Cymbalta & My Jack*** Pain Dr.

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drjimmy
Regular Member


Date Joined Dec 2008
Total Posts : 110
   Posted 12/4/2010 12:58 AM (GMT -6)   
Well I've been on Cymbalta 60 MG. for about 5 weeks now and I haven't had any pain relief. So I saw my pain dr. (I hadn't seen him for about 6 months...Instead I've been seeing his nurse practitioner at the same office. My dr had left a real nasty message on my cell phone about 6 months ago after I had the nerve to call too many times with questions and with prior authorization issues that needed his attention. Since I had no place else to turn for my much needed pain meds, I couldn't tell him where to shove it and move on to another clinic. They gave me the option of seeing the nurse practitioner for my monthly appts, so that's how it worked...For some reason my pain dr. actually walked into the room this time, much to my surprise). It was my primary physician who had started me on Cymbalta 60 MG, but I asked the pain dr if he thought we could increase the dose, since the current level wasn't helping. He proceeded to rip into me for my weight issues (I'm 6-2 and about 360 pounds). Keep in mind that I was about 322 at my very first office visit and he never, not even once talked to me about my need to lose weight. Of course I knew I had to lose weight without him having to tell me. Now, out of the blue, he quite aggressively tells me I have to lose a bunch of weight, or the pain meds will soon stop working. I tell him that it's not easy, since I'm about 95% sedentary due to my horrible, constant pain. He blames Obamacare and says that he needs to justify why he's prescribing all these heavy pain meds. He says if I'm sedentary and not losing weight, what's the benefit of the pain meds (Um, how about pain relief? How about without it, I'd just lose all hope and want to die?). Then he says, if I don't start showing significant and continuous weight loss, starting with the next office visit in 1 month, he will start reducing my dose of pain meds. He said if I can't lose the weight on my own, than I need to go for gastric bypass. So basically, after over a tear and a half of office visits with no talk of weight loss, he's threatening me with losing some of my pain meds if I don't start losing significant weight in 1 month and continue month after month. I left the office fighting back tears. My wife and nephew were waiting for me in the car and I didn't want them (especially my nephew) to see my emotional state at that time. I get within 5 feet of the car and my nephew asks, what's wrong? So I guess I didn't do a very good job of acting strong. So that's where I'm at. I'm terrifies of losing my pain meds. Every time I take a bite of food, I get scared and nervous, even if it's something that's on my diet. My wife told me I should have started crying in the office, so he could see how much of an ***hole he was. I'm so tired of having to walk on eggshells and taking crap, or else risk losing my doctor and thus my lifeline (pain meds). Has anyone else experienced anything similar to this from their doctor? I think my depression has gotten worse since I stopped the Prozac & started Cymbalta. I'm going through all kinds of mood swings, sudden frustration and anxiety. My wife says I've gotten much worse, and she's worried about me...I can go from zero to crying in no time. If I was getting pain relief, I'd consider it a trade-off...Less pain vs more depression. Maybe once my pain improved enough, my depression would get better? Who knows? Im going to ask my primary physician to bump me up to 90 MG of Cymbalta and see what happens. I'm not a very jolly person, this holiday season.
Herniated Lumbar Disks L5 S1, L2 L3
Herniated Cervical Disks C6 C7
Spinal Stenosis
Degenerative Arthritis Left Knee
Pes Planus Both Feet
Multiple Neuropathies
Brachial Plexus/Thoracic Outlet Syndrome
Nerve Pain in Arms, Hands, Back, Legs, Feet, Groin, Testicles

Retired Mom
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Date Joined Feb 2010
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   Posted 12/4/2010 6:37 AM (GMT -6)   
What a JERK! Perhaps someone needs to point out to this idiot that most of the population is overweight at this point. Does it make it right? Well, no, but it's virtually impossible to loose weight when you can't move very much. My PM has never addressed weight with me and I WOULD cry if he did. It's one of the things that bothers me so much....that and walking like a duck or a cartoon character when I used to be much slimmer (though not really slim) and wear heals everyday. Now I wear Crocs about every day and sit in my chair most of the time because my meds aren't getting it now and I'm really scared to ask for much more.

