Tag Archives: pain management

Sigh-Atica Part 2

My pretty IV. Never had one that’s pink and purple before.

just like I never had sciatica land me in the hospital before.

it’s been a wild two weeks. I had faith that my doctor’s conservative treatment of steroids and nerve pain medication at bedtime would do the trick.

just like I had faith in him. For the past twenty years or more.

Exactly one week later on Monday, I returned to his office, after making it clear to his staff that it was either his office or urgent care.

Can you be here within the hour? they said. I could and I did. He suggested that we increase the nightly nerve pain medication dose and that I start a narcotic to treat the pain that had settled like hot daggers in my calf. Plus Motrin 600 mg every 8 hours for pain as well. And he would order an MRI.

I said, what about the inflammation? He said since the steroids didn’t work, why repeat them? He said that the Motrin would help with that too. Now, he knows who he is talking to. I gave him a look and all he said to me then was, “OK, Irma?”

Since this wasn’t McDonald’s, I couldn’t change my order at will. I took my prescriptions and limped to my car where my husband waited. I scheduled the MRI, the soonest was Thursday, while in the car waiting for prescriptions to be filled.

The pain was doing me in. Especially in the mornings. I don’t cry easily, but I did a lot of crying Tuesday, Wednesday, and Thursday morning. Bent over whatever countertop I could get to, I bawled with the pain, a walker at my side. We ended up with two of them from when my husband had an MI five years ago, and boy, did they come in handy now.

I ended up taking one Motrin 600 mg. It tore my stomach up. I took it with trepidation, but I was desperate so I took the plunge. I lived to regret it. The narcotic he put me on was like taking water for the pain I had. I sought relief from hot showers, letting the water soothe my leg. And from my trusty heating pad, half expecting to incur 3rd-degree burns before it was all over. Sleep? What was that?

I made it to the MRI on Thursday evening. I was glad it was an evening appointment because that was when my pain was near tolerable, but still, lying in that constricting tube with my eyes tightly shut, my ears plugged with soft foam plugs, and covered with heavy headphones that were supposed to provide music, music that was overpowered by the loud clicking and clanging noises of the machine, all I could think of was that my leg was hurting me. I had to lie flat on my back, and that position was not the most forgiving. And I had to lie still, 30 minutes the tech said. I couldn’t move, even if I’d been able to, wedged in as I was.

That night I made an effort to sleep, but by 4 a.m., when I’d struggled to the bathroom, I lay in bed and cried. I knew the gig was up. It was time for the ER. I took one of my fake pain pills, and gave it an hour. Meanwhile, my husband was up and ready to go. Don’t push me, I said.

We got to the ER at 7 a.m. and it was blissfully empty. Not a soul except the staff. That was a bonus in this covid age. I was in the back getting an IV started within 10 minutes. My nurse was this cute little guy that could have been my son. He pushed Dilaudid and Decadron into my vein and smoothly removed those boiling, hot daggers from my leg. I almost cried again with relief. They’d been in there for over a week.

I had a barrage of doctors come by. They all agreed on the treatment, steroids to reduce the inflammation around the nerve, potent narcotics for pain, a strong muscle relaxer, double the administration of the nerve pain medication, among other meds, and admission until pain controlled sufficiently to go home.

A neurosurgeon had been called and he was the first to arrive. I saw the MRI, he said. You have a slipped disc which is causing pressure on the nerve. It’s a slight protrusion he said, but you have degenerative changes and I would not want to go in there to fix it. Thanks, RA! was my first thought. But I didn’t want him to go in there to fix it, either.

An injection into the nerve was also suggested, but I decided to make that plan B. We would go with the meds, body mechanics, exercises, and physical therapy first.

Last night, I had another great nurse. We spent half the night talking. When the day nurse had asked me what I wanted to share about myself on the info board in my room, I said I have RA, thinking clinically. And she said no, something personal, so I blurted out what I like to do best, reading and writing. He noted that and the conversation started from there and went on most of the night.

