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217229 tn?1192766004

Doctors, Doctors and MORE Doctors... AGGG...

OK.

I went to this VERY nice Doctor in Anchorage.

At first she let me know that she "THOUGHT"  I had bad posture, was overweight and had carpal tunnel which was what was causing my pain - but that she was going to run some tests.

I went back to the hotel thinking --- woohoooooo! I can lose 25 lbs --- I'll be a slimmer me... I'll sit up straight --- and I'll get those gellie keyboard thingies... Wooohooooo! I CAN FIX THIS....

Well - she ruled out Rheumatoid Arthritis --- and she ruled out carpal tunnel... (I noticed she didn't rule out the overweight stuff.... Sigh... Ah well... darn...)

It kind of left me in a slump - because I'm feeling horrible pains...

Anyhow - after much (MUCH MUCH MUCH) testing --- and still waiting on more bloodwork to rule out all other AutoImmune Disorders - she's determined that it's all in my head...

Whoa --- what??????

LMAO!

OK - it's not in my head... It's in my cells to be more precise. Neurons, methinks is the exact word.

Anyhow --- something either VERY MUCH like Fibromyalgia - Neuropathic Pain receptor distribution....

Kinda like a car that emits too many sparks from it's plugs...

That my pain receptors are on Maximum overdrive.

This is all a "preliminary diagnosis" at this point (as we all know things are always "up in the air" in the medical industry) and that I am waiting on more blood tests and some other results.

She prescribed Lyrica and Cymbalta... (Lyrica is a pain receptor "blocker" and Cymbalta is an antidepressant that ALSO assists with the receptor blocking --- but on the serotonin level... I'm not depressed, thank goodness, but she said the combination of the 2 seemed to work the best for her other patients... but that each person is different...)

Now ---- I haven't taken them yet - I'm waiting until tonight or so to see if they make me too drowsy.

I'm not too certain of these drugs - but she did check for HEPATIC problems with it. So far, none that she could find.

Anyhow, I'm to call her if these don't work in a couple of weeks.

And she'll call me if there are any other problems.

I'm a bit confused - because I'm not sure why I should be feeling neuropathic pain that "doesn't" exist... But she tried to explain it like this:

Person "A" stubs toe --- feels pain at level "1"

I stub toe and I'm ready to be shot to be put out of my misery.

LMAO!

That's about right - I'm definitely more sensitive to pain than your average person... but your typical aches and pains? Weird...

So if I get a sore shoulder from sitting too long in one position --- to me that translates to "AN ELEPHANT HAS BEEN SITTING ON MY SHOULDERS".

Now -- the interesting thing here is that I think HCV individuals are more likely to have Neuropathic pain than your average person.

So --- with that in mind - methinks Fibromyalgia is coming up to my diagnosis plate pretty soon.

Well - at least I'm not dying at the moment -- there's always something to be thankful for!!!! LOL!

Hugs to y'all... I just wanted everyone to know what was happening --- cause heck it was an interesting trip.

Now --- questions... ANYONE know ANYTHING about LYRICA or CYMBALTA ---- good or bad?

Have a splendid day folks!

Meki
14 Responses
220090 tn?1379170787
Glad to see you back and especially glad that it is not too serious.

I have developed a mild case of psoriasis since I stopped treatment.  This happened the last time I treated and it lasted a couple of months.  Better psoriasis then HCV!
Take care,
Eric
217229 tn?1192766004
"Better psoriasis then HCV!"

Man --- it's a sad day when we say things like that --- AND THEY ARE SOOOO TRUE! LOL!

Love ya!

Anchortown was interesting... I think I have inherited a bad luck gene or something... ROFLMAO!

The car rental company we used HATES me.

The first car we got lasted 1 day --- then the radiator clamp decided to crack and die --- and the radiator dumped it's fluid.

The second car we got DIED in the middle of traffic about 2 hours later.

I only drove the third car for about 3 hours total... LMAO!

But methinks that I'll be getting a discount from them.

And you know that commercial where they were working on the hotel when the guests arrived with jackhammers?????

I know that FEELING... ROFLMAO!

They were reconstructing the Hotel. Sigh... Go figure eh?

Other than that - My arms look like roadmaps from all the tests - my feet have blisters on them (because I was too silly --- Bought a new pair of shoes and DUH.... walked in them... LOL!) And my hands still tingle from the electrical impulse.

But - I'm not dying... I might feel like I am --- because of some sort of Neurological issue --- (unless the remainder tests come back as a problem) -  but --- I"ve kicked HCV - and I can darn well kick this! Or at least figure out how to make it better.

Right?

RIGHT!!!!

Love ya - get some really good cream - hope you can get it all the itchies taken care of. I hate itchies.

Meki


475300 tn?1312426726
don't cha just love those doctors.  I can't wait until I can say that I kicked HCV!!!!

