I don't know, but I won't give up. Not entirely. Sometimes I take breaks, but I keep doing research, keep looking for studies and new solutions. Recently I found a new term when searching for a solution to my IBS pain that's been acting up. IBS stands for Irritable Bowel Syndrome — which is a catch all for unexplained diarrhea and constipation when other diseases have been ruled out. I used to just have diarrhea, but now since I've been on and off Percocet for four years I get what they call, "alternating" IBS which means I have both. Oh and with the constipation I get stabbing pain in my lower abdomen right before I move my bowels. How exciting. At least I get a one minute warning bell before I need to get to a bathroom.
Sigh. Why don't gastroenterologists take my pain complaints more seriously? Well one of them did, but she thought it must be from adhesions. Adhesions are scar tissue from my c-section (that had happened three years earlier.) Well I had surgery to see if that was the cause, and um, it wasn't. She doesn't take my insurance so I went to a new one. She told me I had the thyroid disorder right before I went under for a colonoscopy, and that was right after the anesthesiologist expressed concern for my doctor prescribed usage of Percocet for my debilitating back pain. "You're too young to have this much pain." Right doc, you got any fucking answers? I mean shit. Why do doctors think they should be talking to a patient whom they've never met before while she's naked in a gown being wheeled on a gurney?
Ugh. Okay. I have a mantra of no anger. No anger. Can't afford it. And the fact is that doctors are as limited in their knowledge of pain conditions as I am. And for whatever reason it has apparently become the patient's job these days to keep track of their health and connect all the dots. I can either accept it, or get angry. So I accept it and keep looking for answers.
So I found a study about "Visceral Hypersensitivity." It's the newest research in digestive issues like heartburn, reflux and IBS. They've found that patients who complain of this kind of pain seem to be sensitized to visceral pain. Visceral is internal organ pain. Somatic pain is y'know external. In fact, people with visceral sensitivity tend to have a higher threshold to external pain. Which explains how easy it is for me to give blood, and yet the moment I have gas I'm crouching in the fetal position.
Anyway. The science is a little above my head, but the pain is somehow due to histamines and serotonin and all that kind of stuff. So old school anti-depressants and some kind of antihistamine that you can only get in Europe and Canada. So that is a no-go, until my husband or I travel to Canada. The old school anti-depressants are tri-cyclic. Americans being a depressed and anxious lot, those are a little easier to come by. Plus, it's supposed to help with neuropathic pain, and PMDD...does that sound like my new and perfect drug?
Well, sort of.
Within 24 hours of taking nortriptyline (Pamelor or Aventyl) I had already started to experience one of the side effects (dry mouth) and the next day I forgot to take Percocet until the evening because, frankly, for the first time in months I had no back pain. I've been an emotional mess the last two weeks, but notriptyline takes longer to have anti-depressant effects than it does to take care of pain. What's funny is that I took this medicine for IBS pain and have had it actually treat my lower back. So far this has held true. In the last couple of days leading up to my period I'm somewhat okay emotionally, but y'know I'm never great even on Prozac. So far, nortriptyline is stopping me from circling the black hole.
So it's treating my IBS (I think, I actually haven't had any in a while, probably more due to my probiotic that I take called Align) , lower back and the worst emotional effects of PMDD. What about menstrual cramps?
Nope. No go.
I didn't expect that to happen, but still it's kind of annoying to be able to start titrating off Percocet only to get sidelined by the mother of all pain. And my internist didn't seem to understand how bad my menstrual cramps actually are. I still honestly wonder what drugs would exist if men had to go through this every month. Okay, no anger, no anger.
My cramps have always been bad, but in my 20's I was able to stop them with ibuprofen. Not so anymore. They used to last about one to two days; now we're talking a solid four if not longer. Last month I was basically in a dream/drugged state for four days while on vacation having my period. It's brutal. And I get cramps for a week before my period too. I've read that this might be due to my thyroid disorder that's gone untreated for four years (can't get angry, can't get angry) but it's still pretty horrible. And I'm getting a bit angry at my internist who just told me to supplement the ibuprofen with Tylenol. What? Tylenol? That's, um, that's NEVER WORKED. Ugh.
So. No titrating off the Percocet until my period is over. Because for the past year I've had to take Percocet, Ibuprofen AND valium in order to control the menstural pain. How normal is this? And why is this okay?
It's not okay. Going to call my internist and talk to him about this in more detail. He seemed a bit rushed and distracted when I was there and to be fair I made the appointment to get an antibiotic for my sinus infection.
All those with nerve related back pain, bulging disks and whatnot? Nortriptyline seems to be a lifesaver. But who knows. I'm cautious these days. I'll give it a glowing recommendation once I don't have to take the Percocet anymore. Until then, I'll keep searching not only for a new drug, but a better solution.