Keep your head up Jimmy. We understand and support you. I hope you find a new Dr soon!!!!
Retired Mom

damouthy1
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Date Joined Sep 2009
Total Posts : 663
   Posted 12/4/2010 6:54 AM (GMT -6)   
What a complete jerk!! I am so sorry to hear that you had to go through that. I hope that in time you can find a new pain doc. Nobody should have to deal with that kind of abuse from a doctor.
Gentle Hugs,
Shannon

Fibromyalgia, Chronic daily headaches, Migraines, Possible Graves Disease, GERD, High blood pressure, Depression and Anxiety

Oxycontin, Percocet, Lopressor, Lexapro, Omeprazole, Promethazine as needed for nausea, Ventolin inhaler and Vitamin D3

Vannie
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Date Joined Aug 2010
Total Posts : 795
   Posted 12/4/2010 7:34 AM (GMT -6)   
Oh, my. I am still shaking my head after reading your post. Sounds as if your doctor needs some meds to help w/his irritation which is actually a sign of depression in some people.

So sorry you had to go through that. If you are like me, you can think of all kinds of things you could have said......long after the appointment, of course. When a doctor acts like that, I get the deer in the headlight syndrome. I can't think or speak. I am just "frozen". I had a rheumatologist once who thought I was a drug seeker. Go figure! My NP used to have to brow beat me into taking pain meds. Now I take them because I cannot function w/o them.

Point is, some doctors are just jerks. There are good docs and bad docs, just like there are good plumbers and bad plumbers. Of course the damage bad docs and do is a lot more serious. Someone in pain does not need to be treated so poorly by the very person they are trusting to help him/her. That is such a betrayal on your doctors part.

Do you have the option of seeing another pain specialist? Can your GP help you with this?

Wish I had some answers for you and I'm so sorry you had to go through this. Don't let his attitude mess w/your sense of worth and human dignity. He has no right nor power to do so, unless you give in and let him have that power. Stay true to yourself, Drjimmy.

Best wishes to you. Please let us know how you are doing.

Peace,
V
Fibromyalgia, Inflammatory Arthritis, Osteoarthritis, Asthma
Plaquenil, Lexapro, Cardizem, Lisinopril, Advair, Lipitor, Vit D, Joint Supplements, Soma, Tramadol
Be Kind To Others For Everyone Is Fighting Some Kind of Battle

flower123
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Date Joined Apr 2009
Total Posts : 856
   Posted 12/4/2010 8:25 AM (GMT -6)   
Wow. I'm so sorry that your doctor treated you that way. Can you find another doctor? I know that it's much easier said than done, but what he did to you is TERRIBLE. I know also that for me, when a doctor has been rude to me, that that really effects the way I feel about going to doctors in general. I'm convinced that the reason I get so nervous when I go to the doctors (ANY doctor), is because of what one of my past doctors did/said to me. They can really make or break you. It's disgusting.

I would look for another doctor. I know that you're scared of your lifeline being taken away, but you should never have to go through this again--you shouldn't have had to go through it to begin with.

Hugs,

Flower

Mrs. Dani
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Date Joined Jun 2009
Total Posts : 2787
   Posted 12/4/2010 9:45 AM (GMT -6)   
Dear Jimmy,

    You know, it isn't often that I feel that someone should change their entire health support system and find new physicians. In your case though.... I truly *feel* that your doctors behavior was inapproiate and in my opinion abusive. There are many ways to approach a patient about life style choices. Many ways to approach a patient about making positive changes. I do not think that your doctor was looking out for your best interest when he went on a tirade about your weight.

