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Chronic Pain members - Welcome, please introduce yourself
Chronic Pain | Last Active: 6 hours ago | Replies (7051)Comment receiving replies
I developed earaches in September 2016. My primary care found no ear or sinus infection and sent me to an ENT, who diagnosed TMJ pain. I went to my dentist for help. He gave me weekly anesthesia shots into trigger points (OUCH!) and exercises to do, including massaging the trigger points and opening my mouth as wide as I could numerous times in the shower while my face was warm and wet. (I have been wearing a night guard made by my dentist for over 20 years; he replaces them as they wear out.) The pain continued and only got worse; it was at the top of my head, in my ears, in my jaw, above my palate (as though I'd eaten hot food). My dentist sent me to an oral surgeon, who did 360-degree x-rays and found no joint damage. He told me I was therefore not a candidate for surgery (YAY!) and prescribed Flexeril, a muscle relaxer. The pain only got worse, and I continued to wake up in the night with horrific pain. Ibuprofen didn't even touch it.
My dentist then sent me to a physical therapist, who didn't listen to a word I said. I came in on a "good" pain day: my pain level was about a 5 out of 10 (10 being the worst). After his examination and showing me how to do various exercises, he triumphantly told me that my pain level was now reduced. I said "No. My pain level is now about 7.5." He said he didn't believe me. He attempted to push me to go to his outside clinic to get "magnet therapy," and he tried to push me to see a friend of his who is a naturopath. Two days after this session, I was still in excruciating pain and doubt I'd ever return to this physical therapist, although he had me schedule 4 more 1-hour sessions with him.
I called my dentist again, and he called in a prescription for Tylenol plus codeine, which I can take every 4 to 6 hours. My dentist seems to have no further solutions for me.
My primary care is currently out of town, but I will see her when she gets back (in August); she may be referring me to a pain management specialist, which my dentist recommended--however, my dentist refuses to give me a referral to such a specialist, even though the specialist will take referrals from dentists or doctors.
I have been treated for many years for clinical depression and panic/anxiety disorder by my psychiatrist, and the meds have helped me immensely. On Monday I see my psychiatrist for my usual 6-month med check, and I'm going to ask him for help with the terrible TMJ pain. I have also had fibromyalgia and chronic fatigue syndrome for a long time. The fibro pain has greatly lessened over time and hardly bothers me, but the CFS continues.
The TMJ pain makes it difficult to concentrate. I'm self-employed, and I enjoy my work. But pain gets in the way, as it does in every single situation: work or pastimes. My dentist mentioned massage therapy, but I'm in too much pain right now to try it. Another friend mentioned using a TENS unit. I feel as though I'm not living; to be in constant pain is hardly living, at least to me.
Any other suggestions? Would a TENS unit help? I'm more than willing to purchase one. I'll try just about anything to be pain free. Sometimes I am pain free. But I spend about 2 weeks out of every month in serious pain. I am feeling very discouraged.
Replies to "I developed earaches in September 2016. My primary care found no ear or sinus infection and..."
Kdubois:Marield65 here. Thanks for getting back so quickly. How would I get in touch with One Ome? Do they test you for specific meds? Or what is in the med.Thanks Marie
Hi @marield65, at this point, only doctors can place orders with OneOme. I apologize if you mentioned it already, but which state do you live in? I want to ensure that OneOme has been certified by the state in which you live. (Each PGx testing company needs to be certified by each of state to be able to provide mail order kits to residents of the state, or the doctor ordering needs to be practicing in a state that has certified the PGx company if the patient lives in an uncertified state.)
Hi Kdubois, this is Marie from Rhode Island. Can you tell me if this state does it?
@marield65... YES... OneOme is certified in Rhode Island through 12/30/2018. (https://oneome.com/licensing)
To order, ask your doctor to go to OneOme.com and click the For Providers link at the top of the page.
You can also go to the site and click the For Patients link to read more about it.
I just realized that I never answered your question above regarding testing for specific meds. The industry already knows which genes metabolize which medications. PGx companies analyze your genes to determine if there are polymorphisms that make you metabolize a drug normally, too slowly, or too quickly. The report received after testing tells you several things... it tells you whether the gene tested came back normal or polymorphic, and if it was found to be polymorphic, they can also tell the metabolizer status for the gene. (For instance, for some of my enzymes, I'm an Intermediate metabolizer, which means my metabolism is basically a notch slower than Normal. For one of my enzymes, I'm a Poor, which is like being two notches slower than normal. For another enzyme, I'm two notches faster than Normal but only if the enzyme is induced to do so by another drug, food, or supplement.)