((((((hugs)))))))

Denise
446474 tn?1446351282
Hi! Thanks Meki for the update! Always good to hear from you and glad you may be getting to the bottom of what is causing the pain your having. Here are some resources that may be helpful for you....

What is Diabetic Nerve Pain?

Diabetic Nerve Pain is caused by damage to your nerves. It is also known as Diabetic Peripheral Neuropathy, or DPN. DPN is often found in people with diabetes who have high blood sugar levels over time. Your doctor may be able to help you get better control of your blood sugar level. This may help prevent more nerve damage. If you still feel some pain, LYRICA may be able to help you.

What Does Diabetic Nerve Pain Feel Like?

If you have nerve pain, it may be hard to do simple things like dressing, walking, or even just lying down.

Some people with DPN may have symptoms that include:

Tingling in the toes and ankles
Burning in the feet that gets worse at night
Pain when wearing shoes or standing
LYRICA helps reduce the nerve pain that can come with diabetes. Some people start to feel pain relief as soon as 1 week after they start taking LYRICA.  

http://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/jun00pain.htm
Signs and Symptoms

Several features of neuropathy distinguish it from other types of pain. Pain is delayed in onset after the injury occurs. Patients often describe their pain as “electrical” or “burning.” Other descriptors include feelings of extreme cold, “like frostbite,” despite an absence of temperature changes upon physical exam. Patients with diabetic neuropathy or Guillain-Barre syndrome sometimes experience numbness, tingling, or “needles and pins” sensations. Pain descriptors vary between patients, and don’t reliably identify the etiology. Pain may worsen with activity or with wearing clothes over the affected area, or may have a daily pattern.
A neuropathy diagnosis involves signs of sensory dysfunction on physical examination accompanied by correlating evidence of nervous system injury. There may be motor dysfunction as well. Patients often develop secondary myofascial pain. Negative findings on diagnostic tests do not rule out neuropathic pain.

Certain physical examination techniques help to identify abnormal sensory perceptions. Patients may have allodynia, a painful response to a typically nonpainful stimulus. Allodynia is elicited by brushing the affected area with a fingertip or cotton swab, or by thermal stimulation with a cold or warm object. Patients sometimes experience hyperpathia, an exaggerated pain response to a minor painful response, such as pinpricks. The pain tends to increase with repeated exposure, may spread outside of the contacted area (summation), and may include painful after-sensations.

Neuropathic pain clearly can impact a patient’s ability to carry out his or her activities of daily living (ADLs). Increased pain during the night interferes with sleep. The patient may have difficulty ambulating without feeling pain. Handling eating utensils or tools may cause pain. The patient may guard an affected painful limb, limit social activities, or develop depression.1,5 Pain relief is important to improve the patient’s quality of life.


Here is an indepth article from the Mayo Clinic 2006 "CONSENSUS GUIDELINES:
ASSESSMENT, DIAGNOSIS, AND TREATMENT OF
DIABETIC PERIPHERAL NEUROPATHIC PAIN"
http://www.mayoclinicproceedings.com/pdf/DPNPSuppl.pdf

Meki, Please check out this warning regarding interaction with the liver.

http://www.lilly.ca/searchable/media/hcp/cymbalta.pdf

January 28, 2008
CYMBALTA™
IMPORTANT SAFETY INFORMATION
SUBJECT: CYMBALTA™ (duloxetine hydrochloride) Now Available in Canada for the symptomatic relief of major depressive disorder (MDD) and the management of neuropathic pain associated with diabetic peripheral neuropathy (DPN).

WARNING on Potential Hepatic Events
Dear Healthcare Professional:
Eli Lilly Canada Inc. and Boehringer Ingelheim (Canada) Ltd. are pleased to inform you of the launch and availability of CYMBALTA™ (duloxetine hydrochloride). CYMBALTA is a selective serotonin and noradrenaline reuptake inhibitor (SNRI) for oral administration. Please note important information on the safety of CYMBALTA.

Warning on Hepatic Effects
Severe elevations of liver enzymes (>10 times the upper limit of normal) or liver injury with a cholestatic or mixed pattern have been rarely reported, in some cases, associated with excessive alcohol use or pre-existing liver disease.

• CYMBALTA is contraindicated in patients with any liver disease resulting in hepatic impairment.
• Because it is possible that duloxetine and alcohol may interact to cause liver injury or that duloxetine may aggravate pre-existing liver disease, CYMBALTA should not ordinarily be prescribed to patients with substantial alcohol use.
• Patients and healthcare professionals should be aware of the signs and symptoms of liver damage (pruritus, dark urine, jaundice, right upper quadrant tenderness, or unexplained “flu-like” symptoms) and healthcare professionals are encouraged to investigate such symptoms promptly.