    I would understand, if say he contacted your primary care so that he could approach you find out your feelings regarding you weight. Even if say, you were approached by either one with tools and resources to even just change your nutrition choices daily. Then see if you are comfortable with changing your lifestyle. But... none of that was the case.

    You were approached in a negative, aggressive, abusive manner. You were threatened, belittled, ridiculed and unfairly judged. It is so important at this point to speak with the hospital administrator and let them know what happened. How it happened, what was said. All of it. It would be very damaging if all of what he said and did was done to someone who isn't as strong as you are.

     Yes, I completely agree it is time to talk to your primary care doctor about a Cymbalta increase. Remember that depression is a chronic illness just like your pain is. It needs to be treated or else it can get out of control. From your post, I can tell you are fed up with the pain AND the depression. A increase might be just the thing to help both or those? If not, then perhaps switching to something new or going back to the Prozac since you already know it works well for you.

    While you are with your primary care, speak to him about the incident and about your care with the pain management doctor the last 6 months. See if he can refer you to someone else. Make sure he sends your records over or requests them from you current PM, then sends them over to a new one.

     Most of all, I am terribly sorry you were treated so badly. It isn't okay. Not at all. Not under ANY circumstances. You pay your PM, and quite well I might add. You do not deserve to be treated like that. Especially NOT from someone that you pay to provide a service for you.

     I hope at some point the pain and depression ease up enough for you to get some true rest. Hang in there stay strong!

*warm hugg*
       dani


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

Chronic Pain Moderator
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antbuggey
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Date Joined May 2010
Total Posts : 594
   Posted 12/4/2010 10:49 AM (GMT -6)   
Dear Jimmy.

OMG....that is totally ridiculous! I do not know what is up with doctors thinking they are God anymore! It seems I keep hearing more and more horror stories about how doctors are treating their patients and it is sickening! I am so very sorry you were treated that way! Any human being who has ever had weight issues can relate but a "so-called" medical professional is going to belittle you like that! I struggled with my weight some my whole life and now with CP and depression, I have gained a ton of weight, and I am not quite sure how to fix it! So now I hurt all the time, I am depressed all the time and my weight problem just compounds all of it! I can not imagine how I would feel if my doctor approached me like that! What happened to "First, do no harm"? Your doctor has done harm treating you like that! I think many doctors need to go back and study the Hippocratic Oath!!

Again, I am very sorry you were treated that way! I hope that your suffering eases soon! Take care of you!

Hugs,
Beckey
Rheumatoid Arthritis, Spinal Stenosis L3/L4, L4/L5 & L5/S1 with Nerve Impingement, Fibromyalgia, TMJ, GERD, Severe Depression, VERY Large Cyst Right Ovary causing mild twisting, Small Cysts Left Ovary & 3 Large Cysts Uterus

Medications - MS-Contin, Plaquenil, Cymbalta, Famotidine and currently Prednisone

Chartreux
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Date Joined Aug 2006
Total Posts : 9664
   Posted 12/4/2010 12:07 PM (GMT -6)   
This doctor was rude and inconsiderate towards you and you need to look for a better doctor
as you deserve it, no one should have to tolerate this.
He could've said to start maybe on physical therapy to try to get you up and moving, but
to say what he did was wrong...
please seek out care from another doctor.
(((((((((((((((((((((((((((((((((((Jimmy)))))))))))))))))))))))))))))))))))))))))))))))
Healing Hugz

Beckey, doctors need classes that'll teach compassion, a doctor would expect compassion
from a fellow physician, so we should also get that same type of compassion, peroid...
(just agreeing with you)
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

