I Will Be Trying Flector Vs Lidocaine Patches

So I have become quite addicted to wearing my Lidocaine patches. I started a few months back to try 30 days worth of Lidocaine patches to see if it would break my pain cycle.

It does actually make me feel better. I mean, it doesn’t cure me or anything, but it does make me feel better.

However, at the end of the 30 days, I was supposed to stop. I just can’t bring myself to stop relying them.

Yet, I wonder? What makes me feel better, the Lidocaine or the fact that it comes in a patch form? I wonder if my back just feels a bit more stable having something back there. Kind of like the tape that athletes use. Therefore, I asked my doctor to write for Flector patch, which is an anti-inflammatory patch. That way I can try a different class of drugs in patch form and rule out if it is medication, sensation, or both. I’m gonna start tomorrow with a five day trial to see if I can determine what makes me feel better. I had a hard time convincing my doctor, he just wanted to write for a Fector cream, but I insisted. He completely was not paying attention to my rationale.

The unfortunate part of this is that my new insurance, which is shit, does not pay for Flector. There is also no generic. That means that a 30 day supply is $300. I got 10 for my trial, but I can’t believe it. How can they not cover it when there is no generic? My Synthroid, Calcitriol, and Lidocaine patches weren’t covered either. It is really quite shocking. I can only imagine what will happen when I need a new MRI or a CT. I’m confident that my insurance company will not cover it or deny authorization.

The other shocking thing was the pharmacist. I had an inkling that the Flector patches would not be covered since my Synthroid, Calcitriol, and Lidocaine patches weren’t. So I asked the pharmacist if there was a generic of Flector patch or any generic anti-inflammatory patch. He said there was, which was the Lidocaine patch.

This is completely inaccurate. Lidocaine is an anesthetic. Flector is an anti-inflammatory agent. These are two totally different mechanisms. I can not believe that a pharmacist gave such horrible advice and completely inaccurate! What if I hadn’t known this! My God! It’s not life threatening or anything but these are two totally different classes of drugs! All I have to say is be careful people!

I will report back next week how my trial goes. I have to be judicious though and not take any chances. My commitment needs to be at it’s strongest. These medications are now too expensive to be willy-nilly about my plan of attack.

****

Madeline Fresco is a novelist who lives in San Diego. She is the author of CROSSED THE LINE, available for Kindle at Amazon.com, for Nook at Barnes & Noble, and as an ePub at other eBook retailers. You can also listen to her novel as a free, serialized audiobook atmadelinefresco.com. Her second book THE CHOICE, is available on Kindle at Amazon. Her third book ANGUISH, is available for Kindle at Amazon.com

Annular tear doctor appointments: Tricyclic Antidepressants

One of the things my pain management doctor RS suggested was taking antidepressants. I know, I know. The last time I took an antidepressant, Venlafaxine, I didn’t like it and had horrible withdrawals.

 

However, he stated that he thought this class of antidepressants would be better.

 

He probably went on about the Tricyclics for thirty minutes or so of the appointment. He felt that they had a lot of benefits — more so than the class of antidepressants that I went on early.

 

The Venlafaxine was supposed to prevent a chronic pain syndrome from occurring. Well, we all know THAT didn’t happen. Yet, this time, he spoke about the drug having anticholinergic effects, antihistamine effects, and about locking pain signals from reaching the brain.

 

I just copied and pasted this from Wikipedia (thanks Wikipedia!):

 

Chronic pain

The TCAs show efficacy in the clinical treatment of a number of different types of chronic pain, notably neuralgia or neuropathic pain and fibromyalgia.[11][12] The precise mechanism of action in explanation of their analgesic efficacy is unclear, but it is thought that they indirectly modulate the opioid system in the brain downstream via serotonergic and noradrenergic neuromodulation, among other properties.[13][14][15] They are also effective in migraine prophylaxis, though not in the instant relief of an acute migraine attack. They may also be effective to prevent chronic tension headaches.

 

However, because of the awful withdrawal from the Venlefaxine, I called my primary care physician and asked his advice on whether or not he thought it was a good idea, especially since the Venlafaxine didn’t help at all. He said he would try it if he were me. He said, unlike the Venlafaxine, which he stated I had to be on for a good three to 6 months to see if it was working, that the Tricyclics I only needed to be on it for a few weeks.

 

We went back and forth, but I agreed that I would try it for a good 4 weeks to see if it would work or not. I have to admit, not having to commit to them for 3 to 6 months helped my make the decision. Oh, and the best part? He said, unlike the Venlafaxine, that the Tricyclics were easier to withdrawal from.

 

Phew! That’s all I needed to hear.

 

I like the fact that I don’t have to commit to it for that long and that the risk of withdrawal symptoms are minimal.

 

There was a snafu though. I called the pain management doctor’s office to tell them I’d go on the meds. They called me back later and said that they needed my pharmacy’s phone number so they could call in the Cymbalta. Thank God I am a nurse, and for whatever reason, remember that Cymbalta and Venlafaxine are in the same antidepressant class! I was like, woah, wait a minute, I don’t think Cymbalta is a Tricyclic. Sure enough, they were going to order the wrong med for me! Ugh! People! You HAVE to check up on your doctors!

