Went for a follow-up at the pain clinic yesterday. As I suspected, my "pain journal" confirms that IV lidocaine didn't really do anything for me. So there I sat in the exam room with the nurse practitioner who works with the pain doc, squirming in my chair because it was about 3:30 pm, when the pain is at its worst. She flipped through my chart and sighed. "You already tried Zonegran?" "Yep." Another sigh.
To make a long story short, I'm going to taper off the Lyrica and start taking another tricyclic. Already, I can tell that taking less Lyrica is making things worse. So I'm frustrated, and apparently I'm making the people at the pain clinic somewhat frustrated, too. I'm starting to wonder if I'm the World's Biggest Baby, or, alternatively, if I'm underreporting my pain.
So far, I've not reported a pain level more than 5 on a scale of 1 to 10. See, they describe a '10' as "the worst pain you can imagine," and I've got a pretty fertile imagination, so when I try to imagine a '10', I think about having your arm ripped off or getting shot in the groin, and I think, "Well, it's certainly not that bad, is it?" Maybe it is. Maybe a 4 that last from 10:00 am until the third glass of wine in the evening is about the same as getting shot in the groin, which, I assume, only persists until you pass out or are anaesthetized.
Sigh.
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1 comment:
The Mankoski pain scale helps define how bad the pain is. I think just randomly asking people to pick a number isn't helpful. Sounds like you are somewhere between a 6 or a 7, in which case you are under reporting. My worse kidney stone was a 9- but I was wishing I would pass out/die at the time :)
The lidocaine treatment sound pretty sketchy to me... we have nerves that inhibit pain/sensation as well as relay pain/sensation. Seems to me like if you were to just try to marginally dull everything (unlike an epidural of lidocaine that is higher dose and just knocks everything out) you are inhibiting both the fibers that relay pain and those that inhibiting sensation.
This is the holy grail of a lot of pharmaceuticals now- the drug that isolates a particular part of the pain mechanism. They are getting a better handle of the chemicals of the mechanism and systmatically trying to knock them out one by one.... hopefully they will figure it out soon!
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