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star_stuff

welcome me to the chronic pain train....

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Well, last Friday I went to a primary care doc with severe pain in my left shoulder and along the left side of my neck. She x-rayed my shoulder and neck, and found that my cervical spine was straight, and the top two vertebrae are fused together. She referred me to a dermatologist, thinking this might be psoriatic arthritis, and put me on 500mg naproxen + 1g acetaminophen for pain during the day and 50mg tramadol at night, and started a 6-day course of methylprednisolone, which I finished today. I just started physical therapy. The daytime meds still leave me with 3-4 pain all day, and the tramadol seems to wear off in the middle of the night, leaving me with 7-9 pain until the next one kicks in. 

I don't know what I have yet, but I figure I need to lose 30lbs, so I started a keto diet, and am looking to add anti-inflammatory foods. I'm frustrated, and feel clueless, and oh, yeah, I'm in a lot of pain. Has anyone else been down this road? Anyone have any suggestions?

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Well if you are at pain level 3-4 that is unexceptable.  You should be lower if you are on meds. You need to tell your doc this. They will do something  about your meds if  you communicate with them. Tramadol is weak but you can take more. If the diagnosis is correct Naproxen is a good drug for psoriatic arthritis. You can take up to 1000 mg/day, usually in a divided dose. Up to 1,500 mg/day for 6 months or less. Naproxen is hard on the GI but in general the safest NSAID. You may need stronger pain meds. Docs will dole them out but only after you have tried the other options. Steroid injections into the site of pain can be a big help. 

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I don't understand why she referred you to a dermatologist. They deal with skin issues, which you would go to if you had psoriasis,. However you might have psoriatic arthritis for which you should see a rheumatologist as it's an inflammatory arthritis which is their area.  I have a close friend with it and have been supporting her on her journey with PA.

I also don't know why she gave your prednisone either. That is a sore spot with me because I had a doctor that prescribed it to me and it messed up with the results of some blood tests I had to take to get a diagnosis,  sent me into mania, and other things I won't get into here. She shouldh't have prescribed them and should have waited for the rheumatologist make that call. 

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Hey, notloki and dilemma. Thanks for responding, and sorry it's been so long.

So, the pain is getting worse, and now I also hurt in my lower back and right thigh. On Friday, I saw my regular primary care doc. She said she reviewed my xrays, including ones from last year that they took after I pulled a back muscle. She said that, while she couldn't rule out anything degenerative or autoimmune, it was clear I had damage to my cervical and lumbar spines. She thought that I injured my back 10 years ago, while serving overseas in the military. She referred me to some spine and pain clinic, and gave me a shot of toradol.

The toradol made me feel pretty good, and by midday, I could barely feel my shoulder and neck pain. But, by 6pm, everything was worse. A lot worse. the shoulder and neck pain was cranked up to ten, and my lower spine and left thigh were just as bad. I took 2 tramadol 50mg, 3 10mg flexeril, a 20mg suvorexant, 500mg naproxen, and 1000 mg acetaminophen, and for 2 horrible hours prayed for sleep, coma, or death. None of those things saved me until very late last night, because even when the pain began to subside, I started getting stomach cramps, like bad. 

I woke up at 1pm today, and the pain was back down to like 4, but now my left thigh hurts all the time (before it only hurt when I walked a lot). I took 500mg naproxen and 1,000mg tylenol, and went to the grocery store. The stomach cramps returned, so I guess I'm reacting to NSAIDS now, on top of everything else. Anyone have experience with Celebrex?

dilemma, I'm sorry you had that experience with prednisone. I think they gave me steroids to reduce inflammation in my spine, and when I was in the middle of that steroid course, I felt a bit - I mean, just a bit - better. I'm hoping this spine doctor will do an MRI and do something meaningful with this pain. 

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Good luck with the spine doctor. Hope they can get to the bottom of it soon.

I took Celebrex a while ago for the osteo-arthritis in my knee before I had knee replacement surgery. It worked well.

 

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I have to take extra famotidine and add Nexium if I am going to take a NSAID. 

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I've been taking 40mg omeprozole (basically, 2 prilosec) every day for years for reflux. But, this pain is a strong cramp, and hurts almost as bad as everything else. 

 

Thanks for the well-wishes!

