A Plan Goes Awry

It has finally dawned on me…remember that my GP, Mommy and I are using me as a lab rat for my treatment plan. This could be the reason that I’m feeling worse (inside, not necessarily pain-wise) than I ever have before (except perhaps after an operation where a knife-wielding surgeon has carved up parts of my body)!

The plan is/was to replace Sertraline AND Lyrica with just Cymbalta:

1. maintain Lyrica dosage – 150 mg am & pm (til step 6);

No problem with this part of the plan.

2. stop taking the Prednisolone;

No problem here, either

3. Wean off Sertraline over the week;

Slowly becoming more irritable (or so I have been told!)

4. no anti-depressant for one week;

Really irritable, some collapsing on the floor in tears, really tired – this would be when I posted the SQUISH picture, and started the Things I Have Lost series

5. 4 weeks of 30mg Cymbalta;

No real help on this minimal dosage, still really tired, not quite as much crying, can’t be bothered with much, lots of pain EVERYWHERE! – and that would be The Mess That Blubbered

6. 4 weeks on 60mg Cymbalta – NOW:

Not impressed with Cymbalta as an anti-depressant (not even up to the FM dosage yet), feeling nothing but exhausted ALL the time, really noticing temperature changes within my own body

So now, I’m supposed to increase the Cymbalta again while reducing my Lyrica but I really can’t see how the Cymbalta is going to help me with pain management when it can’t even cope with the depression in my body, and it appears to be making a lot of symptoms worse

And I’m just not sure where to go from here…

A Balanced Body

Ahh…BodyBalance:

BODYBALANCE™ is the Yoga, Tai Chi, Pilates workout that builds flexibility and strength and leaves you feeling centred and calm. Controlled breathing, concentration and a carefully structured series of stretches, moves and poses to music create a holistic workout that brings the body into a state of harmony and balance.

The class started with a tai-chi warm-up…cool – I can handle that! Then, into some of the yoga moves that I had done previously. When we hit the downward dog,

I had to dodge Mommy’s dirty looks – what the hell have you gotten me into? Down into the plank – if looks could kill!

The Plank!

And onto the mat for the yucky part – pilates core workout! Guess what? I still haven’t developed any stomach muscles (ummm…and it seems neither has Mommy!) More yoga, some flowing tai chi and finishing with a 10 minute meditation to clear the mind.

(I haven’t gone into great detail because the class was definitely, as promised, a fusion of all three other classes: yoga, pilates and tai-chi as described in previous posts).

I must say that the final meditation was very much appreciated, as I dripped sweat onto my mat and waited to be scraped from the floor.

Earlier in the day, Mommy and I went to visit the doctor (rheumatologist #3). I tried to motivate him with the promise of fame, fortune and untold riches (He could be the One! The One who could show empathy! The One who could publish numerous journal articles! The One that all FM patients would seek!) Erm…it seems he wasn’t interested.

So, the plan is:

  1. maintain Lyrica dosage – 150 mg am & pm (til step 6);
  2. stop taking the Prednisolone (no weaning as I was only on it for a week);
  3. visit GP on Friday to start weaning off Sertraline (anti-depressant actually being used for depression) over the week;
  4. no anti-depressant for one week (should be some interesting posts that week!);
  5. start Cymbalta (until we find correct dose for my depression);
  6. reduce morning dose Lyrica;
  7. reduce evening dose Lyrica.

Of course, steps 6 and 7 will only be attempted if necessary; and step 5 may take quite a while. If at any stage, I find that everything feels better, then I’ll be leaving it as is. I have a follow-up appointment with Rheumatologist #3 in 3 months.

So it looks like it’s up to me and Mommy (and my poor GP – she doesn’t know yet! with as much input from you guys as you feel like giving) to discover the secret (at least, the one that works for me) behind managing the pain, fatigue and fog and returning to work.

Oh! What a Beautiful Morning!

The sun has come through those doggone clouds that have been here all week (and will return soon – Winter is coming!) The sky is blue. And I’m feeling exceptionally positive! (That could be because of the prednisolone, though, because all your warnings were correct and the ups and downs of this drug are berserk!) But everything is better when the sun is shining (except when it is too bright and causes my eyes and head to hurt – can’t I just be happy?)