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

Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 12/4/2010 2:51 PM (GMT -6)   
I feel for you Jimmy. Been there done that and the jerk of a doctor that did it to me almost came away with a broken nose because of it. When it happened to me it wasn't over pain meds but rather because of me being diabetic. Due to money issues I had to stop taking all of my diabetes meds and when I finally had the money to get back on them my regular PCP was on vacation so I agreed to see one of the other doctors in that office. That jerk came in and asked why I was there and I told him and then he rips into me for not taking care of myself and flat out told me I was fat....which was a really good one since that azz had to weigh 30 lbs more than I did at that time....LOL. Anyway I got up and started to walk out at which point he told me he wasn't done with what he had to say and tried to block my way. I just looked at him and told him to either step aside and let me pass or I was going to knock him on his ass. He moved and I left. The next week my PCP was back and I made an appointment with him and told him exactly what happened. Needless to say my PCP was MAD at the way I was treated and the last thing I heard on my way out of the office was my PCP telling that jerk if he ever heard of him treating anyone that way again he was going to be reported to the state medical board.

Anyway, I suggest you talk to your PCP and tell him about what happened and tell him you want to find a new pain management doctor and get a referral and also ask if your PCP will handle your pain meds until you can get switched over.

While the new health care law does require doctors to "justify" their decisions on treatments any doctor worth 2 cents already has that justification as part of the patient file. Also the intent of that justification is keep doctors from wasting time and money on tests, procedures, hospital stays, and treatments that are ineffective. For example why put someone on Tylenol 3 for pain for months and months when it does not effectively treat that pain.

Post Edited By Moderator (straydog) : 12/5/2010 3:00:08 PM (GMT-7)


spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 12/4/2010 4:01 PM (GMT -6)   
your doctor should go into a different branch of medicine because he has no idea what PAIN! is and he is the type i think takes it personally when you come in need of help. you must find a different physician to manage your long list of chronic pain problems. if you only gained 38 lbs. over a long period on cymbalta you have not done to bad. cymbalta can cause major weight gain and is liver straining. with your neuropathies all over raising it 30mg will probably not be the deciding factor and your taking the risk of severe side-effects (weight gain) the more you take. i don't know if you have tried putting Lyrica or Neurontin with the Cymbalta 60mg but it can help relieve nerve pain real well. you need a doctor to help you find the right doses that help and are not high in adverse effects. Effexor that is a SNRI like Cymbalta works for neuropathies like DPNP and phantom-limb pain. it might be a better anti-depressant and it is related molecularly to tramadol and tapentadol and is also refered to as a atypical-opioid like them. spinal stenosis pain is severe and anti-depressants and anti-convulsant medications are only considered adjuvants to opioid analgesics. your pain management should not be conditional on your weight and i am not aware of any changes that have been made to pain medicine protocal due to "Obama-Care". good luck getting in with a good doctor, you just have to look around.

undetermined_dimension
Regular Member


Date Joined Dec 2010
Total Posts : 38
   Posted 12/4/2010 5:07 PM (GMT -6)   
Oh honey! I'm so very very sorry!! What an awful experience and such frightening future you are looking at! I agree with dani 500% report it, document it and find a new dr! they have to give you a emergency dr to maintain what you are already doing until you can find another specialist. i have been faced with that horrific cruelty my whole life and have been labeled a drug seeker because they cannot find out what is wrong and then a while later i am rushed in for surgery because something was terribly wrong and they wouldn't listen. it is a very very hard place to be in and a terrifying one at that.

I know that this is a very strange idea but it feel that for some it is just the thing. Linda Goodman has a book called Star Signs: The Secret Codes of the Universe: Forgotten Rainbows and Forgotten Melodies of Ancient Wisdom. in this book is a detailed spectrum treatment for weight. you have to really, really want to do it because it is not easy and some of the necessary equipment hard to find (but cheap). let me know if this sounds like something your interested in and i will share where i obtained my stuff. there is also a section on the purple plate which i have always wanted but never could yet and then keep forgetting, lol.

keep your head up!!
Make me strong in spirit
Courageous in action
Gentle of heart
Let me act in wisdom
Conquer my fear and doubt
Discover my own hidden gifts
Meet others with compassion
Be a source of healing energies
And face each day with hope and joy

Alcie
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Date Joined Oct 2009
Total Posts : 5004
   Posted 12/4/2010 5:38 PM (GMT -6)   
OK, I agree that you shouldn't have been treated that way. Now lets take a look from the angle spinal soldier suggested.

