If I continue taking MS Contin even when I am not in pain, how will I know when a pain cycle has ended? In the past, I had tapered my narcotics as the pain level came down. Now, with pain levels around 3 and not taking any Percocet, I don't know if the pain has ended or whether it is just treated with narcotics enough not to notice. Does it matter?
Sexual dysfunction continues to be problematic. I will talk to Andy Schakel about it today during my follow up appointment. I am frustrated and starting to want to avoid intimacy to circumvent the issue. This is not what I am committed to and will work towards resolving the issue. I am guessing it is medication related. Perhaps some sort of change will make a difference. I have been told that sexual dysfunction has been much less problematic when I am between pain cycles, but if I don't know that my body's pain level has decreased, has can I know? Right now my pain level is down, but this continues to be an issue.
The current neuropathy treatment is successful enough. I continue experiencing discomfort when applying the Neurontin gel, but dropping my oral Neurontin dose is a good thing. I will continue this treatment for the foreseeable future. I still have neuropathic pain on the tops of both feet and especially around my ankles.
I have only one active ulcer and continue using Morphine gel on it. The others have mostly healed. 3 times daily is difficult to do, but I have been able to do twice daily very regularly. I use Neurontin gel at the same times, also twice daily.
I saw my dermatologist Dr. Nancy Leitch yesterday for a med recheck. I shared with her my concern about the rapid progression of this condition. Many years ago we discussed low molecular weight Heparin therapy and I brought it up again. We did not use this therapy back then due to my concerns about the potential side effects associated with taking a strong anti-coagulant, namely bleeding more than normal when injured. We did not know at the time how fast this condition would progress, which is what brings it back up now. She is looking into the proper dose and will call in a prescription by this week's end to start treatment. This therapy will be taking in addition to all other therapies, with the possible exception of the daily dose of aspirin, which I may discontinue. This medication is injected subcutaneously, which will take some getting used to. I will need to check into how to fly with syringes as well for when I travel. I may need to always check my luggage.
I had my liver function checked as is ordered by Dr. Leitch twice yearly.
Dr. Leitch also brought up PUVA treatment again which uses ultraviolet lights much like a tanning bed. If I remember, this treatment was 3 office visits weekly every week, and this schedule is difficult for me to keep. I don't remember seeing dramatic results when we tried it years ago. I do get a lot of sun exposure during the spring, summer, and fall months from spending time outside coaching softball, yard work, and cycling. I do not see utilizing this therapy again at this time. Other than this PUVA therapy, I believe I am doing everything that other patients with this condition have tried.
Dr. Leitch is calling Wound Care Clinic, a clinic that does hyperbaric treatment of wounds that reportedly speeds the healing process, to see if Health Partners will cover the treatment. This treatment is covered for similar ulcers due to diabetes. If so, I will schedule therapy next time I have ulcers break through.
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