Well, it's been a while since I've had a really bad headache, so I guess that I am due one. My fibro has had some days of acting up where I have to go home and go to bed early. Now, it seems like they are ganging up on me.
Right around 11:00 this morning, I was starting to get a headache in the right side of my head. I had felt it soming on for a little bit, so I took a Fioricet at that time.
Now at 1:30, I have pain shooting from the back of the right side of my head to the top of my head. I also have a feeling of fullness in my right ear and my right eye feels heavy and droopy.
Moving my head in any direction causes a stabbing pain in my forehead. I have 2 hours left in my day and am going to try to tough it out rather than leave early as I am trying to save my sick time.
To make matters a little worse is that tonight is Halloween and I want o be able to take my youngest girl trick-or-treating around the neighborhood. Right no, I'm not too sure how that is going to play out.
Wednesday, October 31, 2012
Wednesday, October 10, 2012
The Walking Dead, Part III
Here I am a month later, with headaches mostly under control (except for today) and extreme fatigue. I don't know how I am going to make it through the day. To make things worse, I am coming off of a rough and late night (I wanted to go to bed at 8:00PM)
I have a doctor's appointment today at 3:30 with my practitioner and just wish that I could go home and sleep.
Well, as I've learned before, I just keep telling myself, "It's just one more hour. It's just one more hour."
Thursday, October 4, 2012
Describing Pain
What is Pain? What causes pain? This post comes from http://www.medicalnewstoday.com/articles/145750.php and is a great way to look at describing pain to a doctor or others. If you're like me, sometimes it is difficult to describe the type of pain that you are having. People without a chronic condition may be wondering what I mean by that statement, but it's true.
When seeing a doctor, especially for something new, I try to explain only the new symptoms that I am having.
Other times, it may be difficult to try to describe the pain in words. It's difficult to try to write about it because often it cannot be adequately described. Yes, I know that that sounds strange.
Anyway, here is the article...
The English word 'pain' probably comes from Old French (peine), Latin (poena - meaning punishment pain), or Ancient Greek (poine - a word more related to penalty), or a combination of all three.
In medicine pain relates to a sensation that hurts. If you feel pain it hurts, you feel discomfort, distress and perhaps agony, depending on the severity of it. Pain can be steady and constant, in which case it may be an ache. It might be a throbbing pain - a pulsating pain. The pain could have a pinching sensation, or a stabbing one.
Only the person who is experiencing the pain can describe it properly. Pain is a very individual experience.
Chronic pain - this sensation lasts much longer than acute pain. Chronic pain can be mild or intense (severe).
How do we classify pain?
Pain can be nociceptive, non-nociveptive, somatic, visceral, neuropathic, or sympathetic. Look at the table below.
Nociceptive Pain - specific pain receptors are stimulated. These receptors sense temperature (hot/cold), vibration, stretch, and chemicals released from damaged cells.
Somatic Pain - a type of nociceptive pain. Pain felt on the skin, muscle, joints, bones and ligaments is called somatic pain. The term musculo-skeletal pain means somatic pain. The pain receptors are sensitive to temperature (hot/cold), vibration, and stretch (in the muscles). They are also sensitive to inflammation, as would happen if you cut yourself, sprain something that causes tissue damage. Pain as a result of lack of oxygen, as in ischemic muscle cramps, are a type of nociceptive pain. Somatic pain is generally sharp and well localized - if you touch it or move the affected area the pain will worsen.
Visceral Pain - a type of nociceptive pain. It is felt in the internal organs and main body cavities. The cavities are divided into the thorax (lungs and heart), abdomen (bowels, spleen, liver and kidneys), and the pelvis (ovaries, bladder, and the womb). The pain receptors - nociceptors - sense inflammation, stretch and ischemia (oxygen starvation).
Visceral pain is more difficult to localize than somatic pain. The sensation is more likely to be a vague deep ache. Colicky and cramping sensations are generally types of visceral pain. Visceral pain commonly refers to some type of back pain - pelvic pain generally refers to the lower back, abdominal pain to the mid-back, and thoracic pain to the upper back (see below for the meaning of referred pain).
Nerve Pain or Neuropathic Pain
Nerve pain is also known as neuropathic pain. It is a type of non-nociceptive pain. It comes from within the nervous system itself. People often refer to it as pinched nerve, or trapped nerve. The pain can originate from the nerves between the tissues and the spinal cord (peripheral nervous system) and the nerves between the spinal cord and the brain (central nervous system, or CNS).
