Stacy, I wonder if she'd be willing to prescribe a starter dose of Nortriptyline. I started on just Nortriptyline but added Gabapentin when the PN pain spread from legs to arms, and the combination is still (eight months later) keeping the PN pain under control. And I guess it helps with EM too. I've read that the combination of Gabapentin and Nortriptyline (or probably Amitryptline) is better than either drug alone.

Yes--that's why I spread out my Gapentin (smaller doses three or four times a day).

My PITA doctor got pissy when I left message I could not do cymbalta so her nurse just called in another RX for more gaba and said we would "deal with it" when I come to see her next week.

Leaving me stuck and in pain. SO, on my own I decided to take 1 at 11 am and another at 6 pm and 2 before bed, around 11 pm. Each pill is 300mg. She had been having me do 3 at bed time. So whatever. This new dosing is helping me MUCH MORE. Why she couldn't just suggest it, well, nevermind, I know why. She literally disliked me just because I take lots of supplements. Not sure what will happen when I go next week. She will get all offended that I decided to does myself, but she certainly didn't care enough to try and help me.

This is working better but not great, still cant get up a lot. Still cant leave my house. Still use water but less frequently, get more sleep.

Definately more side effects. But this is my life now, as you all can relate. I accept it.

I'm not surprised the dosing you are doing now is helping. Actually, that is the 'typical' dosing, I thought (3 times a day). The half-life is like 5-6 hours, so 3 times a day seems appropriate for better/consistent coverage.

I hope your visit next is more productive then the first one. I'd ask her some pointed questions (particularly why she's dismissing EM), but in the next breath, I'd give her an opportunity to tell you what the long term approach and plan is and where she sees this going.

Stacey, I can't offer more then what has been said already. I just want to say hang in there! Hopefully, you will find the right dosage and treatment to at least lower your pain.

In the mean time know you are in my thought and prayers.

I went to my dr today. God answered my prayer and she was like a different woman, literally, kind, sweet, NICE, open to suggestion...PRAYER WORKS. amen

Even hubby said the change was night and day. She even looked at and READ the EM info and agreed I probably had it as a secondary condition. However, she said treatment remains the same either way, which is somewhat correct and I knew that, though there are other options. She said the magnesium is simply over the counter choice, which I was not sure of, I thought Dr Cohen used stronger stuff but I didn't know.

The said no to gout in her opinion, which I agree, my symptoms do not present as gout. She did draw blood to test for heavy metals at my suggestion, though I believe hair testing is better, this was my only option. She does not feel the need for any further testing, which surprised me since we have not tested for hardly anything. In her opinion, it seemed she felt the options are not anything reversable so why test.

Treatment is remain on gaba until it wont work anymore, raising to the limit. Which may be sooner than later, since my muscle pain is bad. She was surprised by that but I seem to have issues with muscle pain as even micardis did it to me and it was a rare side effect for that med also.

She is calling in a compounding cream with gaba, nortriptline, and lidocane.

She also suggested ultra sound therapy.

After that she wants cymbalta or lyrica. I kept silent on that.

One day at a time. One hour at a time. One moment at a time.

The compounding cream is a good idea. See, I suggested to you to give her a chance....It is a good sign for you that she looked this up and understands it. Some doctors will do this and others refuse.
The ones that refuse to look stuff up, should be fired ASAP. (they have closed minds and big egos).

But this one is working with you and your problems are complex and not easy fixes ...so you have to be patient.

Yes. The compounding cream was my idea also.

It is very wise to go in knowing your stuff. That would be my suggestion to any new people going to a doctor, know your stuff. Know what you want, why, what tests you want to do, everything.

It was my idea to do gaba through the day, my idea for heavy metal test, my idea for a compounding cream, she seemed surprised I knew to ask for this and said yes, that is a good idea, and most surprising, she did NOT mention one single word about that $3,000 test I was supposed to do. I was waiting for her to ask but she didn't. I can't believe she wanted me to do a test that cost that much and then she didn't even ask if or why I didn't do it, nothing. Guess it was not that important, just MY money.

The only idea she had was ultra sound which I can't imagine would help and if so, temporary help that costs too much to keep up.

I feel it was a better appointment in that she was compliant and nice but that is about it. I am very surprised she has no other tests to run to continue to find out what exactly I have or what might be causing it. It seems she doesn't really care as pain meds are the only answer...again, something I have said here before...why spend all the time and money when it doesnt seem to matter in the end.

I'm glad you had a better appointment and interaction with the doctor. I too am surprised she mentioned the expensive ultra sound but no mention of ANY testing to find the cause.

Did she at least increase the gaba to something other then once a day, so you get better coverage?

Also, did she have a cap on the dose of gapa that she'll go to before quitting?

I'd say give this (and her) a try. At the next visit you can bring up the subject again about testing (like skin biopsy). She may have a different opinion that day.

She said the cap is 4,000 but I dont think I will make it there, my muscle pain is getting worse. I meant to ask her what to do about it, after I told her about it and she was surprised she never said anything again other than if I cant handle side effects I will have to quit.

Yes, she said I can increase as I need to, just call her for increases. She wrote a new script and said what I am doing is working keep doing it.

I am scared it may be a problem for me for many drugs, and I dont know what to do. My left thigh feels like someone punched me, it is deep muscle pain in one spot.

I do not want a skin biopsy, dont feel it is useful, but she seemed open to testing if I suggest I want it, just not sure what to suggest. Why does it always feel like I am my own doctor.

Right now my focus is stuck on this darn muscle pain.

Also, do you all get handicap parking stickers?? I really could use this for myself but feel silly asking for it since I do not appear handicap.