Good morning @gmacalypso. I'm Rachel, it's nice to meet you. I empathize with your pain and symptoms from central nerve pain and like that you've said you are trying to stay positive. That is a huge piece!

It's no wonder you're feeling worn down. Nerve changes that affect your whole body are overwhelming, I share in your journey, although different causes, same outcome. Central Sensitization Syndrome is what shadows my life now. My noticeable changes began at 43, slowly but surely. Small Fiber Neuropathy entered at 47 as well as a plethora of sensory and CNS dysfunctions. Just letting you know that you are not alone. I'm 52, I'm right there with you and understand and experience (or have experienced) the symptoms you describe.

Sometimes switching nerves medications helps. I receive benefit from Pregabalin (Lyrica) which took time to acclimate to regarding side effects and find a dose that was appropriate. 1 week down for you, that's a start, but give it time. Patience of waiting was not always my strong suit. Some folks do receive help from Tramadol or Low Dose Naltrexone. Agreed, the cold is not our friend, is it? I live in upstate NY.

Each person is on their own journey. It can be quite a path of experimenting and learning how to live with change. My advice is to stay as active as possible and remember that your central nervous system may like to play tricks on you, but don't let it win!

How are your emotional changes and needs being met? Living with chronic symptoms affects our emotions and behaviors. How have you been handling such changes? Do you have a good support system in friends or family?

If your body can tolerate side effects well, Buprenorphine is the way to go. My body had enough and I walked away from it. Went to a short acting opioid with strict control of quantity. Same ole song and dance and doesn't matter CRPS 20+ years. Lol.

I wish I had a better solution for what you're going through. It's all hit-and-miss with pharmaceuticals because everyone's body reacts differently. Seeing how you took gabapentin, and are progressing to Lyrica, I'd imagine you may hear about other antidepressants, anticonvulsants, and what ever they are throwing at people on the conservative side these days. My personal choice, I refuse to try it all again.

My suggestion is keep a pain journal in between appointments so you have real time literature to share. Do use Google for your search with ailment/disorder with keyword searches (e.g. antidepressants, anticonvulsants, etc.). Have a say in your treatment. To do so you must educate yourself in the basics, like:

What are anticonvulsants (antidepressants, etc.)? How do they work? What is success for ailment/disorder? Side effects and at what dosage? Tied in with ailment/disorder and pinpoint medical published articles in the past 5 years. Be aware, depending on the doctor, some view this as self-care and are offended. My opinion, find a new doctor. I educate myself so I can hold a conversation on their level, and keep a journal for show-and-tell.