Friday, September 23, 2011

Decisions...Decisions

Good morning everyone!  I say that because it's 730am and I have been up for about 2 hours now!  Which is very unusual when I am not working...which I have yet to do in over a month.  I continue to be on my leave of absence for the rest of this week and the beginning of next week.  I follow up with my Neurologist next week to plan my next step.  Right now...it's totally stressing me out as I have had quite some time to think about my current work situation and I have had some opportunities arise...so I have decisions to make, that only I can decide.  I honestly DO NOT know what to do!  I'd love the Man upstairs to just tap me on the shoulder and whisper into my ear and tell me what to do.  My decision could either turn out to be great for me or terrible for me...but I will never know if I do not take that leap of faith.  However...it involves my livelihood and the wrong choice could be detrimental...or a blessing.

How does one choose?!?

On a different note, Wednesday I had my EMG and nerve conduction study.  To say I was nervous is an understatement.  I tend to have severe anticipatory anxiety...and in reality it wasn't that bad.  The electric "shocks" throughout my left leg were a little uncomfortable...but I tolerated it quite well.  I barely felt the zaps to my arm...and the needle portion of the test didn't phase me a bit.  Sad to say...I am used to lots of needle pokes and have almost become immune to them.

The reason being that I hardly felt any of the currents going through my left arm is because I do in fact have neuropathy in that arm.  Really still not quite sure why, but it explains the aching, numbness, tingling and weakness.

As far as my legs, all came out all clear.  The Neuro that performed these tests concluded that the problem with my legs going numb is most likely stemming from a problem in my spinal cord and not my peripheral nerves.  So that remains a mystery.

He prescribed an elbow brace, which I have yet to find one that I'd be willing to wear, to keep me from bending my arm and causing further nerve damage.

I tried on several at the store. One was this hideous long, bulky black thing and I could still bend my arm, so I figured that is defeating the purpose.  I then tried wrapping an ace bandage around my elbow, which he suggested as an alternative...but after 5 minutes, my arm was blue and obviously cutting off circulation.  So I took it off and haven't tried it since.  Obviously I just need to wrap it looser...but I am being stubborn.  I can't function with my arm being straight all the time!  I am left handed for goodness sake! 

What I am wondering, and will have to ask my doctor next week...is the neuropathy and nerve damage permanent?  I can't remember that from nursing school...I suppose I could Web MD it.

As I mentioned previously, I was given prescriptions for Amitriptyline and Verapamil to control my head.  After several weeks of the Amitriptyline and titrating up and weaning down on it to find the right dosage for me...I have come to the conclusion it has proven to be ineffective.  Not only has it done nothing to improve my chronic headaches, it is also not controlling my anxiety issues as the SSRI's did, and the side effects are so tough to take.  So my doctor told me if I felt that it wasn't working, I could stop it.  It's been 3 days now without it.

That's what I really like about her...if a med isn't working, she is quick to say get rid of it as opposed to keeping me full of drugs just for the hell of it.  My goal is to take as little as possible.  Previous physicians have had me on a bazillion pills that were not even doing a damn thing!

I am continuing with the Verapamil ER 120 mg every night before bed.  I have tolerated it well with no side effects.  The only issue is I have been very tachycardic with my heartrate consistently between 100-150 bpm.  I am thinking the calcium channel blocker is not controlling my blood pressure and pulse quite as well as the beta-blockers did, but it could also be the rise in anxiety.

For the anxiety I have been taking Xanax as needed.  I used to take it almost every night as it helped me sleep, but over the past 2 months or so, I stopped that habit because I was building a high tolerance to it.  However, over the past week or two, I notice I am needing to take it during the day sometimes to calm me down and hopefully lower my heart rate.  I am pretty sure I will need to go back on an SSRI next week.  Which I am content in doing.  I've been taking them since my twenties when I was experiencing panic attacks and agoraphobia.  If only one also worked as a Migraine preventative.  As far as I know, none of them do...but does anyone have any information on that?

