Had doctor's appointment this week

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Veteran Member

Date Joined Jun 2008
Total Posts : 846
   Posted 9/26/2009 11:08 AM (GMT -7)   
I told my NP some of my concerns during my appointment to get a refill for my amitriptyline. He has given me a PPI for that lump in the stomach. He also said the lump in the back of the throat is probably related, and both from an ulcer that probably developed after the Naproxen. I didn't want to add that I had tickles in the back of my throat since this summer, sometimes severe enough to make me choke. I don't think that is the same thing, but it doesn't happen too often anyway. So we'll see what develops.

He is happy for my my facial pain has receded so much. He seems to be hopeful that once I get my tooth pulled in 2 weeks, the pain will disappear. I don't see how a bad tooth can cause lighting bolt type pain near the eye, or on the other side of the face, or even in the tongue for that matter, but once again, we'll see what develops. The background steady ache, or the cramping/ crushing pain is more concentrated near that tooth when it comes. Right now it is controlled, and I hope it stays that way for a loong time!

I mentioned to him that even though I was getting a refill for 50 mgs/day now if he should ask for 25 mg tablets, in case they want to raise it again if the pain comes back. That's what he has been doing each time I get more breakthrough pain. He said I was pretty much at the max for nerve pain, and if I needed more, they would try another drug in combination. I am upset about this as I know I tolerate the amitriptyline very well now, and it's proven to work. Also, in my research, I saw that there are different schools of thought for treating nerve pain with it, with the range being from 50-150 mgs/day. I don't want to tell him how to do his job though, and I do trust his instincts. Once again, we'll see, as I don't need an increase yet, if ever.

I mentioned my rib pain, and he thinks it was from straining too much doing my pilates, a twisting exercise for the side of the stomach. I hope it heals soon. It has been about 2-3 weeks now, and I haven't even been able to do this exercise in that long b/c my knee still won't bend. I am so tender there in the morning, and any type of twisting really hurts.

Hope you are all having a good weekend!
many gentle hugs,
possible fibro and trigeminal neuralgia
50 mgs amitriptyline

Regular Member

Date Joined Jan 2009
Total Posts : 386
   Posted 9/26/2009 12:22 PM (GMT -7)   
Hi Mamanan.....Good luck on your tooth being pulled. I haven't had that done in a few years. I was doing well with my facial pain until this last week it is really starting to distract me. Grrr!

I have rib pain off and on, mostly to the sides of my body. It just feels like someone has their fingers in between each rib trying to pry them apart. Glad to hear you are doing pilates! I was doing good on my bike (stationary) for a few months, but work and my pain level and fatigue had gotten the best of me so I am lucky if I ride it once a week. :-(

Fibromyalgia, Atypical Trigeminal Neuralgia, Gastritis
300mg Gabapentin, 50mg Pristiq, Vitamin D3, Vitamin E, Ultracet

Regular Member

Date Joined Sep 2009
Total Posts : 124
   Posted 9/26/2009 12:51 PM (GMT -7)   
i take 150mgs amitriptyline a day, as 3 tabs 50mg each at bedtime. i've gone as far as 200mg a day for several weeks as needed. i've been on this dosage for 6 yrs and it really helps. wicked dry mouth but its worth it

this has been approved by both my pcp internist and my psychiatrist who is very knowledgeable on psychopharmicology
fibro, migraines, ibs

Forum Moderator

Date Joined Apr 2005
Total Posts : 17526
   Posted 9/26/2009 2:20 PM (GMT -7)   
I'm glad you are getting some answers now.  As far as the facial pain goes, those nerves are pretty much interconnected.  Here is a site that shows a diagram of the facial nerves.  You will see they can be in the jaw, tongue, and behind the eyes as well as the cheeks.  If your tooth is inflamming one of the nerves, it looks like it could travel to other nerves easily.  I'm just guessing here but it does make sense.  I do hope that is the case for you.
Forum Moderator/ Fibromyalgia
Fibromyalgia, Crohn's Disease, Ostomy, Diabetes, Autoimmune Inner Ear Disease, Osteoporosis
God does not give us a spirit of fear, but of power and of love and of a sound mind.    2 Timothy 1:7

Regular Member

Date Joined Sep 2009
Total Posts : 46
   Posted 9/26/2009 2:35 PM (GMT -7)   

I had a dentist call it "referred pain".

Once the tooth was pulled, it went away completely.

Feel better,

"You never change things by fighting the existing reality.
To change something, build a new model that makes the existing model obsolete."
- R. Buckminster Fuller

Veteran Member

Date Joined Aug 2007
Total Posts : 6067
   Posted 9/26/2009 4:02 PM (GMT -7)   
Mamanan, we already know we don't feel normal pain like the rest of the world does. You can push on the top of my head and my lower back hurts, we are weird or maybe we are normal and the rest of the world is weird. turn I hope getting the tooth extracted solves that problem and you get the rest of the things taken care of.
Why are docs not on the same page, don't they learn the same things in school??? shakehead Your doc says 50 mg of amitriptyline is as high as you can go, mine is 100 and beanley's 150???
luv and hugs
Forum Moderator Fibromyalgia
Fibro,Sjogrens, Anxiety, Gastroparesis, IBS, Gastritis, Allergies, High Blood Pressure, Low Blood Sodium, Osteoarthritis and Celiac
Amitriptyline, Celexa, Xanax, Synthroid, Zyrtec, Micardis, Spironalactone, Tylenol, Reglan, Lidoderm Patches, Carafate and Prilosec
Vit D/calcium

Regular Member

Date Joined Sep 2009
Total Posts : 46
   Posted 9/26/2009 4:15 PM (GMT -7)   
Yeah, Marlee... Doctors aren't on the same page because most of them have become so isolated inside their specialtes that they can no longer see or treat the whole person.  I just saw the Neurologist yesterday. I'd swear that, when he looked at me, all he saw was a bunch of nerves in the form of a humanoid. He could barely respond to my words.
"You never change things by fighting the existing reality.
To change something, build a new model that makes the existing model obsolete."
- R. Buckminster Fuller

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