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anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/12/2009 11:09 PM (GMT -7)   
I did see my PCP today(well, Wednesday). I know I needed to check on my BP. It has still been pretty high. And today it was 164/98. Anyway, I made the appt. for that and to get her clearance so I can join the fitness/wellness center instead of PT. Anyway, I haven't been in a while, so I caught her up to date on what has been going on. She seemed concerned about me still being in pain after having the surgery(laminectomy). I told her that I wasn't dragging my leg or limping anymore, and that part is good. The difference is before I had the surgery, if I would sit down, it did help somewhat. Now, no matter what I do, the pain is the same. A bunch of back and forth and so on... Anyway, she wrote me a rx. for wellbutrin sr 150mg to take once a day. She said it should help with the nerve pain. Well, I would like some feedback on this. Is this comparable to Lyrica or Cymbalta? I haven't tried those due to they don't offer generic. Now, should I call my PM before I start this? I know about the contract I signed and I don't know if this applies to that. I think it is only for pain meds that it is what they are talking about. Anyway, I would like to know if you have tried this before, if it has benefited you, and if there were any bad side effects. I did look it up on the internet briefly. I just read about it being an antidepressant and used to stop smoking. Well, I do smoke and I am not ready to quit yet. I want to know if it is helpful for nerve pain. I understand that each person is different and reacts differentllly to medication. I will keep that in mind. But I am asking for opinions here. Thanks. She said I could stop the elavil or take them both. I just don't know if I should talk to my PM about this before I start it. I will still take the elavil. She said I can take both. And I will increase my BP meds to twice a day and go back in 3 weeks to see how the BP is and how the new med is working. She ok'd me to join the fitness center.
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/13/2009 12:10 AM (GMT -7)   
Anice,
I'm not sure about the wellbutrin helping with nerve pain. It's possible it does, and I just don't know about it, but I'd suggest going to the pharmaceutical's website and reading about its on and off label uses. It's marketed as Zyban for smoking; they're the same drug, but if you get it for smoking it costs more.

One thing I do know is that wellbutrin has some side effects and shouldn't be taken if you have an eating disorder, seizure disorder, or bipolar episodes. It can trigger manic episodes, although as with everything, it doesn't for everyone. Because of these things, I wonder about it with high BP. Since you're a nurse, you ought to be able to handle reading the info. if you go to wellbutrin.com (it's like the info. you get on the long insert) and see what you learn both about nerve pain and BP issues. Sometimes PCP's are ok with basic depression, but when it's complicated often a specialist (in that case a psychiatrist, although depending on your PM's training he/she may know) can do a better job of mixing these medications.

I take effexor because I had one significant side effect with cymbalta. My cousin, who is a pharmacist, said effexor is the next closest drug to cymbalta, but I'm not sure if there's a generic yet. I guess I'm going to find out soon enough as without insurance, I won't be able to afford the extended release I now take. Will your insurance cover cymbalta?

Lyrica is a different class of med. It's designed to help with nerve pain, but it's not an anti-depressant. Have you ever tried neurontin (generic is gapapentin - that's what I take). Lyrica isn't supposed to have as many side effects, but again, it's all individual.

I'd really go to the wellbutrin website and read up on it. I'd do it now for you, but I'm exhausted!

I am glad you're getting that BP checked!

Hugs,

PaLady

BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 8/13/2009 2:16 AM (GMT -7)   
I definitely would call your PM before you start it. Even though it's not a narcotic medication, your PCP is treating your pain, which could put you in an awkward position with your pain doctor.

There is a generic for Wellbutrin SR, but it's a little confusing because Wellbutrin is Bupropion, which, as PA pointed out, is the same drug as Zyban. The confusing part is that the generic for Zyban is called Bupropion, but the generic name is called Budeprion SR. I have no idea why they did that.

I'd never heard of using Wellbutrin for nerve pain, but I just ran a quick search... lo and behold, I found several references for using it successfully to treat pain associated with various forms of neuropathy. From the few articles I scanned, it looks like it was being studied heavily and headed for FDA approval when Lyrica came onto the market and kinda blew it out of the water.

