Thanks, everyone. Yes, my doctor is starting me slow on the topomax. He did warn me that some people don't tolerate it well, but I agreed that it was worth a shot since just about anything is right now. He's starting me at 25 mg at bedtime in place of the bedtime dose of lyrica. After one week at that dose, he wants me to increase to 50 mg at bedtime, then 75 the following week, then 100 mg the following week. I will be checking in with him by that time, and if all those increases go okay, he will have me start replacing my daytime lyrica doses as well. I took my first dose last night. I felt sleepier than usual, but I'm not entirely sure how much of that was because of the medicine and how much of that was due to having a stressful and high pain day, and not having slept well lately. I woke up with a headache and felt a little queasy this morning, which again might be the meds and might not. But either way, it certainly wasn't a bad enough reaction to keep me from taking it again tonight. It frequently takes me a little while to adjust to a new med anyway. Tramadol was *horrible* at first, to the point where I stopped taking it, but since my doctor refused to give me anything else at the time, I tried it again several days later (and took it slower that time). I had a hard time getting the doctors to do anything for my back pain when it flared back up in 2008, even though they knew I had a long history of back pain and back surgeries.
I'm just now looking into the surgeon he referred me to, and I can't say I'm hugely impressed. He seems fine, and the hospital's rating for this type of surgery is not bad, but there is certainly better within the city. But they don't officially partner with the medical practice where I get all my care now. I forsee myself needing to see at least a couple surgeons before committing to having surgery though. If anyone has a surgeon they can recommend in Boston or the surrounding area, I'd really appreciate it.
Scoliosis fusion w/rods - 1992; herniated disc - 1996; partial removal of rods - 1997; microdiscectomy - 1997; sudden increase in pain - 2008; since 2008 I've tried the following non-pharmaceutical treatments: physical therapy, aquatic therapy, TENS, acupuncture, trigger point injections, selective nerve root blocks; other diagnoses: depression, anxiety, add; current medications: tramadol, lyrica, baclofen, vicodin, welbutrin, ativan, ritalin