Thursday, March 18, 2010

Nerve Agony & some Relief

Pudendal Pain and Sciatica

My neuropathy has been going off the scale painwise the last few days.  Went to urgent care Tuesday afternoon just to make sure I didn't have a urinary tract infection or a problem with The Belly.  Sometimes I get in so much pain everywhere it get's hard for me to determine what is happening.  When the tests for that came up negative, I then got an appointment with my PCP yesterday to see what I could do for the nerve pain.  He presecribed a medication that is in the muscle relaxant class, but seems to disconnect the nerve pain somewhat from the brain, called Soma or carisopordol. 

I am down to where it is very painful to walk, lie down, stand, sit, or drive a car.  I think its a combination of all the walking and standing I did at the client's last month, the prodding and poking at my cancer exam, and trying to clean house like a normal person (mop and vacuum).  My feet are freezing, but the pain is like fire through the bottoms of my feet.  The muscles in my right leg are all bunched up (the right side is more painful this time) and I have nerve pain right through the middle of me in the "saddle" section.  The percocet I have doesn't even touch this level of pain.

My PCP said that lack of sleep lets the pain build up because sleep lets the nerves discharge and the muscles rest.  Well, I've not been able to sleep well for months, but last night I was able to.  He said I need to just sleep for a couple of days, take the percocet and Soma and see if I can get the aggravated nerves to go back to sleep.  Not sure if I can, we are short handed at work.  Not sure if I can work, I am so in pain. Augh!

I was able to work from  home yesterday, but the problem is that sitting up very long is very very painful.  I haven't called in yet.  I feel so bad for my bosses.  I just get myself where I maybe can be really productive and something like this happens.

My PCP and I discussed my longterm prognosis with this being from radiation side effects.  Not good.  Probably more pain, more disability in my future.  However, I did sleep last night with the Soma. I am in quite a bit of pain now, thinking I should take another one (one every twelve hours is the script and it's been over 12) but will check with the office first.  I wonder if it helps headaches?  The percocet makes The Headache worse.  My PCP seems to think I have high tolerance to pain, but I feel like my pain tolerance is very low for me.  Maybe he sees more people with pain, and in comparison I'm tougher??  Or maybe he just wanted to boost my spirits.

Here is a pain scale from the Pudendal Pain website I found, it is one of the best pain scales I have found out there because it describes in detail the levels, although some migraine sufferers I know can have pain in the 9 or 10 range also.  I think I am at an 7 with the nerve pain going towards a non-functional 8.  Maybe I should take the medication, eh?

 

Comparative Pain Scale
0
No pain. Feeling perfectly normal.

Minor

Does not interfere with most activities. Able to adapt to pain psychologically and with medication or devices such as cushions.

1

Very Mild
Very light barely noticeable pain, like a mosquito bite or a poison ivy itch. Most of the time you never think about the pain.
2

Discomforting
Minor pain, like lightly pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails. Note that people react differently to this self-test.
3

Tolerable
Very noticeable pain, like an accidental ut, a blow to the nose causing a bloody nose, or a doctor giving you an injection. The pain is not so strong that you cannot get used to it. Eventually, most of the time you don't notice the pain. You have adapted to it.

Moderate

Interferes with many activities. Requires lifestyle changes but patient remains independent. Unable to adapt to pain.

4

Distressing
Strong, deep pain, like an average toothache, the initial pain from a bee sting, or minor trauma to part of the body, such as stubbing your toe real hard. So strong you notice the pain all the time and cannot completely adapt. This pain level can be simulated by pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails, and squeezing real hard. Note how the simulated pain is initially piercing but becomes dull after that.
5

Very

Distressing
Strong, deep, piercing pain, such as a sprained ankle when you stand on it wrong, or mild back pain. Not only do you notice the pain all the time, you are now so preoccupied with managing it that you normal lifestyle is curtailed. Temporary personality disorders are frequent.
6

Intense
Strong, deep, piercing pain so strong it seems to partially dominate your senses, causing you to think somewhat unclearly. At this point you begin to have trouble holding a job or maintaining normal social relationships. Comparable to a bad non-migraine headache combined with several bee stings, or a bad back pain.

Severe

Unable to engage in normal activities. Patient is disabled and unable to function independently.

7

Very

Intense

Same as 6 except the pain completely dominates your senses, causing you to think unclearly about half the time. At this point you are effectively disabled and frequently cannot live alone. Comparable to an average migraine headache.

8

Utterly

Horrible
Pain so intense you can no longer think clearly at all, and have often undergone severe personality change if the pain has been present for a long time. Suicide is frequently contemplated and sometimes tried. Comparable to childbirth or a real bad migraine headache.
9

Excruciating

Unbearable
Pain so intense you cannot tolerate it and demand pain killers or surgery, no matter what the side effects or risk. If this doesn't work, suicide is frequent since there is no more joy in life whatsoever. Comparable to throat cancer.
10

Unimaginable

Unspeakable
Pain so intense you will go unconscious shortly. Most people have never experienced this level of pain. Those who have suffered a severe accident, such as a crushed hand, and lost consciousness as a result of the pain and not blood loss, have experienced level 10.

6 comments:

  1. Good to know I am at Utterly Horrible :) Hope you feel better soon Emmy... (by the way, with the meds that help, for 2 hours every 6 I am only at Intense.. not so bad really.)

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  2. For two years I went from Very Intense to Utterly Horrible to Excruciating Unbearable to Unimaginable Unspeakable and back down every 4 days. It's bad with Intense pain seems like God sent relief!!!

    The Soma is helping with the nerve pain, it's still there even with soma, percocet and phenergan but I think I may have drifted back to intense since I took my meds about an hour ago. Maybe my blood pressure will go down now.

    Don't know how you do it Shel! You are tough pioneer woman stock.

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  3. Wow. I'm so sorry for your ongoing struggles. I wish I had a magic wand for all of us....

    I'm with Shel - I'm glad to know that what I have often called "Utterly Horrible" is absolutely correct! Now I can say I spotted an 8 for what it was before I even knew it! See? I knew there had to be a silver lining to utterly horrible.

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  4. If the description of the pain wasn't so durn accurate, it would be funny.

    Being Utterly Horrible myself at times I think the description is right about the personality changes. I don't think you feel about yourself the same after dwelling in Utterly Horrible land too long.

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  5. Winny, I know your constant agony with pain! Great chart to compare. I probably compare to a #4. I know I have a high tolerance for pain though. ((((WNPP))))

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  6. "distressing" sounds bad enough!!! #4 just doesn't have the umph the description does....

    I think my pain tolerance is lower since experiencing non-stop ouchiness for several years. Thanks for the hugs!

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