Here's a couple of journal references I found -

Efficacy of sustained-release bupropion in neuropathic pain : An open-label study

cat.inist.fr/?aModele=afficheN&cpsidt=1305565

cat.inist.fr said...
Results: Fifteen patients (68%) reported that their pain relief was improved or much improved with bupropion. The mean average pain score at week 1 was 6.7, which decreased at the end of week 8 to 5.3 (paired t test, t[df = 21]3.327; p = 0.003) in all patients studied and to 3.8 (paired t test, t[df = 14]3.754; p = 0.002) in the patients who improved. Pain relief was statistically significant at week 5 (paired t test, t[df = 21]3.816; p = 0.001) and continued throughout weeks 6, 7, and 8. Most patients were not depressed, and analgesia was observed to occur without change in depression ratings in most patients who responded. Side effects were rated as mild and consisted primarily of insomnia (8 patients), tremor (3 patients), and gastrointestinal upset (2 patients). These symptoms had a tendency to recede with continuation of therapy. Conclusions: This uncontrolled pilot study suggests that bupropion may be an effective and tolerated treatment for some patients with neuropathic pain. Blockade of norepinephrine reuptake may mediate this effect. The role of dopamine reuptake blockade is uncertain. A larger randomized, double-blind, placebo-controlled study is currently underway to confirm these preliminary results.


Double-blind, randomized trial of bupropion SR for the treatment of neuropathic pain

www.neurology.org/cgi/content/abstract/57/9/1583

neurology.org said...
Results:— While the patients took bupropion SR, neuropathic pain relief was improved or much improved in 30 (73%) patients, and one of these patients became pain-free. The mean average pain score at baseline was 5.7, which remained unchanged at the end of week 6 with placebo, but decreased by 1.7 points to 4.0 (p < 0.001) during therapy with bupropion SR. Pain relief with bupropion SR was significant at week 2 (p < 0.05) and continued throughout weeks 3 through 6 (p < 0.001). A significant decrease in interference of pain on quality of life was observed while patients were receiving bupropion SR compared with placebo. Side effects experienced with bupropion SR were not dose-limiting and consisted primarily of dry mouth, insomnia, headache, gastrointestinal upset, tremor, constipation, and dizziness.

Conclusion:— This placebo-controlled crossover trial showed that bupropion SR (150–300 mg daily) was effective and well tolerated for the treatment of neuropathic pain.

Post Edited (BionicWoman) : 8/13/2009 3:20:27 AM (GMT-6)


skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 8/13/2009 8:12 AM (GMT -7)   
Hi Anice,

I've never been on wellbutrin, but my psychiatrist is planning on starting me on it in in several weeks. I have treatment-resistant depression, so the plan is to add the wellbutrin into the mix after I have reached a certain dosage zoloft, as there has been good success with this combo. I've never heard of it being used for pain, but the info BionicWoman provided you is interesting! It would be fabulous if this helped with the pain, too! Good luck, I hope this helps you!

Skeye

anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/13/2009 9:03 AM (GMT -7)   
PaLady, Thank you. And I know you would look it up for me, that was really sweet of you. But you have so much going on yourself. I will do some research on this at some point today. I do have insurance but the copay for non generic meds are pretty high still. I do know I've heard alot of good things about Cymbalta. But I can't try that one due to the cost. I did try the Neurontin before. Personally I had horrible side effects from it. I had the worst night terrors. They were terrible. Needless to say, I didn't take that for long. The bad thing about that is that it did seem to help the pain a little...Anyway, I'll find out about this med. I've heard of it but don't know if it can be used for nerve pain. I do know about the antidepressant and for the smoking.

Bionic Woman, Thank you so much. It was most helpful. I will do some more looking around and see what else I can find out about it. I did put in a call to the PM to let them know about her prescribing it to me. I just feel better for him to know and approve it-since he is the one treating my pain. They haven't called me back yet.

