Status Update May 30, 2014

I spent the day yesterday in the ER at NY Methodist (which may be the worst place in the world) because of some bad side effects from one of the meds I'm taking. I laid on a gurney in a busy hallway for an hour, then got put in a bay and waited another hour and a half before I was seen by a nurse, which is par for the course at this hospital. The woman I was sharing a bay with was there for a heart issue and wasn't seen for 2 hours. The ER is filled with the noises of people constantly yelling and screaming, and the only reason I was finally seen by a nurse was because I screamed out I NEED A NURSE at the top of my lungs. Good times. I'm feeling a lot better today though, and so happy to be home and not there. Much love and thanks to Pete, Alice and Rachel for coming and taking care of me and being my advocates.

On Wednesday I had an appointment with my pain specialist, where we reviewed an MRI of my thoracic spine that she had ordered. Previously I've had an MRI of my chest, where inflammation was found at one of my costochondral junctions, which my doctor says is where the rib connects to the spine. This MRI showed facet arthrosis in my mid/lower spine, most pronounced in T10-T11, which is where the inflammation was seen in my other MRI. My doctor says facet arthrosis is fluid buildup along the spine, which is something that happens in younger people as a result of inflammation. So she wants to try doing another shot of steroids directly into the spine where that fluid is, with the hope being that it is the source of the pain that radiates all the way around my ribs. Previously I got injections in the front left side of my ribs, and on each side along my back, but I haven't gotten any along the spine yet. So, it's promising, but I am still skeptical because every injection I've gotten up until now has caused me nothing but extreme pain. Now all I have to do is pick a day that I want to be in a lot of pain and make an appointment! I'll post an update once I've gotten the injections.

In the mean time, I'm still slowly building up to the full dosage of Cymbalta. It's taking me awhile because I'm really prone to nausea, but hopefully I'll be up to the full dose in 2-3 weeks. As of now, no change in my pain, but that's to be expected because I'm not at the full dose yet, and it can take a month to take full effect.

Status Update May 24, 2014

Right now the main doctor I'm seeing is a pain specialist, who I've been seeing since the beginning of April 2014. In April she gave me two rounds of intercostal nerve blocks, which are 6 injections in my back of a steroid and anesthesia meant to kill the nerves that go between my ribs, from the back to the front. Anyway, they didn't work, just caused me a lot of pain on the day I got them.

At my follow up appointment she suggested I get an implant - a spinal cord stimulator, which would have to be implanted surgically and would involve a week of having it attached to me by wires in my back with open wounds prone to infection while I try it out. I wasn't too keen on the idea, so instead I asked to try some of the meds that I've had suggested to me but haven't tried yet.

So now I'm trying a higher dose of Cymbalta, because apparently the dosage I tried before isn't typically what is used for pain management. The Cymbalta has made me really nauseous so I'm having to build up to the high dosage slowly over the process of a couple weeks, which is what I'm doing now. Also when I'm not too nauseous I'm doing some postural restoration exercises given to me by a great physical therapist in Portland OR (let me know if you're ever there and need a recommendation). I just got custom orthotics for my shoes as well and they're awesome. I'm very normcore these days.

I also have a prescription for a TENS unit, I just need to do some more research on where to get it then I'll pick one up.  Once I'm used to Cymbalta my doctor wants to try adding Lyrica, a fibromyalgia medication, and see how the two drugs work together.  My next appointment is on Wednesday. 

Treatments & Medications I've tried

These are all things that I've tried that have not worked:

Treatments:

• Physical Therapy
• Graston Technique (I do not recommend this. So painful.)
• Acupuncture
• Six Food Elimination Diet (to rule out food allergies)
• Cortisone injections
• Intercostal nerve blocks
• Spinal injections
• TENS unit

Medications:

• Ibuprofen
• Omeprazole
• Naproxen
• Celebrex
• Celexa
• Cymbalta
• Voltaren gel
• Lidocaine 5% patches
• Gabapentin
• Xanax
• Tylenol #3 with Codeine
• Zorvolex

I've seen 3 General Practitioners, 2 GI Specialists, a Physiatrist, 2 Physical Therapists, a Chiropractor, a Rheumatologist, and 2 Pain Specialists. I've had 2 normal x-rays, numerous normal blood tests, a normal endoscopy, a normal ultrasound, and an MRI that showed inflammation at one of my pain points, diagnosed as costochondritis.

What's wrong with Kathleen? What is costochondritis?

In early April of 2013, I started getting sharp pain in my lower ribs, on both sides of my ribcage, in the front and the back.  After having a normal ultrasound and endoscopy, I was diagnosed with costochondritis.

What is costochondritis, you may ask? It's an inflammation of the rib or the cartilage that connects the rib to the breastbone. You can learn more about it at the Mayo Clinic's website. Luckily costochondritis isn't life-threatening, but there is no known cause, and no known cure or treatment for it. It mostly affects women, and there has never been a controlled medical study for it. Usually it goes away on its own after a few weeks or months, but it can also be chronic. I've seen posts on forums from people who have had it for over a decade.