Are you absolutely sure it isn't the Cymbalta (or maybe another med) causing some of the trouble? Some of your new or worsening symptoms are in the lists of side effects for that drug. I got absolutely no pain relief from Cymbalta, nothing but side effects. I felt much better after stopping it.

I keep a good journal of my meds (and foods) and my reactions. It's helped a lot in figuring out what side effects I get and how long the meds work. I have a lot of allergies/intolerances to meds, a whole typed page in small font.

For pain all I tolerate is tramadol or vicodin, unless I take zofran to stop nausea and vomiting. My pain doc keeps having me try muscle relaxants because some of my pain is muscle spasms, especially in my spine where, like you, I have disc problems and arthritis. A couple of them are good as sleeping pills but don't work as muscle relaxants at all. Diazepam works just fine for 4 hours, but my doc doesn't "like" it. Yesterday I was at a dinner where I had to sit in a straight back chair for a couple of hours. I popped 2mg and in 15 min the spasms were gone and I made it through the dinner. I wore my back brace on the houre's drive home - wouldn't fit under my outfit.

Do you think any of your pain could be from muscle spasms? I get a tightening in my back, realize I am tensing. If I push lumbar spine backwards, opposite of arching, I get temporary relief. Heating pad helps, but the smallest dose of diazepam (or even half of it) allows me to function. Of course this isn't all of the pain, so I still take the tramadol 3-5 times a day.

I don't like talking to nurse practitioners because they are just not educated enough, but if that's all you've got available work out your own solutions and suggest them. I'd be looking for a new pain doc on the grounds that you don't actually get to see a doc.
Alcie
 
 

Retired Mom
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Date Joined Feb 2010
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   Posted 12/4/2010 5:55 PM (GMT -6)   
Alcie, not to hyjack a thread, but if you Dr doesn't like the diazepam (as mine don't), have you considered taking xanax controlled release. It works just as well for me and I can't take the other muscle relaxers or anything like that. My psych is the one who thought of the xanax controlled release and it is so cheap and works for 24 hours. It's much better than the immediate release for me and much less likely to be abused by anyone (IMHO).
Retired Mom

Alcie
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Date Joined Oct 2009
Total Posts : 5004
   Posted 12/4/2010 7:36 PM (GMT -6)   
Also not trying to hijack, but Xanax is just another benzo, so I can't imagine why pain doc would like that any better. Maybe he thinks I take a lot of diazepam, and I don't! I only take it once a night, at the lowest dose available, and sometimes only half a pill (except for emergencies which is also only 1 pill). I'm absolutely in no danger of abusing. Diazepam (aka Valium) is also generic and really cheap. I didn't know though, that Xanax comes in extended release, so it is worth considering. Diazepam is short acting - 4 hours. Maybe it comes in extended release too. Hmmm.

We're not talking about anxiety and tranquilizing doses! If you hear about Xanax and Valium most people automatically assume psych problems. But in this case we're talking about relief from painful muscle spasms without getting into doses that mess up our minds.

This is why we come here - to learn stuff! I hope this conversation helps drjimmy.
Alcie
 
 

Retired Mom
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Date Joined Feb 2010
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   Posted 12/4/2010 7:42 PM (GMT -6)   
Please don't think I was implying anything.....I'm certainly not. I understand exactly about the muscle spasms and the need for meds that actualy work. I have no idea why they prefer one to another, but I do know they said something one time about the diazepam storing in the fat cells and the xanax not doing this....who knows.

I too hope this helps anyone who needs it. It does wonders for everything from anxiety to muscle spasms to vertigo and especially esophogeal spasms (nutcracker esophogus) (please excuse any spelling errors).