 

So, I have been on the drug for 8 days now. Quite frankly, I have not noticed a difference. It has helped me not drink though, which I am grateful for. The side effects can be drowsiness and I just don’t want to be walking around like a zombie.

 

There is one side effect, that I can’t tell if it is from the Desipramine or the Forteo, is that about 30 minutes to an hour after I take it, I really have to pee. Like, a LOT. I have even tested emptying my bladder right before I go to bed, but, sure enough, 30 minutes later … it’s like a racehorse. It really is disturbing my sleep.

 

Oh, and yesterday I moved up from 1/2 a pill to a whole pill.

 

I’m gonna give it three more weeks, but, if I don’t see a difference, then I will stop taking it. There is no need to be on any more drugs than I need to be.

 

There it is! I’ll keep you posted.

 

P.S., the picture in this blog is of Olympian Gus Kenworthy. He decided to stay a few extra days in Sochi in order to adopt some of the stray dogs there so that they wouldn’t be shot by the Russians. He deserves a gold medal for that! Good job Gus! Way to be a stand-up human being!

Annular Tear Doctor Appointments: appointment with endocrinologist for Forteo

So I saw the endocrinologist on 1/30/14 to get the Forteo pen. The needle is so small, I’m not too worried about it. It seems fairly straightforward. I put on a need, twist it on to secure it, pull back the plunger, insert the need subcutaneously, and then depress the plunger.

I’m a bit concerned still about actually having to inject myself though! That will be a unique experience.

The doctor said it should take a few weeks to see any results, but it will be hard to gauge. I mean, how does one tell overnight if they are healing more. We presume that after 4 weeks I should be able to tell. I mean, I’ve made such little strides with my improvement thus far, that any real improvement might be able ot be contributed to this drug.

So I am to start this week and once per day and see how I do. This would be the week to see if I have any nausea or any side effects from the hormone. I need to be careful of my calcium, so I will get my blood drawn every three days or so.

Alright, I guess we will see how it goes …

Random Ramblings: Forteo (PTH replacement)

Alright, so here we go. I’ve decided to go with the drug. It’s called Forteo. After talking with a bunch of friends and running it past my Endocrinologist (the doctor who would actually be prescribing the drug), I have been convinced to try it.

One person’s advice was really good. They said that since I don’t have any PTH, my chances would probably be slimmer of getting Osteosarcoma because I’m not enhancing an already there hormone. I just don’t have any. That logic made sense to me and made me feel better.

However, the drug is administered via daily injection.

Now, I don’t mind needles. I don’t mind people drawing my blood. I could get my blood drawn every day and I wouldn’t mind. I’d prefer not to, don’t get me wrong, but it would be no big deal.

It’s another thing to have to stab yourself.

Not sure I’m liking this concept.

My appointment is next week Thursday. I’m not sure if I get the drug that day, or if it’s just for tests and such.

I’ll keep you informed.

Random Ramblings: PTH injection

I don’t know what to do. My primary care doc wants to start me on a non-FDA approved drug. It has a black box warning that states it may cause Osteosarcoma. That is bone cancer. However, he does think that by giving me this drug, it might help me heal.

I’m not sure what to do. I want my back to heal. It’s been over a year and a half. I’m just not progressing. Maybe this is the answer?

But if it’s not, then I have the chance of having bone caner. Bone cancer is also immensely hard to treat. That would not be something that you can easily just cut out.

I already had cancer once, I don’t know if this increases my chances or not. My gut says this isn’t the way to go, but I’m out of options.

What should I do?

Random Ramblings: Follow up doctor appointment post trigger point injection

Happy Halloween

Two weeks ago I got the trigger point injection near L5-S1 in the erector spinae muscle. I have to say, when I get the prolotherapy injections, usually within three days I can’t feel the injection site anymore. With the trigger point, it took about a week in a half. That made it a lot harder to tell if it was “working” or not.

Yet, within the last two days I was able to walk farther, I was able to bend a little bit more, which was very rewarding.

I saw him today and he was pleased with my progress. That made me feel good. I hate it when I go, like the other day with my Endocrinologist, and he/she seems disappointed or discouraged. Because I had made some progress, he wanted to wait on giving me oral steroids. He seems pretty opposed to them. I asked if it was because they can cause weaken the ligaments and tendons in the body, and I have this problem where I don’t seem to heal as easily as other people — he said that wasn’t it. He said that it was because it can cause necrosis in something in the hip? That seemed rare to me and I didn’t probe any further.