Neuropathic pain can be caused by nerve degeneration, as might be the case in a stroke, multiple-sclerosis, or oxygen starvation. It could be due to a trapped nerve, meaning there is pressure on the nerve. A torn or slipped disc will cause nerve inflammation, which will trigger neuropathic pain. Nerve infection, such as shingles, can also cause neuropathic pain.
Pain that comes from the nervous system is called non-nociceptive because there are no specific pain receptors. Nociceptive in this text means responding to pain. When a nerve is injured it becomes unstable and its signaling system becomes muddled and haphazard. The brain interprets these abnormal signals as pain. This randomness can also cause other sensations, such as numbness, pins and needles, tingling, and hypersensitivity to temperature, vibration and touch. The pain can sometimes be unpredictable because of this.
Sympathetic Pain
The sympathetic nervous system controls our blood flow to our skin and muscles, perspiration (sweating) by the skin, and how quickly the peripheral nervous system works.
Sympathetic pain occurs generally after a fracture or a soft tissue injury of the limbs. This pain is non-nociceptive - there are no specific pain receptors. As with neuropathic pain, the nerve is injured, becomes unstable and fires off random, chaotic, abnormal signals to the brain, which interprets them as pain.
Generally with this kind of pain the skin and the area around the injury become extremely sensitive. The pain often becomes so intense that the sufferer daren't use the affected arm or leg. Lack of limb use after a time can cause other problems, such as muscle wasting, osteoporosis, and stiffness in the joints.
Here is a list of some pain measures used today:
Numerical Rating Scales
The patient is given a form which asks him to tick from 0 to 10 what his level of pain is. 0 is no pain, 5 is moderate pain, and 10 is the worst pain imaginable.
The Numerical Rating Scales are useful if you want to measure any changes in pain, as well as gauging the patient's response to pain treatment. If the patient has dyslexia, autism, or is very elderly and has dementia this may not be the best tool (see the ones below).
Verbal Descriptor Scale
This type of scale exists in many different forms. The patient is asked questions and responds verbally choosing from such terms as mild, moderate, severe, no pain, mild pain, discomforting, distressing, horrible, and excruciating.
Elderly patients with cognitive impairment, very young children, and people who respond better to verbal stimuli tend to have better completion rates with this type of scale, compared to the written numerical scale. Children respond even better to the faces scale (description below).
Faces Scale
The patient sees a series of faces. The first one is calm and happy, the second less so, etc., and the final one has an expression of extreme pain. This scale is used mainly for children, but can also be used with elderly patients with cognitive impairment. Patients with autism may respond better to this type of approach - people with autism tend to respond to visual stimuli well.
Brief Pain Inventory
This is a much more comprehensive written questionnaire. Not only does it gauge current level of pain, but also records the peaks and troughs of pain during previous days, how pain has affected mood, activity, sleep patterns, and how the pain may have affected the patient's interpersonal relationship. The questionnaire also has diagrams which the patient shades - the shaded parts being where the pain is located and where it is most severe.
McGill Pain Questionnaire
This questionnaire measures the intensity (severity) of the pain, the quality of the pain, mood, and understanding of the pain. It is also known as the McGill Pain Index. It is a scale of rating pain developed at McGill University by Melzack and Torgerson (1971).
Look at the 20 groups below.
Group 1 - Flickering, Pulsing, Quivering, Throbbing, Beating, Pounding
Group 2 - Jumping, Flashing, Shooting
Group 3 - Pricking, Boring, Drilling, Stabbing
Group 4 - Sharp, Gritting, Lacerating
Group 5 - Pinching, Pressing, Gnawing, Cramping, Crushing
Group 6 - Tugging, Pulling, Wrenching
Group 7 - Hot, Burning, Scalding, Searing
Group 8 - Tingling, Itching, Smarting, Stinging
Group 9 - Dull, Sore, Hurting, Aching, Heavy
Group 10 - Tender, Taunt, Rasping, Splitting
Group 11 - Tiring, Exhausting
Group 12 - Sickening, Suffocating
Group 13 - Fearful, Frightful, Terrifying
Group 14 - Punishing, Grueling, Cruel, Vicious, Killing
Group 15 - Wretched, Binding
Group 16 - Annoying, Troublesome, Miserable, Intense, Unbearable
Group 17 - Spreading, Radiating, Penetrating, Piercing
Group 18 - Tight, Numb, Squeezing, Drawing, Tearing
Group 19 - Cool, Cold, Freezing
Group 20 - Nagging, Nauseating, Agonizing, Dreadful, Torturing
Measuring pain when the patient is cognitively impaired
In this case doctors say that the patient's subjective pain report is the most effective and accurate way of evaluating pain. If the severely cognitively impaired patient is observed carefully it is possible to pick out clues as to the presence of pain, e.g. restlessness, crying, moaning, groaning, grimacing, resistance to care, reduced social interactions, increased wandering, not eating, and sleeping problems.
Analgesics are good at relieving nociceptive pain, but not neuropathic pain. Chronic pain - long-lasting pain - may need other non-drug treatments as well.
Opioid Analgesics
Opioid analgesics are also known as narcotics. These are the strongest painkillers and are commonly used after surgery, for cancer, broken bones, burns, and various other situations. Even though opioids are not commonly used to treat non-cancer pain, their usage for non-cancer pain is becoming more widespread and acceptable. Some patients do not respond well to opioids and should not take them.
The patient will be given opioids in gradually increasing dosages. The ideal dose is reached when the pain is relieved and the side-effects are tolerable (increase any higher and the side effects become too much for the patient). Dosages should be generally much lower for older patients and infants.
The patient is administered opioids every few hours - each dose coinciding with the moment just before the pain starts becoming severe. Some patients are given higher dosages if the pain becomes more intense, while others are given other medications alongside the opioid. Pain can become more intense if the patient needs to move about, or if a wound dressing needs to be changed.
The dosage goes down if the pain intensity drops, until if possible, the doctor switches to a non-opioid analgesic.
People with kidney failure, liver problems, COPD (chronic obstructive pulmonary disease, dementia, tend to have more side effects when given opioids. The most common opioid side effects are drowsiness, constipation, nausea, vomiting, and itching. Generally, the side effects lessen as after time. Taking too much opioid can be dangerous. Patients who take opioids for long period become physically dependent and will have withdrawal symptoms when treatment is stopped - it is important that their dosage is tapered off gradually.
Nonopioid Analgesics
Nonopioid analgesics are used generally for mild to moderate pain. They are not addictive and their pain-relieving effects do not dwindle over time.
NSAIDs (nonsteroidal anti-inflammatory drugs)
These may be obtained either OTC (over-the-counter) or as a prescription medication, it depends on the dosage. Low dosage NSAIDs are effective for headaches, muscle aches, fever, and minor pains. At a higher dose they help reduce joint inflammation. There are three main types of NSAIDs, and they all block prostaglandins - hormone-like substances that cause pain, inflammation, muscle cramps, and fever.
When seeing a doctor, especially for something new, I try to explain only the new symptoms that I am having.
"Yes, doctor, I have pain there, but it is not the same pain that I usually have."
Other times, it may be difficult to try to describe the pain in words. It's difficult to try to write about it because often it cannot be adequately described. Yes, I know that that sounds strange.
Anyway, here is the article...
The English word 'pain' probably comes from Old French (peine), Latin (poena - meaning punishment pain), or Ancient Greek (poine - a word more related to penalty), or a combination of all three.
In medicine pain relates to a sensation that hurts. If you feel pain it hurts, you feel discomfort, distress and perhaps agony, depending on the severity of it. Pain can be steady and constant, in which case it may be an ache. It might be a throbbing pain - a pulsating pain. The pain could have a pinching sensation, or a stabbing one.
Only the person who is experiencing the pain can describe it properly. Pain is a very individual experience.
Types of pain
Acute pain - this can be intense and short-lived, in which case we call it acute pain. Acute pain may be an indication of an injury. When the injury heals the pain usually goes away.Chronic pain - this sensation lasts much longer than acute pain. Chronic pain can be mild or intense (severe).
How do we classify pain?
Pain can be nociceptive, non-nociveptive, somatic, visceral, neuropathic, or sympathetic. Look at the table below.
| Pain | |||
| Nociceptive | Non-Nociceptive | ||
| Somatic | Visceral | Neuropathic | Sympathetic |
Nociceptive Pain - specific pain receptors are stimulated. These receptors sense temperature (hot/cold), vibration, stretch, and chemicals released from damaged cells.
