Still Doing Well

I feel quite fortunate to be able to say that even though the piriformis is still inflammed, I’m able to manage things. It is taking a little bit to get used to the new drug regime – cymbalta and nortriptyline – but I am getting  used to it. I really felt out of it for the first 5 weeks. The doctor told me to play around with the timing and I think that I have found a balance. I take the cymbalta at 1:30PM instead of at bedtime. I had a terrible time with my gut and pain which is what prompted the desire to change. That has been resolved and I am also no longer sleeping so much. I awake on my own between 6 and 7 which is my normal time.

Neuropathic Pain

I find it very interesting to see the pain managed so successfully with non-narcotic drugs. I’ve been in pain for years supposedly from my arthritis although my case is quite complicated. But isn’t everyone’s case different and complicated in other ways?

NSAIDs (non-steroidal anti-inflammatories) helped the pain but this was far from complete. And these types of drugs are not meant to be taken forever. The ideal case is that you get an acute inflammation from something eg spraining your ankle and you go on the NSAIDs for 10 days to aid with the healing.  Arthritis, however, is not an acute situation but rather is chronic. People go on the NSAIDs because of the pain and the drugs help to different degrees.Unless the patient is persistent about their level of pain, it often stops here. And the patients’ don’t know what is “normal” pain from arthritis. The one thing that they do know is they can’t manage many “normal” daily tasks and this can impact their quality of life (QOL) to varying degrees.

Update August 21, 2009

Well, I can hardly believe the difference between now and the last post. Let me start off by saying that the pain is well under control. In fact, most of the time during the past week I have not had any pain. That’s a show stopper.

Two weeks ago, I had to stop taking my Arthrotec (an antiinflammatory) because I was having the steroid injection into the piriformis muscle. I began taking Cymbalta several weeks prior to that. I’ve had to stop the NSAIDS before and couldn’t wait until the time I could start them again because of the increase in pain. Believe it or not, I didn’t even notice the difference. I was stunned. After a couple of days I thought the inflammation would come back and the pain would get worse. Nada. And now it’s been two weeks and I haven’t taken a single antiinflammatory.

Quinine?? Nocturnal Muscle Cramps and More

Hi Everyone

I saw a neurologist while I was in Mexico (in Queretaro). He’s fabulous. One of the many things that came out of the meeting was his suggestion to try quinine for my cramping.

I have Small Fibre Polyneuropathy which means that the small muscles fibres are always firing. That can be pretty bad and tiring. I also have Periodic Limb Movement Disorder which was diagnosed here at the UBC Sleep Disorders Clinic. All involve hyperexcitable muscles.

Anyway, I tried the quinine (325 mg) available by prescription in Canada and the US. I tried it in Mexico where it is available over the counter. Anyway, the spasms stopped. Maybe not all of the them but the ones that were in my legs and feet, arms and hands stopped. Just like that. It’s been about a month now and I can’t believe it.

Hot Yoga – Bikram’s Yoga

I’ll finish the post on the matwork but I wanted you all to know that I decided to try Bikram’s Yoga as it is a heated form of yoga and I seem to be responding so well to heat. The room is about 40 Celsius and it’s a moist heat. I was beginning to feel tight in my legs and calves from the elliptical and also in the back from the reformer. So I thought the hot yoga might balance everything out.

Move Just Move

I’ve certainly found out that moving is a key in pain control. And I do mean moving. Every 5-15 minutes I’m up and I might just walk around the house, do a few stretches and then sit down again. And since doing that I have not had to take anything for pain. I can’t believe the difference.