Friday, October 23, 2015

Pain Chronicles: A Relatively New Wrinkle

It seems like the day after my 8/19/15 appointment with my endocrinologist I've had this weirdness develop. It's a new issue related to an old issue if that makes sense. I have had a dull-to-agonizing throbbing pain and spasm in about 3-4 muscle groups from my neck/shoulder, elbow, forearm, and wrist on my right side. Chiropractic adjustments and deep tissue massages have not been able to unlock this pain mystery, though my chiropractor has been doing trigger point ultrasound therapy and that has helped minimize the pain temporarily.

While away on vacation at the end of August the pain amped up considerably, to the point where I called my chiropractor, worried that something was seriously wrong. Chiropractor arranged for an MRI to be done the evening I returned from my trip, and I scheduled an appointment with my physiatrist. 

Unfortunately, the MRI machine went offline the evening of my scheduled appointment, so my appointment was jockeyed to the next day and the only available appointment was scheduled two hours after my scheduled appointment with my pain doctor. Beggars can't be choosers, I had to accept this.

Pain doctor told me to bear with it an additional two weeks, and if it did not self-resolve by then, for me to come back in for an EMG so we could figure out, specifically, which nerve was involved, and then I'd move forward towards a discussion on how to address the situation.

I gave it two weeks, and procrastinated scheduling the EMG, as I felt the tiniest bit better. By three weeks, I thought I had turned a corner and was on the road to resolution. 

At current writing, about two weeks ago, I attempted to hang curtain hardware. Due to some peskiness with the drywall anchors I was using, it took an unusual amount of time to do a relatively simple task. Literally: Three hours. Granted, I took breaks, but even so it was approximately three hours with my arms above my head. As I was attempting to do this relatively simple task, a task I've done hundreds of times before in my life, I could feel something in me change. At first I thought it was just my mood being altered; however, I feel that the physical was affecting the mental, and I was more aware of being in a foul mood before I realized I was in crisis.

My spasms were back with a vengeance. My upper EMG was scheduled on 10/19/15, and to everyone's surprise (mine, my chiropractor, my physiatrist), my pain is not nerve related. All nerve activity was normal. So this leaves muscular or skeletal pain. Physiatrist sent me home with some samples of Flector patches (a transdermal NSAID) and said for me to call in a few days and let him know if they were helping.

To be honest, I don't know if the patches alone are helping or if it's a combination of the ultrasound therapy I do at night PLUS the patches, but I felt like there was some change, even if it were a small change.

So I called the doctor to have an Rx phoned in to the pharmacy, and if he could also call in an Rx for a muscle relaxant that would be very helpful. 

10/21/15 I had an appointment with my chiropractor (a standing appointment, not an on demand OMG I am in pain appointment), and I gave him the quick and dirty of what the physiatrist had to say about it not being nerve related. 

Trying to do a differential on my situation is interesting and challenging as I am not exhibiting any signs of auto immune related pain issues such as RA, PA, Lupus, so that leaves non-auto immune muscular-skeleton related issues (whatever THOSE might be--I'm still reading up on this).

Last night, I picked up my prescriptions, and took my first dose of Flexeril. After dinner, I did my usual ultrasound therapy and was able to drop off to sleep. I woke up this morning feeling ever-so-slightly "refreshed." I took a hot shower, put a Flector patch on, packed a Flexeril in my pill caddy for the day (Rx is written 2 daily as needed), and I am hoping for the best.

In the meantime, I am not doing any tasks that require my arms to be above my head, nor am I doing anything which requires my elbow to be bent for protracted periods of time.

I'm speculating that my situation might be  several separate issues flaring up in tandem: perhaps shoulder bursitis, tendonitis, and perhaps carpal tunnel (even though my right hand is my non-dominant hand, when I crochet, this is the hand that throws the yarn over my hook). My first impulse was to think it was possibly Double Crush Syndrome, however, from a neurological viewpoint, it doesn't look to be the case.

Note to self: First full day of both, Flector and Flexeril. Reassess situation in one week.