However, at the end of the appointment (stupid me!) I asked what stretches I could do to help loosen up the lower part of my back now that I seem to have much better range up top. Hmm. That didn’t go as well. First he had me sit in a chair and put my feet up on a stool out in front of me. I just teeter-tottered back. I had to openly laugh out loud at my rigidity. Sometimes, how unwell I am makes me laugh. Then he tried taking the stool out. That was better. But. We HAD to take it a step further. I pointed to the spot where it was tight. He decided to then place his thumb in that area and press really, really hard. I asked him what the goal of that was, and he said to loosen up the scar tissue that had formed there. However, he kept having me bend forward while I did it. As we all know, I can’t ever tell when I am doing something if I am hurting myself. So, now I’m a bit on the freaked out side that I might have done something stupid. Remember, my last set back was, and still is ongoing, 9 weeks ago. When all of this started, I only had a T10-T11 ligament tear. It was after one stupid move at the physical therapist office that caused an annular tear in my L5-S1 disc. I have to be so very careful every time I do something since my body is so fragile.

Now it’s a difficult wait game. I will at least not freak out tonight. If I wake up tomorrow morning and I am significantly restricted or in pain, then I will very much start to worry if I actually set myself back.

Next appointment is in three weeks on November 20th, 2013.

On a side note, Happy Halloween everyone.  Halloween is actually my favorite holiday/non-holiday. It’s all about having fun, being a little goofy, and candy! There is no family drama wrapped up in this day, and everyone gets great pictures out of it.

Enjoy. And, if you are in pain, just watch  spooky movie with some popcorn and some candy. Partake as much as you can!

4 days post trigger point injections

How do I feel a few days post trigger point injections?

Eh.

It seems to help the pain in the muscle a bit. But it really does highlight the fact that it is more than just the muscle. It really starts to ache right in the middle of my spine at the L5-S1 area, and, I have to say, just a bit lower than that also. Not sure what that means, but I will ask.

 

Was a bit sad today. Tried to get it together — hard to. Hard to be missing out on so much. Hard to get over my can do attitude of just pushing through. I can’t just push through. It makes me feel helpless.

Interesting day at the doctor’s office

Was supposed to get PRP today. That’s platelet rich plasma. Actually, I was supposed to get it last week, until I realized that I was on Celebrex and that meant that I couldn’t get it done. Funny, my doctor didn’t realize it, I had to tell him.

 

So I get there today, and he tells me that we can’t do it because he doesn’t have the right equipment. Really? I had to secure a ride, go off my anti-inflammatory, and suffer the pain of driving there — for him not to have the equipment? That’s just so irresponsible.

 

The other issue I have is that I talked to him about maybe some questions I might have about an alternate way to go — the whole steroid route. Someone in my life was questioning whether I should or should not have the PRP. So I simply asked. Well, before I know it, I’m getting steroid injections. Now, I’m going down the steroid route. That means two weeks from now if the trigger point injections don’t work, I will then take an oral dose pack. If that doesn’t work, I will also have an SI trigger point injection.

 

I’m a little miffed at myself, because, again, I let myself be swayed. I wanted the PRP. I should have stayed with that. I’m also a little perturbed that the doctor was so easily swayed. He should have stuck to his guns if he thought the PRP was the way to go. It should have still been the way to go even if he didn’t have the kit.

 

We will see how things go.

 

So now I have a follow-up appointment in two weeks. Who knows? Maybe this will help. I really have to say that I doubt it, but I will cross my fingers.

Venlafaxine Day 3 (night) to Day 5 (night)

The last post I had the immediate release pills at bedside in case I needed them. Good news … I held out!  While I was a bit nauseous, it wasn’t anything compared to the night before. Only new thing was I had a really, really hard time falling asleep, if you can call what I eventually did as sleep.

The next day was day 4. I could NOT get out of bed. I felt like when you drink way too much — but just a hair short from puking your guts out all day. You know — you’re dizzy, the room kind of spins. If you move too quickly you feel the need to blink it away. Unbelievable thirst. Mild queasiness.

The rest of the day it remained like that.

Then, by that night, all I wanted was to crawl back into bed and sleep forever. Funny thing about that is then my new symptom was insomnia.

So today, Day 5, I woke up after having only one measly hour of sleep. Yet, I feel better. I could eat a bit more, but by now I was so hungry, I scarfed down my soup and that put my system into a bit of a shock. I went for my walk today and didn’t feel too much dizziness. So all in all, I feel like I turned the corner.

But, please, let sleep come tonight.

So, if you are reading this — hang in there. Day 5 baby!

Spoke to doctor about Venlafaxine withdrawal symptoms — new game plan

I just got off the phone with the doctor. First off, he apologized for not making the connection that I’d be the type to go through a withdrawal, even from such a low dose (I always struggle with side effects when prescribed drugs — I’m super sensitive).

He stated it usually takes up to two weeks to successfully wean. Based on my description of symptoms, he said tomorrow should be better.

If tonight, I feel like it is a living hell again, he has ordered immediate release, 25mg tables of Venlafaxine. I should break the tablet in two and take half. He said that should help management of the withdrawal symptoms and to wean from there.

So there it is. Hope this helps. I will let you all know how I feel as the night progresses. Hopefully, this helps someone out there in the future who has to go through Venlafaxine withdrawal.