Skeye, Thank you too. It would be great if it helps. I just want to find out a little more about it before starting to take it.

I'll post again and let you know what the PM says about this. Thanks again for your responses.
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/13/2009 11:08 AM (GMT -7)   
Bionic - great job with the research! Looks like wellbutrin's SNRI (norepinephrine reuptake inhibitor) effects are what may help nerve pain, and that's one of the things cymbalta does (cymbalta just combines SNRI and SSRI - did I say that before? LOL). Interesting research. I can't take it because of a seizure disorder but that's exactly the problems the cymbalta affected for me. The effexor is an SNRI.

Anice - I'd agree with Bionic's suggestion to at least inform your PM because if it's being prescribed primarily for pain, then it is part of pain management. If it was being prescribed for depression, then maybe it wouldn't be as critical to inform your PM until your next visit. But a phone call can never hurt - you never know when your PM may have a different course of action in mind.

I primarily wondered about the effects on BP, but sounds like your PCP knows what he/she is doing with this.

Let us know how it works out!

Hugs,

PaLady

anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/13/2009 11:13 AM (GMT -7)   
The nurse called me back. The PM said yes it was okay to start the wellbutrin sr. And that it is being used for nerve pain now too. I will get this filled today and start it in the morning. Maybe it will help.

Monday I have my doctor appt. I will find out then if hel'll release me to go back to work. And Wednesday I have an appt to see my PM. And on Thursday I hope to go back to work. So we'll see what happens with all that.
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/13/2009 11:19 AM (GMT -7)   
Anice,
That's great. I'll be curious if it helps, but it looks like it's definitely worth a try. Not sure how long it may take for it to help, though, as I know for the anti-depressant effects it can take a few weeks. So don't be disappointed if it doesn't help right away. Give it a fair trial.

Bionic - if I was sure I was going to chat tonight, I'd invite you to be my date! ;-)

PaLady

anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/13/2009 12:39 PM (GMT -7)   
PaLady, I will give it a try. It may help. And if it doesn't help with the nerve pain(left hip and buttock), then it may help with the depression issues. So if not for one thing then maybe for another. Emotionally I am doing better. Lord knows I've cried buckets of tears over the past couple months. I just have to accept that this is the way it is. I'll have to make the best of it. It is hard to accept. But what choice do I have? I hoped. I tried. And this is what I have. It hurts me emotionally because I so wanted to get better...

I talked to the doctor I work for last night. I told him my plans about going back to work next week. He said he wants me back. He misses me. And he said the patients and their parents often ask about me.He said he doesn't want me to come back until I am really ready. He said he'll hold my job as long as that takes,not to worry about that at all. That made me feel good. He said one thing concerns him. I am telling him about my pain, how it feels, how bad it hurts, and that I think I waited too long to have the surgery. He said that he is hearing what I am saying but he doesn't understand how I can be in such good spirits. I guess he thought I am really losing it. I did try hard to be in a good mood while I talked to him. I didn't want to be all down in the dumps like I usually am. I just told him that I had to come to terms with it. And I have to go on with my life the best I can. I did assure him that I will not be taking the pain meds while I am working. He said he admired and respected my stand on that. Although they do not make me feel high or funny in the head, I do not want to take any chances to jeopardize my judgement since I am working with children and medication. I enjoyed talking to him. He said we are getting really busy with the back to school well visits and immunizations. I want so much to be a part of that. Gosh, I miss that place...It is rare to really love your job, I know that. I am so thankful for my job. That is why I've been there for 13 years...I did not always feel this way. I had burn out real bad when I was in the lab. It was so hard doing lab for 4 doctors and being that busy. It was just too much. When I changed positions, and started nursing for 1 doctor, it was like a huge weight was lifted off my shoulders. I really love it. Anyway, I explained how I want the ortho. doctor to release me to go back to work. I respect him. And I am not holding him liable for this pain. It isn't that I hold him responsible for this. I know it was my fault for waiting so long to have the surgery. I will sign a AMA(against medical advice) if I have to. That is how bad I want to get back to work. He said it might work. He said to just be honest and explain my stand on this. It isn't disrespecting him by disagreeing. He also suggested contacting my nursing supervisor and asking what she thinks the best way to handle this-if the ortho. doctor still refuses to release me and I want to come back to work. I have a call into her now. She hasn't returned my call yet, but she will. So much is going on in my mind. I also thought of something else. I want a copy of the surgery report. I will ask for this on Monday. I just don't want him thinking I am going to do anything legal with it. I have no intention of that whatsoever. I just want to read what he saw and what he did exactly. I plan to do that.