He held my hand on the way to the bathroom and back. This was an observation unit where the rooms do not have their own bathrooms. It wasn’t far from my room, but it might as well have been miles away. And once on the way back, which was the most painful part as my nerve was now awakened to the fact that I was upright and moving, I said the bad word that rhymes with truck.

I immediately said sorry, but he started laughing. By this time we felt we knew each other, and he said, I never thought I would hear that word from you. And then I started to laugh, in-between gasps of pain.

I fell asleep between 3 and 6 a.m., when he woke me up for my meds. And later, when I managed to get to the bathroom alone as the day nurse didn’t respond to my call, I discovered that half my pain was gone! It only hurt from the knee down and that was cut in half as well. It was hallelujah time, and time to arrange for going home. The meds had made progress in less than a day.

The board in my room.

Inner Peace and Invisible Pain

I have survived over a week with shingles and I have to say it was not easy. After having four kids, and RA, I should have a high tolerance for pain, I would think. Apparently, I do not.

But then again, the above mentioned wasn’t nerve pain. That falls into a category all by its unique self. I call it the invisible pain.

The rash has subsided, gone to pink again, but the swelling persists. I have a lopsided belly and my hip area is exquisitely tender, yet hard to the touch. I had no idea there was so much swelling involved with shingles. And since it’s the right side of my belly that’s inflamed, I feared for my liver. After nine years of methotrexate, I should fear for my liver!

But, my doctor palpated and said it was fine, just inflammation. A word I’m all too familiar with. And because of its immunosuppression side effects, he took me off the mtx until further notice. Today, I should contact my rheumatologist and tell him about it. Maybe he wants to start something else.

I’ve hesitated to call him because I’m afraid he’ll want to see me and a visit to him is a three-hour sitting around marathon. I can’t sit right now, not for three freaking hours! But, perhaps we can speak on the phone.

I never thought something could make RA take a back seat, medically speaking, but hats off to shingles. The pain is akin to having a flaming torch applied to your side, while a thousand knives hack away at you by turns.

After twelve days, the temperature on that torch is somewhat diminished and the number of knives has decreased to the hundreds. The area they now concentrate on is thankfully smaller. Maybe that’s why the effect feels lessened.

Yet strangely, amidst all this, I feel inner peace. I am being tenderly cared for, dare I say even pampered and catered to. I’m receiving the type of medicine one can’t buy, and has no price. One whose value can never be quantified, and best of all, comes with no side effects.

Unless, you count love.

Maskerade

RA is such a handy little villain. So easy to blame for whatever feels wrong. If I’m tired, I blame RA. If I’m fatigued, I definitely blame RA. If my joints ache for any reason, it’s RA’s fault. If my hands are stiff, sore and swollen, well, we know why, don’t we?

So, this past week my hip hurt. Bad. Immediately, I thought bursitis. It’s back. Suck it up. It’s RA at work again. I downed some of my friend/nemesis, good ole Prednisone. 20 mg. Take that, RA.

But the next day, there was no improvement, rather it felt infinitesimally worse. How could that be? I downed another 20 mg. And what struck me as strange was that it did not hurt to walk. That did not jibe with bursitis, but I pushed that to the back of my mind and concentrated on the exquisite pain I felt just touching the skin around the right side of my pelvis.

I added the heating pad to my regimen, sleeping on it, exactly like you’re not supposed to do. I depended on its automatic shut-off. And anyhow, who was sleeping? 10 mg of Flexeril afforded me three hours tops. The pain was King!

Soon there were bags under my eyes from sleep deprivation and a funny little trail of pink dots over my hip. “I don’t like the looks of that,” said my husband. “Stop using that heating pad.”

But of course, I didn’t. It was palliative; it was a placebo for my pain. The dots got bigger and redder. But still I could walk without the slightest limp. How could it be bursitis?

Yesterday I caved. Went to the Urgent Care. My heart rate was 108, my BP was 160 over what I don’t remember. My systolic BP usually runs between 110 and 120, my heart rate 80 something.  Yep, I was in pain. In so much pain, I couldn’t even multiply 2.5 times 6 to tell the nurse what my weekly Methotrexate dose is. Me, who could calculate IV drips in my head couldn’t multiply simple numbers.