Today I woke to marvellous comments on all my social media sites – it was almost like it was my birthday…but better – because I didn’t have to get a year older! The total and utter depletion of any energy from my body, that was yesterday, has been replaced with (some) buoyancy.

My Sickness Allowance came in so I was able to pay some money to my VISA. (I don’t even realise how much stress that puts on me until I press the PAY button and I can sigh with (some) relief.)

My wonderful Mommy and her cantankerous (yet loveable) partner, Henry, are going to ambush my previous rheumatologist. I have been waiting 7 weeks for him to complete a medical report so I can continue my appeal for Disability. I’m really glad I’m not going to be there – it will be really loud and embarrassing, but it should scare the shit out of him! There are appropriate times to cause a scene! This is one. If I don’t get that form returned in time, I will miss out on approximately $2000 in back pay. Go Henry!!!!

I am returning to the doctor, armed with all of your drug suggestions, to plot the next path in my course. I was thinking about it yesterday. I’ve decided I want a young, motivated doctor – some-one who is still positive and wants to be the best! some-one who wants to discover new things, who wants to be published, who is willing to experiment with new things! It seems that the older the doctor, the more jaded he has become! We need CHANGE THE WORLD doctors!

This evening, Mommy and I are going to our first BodyBalance class, which is supposed to be a fusion of tai-chi, yoga and pilates. Yay! some-one to come to classes with me! I’m looking forward to it – I can imagine Mommy and I giggling at the back of the room, like schoolgirls, falling and having to help each other up. You know I will let you all know how the class goes.

So, all-in-all, a great (actually, probably really normal – but it’s amazing what a positive attitude will get you) sounding day!

And, in case, you’ve been waiting with bated breath – here are some photos from Z’s party:

Mommy’s Little Helper

Four new little white pills have been added to my morning diet – Prednisolone.

Prednisolone is used to reduce inflammation in the body. Because I had an MRI on my feet, due to the incredible pains I have in my feet – does anyone else have this? – and it showed some inflammation, my doctor decided to prescribe this for me for a week. Basically, it’s a test. Whatever happens I won’t be staying on it, as it can cause huge weight gain and I already have too much of this problem. So, if it works to help reduce pain, my doctor will be trying to find another, similar agent to do the same thing. If it doesn’t work, then it’s on to the next strategy.

Prednisolene is a glucocorticoid, sometimes known as a steroid or corticosteroid. It is used to treat many illnesses, including serious illness, involving inflammation in the body, and to stop reactions known as autoimmune reactions which occur when the body’s immune system attacks the body itself and causes damage. It stops the body from producing a substance that causes tenderness, swelling and irritation. Ooh – sounds good!

In general this drug is used for allergies including severe allergic reactions, inflammation affecting the lungs (including asthma), blood vessels, heart, bowel, kidneys, muscles and joints (including rheumatoid arthritis, rheumatic fever and systemic lupus erythematosus or SLE), eye, ear or nervous system.

They should not be confused with male or female steroid hormones, which are known for their misuse among athletes. So I will not be displaying giant biceps anytime soon.

After some internet research, I discovered one study that showed that Prednisone was found to produce no significant benefits when given to fibromyalgia patients. Bum! But I’ll still try it for the week!

But then, a Californian doctor had claimed that fibromyalgia can be treated by boosting stress hormone cortisol with low doses of hydrocortisone (Predinisone is about 4 times stronger than hydrocortisone). According to Dr Kent Holtorf, the treatment offers great health benefits with less risk, compared to other treatments for the condition.

Dr Holtorf believes that patients with fibromyalgia have low levels of steroid hormone cortisol, due to dysfunction in a brain system that regulates response to stress, known as the hypothalamic-pituitary-adrenal axis. Of 500 consecutive patients treated with the steroid at his clinic, Holtorf says 94% showed some improvement and 62% showed substantial improvement by the fourth visit.

William C. Reeves, director of the chronic viral diseases branch of the CDC, believes that most patients with fibromyalgia could benefit from taking low-dose hydrocortisone, but he says the treatment is not without risks. Some patients have experienced side effects especially those administered with higher steroid doses.

Anyone any clearer on whether this is going to help or not?