Best to all!
Retired Mom

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16301
   Posted 12/5/2010 4:07 PM (GMT -6)   
Well, I can tell you this much, when he made that nasty call 6 months ago you should have got busy finding other PM drs to take over your care. Jim is right, I would go back to my PCP and tell him what is going on and get him to refer you somewhere else. I don't care if you have to drive some distance a good dr is worth it. You are not bound over to this this jerk for your care, only if you let him. The writing is on the wall here, you will soon find yourself with no pain medication, don't let him do that to you. I am quite sure he has a staff to take care of pre-authorizations and as your dr he is suppose to answer your questions. The ball is in your court now, make the next throw a good one-get a new dr.. Shame on that jerk.
Moderator Chronic Pain Forum

merrygirl
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Date Joined Jun 2007
Total Posts : 702
   Posted 12/6/2010 3:54 PM (GMT -6)   

wow that sounds like and awful visit.

 

I am obese and I recently increased my dose of cymbalta to 90 mg  and it helped quite a bit compared to 60.  I also started weight watchers and so far lost 5 pounds. It has been "easy" and I would suggest weight watchers to anyone. I am type 2 diabetic. I havent been starving, just losing a little weight in a few weeks. Not saying the doctors right but weight watchers isnt expensive, and its not just for women. I hope you will find a  new pain doctor. This guy/gal has it out for you.


spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 12/6/2010 4:15 PM (GMT -6)   
hey man, how are ya! i just wanted to mention the diazepam is a great muscle relaxant and one reason is it's very long acting! valium is one of the longer acting benzodiazepine. like Alcie mentioned she could take 2mg for spasm pain and it would work just a few hours which it probably kept it's anti-spasmotic effect 4-6 hours and tapered down but the diazepam had a long time of metabolizing to do before it was done. like methadone if you take the diazepam before the half-life is over from the last dose you will get drug-accumulation in your system and have multipled effects good and bad. anyway what i really was thinking is the stenosis probably in your lumbar spine is the real urgent issue. if your spinal nerve pathways are not decompressed and it gets worse you won't have a choice if you want to be active and do some physical theraphy because you will not be able. i have seen a couple cases just like yours and they all improved and some a lot. the thing about it is there managing doctor for a couple year period was a spinal-surgery specialist, either a orthopedic-surgeon, a neurosurgeon, or a spinal sub specialist. quite a few spine doctors that are good do several stenosis decompression surgeries on obese patients. the first move i would make is find out who the major spine surgeons are and get with one for a consultation and tell him you need a new physician for chronic pain mangment if you develop a relationship with them if they want to take on your tough case. in the mean time try to find a new pain mang. doctor yourself and ask your PCP and ask the PCP if he knows who the more trained spine doctors are. fight the good fight and i'm sure you will find a good MD you like.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,

current Rx: OxyContin 80mg q8hrs. , MSIR 30mg prn qid,vistaril50mg prn nausea, Lyrica 150mg 2x,Adderall 20mgs 1x A.M. 10mg PM prn, Soma 350 mg 3X, Relafen 1000mg 1x, lorazepam 1mg bid prn, Supplements: CO-Q10 100mg, Vitamin D 2000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, GABA 750mg,

nasalady
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Date Joined Sep 2009
Total Posts : 1176
   Posted 12/6/2010 4:41 PM (GMT -6)   
((((((((((drjimmy)))))))))))

What a $&#@**@& that doctor is!!!! I'm so sorry you had to go through that!! The thing is that Cymbalta itself can could be part of the problem....I take it with Lyrica for pain, and the two of them together are very effective, but both of them cause weight gain. Those two plus my prednisone have caused me to gain a LOT of weight over the past 2 1/2 years, but the prednisone saved my liver, and I know that the Cymbalta plus Lyrica definitely helps my fibro pain.

