Wednesday, February 16, 2011

The verdict from the pain doctor.... 

Went to see the new pain management specialist, and my first reaction was RELIEF! The doc was nice, intuitive and smart. I have gotten incredibly defensive and paranoid about seeing new doctors after some of the awful experiences I've had (several of them in Sioux Falls, unfortunately). With fibromyalgia and sero-negative Sjogren's, I've gotten used to having to prove to every new MD that I really do have both, and that I really am too sick to be able to work. But I handed this doc my considerable list of problems, and instead of challenging it or patting me on the head telling me that I look great (which happens a lot), she said that it definitely fit the profile of someone with severe fibromyalgia, CMP and autoimmune arthritis. It is rare to find to find MDs that know much about chronic myofascial pain; she explained to me that my trigger points are part of the reason I have so much trouble with exercise.

I had a brief physical exam where she checked strength and range of motion in my limbs and in my back. I thought I did pretty well except when she touched my right foot and I yelped. But she was very concerned with my trapezius muscles, which are hard as rock. She pointed out that they are pulling the spine out of alignment & aggravating the fibromyalgia.

She did suggest looking into taking Savella, an anti-depressant of the SNRI variety, since that's pretty much the only pain medication I hadn't tried. But I expressed concern about potential side effects, and she conceded that, due to my experience with permanent damage from serotonin-altering medication, it might not be worth the risk to me. I am just too sensitive to anything that crosses the brain/blood barrier. So we are going to skip the medication route, which is more than okay by me.

What we ARE going to do, though, is intensive mysofascial therapy including ultrasound and trigger point injections on the trapezius muscles. I will go to a physical therapist three times a week for four weeks starting on Tuesday. And I will go back to her to report on my progress on March 8.

What was even more cool was that she was impressed by, rather than dismissive of, the knowledge I have of my ailments. She encouraged me to continue what I am already doing to stay healthy like water therapy, spinal stabilization exercises, chiropractic, etc. It was refreshing to not be chewed out for not exercising harder.

She was realistic and honest, which I prefer because I can handle the truth. She said that while there is no way to cure me, it is definitely possible to prevent my getting any worse. The goal is to diminish the sources of pain enough for me to become more active. That would be awesome!

I have done PT many times. I was doing pretty well in my last sessions in 2006 for rehab of my lower back (old permanent injury of right SI joint and a compressed disc). Unfortunately, my husband had to change jobs, and his new employer only offered insurance that wouldn't cover ANY of the treatments, and I had to discontinue it abruptly. But I kept doing strengthening exercises at home, and I still do them.

I am willing to do the PT, ultrasound, injections, etc. as long as the insurance will cover them. I wish money wasn't an issue, but it is. I don't mind pain so much if I know that eventually I will obtain some mobility or other long-lasting benefit from it. What really gets me is how exhausting three times a week is. But I will do it no matter what.

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