Tuesday, April 19, 2011

My pain management adventure

Back in December sitting at work I felt like I went into back labor. Only thing was I wasn't pregnant. My back started to spasm. I went to the doctor that night and was told I sprain or stained my back, given a back brace and a prescription and told I should be better in a few weeks. I'm not one to take medicine of any kind. My doctor calls me a minimalist. As you can imagine I wasn't looking forward pain meds for a couple weeks

My prescription was a muscle relaxer called Flexril and an anti-inflammatory called Mobic. Flexril worked, it knocked me out and made it extremely hard to wake up. Mobic was like taking a children's vitamin for pain. Worthless! I couldn't take anything else 24 hours after  Mobic. The next day I saw a doctor from the Occupational therapy since my pain started at work and California is a no fault state. He agreed with the doctor I had seen the night before and added Physical therapy to my prescription twice a week for 6 visits.

Flexril made me feel drunk all day. Unable to focus on anything and I wasn't stable standing. The physical therapy had to be approved by a workman's comp case manager that wouldn't call me back for three weeks. I had seen the Occupational therapist a second time before my physical therapy finally began. I called my doctor and ended up seeing one of her colleges and got Motrin for my back pain.

My physical therapy began end of December. My therapist is Gina. She hurt me really good the first few times I saw her. I had an electric stimulation thing and heat applied to my back, I got soft tissue massage that was extremely painful and left me sore and given exercises to do. I ended up crying a lot of the pain I had and how I thought physical therapy was not working.

Eight weeks after my back stain I was still in as much pain and sometimes worse pain than day one. I went back to my occupational therapist who prescribed me a different muscle relaxer and more physical therapy.I guess my strained back was not going to heal in a few weeks this point. I'm sick of being handed prescriptions and gong to physical therapy that is painful. I got an appointment with my doctor. Telling her about what has happened, how I hate medications, my fear of becoming a drug addict and my physical therapy that I hate. I end up crying. I'm desperate to stop hurting. I can tell she wants to help me. She tells me because I'm being treating in occupational health if she treats me it could mess up my worker's comp case. I don't care. She asks if she can try to get me a occupational therapist she works with in Martinez where she is. I'm good with that. During this time  my doctor orders me an x-ray. We find out I have degenerative spondylosis and spurring of the spine.


The next day I get an e-mail from her saying I need to get approval from my case worker to change occupational therapists. This sucks because my case worker is impossible to reach. I go on with my current treatment. Physical therapy is getting better. Gina you can tell knows what she's doing. My pain is still there but I have skills now to help and not just medications. When I go back to my occupational therapist he asks if they have corrected the ergonomics at my desk. We think my injury was caused over time sitting at a desk poorly. My job has not fixed it yet. He puts me on modified duty. When I get to work I'm told they can not accommodate my doctor's restrictions and I get put out on disability. I also get a second case work and finally talk to the first one. I'm out of work for almost four weeks waiting on my employer to add a tray to my work station.

During my time off I go to physical therapy, exercise, rest, and I'm either walking around of laying down. I make a lot of progress healing. Then I have to go back to work. The first day is good. The second day back I'm in pain again. Gina send my occupational therapist a note telling me I need more visits. I get 6 more visits once a week. I need to have a follow up ergo evaluation. I go back out of work a few days for pain and now a buzzing feeling in my body. I see my doctor again. I give her details about my physical therapy and some of the things Gina thinks may be going on. My doctor wants me to have a MRI but she has to check with my occupational therapist first. He tells her it's OK with him and I get one done.