I am going to be okay. I will take it one day at a time. I will try to stay focused on the present- now that one is hard...I know this pain is here to stay. I so wish that wasn't true. We all do. But it is here. I'll have to continue to try to accept that-another hard one. I will do the things that help me -this forum( I could literally spend all day here reading posts and usually spend several hours), reading, writing my feelings down, counseling, and just anything I've found that is helpful. I've noticed some pretty big changes in my outlook in the past couple weeks. I don't know what or how it happened. But the depression is getting a little better for me. And I'm not crying all the time anymore. I sure am glad of that one. So we'll see what happens on Monday. I will not leave his office crying this time. I will leave his office with my release papers. I sure hope so. I am going to sit down and make a plan of some sort on the best way to make him see my point and to release me. I just need to get it organized in my head first. He has been talking about this 6 month thing. Well, it has almost been 4 months,close enough. It isn't going to change in 2 months. It didn't work. It is time to go on with my life and get back to work...I hurt all the time. It isn't getting better because it isn't going to get better. I am not being negative. I am being honest. But I will try this wellbutrin and see what happens. My mind is not closed to the possibility of getting better. I just don't have alot of hope about it anymore. I am accepting it the best way I can.
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/13/2009 2:05 PM (GMT -7)   
Anice,
I can understand where you're coming from. The one thing that concerns me is signing papers to go back to work AMA. That might even jeopardize some things down the road for you with pain management. But I would try to have an honest discussion with the doctor if he wants you to stay out longer and ask him to explain why. What is it that might happen in an extra 2 months? What harm might you do to yourself now versus in 2 months? Ask him to convince you. Because maybe there are reasons.

I can't remember - what does your PT say about going back to work full time, knowing what kind of work you do? That to me would weigh heavily in this. And following any instructions from your PT.

You say you know it's not going to get better, but none of us can know that within a few months when it comes to nerve pain. But you could make it worse. But if you can get some pain management that allows you to stay alert enough at work and not make things worse....I just wish you would go back part time. There have to be legal ways to protect your benefits, especially with your employer so much in support of you.

I have a hunch the reason you're feeling better has to do with the counseling, so I hope you keep that up. That plus the anti-depressant value of the wellbutrin may help you manage whatever is in your future.

I do hope this all starts working out for you - with your doctor's support!

Hugs,

PaLady

anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/13/2009 3:25 PM (GMT -7)   
PaLady, Thanks for your reply. I do appreciate you so much. I will sit down and talk to my doctor. If he has reasons as to why he is so determined to keep me at work, I will be open to hear them. I am really not trying to be hard headed and stuborn with this. I just NEED to get back to work. I will use good judgement and not lift anything heavy. I will ask the parents to lift the children for me. And I will use as much care as possible. My PT therapist is for me going back to work. He does seem to understand my financial problems this has put on me. I did stop PT to transition to the fitness center. I did see my PCP yesterday and she did ok and give consent to the fitness center. Now, I am waiting on the paperwork issue. She has to fax consent to the gym before I can start. I really don't see what difference 2 more months will make. I do not know for certain that I won't get better. I may be suprised one day. Who knows? I don't want to do any thing that iwll jepradize my health. I guess me saying I'd sign a AMA is wrong. I just feel so strongly about getting back...

