Seen my PCP today.

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Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 8/10/2011 8:12 PM (GMT -6)   
Had my monthly followup with my PCP today and we covered quite a bit.

First off was my Cymbalta. Still a no go with the state. She said she spent 10 minutes on the phone with those idiots arguing my case and they won't budge. They told her that I had to try both Neurontin and Amitriptyline. Since I have already down the former I am now going to give the latter a shot. It is going to take a few months, unless I have a real bad reaction to it, before we can say that we tried assuming it does not work.

Next on the hit parade was talking about my latest lab work. My A1C was down by 1/2 a point from 13.4 to 12.9. Still horrible but what is interesting is that I stopped taking insulin during this time. During the time I was without a doctor (almost a year) and I wasn't taking any insulin my A1C was 12.1 when I had my first labs done after finding my current PCP. Since that time my insulin use had went from 15u of fast acting per meal and 20u of long acting at bedtime to 50u of fast per meal and 100u of long 2x day, and my A1c results climbed from the 12.1 to 13.4. (Give you an idea...normal is basically 6 or less).

Then we talked about why she wants me to start seeing a Nephrologist. (Kidney specialist). Turns out that my Albumin levels have sharply increased in the past year. Went from 115 to 757, which indicates more kidney damage which is probably due to the diabetes issues. I have my appointment with this specialist in 2 1/2 weeks.

Last but not least we talked about my pain levels and how I was doing since she upped my dose from 3 to 4 per day. I was more than happy to report a lot better over all control and even noticing a slight slow down in how fast my activity induced pain levels increase. It used to take 10-15 minutes and I would be in high moderate to severe pain. Now I can often go 20-25 minutes before it happens. As many of you understand many times victories in the war against pain are not measured in battles won but bullets dodged.

Well thats about it. Since I am going to be seeing a PMD next month I don't have to do a follow up with her or even see the pain nurse. She said to just call in for my refills, but given how slow she often is on this I probably better be calling in about a week and a half or so before I need it.

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted 8/11/2011 5:27 PM (GMT -6)   
I of course am no doctor, but cymbalta, and neurontin are not even used for the same reasons, but of course I am sure that like most meds, I am sure as with alot of meds, they are used for many issues.  Amitripiline I was given in the very first years of my decline into total disability.  It was given to me for depression.  I hated it, it made me feel more than just woosy, it was foggy, woosy, and had a hangover effect.  I certainly hope you have a better reaction than I did.
 
Over the years, in the beginning I was given prescriptions for it time and time again.  After the first time, I never filled another one.  Finally I told my pcp that he was wasting his paper and pen.  I was not going to fill it or take it.  Once was enough.  Hopefully once you give that a try, they will give you what you already know works.
 
Really makes you wonder, doesnt it.  Is anybody listening?
 
Take care and good luck to you, hope it works for you and hope you are feeling well today.
 
Kathy
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 8/11/2011 5:48 PM (GMT -6)   
Thats the government for you. Spend a dollar to save a dime.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

momtofourangels
Veteran Member


Date Joined Apr 2010
Total Posts : 2261
   Posted 8/11/2011 7:02 PM (GMT -6)   
I agree Jim. The government is backwards on a lot of things. medicaid would rather pay for Duragesic patches for me instead of fentanyl the generic. Doesn't make sense, but as long as I get the pain relief it doesn't matter to me.

i really hope the amytriptiline works for you. i took it one time for depression and I had to stop it because it made my heart race and very sleepy, dopey, etc. Just letting you know in case it happens to you. If it doesn't help. I'll be praying that the crazy government will let you have the Cymbalta. I'm on Cymbalta for depression, and it's a great med.

You take care. I hope you're having a low pain evening.

love and hugs
Loretta
Dx: osteoarthritis, bursitis in left hip, Osteoarthrits in right hip, compression fracture in thoracic spine due to falling on frozen ground March 2001 , ddd, spinal stenosis, bone spurs, osteoarthritis in spine, osteoarthritis in both knees
Meds: Fentanyl patch, oxycodone, otc: BenGay, Tylenol Arthritis on occasion

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 8/12/2011 10:24 PM (GMT -6)   
I am already wondering if amytripiline and I are going to get along.

Took my first dose last night about 90 minutes before I was planning on going to bed and I tossed and turned and could not sleep. Finally fell asleep at 6am and other than getting up once to use the bathroom I slept until 7pm this evening.

When I got up couldn't have told you what day it is if my life depended on it. I was, and still am quite irritable. On top of that I am having trouble focusing my thoughts.

If things are not better come Monday I am going to be calling the doc.

Trudy2
Regular Member


Date Joined Dec 2010
Total Posts : 213
   Posted 8/15/2011 6:18 AM (GMT -6)   
I took amitryptilene in the past and it did make me sleepy, and I only took it at night. My Doc did try to increase the dosage once and I could not tolerate it. When I tried to get up the next morning, everything was out of focus and I felt like I couldn't see straight and like I was going to pass out. So we went back to the prior dose. This was several years ago. I no longer take it now and when I suggested it a few months ago to my PMdoc, he looked at the other medications I am on and said that he did not want to add that one in to the mix.

I am on neurontin, cymbalta, wellbutrin, and 2 opiate pain meds at this time. My medicare insurance approved the cymbalta because I was previously on EffexorXR and could not tolerate it. That is exactly the wording the doctor put on the prescription and it went through medicare insurance without a problem, he was kind of surprised. The neurontin does help my nerve pain, and the cymbalta has helped to tone down some pain that I have had in a huge scar in my stomach. Prior to taking cymbalta, I could not stand for anyone to touch the scar and even had to wear pants that were 1 or 2 sizes too big because I could not stand them to touch it either. The opiate pain meds did not do anything to help the scar pain. The opiates are for lumbar back pain and hip joint pain.

Hope this helps you to get the cymbalta approved!

Trudy
DX pyoderma gangrenosum, Acute Myelogenous Leukemia, Bone Marrow Transplant, Chronic Pain syndrome, Chronic Kidney Disease Stage 3, Major Depressive Disorder, Radiculopathy, Bilateral Hip Pain, Insomnia,Left Groin Hernia, Bulging Disk in Lumbar Spine, Tear in Lumbar Spine, Tendonitis and Bursitis in both hips, hypoxia due to sleep apnea and new problems with my lungs. Have had 2 abnormal CT scans.
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