Background
CYMBALTA increases the risk of elevation of serum aminotransferase levels. In clinical trials, the median time to detection of the aminotransferase elevation was about two months. In these patients, these were usually transient and self-limiting with continued use, or resolved upon discontinuation of CYMBALTA.

Post-marketing reports have described cases of hepatitis with or without jaundice, reflecting a mixed or hepatocellular pattern of liver injury. Post-marketing reports indicate that elevated aminotransferase, bilirubin, and alkaline phosphatase have occurred in patients with chronic liver disease, cirrhosis or excessive alcohol use.
The above information is included in the approved Product Monograph for CYMBALTA and comes from clinical trial data and worldwide post-marketing reports.
Usual Recommended Dosing and Administration for Adults
Please review the complete Product Monograph for detailed information before prescribing CYMBALTA.

Major Depressive Disorder:
The recommended dose is 60 mg once daily with or without food. A lower starting dose of 30 mg may be considered for tolerability reasons in some patients, with a target dose of 60 mg/day within 1-2 weeks. Therapeutic response is usually seen after 1-4 weeks of treatment.

Diabetic Peripheral Neuropathic Pain:
The recommended dose is 60 mg once daily with or without food. A lower starting dose of 30 mg may be considered for tolerability reasons in some patients, with a target dose of 60 mg/day within 1-2 weeks. Efficacy of CYMBALTA has been demonstrated within the first week.

CYMBALTA was initially approved in the United States for treatment of MDD in August 2004. Subsequently, CYMBALTA has been marketed in 59 countries worldwide. During the first 3 years of post-market experience worldwide, it is estimated that over 9.5 million patients have been treated with CYMBALTA, accounting for over 3.1 million patient-years of therapy.

Take care of yourself and let us know of any news.
All the best to you.
You always make me smile!
Hector
476246 tn?1418874514
Welcome back. I'm sorry to hear that it is so difficult for them to find out what it really is. I hope that the meds are going to work and relieve you of this horrible pain you are feeling. And that she won't find anything else.

Hugs, Marcia
92903 tn?1309908311
Sorry for all your woes Meki - I hope you guys figure it all out soon.

"AN ELEPHANT HAS BEEN SITTING ON MY SHOULDERS". <-- This gave me quite an alarm, as I've seen first hand what a parrot can 'doo' sitting on a shoulder - but an elephant? Now that could leave quite a mess. That discount from teh rental car may go back in cleaning fees LOL.

Take care :)  
Avatar universal
Check out psychosomatic illness, all your info sounds stress related to me.
148588 tn?1465782409
My neurologist Rxd Lyrica for the type of neuropathy Hector described - damage to the nerve sheaths due to too high blood sugar. I chose not to take it and went on diabetes meds (Metformin) and lost 25 lb instead. My understanding of Lyrica is that it slows nerve impulses down (also used as an anti-sezure med) and must be weaned off of to prevent seizures. I had this option since my neuropathy manifests as numbness rather than pain.
Avatar universal
Hiya lady! My hubby is on Cymbalta for trigeminal (head/ face nerve) pain that mimics cluster headaches. it seems to be working so far...It has a lot of really horrible potential side effects, but so far, it seems to work...He was cautioned not to use alcohol or any other seretonin inhbiting meds with it..When he was first put on it, he was taking Topamax and Imitrex just before and had a Seretonin syndrome develop...So, if you start shaking, feel jittery and have bad insomnia, it may be that...If you drink ANY alcohol while on it, it damages your liver and can cause hallucinations....Pay attention to your labs and what they show for your calcium, potassium, and magnesium levels. any one of these being low can increase/ cause muscle/ nerve pain as they are crucial in the conduction of nerve impulses...Hope this helps! Good luck on finding some relief!                        ~Melinda
253566 tn?1219683299
Hi meki,

I wonder if we are related as I seem to have that same bad luck gene or something.

Good luck in your search. It continues for me as well and my heart goes out to you.

hugs,
frank
167203 tn?1280695680
Hope you can get all the pain woes figured out. I too have pain in my shoulder blades, and neck all the time. I am so sick of Dr's at the moment that I'll deal with that later.

Goofydad...LOL...Elephant vs. Parrot(this could turn into another poopy thread!LOL)

Meki...We love you!!!
Avatar universal
Thanks for the update Meki, for this is a problem I will have to address as well. As I've mentioned to you, I had a bit of hip/leg aching prior to tx, but it diffinitely has worsened during the last 18 months of treatment..I would appreciate it if you could detail further the tests you have already had and the methodology you and your docs have employed to narrow the possibilities and get to the root of the problem(what type of blood tests have you had to check for fibromyalgia and or autoimmune problems, etc.).

I've only had X-rays of my hands and wrists, supposedly to determine if I had arthritis (they said I do not) and I had my cryoglobulin level check and told it was OK. I guess I should go see my GP and start there, is there a particular specialist one would seek out for this problem?
TIA, Pro
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