Anice

BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 8/14/2009 1:28 AM (GMT -7)   
I'm glad the articles were helpful to several. I'm a research ****.. I can't help it.. it's just me. turn

PALady.. you're determined to get me to a cocktail party one way or the other - even a virtual one! tongue

anice, I can't imagine your doctor would make you sign an AMA form to go back to work because of chronic pain. If he did, I'd think he was a total poo-poo head. I can see it if he was reasonably sure that going back to work was going to cause further physical damage to you, but I also would expect that if he came out and told you that was the reason, you wouldn't go back to work right now.

I'm in a little different situation, because I got canned when I ran out of FMLA time between 2 major surgeries. I don't have a job waiting for me, so I don't have the pressure of returning "fast enough." When I told my PM that I needed to start looking for work, because I'm really, really struggling financially, he was adamantly opposed to the whole idea -- and that was a year ago! He told me I wasn't ready, that it was a huge mistake, he wanted me totally and completely focused on rehab, and that I should look at where I can cut expenses if it's a financial matter. That was a kind of stupid thing for him to say, since I'd already cut every last non-essential thing in my life by that point! I mean, seriously, I arranged to re-sell my wireless internet connection to my neighbors so that I could keep my cable internet without paying for it! (Great plan if you can manage it, btw.. LOL!)

When my COBRA ended, my health insurance premium jumped to $600/mo. I actually managed to pay that for 4 months but my bank account finally tanked and I lost it. The month before I knew my insurance was cutting off, I finally had to have one of those heart-to-heart conversations with my doctor and explain that I just can't live indefinitely on a long-term disability policy that only pays 60% of my normal salary. When he went back to the whole "cut expenses" thing, I asked him if he could meet all of his current core financial obligations if his income was cut to the point that his health insurance and mortgage took away 73% of his monthly income right off the top and left him with only 27% of his monthly income to pay for everything else he needed. He admitted that he couldn't do it either, and with that realization, we were able to come to an agreement.

Our agreement has two parts..

The first part is that I come in for an appointment every month and at each visit, he says I'm not ready to return to work. He writes in my chart that I continue to express a desire to return to work, but that I have not yet reached a suitable physical condition. When my LTD caseworker sends him forms to fill out, he goes even further and writes that I'm completely and permanently disabled, that he doesn't expect significant improvement in my condition, and that he doesn't expect I will ever return to any level of employment. I was horrified the first time he gave me a copy of a form that said that, but it seems he hates excessive insurance paperwork and if he says those horrid things to the insurance company, they only send forms once every 6-9 months instead of every month. LOL!

The second part of our agreement is that he knows I'm actively seeking employment, sending out resumes, interviewing for positions, and that when I find the right position, I fully intend to take it. I hadn't counted on that being as hard as it's been, because it seems a lot of people don't want to take a chance on a new hire with physical limitations. They don't say that in the interview, but it's always clear on their face when they ask you to explain the gap in employment. Of course, it's really funny to me because while I won't lie about why I've been out of work, I significantly minimize what I've been through. They'd probably drop dead of fright at the thought of hiring me if they knew the WHOLE truth about that! smhair

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/14/2009 9:34 AM (GMT -7)   
Bionic,
I didn't realize how much similarity there was in our current situations. Or maybe I just don't remember - a likely possibility these days. A mind is a terrible thing to waste.

PaLady

Mrs. Dani
Veteran Member


Date Joined Jun 2009
Total Posts : 2787
   Posted 8/14/2009 9:50 AM (GMT -7)   

 

   Dear Anice,

Good afternoon *huggs* it is good to see you again. I am glad things are FINALLY slowly going in the right direction. I do not know about the differant medicines being used for pain?the anti depressant I take is for pain,  is called Amitryptaline. It works really well, now. But the "start up" was slow. I hope this medication begins to help you as soon as possible thou! I have to get my day goin. sad    But wanted to stop by and say Hi :-)  

*warm huggs*

       dani


TWO roads diverged in a yellow wood,  
And sorry I could not travel both  
And be one traveler, long I stood


anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/14/2009 9:57 PM (GMT -7)   
I started the Wellbutrin SR today. I really haven't noticed a difference. I know it is going to take a while before I can tell if it will work or not. But I did take my first does today. Maybe I'll know in a couple weeks how it is going to work. We'll see.
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/15/2009 12:25 AM (GMT -7)   
Anice,
Yes, it can take a little time. Some people notice some changes sooner than others. Also, sometimes there are a few minor side effects that tend to lessen once your body adjust to the medication. If it's something major, then you would want to call your doctor or pharmacist. But I'll be curious to see if it help with nerve pain. I'll bet it does, but it may not be as noticeable as our regular pain meds (like narcotics), but that's ok. Subtle and slow can be good; turtles can win races!