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Okay, everyone. Thanks for all your input and well-wishes! I saw a spine & pain doc today, and here's what happened:

He said my pain was caused by the compression of vertebrates where my disc is thin or nonexistent (I kind of knew that, already). He said there was a concern about nerve damage because I had weakness in my left arm. He's putting me in for an MRI, and thinks that I would benefit from an epidural of corticosteroids. Until then, he put me on Celebrex 100mg + tylenol 1G during the day, and 300mg gabapentin at night (he knows I have a truckload of 50mg tramadol, and said I could use that if things were bad). In a week, I'm supposed to add a 300mg gabapentin in the mornings, and in another week, add a third in the middle of the day. By then, I should have had my MRI, and the next thing would be the epidural.

That was this morning; so far, so good. I think the Celebrex is better than the Naprosyn for pain (at least for me right now, anyway), without the stomach cramps. My pain right now is around a 2-3, and normally by this time of day I'd be reaching for a tramadol. So, if things aren't much worse tonight, I'll probably just take the gaba (I usually take 100mg tramadol; I still might take a 50mg, just to be safe) with a flexeril, and hope for the best.

** 8pm edit **

I just couldn't stand it, so I took a 50mg tramadol at about 6pm. Gonna message the doc and ask to double my celebrex dosage. When the pain breaks away from those meds, what can I do? I can't keep downing NSAIDS, certainly can't keep downing tylenol, so tramadol is the only tool left in the toolbox. Took a second one just now, with the gabapentin, the flexeril, and the Belsomra. Man, this sucks.

Edited by star_stuff

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I'm glad you and  your doctor have a good road map.  It's always nice to feel like you're making progress. I'm sure that when you're in pain it doesn't seem like things are moving fast enough, but at least you haven't hit a dead end.

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Thanks for the encouragement, dilemma. I'm hoping that epidural is a durable solution (at least a few months at a time). But, that's weeks away, and now I just have to figure out how to make this work.

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I hope the epidural injections work. My mom went through a lot with her back. They'll give you up to 3 of those injections over a few months . They didn't help her and in the last 10 years she has had 3 spine surgeries and with each one she has felt better and better.  She is 83 years old and has been pretty active since that time.

Now I'm not saying that you'll end up with surgeries, but just wanted to give you a data point with somebody that has done well after spine surgeries. They really tried to scare her about even having them, and she's not the only one I know who was discouraged by their scare tactics.

I don't know if she ever tried gabapentin. I never heard of it being good for nerve pain until a couple of years ago.

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Thank you for the input, and I'm glad your mom is doing so well! My mom is 83, and my dad is 85, and I moved back home last year to help keep them out of assisted living.

The spine doctor I'm seeing is all about non-surgical treatment. I haven't had a serious conversation with any doctor about surgery, but after I have the MRI, I will look into it. Before I make any decisions like that, though, I want to see how the epidural treatments work for me. I've never had an epidural before, and I expect the procedure itself is painful, and do I want to that 4 times a year for the rest of my life? I guess I have questions that can only be answered by experience. But, thanks for your feedback, because yeah, I'm scared that surgery will fuck me up even worse, but I admit that my fear may not fit the facts.

Gabapentin - meh. Okay, last night I wimped out and took 100mg tramadol. Tonight, I'll try not taking the tramadol at all. But, I do feel a difference this morning - I'm groggy as hell. I hope this is a side effect that will fade, but I have a friend on gabapentin who always blames it for him being late in the mornings. I hate waking up and feeling kinda drunk for the next 3 hours, even after my coffee and Concerta. Oh, but what about the pain? Well, this morning I hurt, just like every morning for the last 3 weeks. So, I have to give this more time.

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On 10/21/2020 at 6:06 AM, star_stuff said:

I want to see how the epidural treatments work for me. I've never had an epidural before, and I expect the procedure itself is painful, and do I want to that 4 times a year for the rest of my life? I guess I have questions that can only be answered by experience. But, thanks for your feedback, because yeah, I'm scared that surgery will fuck me up even worse, but I admit that my fear may not fit the facts.

They are painless, I usually do 3-4 a year. They numb up the injection site to the point you can't feel anything. I also get an IV for Versed. They inject C1 through C5

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