coming off the phone but felt that if I didn't get myself up there I wouldn't get any help. So I tried to get dressed, and that's when I had a bad fall. My legs couldn't hold me and I hurt my knee and back falling, and couldn't get back up. Baz was extremely distressed by this and rang 999.

An ambulance came, by this point I couldn't feel my feet at all and my back was spasming so much I was struggling to breathe. The ambulance team were amazing and gave me IV morphine and a "gas and air" thing to breathe through for the pain. Then, when I was "stoned enough", they got me into the ambulance and to the hospital casualty department. I saw a doctor there who had to do the cauda equina test as protocol, and she said that because I already had an MRI done she was admitting me to control the pain and probably to have surgery the next day. I was taken up to an Assessment Suite ward.

On the ward I saw their consultant who sent for a neurosurgeon. They kept me on IV morphine (directly in rather than a drip) and I was still in pain. the neurosurgeon reviewed my MRI and thought it would be best NOT to operate at the moment as my symptoms didn't align with it (which I knew already and agreed with). The plan at that point was to get my pain consultant (you know, the one that keeps ditching me) out the next morning. They said their number one priority was to make sure I didn't go home unmanaged, I was so relieved by this promise that I was quite tearful. I had been due to change my buprenorphine patch that night but the ward didn't have any, and I said I wanted it changing to a new med, so they left that for the pain team to work out.

Morning came and went and the nurse told me that my pain consultant had been rude to her on the phone and refused to come down. He said to "stick another patch on her and send her home to see me at her normal appointment". I was heartbroken at this point. By this point I had not had my usual buprenorphine patch and I had a killer migraine - possibly from withdrawing (bit early but could've been) or the morphine. Either way I was in a lot of pain from my back and also couldn't open my eyes or stand up because the migraine was so bad I thought something was badly wrong.

I said the pain consultant's answer wasn't good enough and reminded them that they had promised not to send me home unmanaged. So they got another of their consultants out, and this was where things got a lot better. He was the assessment suite consultant, but also works with patients with fibromyalgia. He said my problems seem a lot like fibro, but not widespread enough, although that doesn't mean I don't (or do) have it. By this point (late afternoon) I had had to admit to myself that the buprenorphine must've been working a bit for me as my back was much worse without it. He said I am getting tolerant, but that doesn't mean it's not working at all. So he suggested that for now, he gives me some temgesic to "top up" when I have a flare like this, which would give me more control and a better idea of if it's working at all. He also upped my pregabalin to 450mg a day (150mg in morning, 300mg at night). He also wanted me to try Cymbalta for the neuropathic pain and for the (understandable) depression the pain is causing. We had a good long chat about how exercise and mood effect my pain and he came up with some great ideas for me to try, including ignoring the pain clinic's ban on exercise and/or physio. He thinks I will turn out to have one of the chronic pain disorders like Fibro as it is clear from the tests they ran that the pain is not being entirely caused by my back problems which are minor in comparison.

So I came home last night with the pain clinic having begrudgingly said that they will now see me in April, although they refused to give a definite date, and I will believe it when I see it - they'll probably send me an appointment and then cancel it again lol.

I decided to only start the Cymbalta last night, rather than the temgesic and pregabalin rises as well, so I could judge any side effects or changes in pain specifically to each. I woke up this morning (after my first full night's sleep in over 6 months) and could FEEL MY THIGHS!!

I know it's early days but I do feel that doctor listened and understood and that's half the issue. The other half is being able to have control back and he totally understood my fears of being seen as a drug seeker (and agreed I need a change of GPs, but I have to do that carefully). If I can help myself during the flares, the less likely it is I will have to seek help elsewhere and get seen as a drug seeker.

All the doctors I saw in hospital think the spinal chord stimulator is a high probability in suitability for me now, especially when they considered that I don't want to spend my life on high level drugs. All the doctors said it's likely that whatever is causing the pain, the nerve damage to my thighs is probably permanent. All of them understood and all were very nice. And they've ALL seen how unhelpful the pain service have been to me and to them. So I do think as much as I am still at home and still wobbly and sore, I am in a much better position now than I was at the beginning of the weekend.

I'm really sorry for my down posts, and embarrassed about my typos on valium! I know I'll get low again, but I also know that there ARE people who care out there if I can access them. I am going to send the nurses and that doctor a card to say thank you. xxx