Later in the exam room, my husband verified that 2.5 x 6 was 15; I was on 15 mg of MTX. The doctor came in, did the normal drive-by history, then took one look at my hip and said, “Aha, you have shingles.”

Shingles!! (Insert four- letter word here!)

Well, blow me down. I’d never even seen a case of shingles in all my years of nursing, though I have read about it. Read about how painful it can be. And ironically, I just finished a course on pain management for my license renewal. How providential.

I was given a shot of Toradol along with some sympathy. The Toradol is for pain and inflammation, the sympathy was a bonus from the nurse. And then, I was sent home with a long list of prescriptions. The Percocet makes me sleepy and dizzy, so I’ve been catching up on my sleep.

But the Lidocaine patches, mercy me, what a blessing. They suck away the peripheral pain from all over my right side. I can touch now without causing that electrifying agony, and paradoxically, my sensation is returning. My skin had felt numb, yet on fire. Neuralgia is a funny thing.  So funny, it almost made me cry.

Now, I have to concede that RA is only indirectly involved in this little incident. The meds I take for it leave me immunosuppressed. But this taught me something. To not let RA mask what might be truly going on. I suffered for four days needlessly. I should have sought treatment sooner. I shouldn’t have waited and self-treated. This lesson was driven home quite piercingly.

Meanwhile, the nurse said I am contagious so I had to tell everybody to stay away for a week. I won’t have my little ray of sunshine this weekend.

smile

My best medicine. A loving smile from my cutie.

My Lover, My Friend

I’ve been trying to say goodbye to my friend called Prednisone. Or at least, so long. He’s a good buddy to have around at your beck and call, as long as he knows his place. His place in the medicine cabinet, that is. But, I think he loves me more than I love him, because he’s gotten a reprieve. Not only will our connection not be decreased, he will stay on board a bit longer.

I was all set to start our goodbye process, a process that can take weeks, even months. We’ve been intimately involved since March when my right hand suffered a blow, or rather a blow-up. It became so swollen and painful, it was basically rendered useless. My left hand jumped into the fray and compensated as best it could, but the only thing that tore at the devil called Pain was my bestest friend.

Candy, I used to call him, though he is a bitter pill to swallow, literally. Every morning he’s there, waiting patiently for me. I want him, but I don’t want him, even though he does make me feel good, spry, nimble, young again.  Like a lover, he gives me a good feeling all over, once that initial swallow of tea takes him down into my innermost.

We will have to continue our relationship through the rest of the year, I suppose. He has a new area to caress and concentrate on. My chest, right over my heart. How ironic is that?

Costochondritis, my doctor calls it. A fancy word for swelling of the cartilage that connects each rib to what is commonly called the breastbone. This pain is not as severe, but then I don’t use my chest like I do my hands. Though one thing it does have in common with the hand pain is that it’s there all the time. All the time.

So, when I leave for The Big Easy in a few days, my good buddy will be first and foremost on my list. I was going to take him along anyway, as insurance. Now, he will go with me as assurance.

Green Bananas

Why is there a picture of bananas on a blog about Rheumatoid Arthritis? Maybe because I am bananas to think anyone will read it.

Maybe it’s because nutrition is so very important in the management of any disease process. And it is of prime importance in the maintenance of a healthy body. Our bodies are made to run like well-oiled machines, but sometimes that oil pan springs a leak.

Maybe because to me, yellow is the color of hope. And the color of sunshine. The sunshine that brings welcome warmth to our aching joints and lights up our day, bringing us out of the darkness whose name is pain.

Yellow is also the color for caution. As we move from stoplight to stoplight in our lives we must proceed with caution. It is what rules the life of someone with RA. We must take care not to overdo, for that invites the pain.

We must also take care to DO. Exercise and motion keeps those joints fluid. True for any body, more so to a body with RA. Use it or lose it could not be more applicable.

As I use this forum to share, connect and inform about my disease, I look for the color green. For green means go. I want to go. Go on with my life, go on with my future, the best way I know how, for me and for those whom I love and love me.

And no, no green bananas for me.