Monday, May 24, 2010

Jacob's Ladder

We are climbing Jacob's Ladder
We are climbing Jacob's Ladder
We are climbing Jacob's Ladder
Soldiers of the cross

Went to see Dr. C. (pain management specialist). I have gotten a lot more relief from the epidural cortisone injection than I did when I had the facet joint cortisone injections. He is puzzled by this, since he thought the MRI ruled out any nerve involvement with my back pain and spasms. And since I do not have sciatica, and haven't since I had the surgery in 1992, the epidural really should not have done squat.

I asked him today about the spinal chord stimulation. He said he thought I would not be an optimum candidate for it, because I do not have the sciatica. But he also said he would keep my file with him and ask a couple of his colleagues what they thought.

Now that I am to the point that the slightest wrong move does not send me into excruciating pain and soul crushing muscle spasms, I will be starting physical therapy to strengthen my core muscles and stretch my back muscles.

Here is where the climbing Jacob's Ladder thing comes in. We have worked from relatively mild anti spasm medications (Flexeril), to medium (Skelaxin), to strong (Soma). We have now left Soma behind and have moved up to Baclofen. He is starting me on a really low dosage, and probably will bump it up later as I am able to tolerate it. Quite frankly, after taking my first dose a few hours ago, I am thinking I may go back down to the Soma. The half tablet I took today has sucked the life right out of me. I feel listless and like I have been dragged behind a truck for 5 miles. There is no way I can function like this, and will likely only be able to take the Baclofen at night. Of course, I can only take the Soma at night as well, because of the drowsiness and lightheadedness. UGH. I am wondering if the Baclofen is something I will get used to so I don't feel like this every time I take it. If not, the next stop up the ladder is Neurontin.

I also had the "You know, doctor, you have me on some heavy duty drugs...and I worry about dependence" talk with him. Having been prescribed the various muscle relaxers and having the standing Vicodin ES prescription, there is cause for some concern. Ultimately, only I know whether I am taking the meds inappropriately or not (I have not taken them inappropriately so far, but the potential is strongly there, and I am at least aware of it). But for me, it added a measure of safety for me to be able to have this conversation with him. Dr. C. reassured me that I was not using the meds excessively and that he would not refill them if he thought I was.

Dr. C. seems to think that some of my problems are related to the buildup of scar tissue around the laminectomy site. That and the osteoarthritis of the facet joints are probably the crux of my issues. And sadly, there may not be a permanent fix for it. He said, at my last visit, that although there is some compression of the discs, that lumbar compression was not the major thing causing my pain and spasms. This may be as good as it gets. And that makes me kind of sad.

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