Sunday, April 01, 2007

Trouble Me

The last couple of months have been a struggle between agony and achievement. Not an uncommon theme in my life. Beginning the middle of January the pain in my lower back and my feet become markedly worse. Waking up in the morning was agonizing at best. When I put my feet on the floor, walking, let alone standing, seemed impossible. My back was difficult to straighten out. The dosage of Vicodin and the Lidocaine patches were not giving any relief. So, I contacted my primary physician and requested referrals to see my pain management specialist and the neurosurgeon I had consulted in October of 2005.

Before I could see the neurosurgeon I would have to have X-rays and MRI's. I will be getting the MRI tomorrow, but I did get my X-rays, and the results weren't pretty. My spine in a period of 18 months, had slipped almost 50% farther than my previous MRI in September 2005. This could easily account for the greater amount of pain and the greater amount of weakness in my legs. The MRI will reveal more about the slippage and if there is indeed a greater amount of root compression on my spinal cord.

In the meantime, I was able to meet with my pain management specialist who has now added a new medication to my pain management regimen: 25mg Fentanyl Patch - i.e., a morphine patch. My willingness to take the morphine patch, which my primary physician had suggested to me late last year, was at the behest of both my girlfriend and mother both of whom are growing tired of my constant resistance to getting as much medication as possible to make me functional as possible.

Accepting the morphine patch was not easy for me. I just don't want to believe I am so far gone and my pain is so out of my control that I need a medication as intense as morphine. Even after 3 years of knowing that my life will always be one with chronic pain, I am still fighting the inevitability of my fate. On the lighter side, after almost 2 weeks with the Fentanyl patch, I have found greater relief and been able to sleep more than 5 hours a night. Not every night, but most are better. My dreams have been a lot more "technicolor," but my night sweats have increased, so have my day sweats come to think of it! I have moments of intense fatigue and lightheadedness but that's to be expected. I will adjust to the morphine as I did the Vicodine.

In my earliest entries in this blog, I posted some scans of my X-rays to show the physical evidence of my disabilities. I think the evidence can be extremely helpful in understanding exactly what persons like me live with. So, I have posted here an X-ray comparison between the first 1994 X-ray of my spine and the most recent which was taken almost three weeks ago.

I added the white marks to illustrate more clearly the increase of slippage over that same period of time. I wish I could say that my own denial and continued physical activity has increased the deterioration; however, over the last 18 months, in which the almost 50% increase in slippage has occurred, my physical activity has decreased significantly!

In truth, as much as the 25mg of morphine has helped since being added to my 20/2,000 mg of Vicodin a day, the Lidocaine patches, the Cymbalta and the Ibuprofin, it hasn't given total relief. My pain management specialist has asked me to contact him if I feel I need to try one of the higher dosages, but I want to give the 25 mg a decent amount of time, as well as my body time to adjust, before I take in even heavier opiates to achieve relief.

I will, as always, keep you posted. And you can bet it will not be another two months! I will be getting the MRI tomorrow and seeing the neurosurgeon I hope in the next few weeks. After those results, I will absolutely get back to you.

No comments: