Tuesday, October 19, 2010

My Psychiatrist, the Neurologist

My psychiatrist is awesome. At my regular visit a couple weeks ago, I mentioned how I figured I probably have pudendal neuralgia. He asked what kind of nerve problem it is, and I said, "entrapment?"
Oh, entrapment, that usually benefits from anti-inflammatory meds, and what you might try is, say, 600 mg of ibuprofen at noon and then another 600 mg after you leave work... With anti-pain meds like Neurontin, the risk is that you injure yourself more because the pain means something is wrong, but you can try to play around with it, go up to 300 or 400 mg and see what works for you, try a schedule of one at night and one in the morning to start...
I basically got a starter program for controlling my nerve pain -- from my psychiatrist! I think he must be one in a million. I've never had a doctor step outside his particular BOX to give me advice about my pain.

I've been trying a schedule of Neurontin and ibuprofen for almost two weeks now. I'm up to 100 mg of Neurontin in the morning and 200 mg at night. I take ibuprofen at least once a day, usually around midday, and sometimes again at night.

I can't say I'm feeling too much of a difference. My pain still has its ups and down -- and part of that has to do with whether I've had sex the night before. I upped my Neurontin dose a couple nights ago because we had particularly fun woohoo and I didn't get the shocking flare I'd expected the next day. Woohoo!

(As a side note, someone newly diagnosed asked me in an email if sex really hurts. I told her yes, yes it does -- but that I've realized that the after-sex pain (which usually shows up the next day) isn't anything I didn't experience when I wasn't having sex. The pain during sex can be bad, but I've learned how to think around it and focus on other parts of the experience. I definitely don't have the same sex life or experiences I would've had without the pain, but I'm able to have semi-frequent sex and not completely incinerate.)

I'm not lying down at night like I've planned to in my mind -- I think it would probably help, but I get too distracted by what I'm doing at home to make sure I'm resting my nerve.

And I haven't bought a cushion yet, and that's basically because I've entered the Paradox of Choice -- so many people suggested all different cushions that I don't know which one to choose! So I'm just going to order one and see what happens...

I'm hoping that getting a little more regular with the ibuprofen, getting a cushion, lying down more at night, and finding the right Neurontin dose will make a clear change in my pain. However, just viewing my pain as a treatable (if chronic) nerve problem makes my life so much lighter. I see the current pain as current pain, not pain that will be here always. In the next few months, I'm hoping to find a doctor who can confirm or refine (or refute) my pudendal-neuralgia theory so we can look at other treatments if they're available.

To all my ladies -- remember that your pain is also just current pain!!! I've tried to remind myself of that ever since my vulvodynia started, and it has always brought me at least a moment of peace. You never know what will happen in the future. You're allowed to be sad, but you're not allowed to give up hope for improvement!

1 comment:

  1. Well, psychiatrists, unlike most psychologists, are bona fide medical doctors, so they have to go through medical stuff and know about prescriptions.

    It is an unexpected place to get pain management advice from though!