Soliciting Advice for Chronic Pain Management

[untonuggan]

So it's looking like I'm SOL regarding pain medication. I'm on Lyrica already; I can't take any kind of anything that messes with serotonin; NSAIDs are out with my gut the way it is; don't want opiates because All The Reasons.

My doctor wants me to go to a pain clinic; I'm not sure what they'll do other than offer me strong opiates or something and give me physical therapy, but I'm supposed to be getting PT for my dizziness so yes that would be out for insurance reasons alone, let alone me going bananas. Anyone have experiences to offer on pain clinics?

In the meantime, my side effect journey of daisies and rainbows and leprechauns has made me leery of adding more chemicals to my internal chemistry project. Like, I've *always* hated being on this many meds and just kind of grinned and born it. But seriously? This is frelling ridiculous. And so, yes. I'm looking for non-medication ways to keep this under control, at least until a neurokinin-1 antagonists maybe comes on the market approved for pain management. *crosses fingers* But that could be awhile.

So yes, I'm soliciting suggestions in this post for pain management. I will do my best not to immediately rule them out because, say, I've tried acupuncture and it didn't work. Nothing is too woo for this post. I just want a working list to, er, work off of so I can fucking knit and spin regularly again. (I have knit TWO ROWS this week and spun nothing and it's making me cranky, who knows what I would have done without video games.)

Thank you, dear circle, for all your support!

PS fewer seizures yesterday! woo!

PPS Yes standard disclaimer regarding I know you're not medical professionals blah blah won't sue you blah blah check with my doctor blah blah.

Comments

[spiralsheep]

I'm not a biochemist but... I thought some specific NSAIDS were "neurokinin-1 antagonists" or blocked pain pre-emptively at brain-level rather than after-the-fact at body-level? [insert vague hand-waving here] I read some studies a couple or three years ago when I needed to max out the efficiency of my anti-pain meds (cos bleeding insides, and can't take ♥ codeine ♥ for more than very short periods, &c). ::handwavium + pinch of salt::

Personal experience ahoy!

[spiralsheep]

Also, I hesitate to add this BUT you did ask so.... personal experience ahoy!

I've practiced several forms of meditation successfully for, erm, mumblety-years and the ignore-it technique of controlled dissociation (yes, I called the pig a pig, shocking I know!) works perfectly for my permanent LOUD tinnitus but doesn't work at all for any srs pain ever (and that's apart from potentially being a mental minefield for anyone already suffering dissociative disorders imo). My hypothesis is more or less this: my tinnitus is a symptom/side-effect of another physical process so my body-brain has no vested interest in whether I consciously pay attention to it or not ("lalalala... tinnitus? Y'okay then... lalalala...."), whereas my pain is a physical warning mechanism so my body-brain has a strong vested interest in making me pay attention to it ("HEY, SPIRALSHEEP, DON'T DO THAT THING CONNECTED WITH THE PAIN!"), hence the widely divergent results of ignore-it as a management method.

This probably goes without saying but... (1) not everyone's pain results from specific physical warning mechanisms, (2) the ignore-it method works for some of the people some of the time, and (3) tinnitus shouldn't be ignored until it's been assessed by a qualified medical professional. /disclaimers

/personal experience

[staranise]

A lot of painkillers work on the brain level. Neurokinin-1 is a very specific receptor in the brain that ties into a very specific molecule that's been implicated in a lot of Liz's symptoms. Right now the main thing that acts on that molecule is opioids that have a lot of side effects, like being hella addictive. Medications that target neurokinin-1 (antagonists) have the potential to target symptoms of depression, dissociation, pain, and gastrointestinal problems all at once.

[spiralsheep]

Yes, I know. See the comment you're replying to. ↑

[staranise]

I'm sorry if that came across as 'splainy. I got confused because I thought you were saying that "works on the brain directly" and "neurokinin-1 antagonist" were the same thing, rather than the latter being a very small subclass of the former.

[spiralsheep]

It's ok. You made a statement at me, which is a communication style that's difficult to respond to.

I was specifically researching Diclofenac Sodium and came across some stuff about its effect on the pain/stress/anxiety complex of actions/reactions, which seemed interesting (to me), although not necessarily relevant in this context cos Diclofenac Sodium has some potential side-effects that Liz might find unacceptable risks. I don't remember the precise details of what I read (hence the handwavium). I've checked my records and I would've been reading during the second half of 2011 at the very earliest, probably 2012.

I also knew a psych specialist who was working on anxiety/vagus nerve stuff at a British University at about the same time but, again, although I found her speculations interesting I can't remember what she said. I filed the papers she gave me somewhere but I never read them all the way through because it wasn't immediately applicable to me or anyone I knew.