Somatic Pain - a type of nociceptive pain. Pain felt on the skin, muscle, joints, bones and ligaments is called somatic pain. The term musculo-skeletal pain means somatic pain. The pain receptors are sensitive to temperature (hot/cold), vibration, and stretch (in the muscles). They are also sensitive to inflammation, as would happen if you cut yourself, sprain something that causes tissue damage. Pain as a result of lack of oxygen, as in ischemic muscle cramps, are a type of nociceptive pain. Somatic pain is generally sharp and well localized - if you touch it or move the affected area the pain will worsen.
Visceral Pain - a type of nociceptive pain. It is felt in the internal organs and main body cavities. The cavities are divided into the thorax (lungs and heart), abdomen (bowels, spleen, liver and kidneys), and the pelvis (ovaries, bladder, and the womb). The pain receptors - nociceptors - sense inflammation, stretch and ischemia (oxygen starvation).
Visceral pain is more difficult to localize than somatic pain. The sensation is more likely to be a vague deep ache. Colicky and cramping sensations are generally types of visceral pain. Visceral pain commonly refers to some type of back pain - pelvic pain generally refers to the lower back, abdominal pain to the mid-back, and thoracic pain to the upper back (see below for the meaning of referred pain).
Nerve pain is also known as neuropathic pain. It is a type of non-nociceptive pain. It comes from within the nervous system itself. People often refer to it as pinched nerve, or trapped nerve. The pain can originate from the nerves between the tissues and the spinal cord (peripheral nervous system) and the nerves between the spinal cord and the brain (central nervous system, or CNS).
Neuropathic pain can be caused by nerve degeneration, as might be the case in a stroke, multiple-sclerosis, or oxygen starvation. It could be due to a trapped nerve, meaning there is pressure on the nerve. A torn or slipped disc will cause nerve inflammation, which will trigger neuropathic pain. Nerve infection, such as shingles, can also cause neuropathic pain.
Pain that comes from the nervous system is called non-nociceptive because there are no specific pain receptors. Nociceptive in this text means responding to pain. When a nerve is injured it becomes unstable and its signaling system becomes muddled and haphazard. The brain interprets these abnormal signals as pain. This randomness can also cause other sensations, such as numbness, pins and needles, tingling, and hypersensitivity to temperature, vibration and touch. The pain can sometimes be unpredictable because of this.
Sympathetic Pain
The sympathetic nervous system controls our blood flow to our skin and muscles, perspiration (sweating) by the skin, and how quickly the peripheral nervous system works.
Sympathetic pain occurs generally after a fracture or a soft tissue injury of the limbs. This pain is non-nociceptive - there are no specific pain receptors. As with neuropathic pain, the nerve is injured, becomes unstable and fires off random, chaotic, abnormal signals to the brain, which interprets them as pain.
Generally with this kind of pain the skin and the area around the injury become extremely sensitive. The pain often becomes so intense that the sufferer daren't use the affected arm or leg. Lack of limb use after a time can cause other problems, such as muscle wasting, osteoporosis, and stiffness in the joints.
What is referred pain?
Also known as reflective pain. When pain is felt either next to, or at a distance from the origin of an injury it is called referred pain. For example, when a person has a heart attack, even though the affected area is the heart, the pain is sometimes felt around the shoulders, back and neck, rather than in the chest. We have known about referred pain for centuries, but we still do not know its origins and what causes it.How do you measure pain?
It is virtually impossible to measure a person's pain objectively. Most experts say that the best way to find out how much pain a person is enduring is by a subjective pain report. A comprehensive assessment of pain should include:- The identification of all the pains. This must include the most important ones.
- The site, quality, and radiation of pain
- What factors aggravate and relieve the pain
- When the pain occurs throughout the day
- What impact the pain has on the person's function
- What impact the pain has on the person's mood
- The sufferers' understanding of their pain
Here is a list of some pain measures used today:
Numerical Rating Scales
The patient is given a form which asks him to tick from 0 to 10 what his level of pain is. 0 is no pain, 5 is moderate pain, and 10 is the worst pain imaginable.
| Please rate the pain you have right now | |||||||||
| 0 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| No pain | Moderate pain | Worst pain imaginable | |||||||
The Numerical Rating Scales are useful if you want to measure any changes in pain, as well as gauging the patient's response to pain treatment. If the patient has dyslexia, autism, or is very elderly and has dementia this may not be the best tool (see the ones below).
