i really am glad you have been documenting everything. that helps TONS,espescially when you have been showing ongoing symptoms,which we can all 'forget' about? the timing of some of this stuff too is key to Dx of this condition or any condition actually. i know i have gone back to little mini journals that i have kept while trying various meds and when i espescially had to have two seperate knee surgeries done on my RSD knee? those two really scared me since the fist day i met with my ortho i was told that any cutting into an RSD affected limb could cause a deepening or intensifying of my already horrid pain or even casue the RSD to pspread bilaterally to my 'good' knee too. so kept vey detalied notes. i recently went back and read this stuff(after my latest block actually) i kept and really did remeber things that i had forgetton about? presentation of my RSD was also written down since it was just a bunch of really bad pain and other crappy things without a 'label"yet at that time. those notes really helped my ortho and my NS come to my RSD dx eventually,so trust me,you are doing the best possible thing for yourself in keeping those notes up. if you should ever need to apply for disability,all that stuff will be crucial in you actually obtaining any benefits and just makethings a TON easier for you as far as having to detail and document your disability for SSD. just make copies of everything and NEVER give away to anyone for any reason,your originals or they will be more than likely lost to you forever.

i am wondering what other narcotics you have tried besides that fent patch before he placed you on the strongest of the strong there? good PM is starting out with the lower end of the narcotic spectrum and slowly working your way UP to the fent,ya know what i mean? its just such a very very strong med to be placed on if you have not run thru the other lessor type of narcotics first. you just will need something for down the road here so placing you at the top of the line right away when something less potent and life altering(side effects) just makes good sense. whatever you can get to work on the lower end of that spectrum is just the way to go first,thats all. pretty basic common sense that any good PM should just know for you ya know? does the fent actually even work for your pain or would something else maybe work better for you(this is what really should determne what level of narcotic you go on)?

the other meds that are used to try and treat this type of hell unfortunetly can bring on their own nightmare side effects with them too. i was knocked almost litterally on my ass by lyrica two years ago when it first came out and we wanted to just try it and see? bad choice for me. it really totally shut me down function wise with severe side effects. this is one of those meds that will either be no side effects or be totally incapacitating to others. it just effected my eyes(had up and down double vision.never in my life before or since i went off it have i had that) it made me feel like ihad just consumed a freaking six pack or something with my leg co ordination. could NOT even begin to try and even walk a straight line down the middle of my hallway in my house,no matter how much i tried or how slowly i went,still kept veering off to the left,always. this med also swelled up my already enlarged polycystic kidney in my right so badly it actually popped out of my back and right underneath and along side my ribcage in my front. it is still there,never moved back desptite it going down once i got off lyrica. its just sitting there right at my ribcage. very insane let me tell ya. needless to say,we had to go off. it DID however help with my RSD knee pain and also my central pain,which nothing had even begun to touch ever but lyrica. so that really bummed me out since i know it would have helped me,but the side effects were simply way too much of that trade off of my function. i refuse to give up any more of my function for any med even if it creates more pain for me. its not optional,ya know? honestly quiz,if you really feel way too incapacitated on this stuff,adjustments really do need to be made,seriously. speak to your PM about this. you just NEED to have lessening of your pain but at the same time,be able to have some good quality in your daily life too. its a balance that any good PM should be trying to do for you ya know? this is just where a really good PM who actually knows the ins and outs of trying to manage RSD and its unique type of pain is simply a must have ya know?

if you have other pain areas that DO respond to some level of narcotic,thats the areas you need to use to realistically "gage' what narcotic would be best for your types of pain process since historically,RSD just does NOT respond real well to any level of actual narcotics. my other pain does respond except the RSD and the central. i have like five major seperate pain generators going on in my body so we try and hit the ones best that do respond and just keep trying other methods to try and keep the others in check or just treat my flares as they happen. i too use the electrical stim(the TENS) only to try and treat my RSD flres. as long as i can 'meet" that intensity level with the stim signal and go one notch above it,i can create 'tolerable" on a really good day. its the only thing that i seem to be able to actually use that does not create hellish side effects for me to have to deal with. that and lidocaine patches also really help when my central fires up on me too. these two things are what i have found that help with my out of the box type pain syndromes much more effectively than anything else,and like i said before,NO side effects from this stuff. thats a huge thing for me. i seem to have very strong side effect reactions to just about every anti S med or cymbalta too that i have tried. i am just sick of that nasty trade off ya know?

speaking up to your PM really would help get you to that place where you are not trading off total function for pain control. also,never ever start more than one med at a time to try. otherwise you have too many new meds being introduced to your system at one time and could not possibly even narrow down any real side effect issue too,ya know? one ,med at a time and then wait like a ferw weeks before introducing any other new ones. i usually keep a little journal of every new med just so I know what casueing problems for me. it also helps to be able to go back and reread just what occured with one med when you start having problems with another too. it just sounds like your doc just hit you with way too much at a time,espescially when you are also starting fent. it just IS the very top of the narcotic scale. if you actually can obtain some real relief with lessor narcitics,why go that route ya know? i do okay on oxycontin and have been using this as long as it will work for me since i know my PM is going to be a lifelong deal(its now been 4 and a half years). i need the stronger meds for down the road when i grow too tolerant to what i have tried already over a course of many years. the fent right away just does not leave you any real "wiggle room' to go "up' ya know? seriously hon,what would come next when the fent has made it pretty much impossible for you to even begin to go down to the other things like oxycontin,opana or even MS? you would end up having to try even higher amounts of fent just to even begin to try and get some level of pain response from it. any actual surgeries you may need down the road for some parrticular reason will also be a problem as far as even getting good pain control post op. the fent itself just has alot of possible problems that just come along for the ride so if you do not absolutely have to go that route yet,just don't. i am only thinking of you and getting good PM now and later hon. you just really need to find out if this IS your only option here becasue you have actually tried everything else first,or if there is something less that will actually work now for you,thats all. if you have not actually tried the other lessor narcotics,this doc clearly Rxed you the wrong long acting med for your needs right now. i don;t know what your narcotics history is so i cannot tell you exactly,but you do,and know what you have not also tried. that would realistically dictate what narcotics need to be tried before settling for the fent and all that would come along with being on it. the least amount of narcotic that actually works for you should just naturally be the best way to go in treating a long term pain process,thats all. you just need that room to go up when that time hits.you wont get that if you went right to the fent from a lessor med without hitting the great working ones in between that high and low end spectrum of narcotics.

i do hope between you and your PM you can maybe back off some of the meds and then slowly reintroduce them into your system over time and also re eval the need for fent. the stellate will also possibly help with your pain levels too. it has mine anyways. hiefully they wont screw this up the next time. honestly quiz,if you do not respond to the sedation there really is not actual need to cancel that procedure. once they pop in the lidocaine,the pain really is pretty minimal in nature. like i mentioned before,i don;t think i have ever had any actual sedation with any of the many many different types of actual injections i have recieved over the four and a half years i have been getting them from my PM. it is very handalble pain,espescuially when compared to what we are already feeling with what we have. just a thought for you incase things agin don;t work out for you. it is done all the time with just the lido numbing the area first and no sedation added. it is not a must have,ya know? that procedure does not actually take all that long either. you just REALLY need to get this done for alot of different reasons. i do wish you luck this go round and with just speaking up to your PM about whats going on with function on what he has you on. you DO have some say in what they may place you on that has a bad effect or negative impact on your daily living and mobility. just ask him if you could try goping down to something like oxycontin or even opana. good luck hon,marcia