That said, Cymbalta doesn't work for everyone and you may need to try something else; you need to have a good doctor who's willing to work with you for that! I agree with everyone who said to find a new doctor ASAP!! I currently have to drive 3.5 hours south to get to my rheumy and my neurologist, and 4 hours north to get to my Lyme doctor. But as straydog pointed out, if you have GOOD doctors any distance is worth it!! I know someone who flies from CA to NY once a year to see his Lyme doc, and does phone calls/emails the rest of the year.

Anyway, good luck to you! You're in my thoughts and prayers!!
JoAnn
Lyme Disease, Babesiosis, Ehrlichiosis, Bartonella, AIH, Hashimoto's, lupus, fibro, RA, celiac, asthma, psoriasis, adrenal fatigue, pre-diabetic, Raynaud's, hypertension, osteopenia, sleep apnea, RLS, GERD, DDD, severe lower back pain, cubital tunnel, tarsal tunnel, Suprax, Malarone, Alinia, Zithromax, Prednisone, Imuran, Plaquenil, Lyrica, Cymbalta, Levothyroxine, Liothyronine, Atenolol, Cozaar, Zyrtec, Fosamax, Albuterol, Prilosec

http://forty-two-joann.blogspot.com/

Post Edited (nasalady) : 12/6/2010 3:44:51 PM (GMT-7)


spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 12/7/2010 12:36 PM (GMT -6)   
i to have gone from 160lbs. to 190lbs.+ taking 150mg of Lyrica twice a day. i know for a fact it is the reason but at the same time my post-fusion foot neuropathy is a lot better taking it. i get a rash around my torso when i take Cymbalta but i know that has weight gain as a side effect. Wellbutrin (bupropion) is used off label for neuropathies and as a weight loss drug. sometimes bupropion is used as a second or third line treatment if SSRI's are not quite helping or SNRI's, a small dose is added usually of the sustained release version "SR" first and then the "XL" which is a 24 hour version but expensive. that is just a thought for the future as a attempt to get weight off and have other beneficial effects. i know Topimax is similar with weight loss, it is a anti-convulsant that is also also used for migraines and some types of nerve pain or bi-polar/pyschotropic reasons. exercise is the best thing but you have to watch the stenosis. be careful and have a good pain day.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,

current Rx: OxyContin 80mg q8hrs. , MSIR 30mg prn qid,vistaril50mg prn nausea, Lyrica 150mg 2x,Adderall 20mgs 1x A.M. 10mg PM prn, Soma 350 mg 3X, Relafen 1000mg 1x, lorazepam 1mg bid prn, Supplements: CO-Q10 100mg, Vitamin D 2000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, GABA 750mg,

Tirzah
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Date Joined Jul 2008
Total Posts : 2317
   Posted 12/7/2010 1:02 PM (GMT -6)   
J-
I wonder if maybe we have the same doctor. I'm at the bottom of my weight range & at one point was even 10 pounds below my healthy weight range, but was still given basically the same "deal" by my PM -- get more active or lose your pain meds. After ending up in the hospital for over a week, he finally decided that maybe I needed more pain meds, not fewer, in order to become more active.
So that was the "deal" we finally settled on. If I would agree to do at least 10 crunches per day for the next month, he would give me a second, stronger narc to take when things got really bad. Then the next month, it was 15 crunches per day -- and we kept going up in very, very tiny increments. Looking back, it does seem like the right strategy but gosh I wish it had been handled with a bit more foresight & compassion so I didn't have to end up in the hospital, unable to even sit up without help and screaming at the top of my lungs.

