07 May 2006

Feeling Old

*warning: self centred whinging session below*

I can't help that I'm 22 and feeling old. I know I'm not, and shouldn't, but I do. (If that makes sense.)

The past few weeks have been painful. Since the end of March I've been nursing pretty much constant back pain. In contrast, the rest of my joints, which used to hurt more, have been sorted by taking diclofenac, but not my back or my neck it appears.

I've been feeling pretty shit to tell the truth, as online friends will vouch for. I've cried more than I ever have before, my sleep's been disturbed, and I'm feeling distinctly rough. It hurts when I breathe and moves up and down my back like a yo-yo. Add to this the permanent smell of Deep Heat that follows me around, and I feel anything but 22.

The problem is, I can't pin point anything that causes it to hurt. It isn't aggravated by manual handling or exercise (in fact it usually feels better for an hour after the gym), and carrying things don't bother it. Sitting, standing and lying down all hurt, and the most company I've had in the bedroom department comes from a scooby doo hot water bottle. If it weren't for the fact that I need to vacuum, I would have seriously slept on the floor last night.

I mean, I have tablets for it. Wonderful tablets that, while they don't stop it during the day, they do knock me out sufficiently to ensure a good night's sleep. There's one slight problem though... It's not just a good night's sleep; it's usually until 2pm the next day as well. 14 hours sleep a night is a little bit excessive, but it's what my body craves if I take the 25 mg amitriptyline each night. I wasn't getting any work done while I was taking it, so I stopped. This was also the tablet responsible for me sleeping through all my morning lectures at university - to the amusement of my peers and the annoyance of lecturing staff.

Unfortunately, the general concensus of the GP is that I should be taking at least double (50mg) per night. I dread to think what I'd be like if that happened. Rip Van Winkle springs to mind.

I feel a little depressed when I think about my doctor's appointment looming this week. I know what will happen before I go. I'll cry. Snot and tears will flow freely and again, I'll be fobbed off. No doctor has ever examined my back or my neck. They presume it's the same thing that's wrong with my knees, hips and ankles. A fair enough conclusion, I thought. Except that the treatment that works for one doesn't even touch the other.

Is it wrong to want a diagnosis?
My logic is telling me: 'if you know what's wrong with you, you can start finding things out for yourself'

But I seem to have baffled people. I have the symptoms of rheumatoid arthritis (including the family history), but without the blood results to confirm it.

I can't help but wonder how I'm going to cope at medical school* if this carries on...

This post was brought to you with the help of a shit night's sleep, back pain, and the assistance of Wikipedia.

*and yes, that did look vaguely like a decision didn't it?? Let's just say it's in the lap of the gods.


Jo said...

Oh dear, hope you feel better soon. And that the doctor gives you a proper diagnosis.

Old Bar Man said...

Wikipedia legendry.
manual handling, that's a worker for you. I did a risk assesment on a burning-barrel BBQ yesterday.
I'm sure it'll all work out. Deep Heat is an aquired taste.

PanickingFinalist said...

Re: coping with medical school.
You'll be fine. The staff are supportive and the students are friendly. Especially when you're ill - they even give you sabatticals to recover.
Personally, by the looks of your blog, I greatly look forward to having you as a colleague in future.
BTW did you ever see Silent Hill? I thought it was fantastic.

Jayanne said...

I've a bad back but it's compressed disks (beginning with slipped disks), not anything systemic. I do understand though about the problem of not having a diagnosis (I have RSI and recently also an undiagnosed-as-yet legs problem) and about pain and losing sleep.
If the amitryptyline's for pain relief then 25mg is more than enough -- really it is. I'm a bit surprised it knocks you out at that dosage. (I was given 90mg once, it both knocked me out -- but only for say 8 hours' sleep - and overstimulated me at the same time, I rang the doctor and stopped taking it.) If it's to help you sleep, to be honest, a benzodiazepine would knock you out less and its side-effects are less yuck but of course doctors don't like prescribing them -- they will give me them because I don't get addicted or even tolerant.

Have you been referred to a pain clinic? Have your doctors tried neurontin?

Merys said...

I've allegedly been referred to a pain clinic, but I believe the waiting list is very long (i was referred in 2003!).
As for what the doctors have tried, to be honest the last time they advised paracetamol. I wasn't particularly pleased (I'd been taking paracetamol, then PA and brufen, then OTC cocodamol, then OTC cocodamol and brufen for the best part of 2 years, till it stopped being effective.)
I may have cried

Jayanne said...

Pain clinic lists are long but even in Cardiff, not *that* long. There's a good one in London -- is it at St Thomas's? -- that has a 14 month waiting list. Ask your doctors about the wait (i.e. try to push them).

As for what the doctors have tried, to be honest the last time they advised paracetamol.

Damn it. I have to use paracetamol because codeine etc. make me feel really ill. But you should be given better medication. What, depends on what type of pain. Neurontin is used to treat nerve pain, so are the tricyclics (that's why I thought the amitryptyline was for that; but for that, the dose would be smaller).

I saw on Dr Crippen's blog that you've been given it to help you sleep. Unless it's also being used as an antidepressant that doesn't make much sense to me. (I am not a doctor, I just have a lot of experience, partly through an RSI group, with all of this; and, well, I wanted to be a doctor... !) But if it is being used as an antidepressant then they'd probably need to raise the dose.

It's at times like this that I wish doctors would take the risk and prescribe more people mild sleeping pills, for some nights at least. (Every third night, say.)

I may have cried

persistent pain and lack of sleep have that effect anyway, apparent lack of help makes it all worse. I do understand.

Hannah said...

Possibly a little late, but I''ve just been reading through some of your archives.

I can empathasise with some of the pain you're getting (and from the sounds of it, the treatment as well!) I;ve had near constant back and neck pain along with dodgy wrists (and the ankles/feet are starting to show signs as well) for who knows how long. (I'm 21). After bugging my GPs for so long I know they got fed up with me, I eventually got referred to the rheumatology dept of the lcoal hospital.

Cue every test under the sun they could think of. And yes, during this process I've lost count of how many times they suggest I take paracetamol or ibuprofen. RA was ruled out fairly early on (i think i had similar feelings- yes I wouldn't want this but at least it's a diagnosis and therefore a start). After 2 years of this (and nothing in between as no painkiller could be found that would get rid of pain and my stomach would keep down) I eventually got put onto 25mg doses of amitryptyline with the warning that it may make me a feel a little dozy... half an hour after the first dose I was dead to the world for about 15 hours, woke up for about 2 feeling rotten, and then promptly went back to sleep. It scared my other half no end as no matter what he tried, including picking me up and dumping me on the floor at higher distances from the floor, would wake me.

I found however that whilst it would allow me to sleep, it was useless as a pain killer, and even then the effectiveness of it started to wear off. I've now come off it full stop and have been discharged as they can't find anything wrong (that they can treat). I'm apparently on a waiting list for a pain clinic but I won't be holding my breath.

It feels like every time you go to the doctor you get your hopes up and then dashed and it leaves you feeling worse than before. Especially when I was discharged, even though I had semi mentally prepared myself for it!

I had acupuncture for a while and it did help, although again it started to diminish in effectiveness. Not to mention that I had a dodgy needle put in my lower back which even now causes problems with the nerve.

Battle on- i suspect you'll be surprised. And whilst it doesn't help, you have my sympathy and wishes for the best.

PS. I may lurk and in frequently comment (it's a long term habit!) but I enjoy reading your blog. Sorry this was such a long comment (and a bit personalised, but it really hit home whilst I was reading your descriptions of what you were going through)