Verbal Descriptor Scale
This type of scale exists in many different forms. The patient is asked questions and responds verbally choosing from such terms as mild, moderate, severe, no pain, mild pain, discomforting, distressing, horrible, and excruciating.
Elderly patients with cognitive impairment, very young children, and people who respond better to verbal stimuli tend to have better completion rates with this type of scale, compared to the written numerical scale. Children respond even better to the faces scale (description below).
Faces Scale
The patient sees a series of faces. The first one is calm and happy, the second less so, etc., and the final one has an expression of extreme pain. This scale is used mainly for children, but can also be used with elderly patients with cognitive impairment. Patients with autism may respond better to this type of approach - people with autism tend to respond to visual stimuli well.
Brief Pain Inventory
This is a much more comprehensive written questionnaire. Not only does it gauge current level of pain, but also records the peaks and troughs of pain during previous days, how pain has affected mood, activity, sleep patterns, and how the pain may have affected the patient's interpersonal relationship. The questionnaire also has diagrams which the patient shades - the shaded parts being where the pain is located and where it is most severe.
McGill Pain Questionnaire
This questionnaire measures the intensity (severity) of the pain, the quality of the pain, mood, and understanding of the pain. It is also known as the McGill Pain Index. It is a scale of rating pain developed at McGill University by Melzack and Torgerson (1971).
Look at the 20 groups below.
- Circle one word in each group that best describes your pain.
- Circle only three words from Groups 1 to 10 that best describe your pain response.
- Choose just two words in Groups 11 to 15 that best describe your pain.
- Just pick the one in Group 16.
- Finally, choose just one word from Groups 17-20.
Group 1 - Flickering, Pulsing, Quivering, Throbbing, Beating, Pounding
Group 2 - Jumping, Flashing, Shooting
Group 3 - Pricking, Boring, Drilling, Stabbing
Group 4 - Sharp, Gritting, Lacerating
Group 5 - Pinching, Pressing, Gnawing, Cramping, Crushing
Group 6 - Tugging, Pulling, Wrenching
Group 7 - Hot, Burning, Scalding, Searing
Group 8 - Tingling, Itching, Smarting, Stinging
Group 9 - Dull, Sore, Hurting, Aching, Heavy
Group 10 - Tender, Taunt, Rasping, Splitting
Group 11 - Tiring, Exhausting
Group 12 - Sickening, Suffocating
Group 13 - Fearful, Frightful, Terrifying
Group 14 - Punishing, Grueling, Cruel, Vicious, Killing
Group 15 - Wretched, Binding
Group 16 - Annoying, Troublesome, Miserable, Intense, Unbearable
Group 17 - Spreading, Radiating, Penetrating, Piercing
Group 18 - Tight, Numb, Squeezing, Drawing, Tearing
Group 19 - Cool, Cold, Freezing
Group 20 - Nagging, Nauseating, Agonizing, Dreadful, Torturing
Measuring pain when the patient is cognitively impaired
In this case doctors say that the patient's subjective pain report is the most effective and accurate way of evaluating pain. If the severely cognitively impaired patient is observed carefully it is possible to pick out clues as to the presence of pain, e.g. restlessness, crying, moaning, groaning, grimacing, resistance to care, reduced social interactions, increased wandering, not eating, and sleeping problems.
What are the treatments for pain?
An underlying disorder, if treated effectively, will also get rid of the pain, or at least reduce it. If you have an infection and take antibiotics, the antibiotics may get rid of that infection, resulting also in the elimination of pain. Even if an underlying problem can be treated, you may still need analgesics (pain relievers).Analgesics are good at relieving nociceptive pain, but not neuropathic pain. Chronic pain - long-lasting pain - may need other non-drug treatments as well.
Opioid Analgesics
Opioid analgesics are also known as narcotics. These are the strongest painkillers and are commonly used after surgery, for cancer, broken bones, burns, and various other situations. Even though opioids are not commonly used to treat non-cancer pain, their usage for non-cancer pain is becoming more widespread and acceptable. Some patients do not respond well to opioids and should not take them.
