Cora wrote:how would you describe your quality of life these days, in terms of energy, pain, functioning? Have you been on a lot of other meds, or what other meds are you considering.
I would say on a quality of life scale 1-10, with 10 being the highest my quality of life average is about a 5. I am able to work as an RN on an ICU step down floor a few hours a week (like 4-8 usually), do most of my own household chores and run errands, and care for my 16 month old daughter and husband. But I am not able to do a LOT of the things I want to do such as exercise (other than light yoga/walking), have intercourse without pain (and therefore it is infrequent), sit (i don't sit at all other than driving and an occasional meal, max time 15 mins on a donut), and because I can't sit my social life is greatly suffering (I don't even go to church some weeks because I can't stand for the entire service). I know some people would say that's NO quality of life, but I feel I am being pretty resonable. My life could be SO MUCH worse. I can do most of what I NEED to do (other than work more), but little of what I WANT to do. My pain levels mostly stay in the 3-5 level. Most days my energy level is acceptable. I do have a toddler so I know I would be worn out even if I didn't have chronic pain, but as long as I get at least 8 hours of sleep I can accomplish what I need to most days (other than when I am in a flare of course).
Meds I have tried:
Amiptriptyline/Desipramine (both TCA's): I couldn't function on Elavil (way too sedating). I would choose Desipramine or Nortriptyline if I were you and wanted to try a TCA. They have less cholingeric side effects and for me Desipramine was much less sedating although I was still pretty drowsy on it and by 9pm I was out like a light (it did help me sleep). When I stopped it, my energy levels were much better. I had tachycardia on the TCA which is another reason I wanted to stop it (besides the fact it didn't seem to help my pain). My HR still is higher than it used to be and I don't know if it's because of chronic pain, lack of exercise, or what.
Neurontin: I am currently on this and have gotten the most relief from it so far (but that's not saying much with pain levels at 5 some days). I don't have side effects that I notice much from it and I still sleep well on it. I just need more of it. I take 800TID, but after 4 hours I can feel it wearing off usually.
Ultracet (37.5mg Tramadol/235mgAcetaminophen): I take this when I am in a bad flare and I never hardly take more than one pill a day. I have been on the same 30 pills since June if that tells you how much I use it
It tends to increase my HR and I get a mild-mod headache with it. It doesn't do a lot for my pain, but it takes the edge off if it's a particularly bad day or I know I am going to have to travel or sit a lot or something.
Lortab 5/325: I have only used this a few times when I was in a major pain flare and before I got up to higher doses on the Neurontin. I have side effects with it though (nausea, headache, and anxiety) and it doesn't help my pain that much so it's not worth it to me.
Meds I am considering taking:
Lryica: I am scared of the possible side effects, but I think I may have to try this next. And if I am tolerating Neurontin without side effects I don't think I will get a ton of side effects with the Lryica other than maybe weight gain, but if it helps my pain and I can exercise more I can keep that at bay.
Cymbalta: I don't like the idea of being on an antidepressant (other than a TCA) and I don't have real depression problems, but literature shows some people have more improvement in pain when on Lryica and Cymbalta together so I will try it if need be (especially if my myofasical pain symptoms don't get under better control).
Birth control pills: My pain flares based on my cycle so it has been recommended by my urogyno pelvic pain doc to try birth control again. I am fearful because my pain started when I stopped using birth control and got pregnant so me and hormone changes don't go over well
As for Narcotics. I am not opposed to them and when all else fails if I need to live the rest of my life on them I will (as long as the side effects aren't unbearable). The main reason I have chosen to try other meds (like Neurontin and TCAs) before trying narcotics is because of the narcotics side effects and the possibility of physical dependence (although I know it is rare). As a nurse, I understand your feelings of "shame" for using narcotics. I wouldn't be too hard on yourself though. We have chronic pain. It is better to keep the pain under control than to let it get out of hand and if you need narcotics to do that then there is nothing wrong with it. You have one life and you want to live it to the best of your ability. God gave us the blessing of medication and I feel we would be foolish not to use it if it helps our quality of life. I have come a long way, just to let you know. When I first started having this pain I resisted any kinds of meds, haha (what an idiot
). If I were you I would probably try some of the anti-seizure drugs/TCA's, but you have to do what you are most comfortable with.
Whew! Sorry to be so long winded