Monday, April 27, 2020

Back to the present.

Correspondent and non-commenter Mr. Philbin wonders how my back is doing. This may come from the goodness of his heart, or indeed it may come from his desire to inherit my vast collection of Precious Moments figurines upon my passing. As I have drawn up no will, at this time no non-family member can expect to get anything. Sorry, Philbin old boy.

As for the question, though, regular readers of this site (you handsome devils, you) will recall that last February some spinal issues landed me in the hospital in absolute agony. I haven't mentioned  much about my medical progress since, only my financial progress, as bill after bill keeps coming in from my two-night stay. Just FYI: Business Insider says the most expensive hotel in Manhattan is the Central Park Ritz-Carlton, whose rooms start at $4,000 less per night than my hospital bed (not including doctors or treatments or drugs or tests, which are billed separately).

Anyhoo, what about the back itself? When I left the hospital, in grave fear of a relapse, I could not walk more than a hundred feet without shooting pain in my back and/or my leg. Follow-up care with a pain specialist and another spinal injection barely made it scarcely better at all. I was forced to order groceries for pickup and abandon walking the dogs. I wondered if this was going to be as good as I would get for the rest of my life.

The problem is
in here somewhere.
By the time I was due for a follow-up to the follow-up, my pain doc was doing virtual appointments because of the Wuhan Death Virus. I figured he would suggest trying more shots, or maybe go straight to surgery, but to my surprise he recommended... an antidepressant.

What the hey...?

Yep, duloxetine (known as Cymbalta to its friends) is an SNRI drug that for some reason treats chronic musculoskeletal pain (also diabetic peripheral neuropathic pain). I have taken antidepressants in the past, for (duh) depression, and was not eager to go back on one. But I was sick of debilitating pain and was willing to try almost anything.

And what do you know: It works.

I've been able to do normal supermarket runs now, and have walked the dogs for a mile or so at a time without having to stop and wait for the pain to subside. I do have some weird leg and foot cramps and the odd shot of pain, and sometimes a cold feeling in my back where the disks went flooie, but it's almost normal. I am not advised to do very strenuous things, like tossing cabers, but the fact that I'm able to do normal things without suffering is almost a miracle compared to how I felt that night I came home from the hospital.

Now, duloxetine does not actually change the situation; it doesn't put slipped disks back in place or heal bone or anything. I am mindful that the whole spine issue could come crashing down on me again. The doctor said these things can improve on their own, so I have hope. But it's definitely improved the pain situation, so thumbs-up for that.

The funny thing is, I don't think the drug has improved my mood at all. It ranges from kind of average to bleak, depending on my worried fixation on money and quarantining and things, probably like everyone else. I think it makes me drowsier, and certainly the naps have been more frequent. But we have plenty of coffee, so I'll get through.

Thanks to everyone but Mr. Philbin for the kind wishes. You're not getting my Precious Moments, pal.

5 comments:

  1. Be careful.

    My doc prescribed gabapentin (Lyrica) for chronic pain following a discectomy and fusion and it made me feel GREAT.

    Until a couple of years later when I decided to go off it. Withdrawal was extremely difficult, mostly as stomach pain and a blacker than black mood, took several weeks to dissipate. This was at a low dose ~25mg per day. Some people are taking 10 times that dose.

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  2. Eek! I'm doubly glad the doctor didn't go that route with me.

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  3. Glad you have found something that works, Fred. I took gabapentin at a high dosage for post-herpetic pain for a period of several months. I thought it interfered with my cognition (my wife concurred). I still have a lesser level of the pain, but have no desire to touch the stuff again. Aspirin and topical anesthetics for me.

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  4. Thanks for the update. I'm glad you were able to get something that helps.

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  5. Wow. I got prescribed gabapentin 300mg 3x day for peripheral neuropathy including pain in my feet. Seems to help but I also get arthritic pain in my joints all over my body.
    I'll have to bring up the effects of stopping with my diabetes clinic PharmD.

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