So on the report, the cover page list drugs in a red-colored section. These are drugs that are to be "used with great caution" based on the polymorphisms. (Basically, these are the "do not take" drugs.) They then provide a yellow-colored drug list... these are to be "used with caution" based on polymorphisms. So, the reports do give you guidelines regarding which drugs will work better or not work as well for you as an individual. They aren't able to list comprehensively because there are so many drugs out there, so after the first few pages, they list your polymorphisms, which can then be used to determine additional drugs by doctors but usually pharmacists on an as-needed basis.
Every time a doctor wants to prescribe a new drug for me, I tell them to send it in to the pharmacy, but they know that before the prescription is filled, my pharmacy and I will review the drug against my polymorphisms to determine if I am able to take the drug. If we decide that it is not a good drug for me, then they know that my pharmacist will be calling them with guidelines to choose a different drug.
Unfortunately, pharmacy computer systems are not currently capable of accepting a patient's polymorphisms as input and then compare evaluate them against drugs, so we have to do this manually each time. Fortunately, most pharmacies have subscriptions to clinicalpharmacology.com and other web site, which is where we find this information, called pharmacokinetics.
@jimhd Jim, as I mentioned somewhere before I had problems with many pharmaceuticals when I had cirrhosis. I had been prescribed prednisone two times, at this point I know I had cirrhosis at those times but it was not too advanced. The first time the prednisone worked well for me. The second time I still did not know I had cirrhosis and the cirrhosis worked well and did what it was supposed to do but I gained a ton of weight in 10 days. I also had oxycontin and loved it because I would just take it at bedtime to lessen the pain from a knee replacement and that allowed me to sleep, in fact helped me to sleep as I guess it does with most people.
When my cirrhosis progressed I had trouble with many, many drugs. Oxycontin and oxycodone kept me awake, literally wide awake, staring at the ceiling until around 6:00 in the morning. That was when my medical oncologist prescribed dilaudid, and that was worse. Also, as I mentioned I had trouble with omeprazole. Long after those problems I finally discovered that cirrhosis often causes drug intolerances. I suspect if I had dilaudid now I would be fine with it. Honestly, cirrhosis effects more things than I ever dreamed possible, that darned liver sure does a lot.
JK
@kdubois Thanks Kelly, so far I am fine with the omeprazole. Due to what I hear are long term effects I am hoping that my dosage will be reduced soon. I am also wondering if somehow I had something in my esophagus that was actually related to varices and that maybe I do not actually have Barrett's. They tell that would be unlikely but I am hoping for an endoscopy soon just to be sure.
I cannot take any NSAIDS, no non-prescription pain relievers other than tylenol, and that in a limited dose. Thankfully I am not in pain frequently and the horrible migraines I had prior to menopause are gone now.
JK
My sister went to the university in Fredonia, my parents were married there in the church where my grandfather was the pastor. My parents lived there for a few years, then Dad moved to Brockport, to pastor a church there for 5 or 6 years, during which time I was born. We lived at the corner of King and Queen Streets.
Before my sister went to Fredonia, she studied piano for a number of years at Eastman School of Music in Rochester. She's 69 tomorrow, and works with music in Minneapolis, for a school, a couple of churches, leads a quartet that performs classical and pop music, and a variety of gigs around the area, playing the piano or keyboard. Her husband just had to retire from playing horns for some of the same venues as my sister, because his hearing has deteriorated.
TMI
Jim
@contentetandwell
I take 80mg of Omeprazole every morning, and I'm not supposed to take NSAIDS, either, but I do because of arthritis pain in my hands and neck. It's been so long since I had the peptic ulcers that I don't worry about it much, nor do I take nearly as much as I used to.
I've been dealing with swallowing problems for a few years, and I know that the rings in my esophagus function randomly, but the ENT doctor I saw on the first of August told me that the base of my tongue isn't working properly. It doesn't form the food into a bolus normally, to get it ready to swallow. So, now I'm waiting to hear the results of the blood tests to see if I have Huntington's Disease. If I do, it means that swallowing will get worse, to the point where I have to have a feeding tube, and the disease is terminal. The research I've done paints a pretty grim picture. I'm hoping that it won't take long to get the test results. I'm having more anxiety, obviously. At this point, I'm staying fairly stable with depression, though I had some rough days last week. It helped to talk with my therapist on Thursday, but it often seems like a long time from one Thursday to the next.
Time to take a shower and go to bed. One good thing that I'm thankful for is that I sleep well. I try not to sleep more than 9 hours.
Jim
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@hazelblumberg first class of females at Colgate!?!? Woot!!!!