MRI's are creepy. The machine it self if giant. The space they put you in is tight and small. There are a lot of loud noises and your in there for a while talk to a guy who's in another room on a speaker. The results take a while to come back, about two weeks. My doctor e-mails me and tells me it looks the same as the x-ray. My occupational therapist says he can't see anything new but my doctor referred me to the Spine Clinic. I add another doctor to my list. Dr. Chen is great. She goes over the MRI with me showing me what I already knew about but also shows me I have herniated disc and arthritis. She orders some blood tests and tells me about my treatment options. The blood tests are to see if I am low on vitamins D and B. They are the vitamins your body uses for immunity and pain. My test come back that my B levels are fine but my D lever is extremely low. I am told to take 10,000 units a day until June when I will have another blood test. My treatment options include an antidepressant called Effexor that is used for chronic pain conditions and the possibility of an epidural injection. The steroid they want to use is cortisone. I have been told my entire life I am allergic to cortisone. Dr.Chen orders an allergy test.

I start taking the Effexor that same day. It gives me the worst panic attack I have ever had in my entire life.I told Warren my husband he may need to call 9-1-1. I curl up in a ball ad hide under some blankets, hyperventilating and trembling. This lasts for hours. I am suppose to increase every three days up to three pills. With each increase comes a panic attack but none as bad as the first. Here is the cool part. My hard spasms in my back I can't feel anymore. The buzzing is gone. I can feel where it hurts but it's not nearly the same. The bad thing is I stabbed my thumb with a knife and didn't feel that either. I only noticed because I was walking through my house dripping blood.

Gina is noticing my muscles are not as tight and are starting to relax. This is good. When you have an injury you body becomes protective and other parts of your body will often compensate to protect the injury. This is what my lower back muscles are doing to protect all the injury in my spine. This is also why I am having back spasms. With less pain in my back and the muscles building up in my abs, butt and thighs I am able to do more. I can do laundry, take a really long walk,  mild hikes, go to the grocery store, cook and work in my garden. This is great, I have motivation to do things and I'm not in pain. My appetite is suppressed because the Effexor makes my stomach a little nauseous and I've lost 19 pounds. I think my life is good.

Then I took Sonny on a walk. Sonny is my four year old. I swear there is not a child on Earth with as mush energy as Sonny. When I take him on walks with me I use a harness. I can't chase him if he runs. I am trying so hard to get better I'm not going to push my self that hard yet. On a walk we go in the harness. Sonny gets a bright idea that he wants to swing from a vine. He grabs the leash part of the harness I have looped on my wrist with both hand and swings. This torks my entire body. I'm in PAIN!!!! Off work again ugh!!! The pain is still not the spasms I've had but intense pressure. Gina can feel the spasms and tightness in my back. My doctor wants to check for a UTI. The tests come back no infection but dehydration. She orders a second test. I'm still waiting to talk to her about that one.

In the mean time Dr.Chen has increased the amount of Effexor pills I should be taking during the day. In doing this I ran out Sunday morning. This has to be the worst experience I've had with these stupid back issues. Effexor is so strong without it my whole body shakes as it is today. Yesterday morning I got to the pharmacy and they where out of Effexor. I was going through with drawls and cried right there in the pharmacy. I e-mailed my doctor twice while I was at the pharmacy. Then I sat in my car for an hour trying to compose my self enough to be able to drive home. The Martinez pharmacy called over to the Walnut Creek Pharmacy and was told they had 200 pills they are filling for me. My daughter was sick at school so I picked her up got her settled at home and went to Walnut Creek to get my drugs.  I can feel the spasms in my back now. They are worse than they were before. I get my pills and clerk says I don't need to wait for the pharmacist to talk to me. I get to my car and take three pills. With in a few hours I stop feeling my spasms. However I took my evening dose of two pills a shortly after that, a half hour before dinner as I had been before I ran out. This made me crazy. I couldn't focus, I was numb, dizzy, hot, sweaty  and did not sleep at all last night. Maybe I should have talked to the pharmacist since I didn't know how to handle taking the Effexor after missing two doses. Today I took the Effexor as normal. I need to e-mail my doctor since today my pain is gone and no pressure or buzzing but I have a headache and slightly blurry vision and it takes me a minute to register when someone is talking to me and I still have trouble focusing.

One last thought...... talking to War this morning we think antidepressants are highly addictive and running out is like a heroin addict going through withdrawals.

1 comment:

Frances said...

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