The emotional part of me wants to say that your doctor totally sucks! Is he trying out for the role of Christmas Grinch? The practical part of me realizes that that probably doesn't help you too much. If you can't switch docs, maybe you could try to set up some kind of basic exercise plan with him, in exchange for meds (yeah, I know that doesn't seem right -- sounds like it should be a crime). From personal experience, I will say to start VERY, VERY slowly. You aren't doing anyone any favors by saying you're gonna run around your block every day -- I tried that & ended up collapsing and puking less than halfway around. Pick something small and do-able and then build on that. When the 10 crunches don't hurt like crazy, add a couple more, and then add a couple more to that. Now I can do over 200 per day and my back pain is much better on most days -- driving or lifting more than 10 lbs still causes acute pain, but the day-to-day is mostly better most of the time.
Depending on your insurance, I would also suggest water therapy. You still build muscle mass (which burns calories & strengthens your core to support your back) without all the horrid joint pain of working out on land. They heat the water up to bathwater temps & it's really not too bad. Maybe something to consider.

As for the depression, gosh I really will probably never understand people's views on that. I left a career I loved, couldn't go out much with friends and family, wasn't even able to care for myself for a time & yet I was supposed to be happy?!! Once I got well enough to start getting some of those things back, my mood improved a lot. I think that's the case with most people. Yeah, there are some people who seem to never be fazed by anything, but really I imagine mostly they are just good pretenders. Everyone said that about a friend of mine who had cancer & yet when we would get together she would say I was one of the few people she could talk to & tell how very scared and sad and overwhelmed she felt. And yet, doctors hold people like her up as examples the rest of us should follow.

So, if you can get another PM, go for it. I just know I physically can't drive long distances so if you're like me, that just means trying to find some small way to appease your doc. Weight is such a sensitive issue. I know when I was trying (and failing) to gain weight I would get so irritated at doctors & random people who would comment on that I wasn't honest, wasn't trying hard enough, wasn't ... whatever. So I can only imagine how painful it must be for you when you are really trying to lose weight & doctors and random people just pile on insults. That sucks. You are trying -- let them know what you have been doing and what you are willing to do. I went to see a nutritionist who helped me pick yummy foods that got my weight up. Maybe seeing a nutritionist would help you find yummy foods to get your weight down. Know that I'm not telling you what to do. Just sharing what worked for me in hopes that maybe it will appease your PM and get him to write you for pain relief so you can get healthy and happy and less pain and every other wonderful thing that you deserve.

blessings,
frances

PS -- Why can't you go back on the Prozac if that helped? I know Cymbalta didn't work for me either. No help for pain. No help for depression. Just side effects. :(

drjimmy
Regular Member


Date Joined Dec 2008
Total Posts : 110
   Posted 12/15/2010 7:34 PM (GMT -6)   
Hey everyone...Wow, I'm amazed at the great amount of support and the huge number of responses to my post! You guys are great!! Sorry I haven't responded sooner...I definitely would like to find a new pain dr. but I've had a real hard time finding pain centers who accept my insurance & are willing to prescribe the heavy pain meds I'm on. I live in Philadelphia and I tried numerous pain centers about a year ago when my insurance changed and I was forced to look for a new pain dr. They all were similar, in that they wanted to go the route of procedures, injections, etc. but would not prescribe my pain meds. I've already had so many injections, epiduaral steroid injections, facet blocks, nerve blocks, etc. And I've tried most of them more than one time. Is there anyone here who lives in the Philadelphia area who could recommend a good pain dr? At the end of December my current health insurance will be canceled and I need to find a new medicare advantage plan quickly, or else go back to straight medicare. With straight medicare I have to pay 20% of all costs, which could be expensive especially if/when I need to have an operation. So I'm in a period of flux, but hopefully things will work out. I'm in too much pain to respond to each of you individually, like I should but I just want to say to everyone who responded to my post...You guys really helped me and made me feel better about myself. I can't say enough about the people in this forum! You guys are great!! I hope everyone is in less pain tonight. Merry Christmas to all.
Herniated Lumbar Disks L5 S1, L2 L3
Herniated Cervical Disks C6 C7
Spinal Stenosis
Degenerative Arthritis Left Knee
Pes Planus Both Feet
Multiple Neuropathies
Brachial Plexus/Thoracic Outlet Syndrome
Nerve Pain in Arms, Hands, Back, Legs, Feet, Groin, Testicles
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