Hey - you're a veteran memer now! Congratulations!

Hugs,

PaLady

BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 8/15/2009 8:33 AM (GMT -7)   
PALady, you didn't forget. I rarely share the miserable portions of my life.. I like to ignore them instead. smilewinkgrin

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 8/15/2009 9:02 AM (GMT -7)   
I just wanted to send well wishes to you for next week in hopes you can get back to work!
I know it's something you need to do, but you also have to ask yourself are you truly ready..
long hours on your feet, having to be nice to even the meanest of people, it's not just a
physical readyiness but emotionally as well, and well ...
Don't push to hard for something you might not be able to handle yet, just promise us that...
Otherwise, good luck to you and lots and lots of soft hugz...
hugz...
Keep us posted as to how it goes, fingers crossed...
((((((((((((((((((((((((((((((((Anice)))))))))))))))))))))))))))))))))))))))))))))))))))
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc, Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's and Ocular Migraines

********>^..^<********>^..^<********>^..^<********


anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/15/2009 10:01 AM (GMT -7)   
Emotionally I am very ready to get back to work. It helped me to know that I help my patients. Physically, honestly I am not so sure. I hurt all the time. And I would say my pain scale is always a 7 or 8, with meds and the tens' unit. I know it won't be easy. And I am pretty sure I'll be close to tears by the days end...but I want to go back. I'll deal with it. I did it before and I can do it again. No, it won't be easy at all. But it isn't going to get any better, atleast any time soon. And I am going to hurt anyway. Might as well hurt and make money...I am working hard on staying calm and not allowing myself to get as upset and worried as I was yesterday.
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/15/2009 1:27 PM (GMT -7)   
Anice,
Your last post really says to me that it truly may be a better idea for you to go back starting on light duty (although sometimes light duty is "sitting" and that may not be easier on you with the nerve pain - something to discuss). Or to go back shorter hours.

Think about it. Yes, you pushed yourself through it before, but eventually you got to a point of having to stop and have the surgery. You'll reach that point again if your strategy is just to push through the pain - especially without taking any major pain meds during the day. I don't mean for this to depress you, but how long do you honestly think you will last that way? You may have to do what pretty much all of us has to face - an adjustment to the way we work, and sometimes working at all. But rather than not work at all, doing some different duties - at least for awhile until you see how it goes - might keep you from getting to the point of not working at all. Think about this smartly, not from the standpoint of anxiety, although I know that's easier said than done.

And White Beard made a great point in your other thread. You aren't the only one responsible for paying the bills.

I'd love to see you go back to work. I would love to go back to work. But for me, things are different. I'm also quite a bit older (I think), and that does make a difference in many ways. If you go back to work fewer hours, or light duty, and can do it, and can then inch up to where you were before - that's great! However if you need more time, at least working a few hours would help you out emotionally, even if it wouldn't give you all the money you need. And it might help save your job for the long run.

Someone mentioned the Serenity Prayer. I use it in some form all the time in my mind, to try to sort things that are happening. Because I can (and sometimes do) get scared and anxious myself. And angry. And depressed. And it's ok to feel all those things, but when it comes to planning and problem solving what to do, I have to get out of my feelings and into my head and ask myself what can I do, and what is beyond my control. And make as much peace with that as I can at the moment.

Believe me, my writing this to you is also writing it to myself. I need to process this same thinking over and over again for my own life.