The patient will be given opioids in gradually increasing dosages. The ideal dose is reached when the pain is relieved and the side-effects are tolerable (increase any higher and the side effects become too much for the patient). Dosages should be generally much lower for older patients and infants.
The patient is administered opioids every few hours - each dose coinciding with the moment just before the pain starts becoming severe. Some patients are given higher dosages if the pain becomes more intense, while others are given other medications alongside the opioid. Pain can become more intense if the patient needs to move about, or if a wound dressing needs to be changed.
The dosage goes down if the pain intensity drops, until if possible, the doctor switches to a non-opioid analgesic.
People with kidney failure, liver problems, COPD (chronic obstructive pulmonary disease, dementia, tend to have more side effects when given opioids. The most common opioid side effects are drowsiness, constipation, nausea, vomiting, and itching. Generally, the side effects lessen as after time. Taking too much opioid can be dangerous. Patients who take opioids for long period become physically dependent and will have withdrawal symptoms when treatment is stopped - it is important that their dosage is tapered off gradually.
Nonopioid Analgesics
Nonopioid analgesics are used generally for mild to moderate pain. They are not addictive and their pain-relieving effects do not dwindle over time.
NSAIDs (nonsteroidal anti-inflammatory drugs)
These may be obtained either OTC (over-the-counter) or as a prescription medication, it depends on the dosage. Low dosage NSAIDs are effective for headaches, muscle aches, fever, and minor pains. At a higher dose they help reduce joint inflammation. There are three main types of NSAIDs, and they all block prostaglandins - hormone-like substances that cause pain, inflammation, muscle cramps, and fever.
- Traditional NSAIDs - the largest subset of NSAIDs. As is the case with most drugs, they do carry a risk of side-effects, such as stomach upset and gastrointestinal bleeding. The risk of side effects is significantly higher if the patient is over 60. At higher doses, they should only be taken when monitored by a doctor.
- COX-2 inhibitors - these also reduce pain and inflammation. However, they are designed to have fewer stomach and gastrointestinal side-effects. In 22004/2005 Vioxx and Bextra were withdrawn from the market after major studies showed Vioxx carried increased cardiovascular risks, while Bextra triggered serious skin reactions. Some other COX-2 inhibitors are also being investigated for side-effects. The FDA told makers of NSAIDs to highlight warnings on their labels in a black box.
- Salicylates - these include aspirin which continues to be a popular medication for many doctors and patients. If your plan to take aspirin more than just occasionally you should consult your doctor. Long term high dosage usage of aspirin carries with it a significant risk of serious undesirable side effects, such as kidney problems and gastrointestinal bleeding. For effective control of arthritis pain and inflammation frequent large doses are needed. Nonacetylated salicylate is designed to have fewer side effects than aspirin. Some doctors may prescribe nonacetylated salicylate if they feel aspirin is too risky for their patient. Nonacetylated salicylate does not have the chemical aspirin has which protects against cardiovascular disease. Some doctors prescribe low dose aspirin along with nonacetylated salicylate for patients who they feel need cardiovascular protection.
Wednesday, October 3, 2012
Daily Update - Migraine/Trip
Just as an update... I am generally headache free, thanks to Verapamil,
Imitrex and Frova!
I had an out of town trip that lasted 3 and 1/2 days. Normally, I do not like traveling as in the event that I have a flare, it is a lot more difficult to handle, not to mention that it is hard to relax when traveling with others as sometimes you cannot just go to your room and lay down, especially if you are supposed to be doing something at work. This usually leads to extended hours, etc. as people usually eat and hang out together.
All-in-all, my trip went decently with me only experiencing a headache Saturday night that was manageable. I ended up taking a Butalbitol and laying down hoping that a migraine was not around the corner. Thankfully, it wasn't!
"We now return you to regularly scheduled Fibromyalgia." ...lol
I had an out of town trip that lasted 3 and 1/2 days. Normally, I do not like traveling as in the event that I have a flare, it is a lot more difficult to handle, not to mention that it is hard to relax when traveling with others as sometimes you cannot just go to your room and lay down, especially if you are supposed to be doing something at work. This usually leads to extended hours, etc. as people usually eat and hang out together.
All-in-all, my trip went decently with me only experiencing a headache Saturday night that was manageable. I ended up taking a Butalbitol and laying down hoping that a migraine was not around the corner. Thankfully, it wasn't!
