Chronic Pain and Depression

[Duckey]

I was in two car accidents. One in 1995 in which I injured my left knee (had the cartledge shaved) and herniated a disc in my neck (C5-C6).  I had two thoracic outlet surgeries in 1997 and 1998 and was on the road to recovery when I had another car accident in 1999 and all the previous injuries were made worse and I also started having right ear and jaw pain and right shoulder pain.  I was treated for depression after the first accident and prescibed prozac. I feel that this worked well. My husband doesn't believe in medications and thinks that I should just pull up my socks and get over it.  I have recently been diagnosed as bi-polar.  I am currently being prescribed zyp[rexa 2.5 mg twice a day.  I was on heavy duty pain medication after another neck surgery (cervical denervation.  After the surgery the pain become intolerable.  I was on transdermal phentanol patch, first 50 mg then 20 mg. One patch every three days.  I got off the patch by starting oxycontin 20 mgs. twice a day.  I have now weaned myself down to oxycontin 20 mg. once a day.  Some days I do not take any and some days I take 2 or 3.  I also started working out at the gym and hired a personal trainer.  I have been working out consistently for 5 months.  My probelem is that I go strong for a while and then collapse.  I get a good routine going for 3 to 4 weeks and then everything falls apart and I am bedridden for 2 to 3 days and then I start all over again.  I have only been taking the zyprexa for 1 1/2 weeks and I have been eating too much and putting on weight.  I am lethargic and can't seem to focus and get myself going  and finish any tasks that I start.  I am on disability and I have a hard time living up to my commitments and running my home and caring for my son and husband properly.  I have had trouble sleeping since the first accident in 1995.  The gym and workouts have made my sleeping a little better.  What I want desperately is to have a steady routine and no ups and downs.  But I do not want to feel drugged and slow moving.  Can you recommend anything for me?

My husband is totally against medication and he is the person who suggested that I start a routine working out at the gym.  I am trying as hard as I can but it seems like I am having trouble with everything I do lately.  For instance to get work done to my house, I have to call 3 to 4 times and I still don't get the results I am looking for.  I am so frustated and my confidence is shattered.  I get fed up and shut down for 2 to 3 days and then I pick myself up and start over.

[Roger Gould, M.D.]

I have a strong recommendation...see a psychotherapist and talk through the conflicts that keep from getting some new momentum in your life....you are in a stop/start pattern, which is a manifestation of a contradictory set of motivations and unconscious agendas.  These can be surfaced and worked out, but you need help to do that.

[KickedThePanic]

The first thing you need to find out is if the excercise is doing further damage! Next, start an excercise regimine in EXTREMELY low amounts and listen to your body. Talk to your doctor about your trouble sleeping. Ask your doctor about physio-therpy. Percodan (Oxycontin) is a very powerful drug. It has been prescribed to you because of the DEGREE and TYPE of pain you are experiencing. Your husband is right to be concerned but you are in alot of pain. It's time to be a little selfish! The others in the household need to take on a little more work as they are more physically capable than you at this point in your treatment.

Good-Luck,

Jerry

[Geeimnpain]

Ditto to above comment, particularly about asking your family to accept more responsibility. I have a few questions to ask....if you have a TRUE diagnosis of Bipolar Disorder, Zyprexa is NOT a first line drug of choice to use...and you're right, it DOES cause weight gain. Neurontin might be a good drug to try to treat both Bipolar Disorder AND Chronic Pain. If Prozac worked for you before, why not use it again?  It's cheap now that it's gone generic.  And, if you DO have Bipolar Disorder, it sounds like you're in the depressed cycle, in which case you could use Prozac along with the Neurontin.

I would recommend you go for REHAB vs. Personal Training..my experience is that those who deliver care in rehab are either Exercise Physiologists or Physical Therapists....Personal Trainers(although they may be certified) are not always the best choice for Chronic Pain sufferers..you may be pushed beyond the limits of what is good and right for YOUR SPECIFIC LIMITATIONS.  Hydrotherapy(water therapy) is terrific!! Keep on keepin' on....there IS hope!!!