Hugs,

PaLady

BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 8/15/2009 10:34 PM (GMT -7)   
anice, I can understand not wanting to take meds while you're working, because of concerns over the cloudy-thinking it could cause in such important situations.. BUT.. I also have to wonder just how impaired your thinking will be in those same important situations by having pain levels of a 7-8 screaming inside your head.

I think sometimes we're too quick to make some of those commitments to our employers about medication and I truly believe it's more about the stigma associated with them and less about the actual impact they have on us. It makes our employers feel better to hear us say "no, I won't take those narcotics while I'm working" like it reinforces to them that we're agreeing not to act like junkies while we're on duty. What we're actually saying is that we agree not to properly manage our medical issues, as a condition of our employment. That's not necessarily serving the best interests of our employers, our patients/clients, or ourselves.

I'm not saying taking or not taking meds is absolutely better one way than the other. It's a very individual thing and depends a great deal on how you respond to your medication. I just thought I'd offer that up for you to consider as you're making your decisions.

anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/16/2009 10:26 AM (GMT -7)   
PaLady, Thank you. You know there are so many times when I read one of your posts, I just wish I could really hug you!!! I read it about 3 times. Yes, I will go back light duty or shorten my hours, if he will agree to let me go back that way. I have to be realistic here...And you are right about the meds...there were many days when I would go into the bathroom between pulling patients back and cry because I hurt so bad and didn't know how to finish out the day...I remember that very vividly. And I don't know exactly how I am going to do it. I think sometimes you do what you have to do. I just don't know anymore. The percocet really doesn't go to my head or make me feel medicated at all. I probably could take it without it bothering my ability to work. I think I'll keep a couple in my purse if I need it. There were 2 days in those 10 months I worked in pain that I took one. It was in the afternoon on both times. And I took 1/2 on both times. I felt bad about it, but I knew I couldn't stay and work if I didn't.

This surgery was something else and it has opened my eyes. I never knew the impact it would be emotionally. I thought surgery was just a physical thing. Boy was I wrong. It has effected me emotionally too. I think I have been on an emotional roller coaster. There are so many different things I feel. And I guess the main one is I am scared. I don't know what my future holds. I guess none of us do. And I know we are supposed to live for today and not worry about tomorrow. I try that. But I am really worried. I plan to return to work. But I seriously wonder how long I'll be able to do it...I'll do the best I can. But I noticed this week, getting things ready for Connor to go back to school, shopping, getting in and out of the car,etc...When I got home I hurt so bad and could do nothing else. It scares me. I do very little as far as housecleaning-husband and son do most of it. But I do cook. And just cooking a meal and being on my feet for about an hour, well, when I do sit down, pain is way high and I can do nothing else. So, this working thing although it will help with the emotional issues, it will be very hard physically. I know this. And I am scared... But waiting longer really isn't going to change things much. I just have to deal with it as best as I can.

Living with chronic pain is so hard. And that goes back to how it effects us emotionally as well as physically. All the limits on what we can and can't do. And having to change or make adjustments to how we do things so that we can still do them. And the the reality of things we can no longer do anymore at all. Don't get me wrong, I am not on the pity pot today...This just hurts me so deeply in my heart to know this it how it is...It is a struggle living this way. And I have to get in a better emotional state. This whole week, I feel so weak emotionally. It is hard to explain. I don't know what happened or how all this started. It's like it hit me like a ton of bricks-bam and it was there. I watch other people and it seems so nice to be able to walk and not hurt...I miss that. It's like I know now the limitations in my life. All the things I used to do that I can't do any longer due to this pain.It is a huge adjustment. And then the reality about thinking the surgery would fix the problem and the pain and it didn't...That is a biggie with me. To think of all the pain I went through and for nothing. A huge disappointment. This all has just impacted me in a big way. And why it is all hitting me like this, I don't know. I don't know what started all this.

I'll try to do things to remain calm and not let this get the best of me. There is just so much going on inside my head...that in itself is scary!!!! I won't let all this drive me over the edge. I will get a grip on these emotions. I will sit down and do some writing and put things in the proper perspective. And I will say the serenity prayer. I haven't said that in a while. I think I am just real keyed up about the doctor appt tomorrow. I try not to be, but I can't help it.