"We now return you to regularly scheduled Fibromyalgia." ...lol
Monday, September 24, 2012
Daily Update - Neurologist Visit
Well, I went to see my neurologist yesterday and I was pleasantly surprised.
He asked about my relief from the headaches, etc. and the said that he was going to increase my Verapamil to try to keep the headaches at bay. He also prescribed Imitrex (100mg) for when my migraines start and Frova to take if the migraine continues more than 1 hour.
He said that my migraine symptoms are typical and that treating them is tricky due to the Fibromyalgia, saying that the two (migraines and fibro) feed off of each other and exacerbate the issue.
He then gave me a shot of Phenergan and Nubain in the hip and I was good to go (since I was going straight home). All this and I was in and out in 20 minutes and on time.
The shot that my neurologist gave me lasted for about 6 hours. I was headache and pain free during that time! It was like my body went on vacation and was totally OK. I wish that I could have that shot every day...lol
So here I am, with a small headache, but generally decent.
He asked about my relief from the headaches, etc. and the said that he was going to increase my Verapamil to try to keep the headaches at bay. He also prescribed Imitrex (100mg) for when my migraines start and Frova to take if the migraine continues more than 1 hour.
He said that my migraine symptoms are typical and that treating them is tricky due to the Fibromyalgia, saying that the two (migraines and fibro) feed off of each other and exacerbate the issue.
He then gave me a shot of Phenergan and Nubain in the hip and I was good to go (since I was going straight home). All this and I was in and out in 20 minutes and on time.
The shot that my neurologist gave me lasted for about 6 hours. I was headache and pain free during that time! It was like my body went on vacation and was totally OK. I wish that I could have that shot every day...lol
So here I am, with a small headache, but generally decent.
Monday, September 3, 2012
Daily update: Stuff and new stuff
I went back to work Tuesday. (Thank God Monday was a holiday). I still have
dizziness and a constant headache, but am pushing myself without trying
to push too hard (I am well aware of the consequences). I've spoken with
my boss and have arranged to work out of a location that is closer to
home for me (8 miles, instead of 26 miles) at least until I see the
neurologist.
All of my bloodwork came back normal and I still have an appointment with a neurologist this Monday.
Today is also a very weird day in that I am having weakness in my legs and hand tremors. I chocked it up to low blood sugar, however, I still have it after eating. I hope that this passes quickly and is not something new to add on to the heap of stuff that I've been experiencing. It's a very unusual feeling not being able to trust your hands or legs.
All of my bloodwork came back normal and I still have an appointment with a neurologist this Monday.
Today is also a very weird day in that I am having weakness in my legs and hand tremors. I chocked it up to low blood sugar, however, I still have it after eating. I hope that this passes quickly and is not something new to add on to the heap of stuff that I've been experiencing. It's a very unusual feeling not being able to trust your hands or legs.
Saturday, September 1, 2012
Dr. Berne’s Chronic Fatigue Syndrome (ME/CFS)/Fibromyalgia Symptom Checklist
This list was sent to my wife and I by another dear friend who also suffers from fibromyalgia. (We all have to stick together :) )
--------------------------------------------------------------------------------------------
Dr. Katrina Berne, a clinical psychologist and author who specializes in ME/CFS & FM, has developed a comprehensive symptom checklist she advises her patients to complete & take to their doctors. This form should be updated every few months to document your symptoms and your progress. It’s especially helpful in the disability application process.
Please indicate on a scale of 1 to 10 the severity and frequency of each symptom, with 10 being the most severe and frequent. Use the past two months as a general guide. If you do not have the symptom, leave the space blank. (Thanks to Dr. Berne for providing this list.)
