I met with Andy Schakel last Tuesday afternoon and talked about the success of our pain management plan, maintaining pain levels around 3-4 since last week. We also talked about the side effects I have been experiencing, namely: I get drowsy, mostly in the afternoons; and continued difficulty achieving orgasm.
He suggested reducing the midday dose of MS Contin from 60 to 30 mg and also slowly decreasing the dose of Neurontin over time. Hopefully we can achieve a balance between the good effects and the side effects.
Since Tuesday, I have noticed I am not as drowsy, which is good, though sexual dysfunction hasn't changed. I am also trying to get more sleep by going to bed earlier. It's possible that lack of restful sleep is a contributing factor to these issues. I do notice that dropping the Neurontin dose increases my parasthesia. I will continue dropping the Neurontin dose further (currently 900 mg TID) to see if it has any positive effect. If the parasthesia gets worse, I will hold the dose to see if it levels out or gets any better at that dose. Otherwise I will increase the dose back to a previous level.
I hope to hear from Dr. Leitch's office today regarding the Heparin treatment so I can start that today as well.
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