Bionic Woman, I thank you for your post. You put things in a different light. I hadn't thought about it that way before. And when my pain levels are high, it does make it hard to have a clear head. And I hadn't thought about it meaning not to properly manage our medical issues by not taking them at work. I just don't want my judgement off while working.

Well, again I've said too much. Today is just one of those days. My emotions are not so good. But I'll work on it. And I do have counseling again tomorrow. That will help some too. I am hurting pretty bad today. Son and I finished up his back to school shopping yesterday. And I am paying for it today... I hope you all have a good day. Thank you all for listening once again...
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/16/2009 12:22 PM (GMT -7)   
Anice,
You're very welcome, and I wish we could hug, too! I'll imagine it, though, and that's a soothing image!

If this adjustment were easy most of us wouldn't be here. You're very right about all the adjustments, limitations and losses. They need to be grieved as they an be huge. Even something that may seem minor to one person is a major change to someone else, and this is personal for each and every one of us.

Something you said really hit home with me, too. I think like you (and probably lots of people) I put a lot of faith in my surgery. I had waited so long, done every other possible treatment, but had always had positive results with surgery in my life before. So I assumed (I think unconsciously, as i never really thought about it much) that surgery would at least give me significant improvement. These past nearly 2 years now have hit me harder emotionally than I thought, too. I didn't realize how much I had invested in surgery being successful - at least partly so. I think maybe it's because I know there's nothing left to choose now except things to help manage the pain. The big ticket item didn't work. And I know this has affected me in ways I don't even think I've given voice to, so reading your post is helpful to me. As I said, writing to you is a bit like writing to myself!

It's ok to have your emotions take some time to heal. Don't beat yourself up for that. It's what your counselor can help with, and it's a process that's not going to happen in a couple of weeks, but emotionally you will get better and find a way to make whatever peace you have to make.

Hugs,

PaLady

anice
Veteran Member


Date Joined Apr 2009
Total Posts : 536
   Posted 8/16/2009 7:38 PM (GMT -7)   
It is hard dealing with the emotions. I don't know where they all came from. I am wondering if it is the Wellbutrin SR. I thought I was doing fairly well emotionally. Then something happened. I find myself getting pretty low just out of the blue. It started about when I started the medicine. I'll pay attention to this. I may have to stop taking it. I think I need to stop taking the Elavil for sure. I have such a hard time getting up in the mornings. And school starts tomorrow. I HAVE to be up early to get Connor to school.

I think all of this is a process. I know I have alot I need to start dealing with. It is a loss to me. I will start to work on this.I am going to counseling tomorrow. I don't know if I'll be able to continue or not. I quit PT to move to the fitness center. I am still waiting for a few bits of paperwork on that. Anyway, counseling was absorbed through the cost of my PT. If I am not doing that anymore, I don't know about the counseling. I'll find out tomorrow.

And tomorrow I go to the doctor. I do hope he will release me to go back to work. I will do everything possible to get him to agree with me in whatever way I have to do. I hope it all works out for the best. I am trying to come to peace about it. I do not want to leave that office crying again...
Anice

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/16/2009 8:23 PM (GMT -7)   
Anice,
Give the wellbutrin a chance. You may want to check with your doctor or pharmacist. Some anti-depressants make you tired, others create insomnia. Sometimes it's a matter of changing when you take it (time of day), and sometimes your body just needs a week or two to get used to it. If you're having a lot of different emotions - like manic feelings - then call your doctor for sure. If it's just being tired then you need to make adjustments and give it some time. That's often one of the transient side effects.

Still, if this doesn't work I think talking at least with your PM if not having a psychiatrist evaluate you (they are the specialists with mediations) would be the best bet. You could also ask your counselor tomorrow. Tell her what you're experiencing and if she can tell you if it sounds like some normal initial side effects.

Hugs,

PaLady
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