DATE:
Fatigue, worsened by physical exertion or stressActivity level decreased to less than 50% of pre-illness activity level
Recurrent flu-like illness
Sore throat
Hoarseness
Tender or swollen lymph nodes (glands), especially in neck & underarms
Shortness of breath with little or no exertion
Frequent sighing
Tremor or trembling
Severe nasal allergies (new or worsened)
Cough
Night sweats
Low-grade fevers
Feeling cold often
Feeling hot often
Cold extremities (hands and feet)
Low body temperature (below 97.6)
Low blood pressure (below 110/70)
Heart palpitations
Dryness of eyes and/or mouth
Increased thirst
Symptoms worsened by temperature changes
Symptoms worsened by air travel
Symptoms worsened by stress
PAIN
HeadacheTender points or trigger points
Muscle pain
Muscle twitching
Muscle weakness
Severe weakness of an arm or leg
Full or partial paralysis of an arm or leg
Joint pain
TMJ syndrome
Chest pain
EYES AND VISION
Eye painChanges in visual acuity (frequent changes in ability to see well)
Difficulty with accommodation (switching focus from one thing to another)
Blind spots in vision
SENSITIVITIES
Sensitivities to medications (unable to tolerate a “normal” dosage)Sensitivities to odors (e.g., cleaning products, exhaust fumes, colognes,
hair sprays)
Sensitivities to foods
Alcohol intolerance
Alteration of taste, smell, and/or hearing
UROGENITAL
Frequent urinationPainful urination or bladder pain
Prostate pain
Impotence
Endometriosis
Worsening of premenstrual syndrome (PMS)
Decreased libido (sex drive)
GASTROINTESTINAL
Stomach ache; abdominal crampsNausea
Vomiting
Esophageal reflux (heartburn)
Frequent diarrhea
Frequent constipation
Bloating; intestinal gas
Decreased appetite
Increased appetite
Food cravings
Weight gain ( _ lbs)
Weight loss ( _ lbs)
GENERAL NEUROLOGICAL
Lightheadedness; feeling”spaced out”Inability to think clearly (“brain fog”)
Seizures
Seizure-like episodes
Syncope (fainting) or blackouts
Sensation that you might faint
Vertigo or dizziness
Numbness or tingling sensations
Tinnitus (ringing in one or both ears)
Photophobia (sensitivity to light)
Noise intolerance
EQUILIBRIUM/PERCEPTION
Feeling spatially disorientedDysequilibrium (balance difficulty)
Staggering gait (clumsy walking; bumping into things)
Dropping things frequently
Difficulty judging distances (e.g. when driving; placing objects on surfaces)
“Not quite seeing” what you are looking at
SLEEP
Hypersomnia (excessive sleeping)Sleep disturbance: unrefreshing or non-restorative sleep
Sleep disturbance: difficulty falling asleep
Sleep disturbance: difficulty staying asleep (frequent awakenings)
Sleep disturbance: vivid or disturbing dreams or nightmares
Altered sleep/wake schedule (alertness/energy best late at night)
COGNITIVE
Difficulty with simple calculations (e.g., balancing checkbook)Word-finding difficulty
Saying the wrong word
Difficulty expressing ideas in words
Difficulty moving your mouth to speak
Slowed speech
Stuttering; stammering
Impaired ability to concentrate
Easily distracted during a task
Difficulty paying attention
Difficulty following a conversation when background noise is present
Losing your train of thought in the middle of a sentence
Difficulty putting tasks or things in proper sequence
Losing track in the middle of a task (remembering what to do next)
Difficulty with short-term memory
Difficulty with long-term memory
Forgetting how to do routine things
Difficulty understanding what you read
Switching left and right
Transposition (reversal) of numbers, words and/or letters when you speak
Transposition (reversal) of numbers, words and/or letters when you write
Difficulty remembering names of objects
Difficulty remembering names of people
Difficulty recognizing faces
Poor judgment
Difficulty making decision
Difficulty following simple written instructions
Difficulty following complicated written instructions
Difficulty following simple oral (spoken) instructions
Difficulty following complicated oral (spoken) instructions
Difficulty integrating information (putting ideas together to form a complete picture or concept)
Difficulty following directions while driving
Becoming lost in familiar locations when driving
Feeling too disoriented to drive
MOOD/EMOTIONS
Depressed moodSuicidal thoughts
Suicide attempt(s)
Feeling worthless
Frequent crying
Feeling helpless and/or hopeless
Inability to enjoy previously enjoyed activities
Increased appetite
Decreased appetite
Anxiety or fear with no obvious cause
Panic attacks
Irritability; overreaction
Rage attacks: anger outbursts with little or no cause
Abrupt, unpredictable mood swings
Phobias (irrational fears)
Personality changes
OTHER
Rashes or soresEczema or psoriasis
Aphthous ulcers (canker sores)
Hair loss
Mitral valve prolapse
Cancer
Dental problems
Periodontal (gum) disease
© copyright 1999 and 2008 by Katrina H. Berne, Ph.D.,
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