So my current treatment plan has really dwindled on the pill popping front...and I am excited about that!

I am taking:
-Verapamil ER 120 mg QH
-Magnesium 400 mg daily
-Xanax 0.25-1mg as needed
-Baclofen 10mg as needed
-Norco 5/325mg as needed
-Phenergan 25mg as needed

Notice:  only ONE daily med!!!  Whoo hoo!  The Mag I do take daily...but supplements don't count to me!  I actually started the Mag again to help counteract the inability to go to the bathroom due to the the other meds...plus it is supposed to be good for me.
In regards to the Baclofen and Norco, my Neuro would like me to stop taking them as the Baclofen hasn't done much for me and the Norco causes rebound HA...but out of desperation I take them as rescue meds until my current prescriptions run out.

That is one topic I plan on bringing up next week...rescue meds!  Essentially...I have none that she has prescribed for me...and I believe rescue medications are just as important as preventative medications when dealing with the unpredictableness (is that a word?) of Migraine and chronic headaches.

I just have no idea which ones I could take.  Not only did I not tolerate Ergots and Triptans...this Neuro won't give them to me anyway because of the Basilar Migraine issue...they're contraindicted...but opiates sometimes make it worse, although if I take enough they just knock me out.  I have never tried Tramadol, which I have heard some of you take...wonder if that would help, or maybe go back to Fioricet?  Who knows!  Now I do know those can also cause rebound HA, but I am VERY careful about that.

Any suggestions would be awesome....I love to hear what other people are taking to try and control their symptoms!

7 comments:

Heather and Kathy said...

I take tramadol 2 times a day. It works okay, not great. It really just takes the edge of the pain so that I can teach or do stuff around the house. However, at night I find I have to take Tylenol PM in addition to the tramadol.

Decisions are so hard when they deal with your lively hood. I often wish God would tap me on the shoulder too and say this is the one but he never seems to do that. I do wish the decision becomes clear of which one you should do.

I hope tomorrow is a better day for you!

Heather

Sue said...

Oh wow, are we ever on the same page work-wise!!!! I wish there was an easy answer. I'll be thinking of you as I go through my own Big Life Decision time. I'll probably end up staying where I am, but something has change about the overtime hours.

I haven't had opiates since 2008. Doc didn't like prescribing them and they weren't working anyway. Topamax was a complete disaster with side-effects.

So, I've had the best results with trigger point and occipital nerve block injections with Botox. This is my third round....so far so good.

Anyway - drug wise, I have Axert 12.5 mg for rescue and 1 mg clonazepam as needed. Hopefully won't need either for awhile.

Jessica said...

I have had many occipital nerve blocks and rounds of Botox. Hoping for another round soon!

I have never tried trigger point injections....are they different?

S.I.F. said...

I hate choices like that! Hopefully you can make the right one soon!

No advice on your meds, but good luck lady!

Photos By Mamie said...

I take tramadol for pain. usually one during the day to take the edge off and 2-3 at night as needed. Mine is for crohn's & RA pain but it works and doesn't give me the loopy narcotic feel.
Hope you can find the right combo for you.
mamie

Sue said...

@Jessica - the trigger point injections that I had were administered by a different doc than the one who does my Botox.

He tests for trigger points with an old fashioned "jump test". In other words, he knows he has found a TP if he applies pressure and it refers the pain (in my case - right temple) immediately and severely. Yes, it makes you want to jump off the table.

Anyway, the difference is that TP injections were a mixture of buvopocaine and cortisone applied to various points including the masseter and sternocleidomastoid muscles.

The Botox doc tends to target the two main nerves in the occipital area that feed ALL of the areas the TP doc injected.

Mimi said...

Good luck with everything! I'm a new follower. And a new migraine blogger trying to connect with other folks like me. Hope you'll visit! We have a lot in common!

Www.migrainemimi.blogspot.com