Friday evening was one of this particularly bad times, with apparently the simplest thing causing it. I’d been working at home during the day so hadn’t done a lot of walking, but made sure I got up and moved around frequently – at least every hour. I was starting to feel a bit rough later in the day, with increasing pain and feeling generally run down. In the evening we took the dog for a short walk round to the shop. On the way I sneezed, and as often happens, it hurt really badly. Unlike most time, the pain didn’t subside. I got home and took my usual evening meds, but still nothing, so I eventually took some oramorph, thinking it was the only way I’d be able to get some sleep. After a while I started to see an improvement. Unfortunately, it seemed to have the effect of completely waking me up. I forced myself to go to bed at about 2am, despite feeling fully awake still, eventually nodding off about 3. I managed about 3-3.5 hours before my body clock told me I’d overslept. Needless to say I was not exactly on best form on Saturday, but at least the pain level was back to tolerable.
I saw Dr Hashemi yesterday to review my pregabalin dose again, and to discuss the pain clinic referral. Given that I don’t seem to be getting any additional benefit from the 300mg dose, I’m going back down to 250mg, and she thinks if I’m ok with that I can see how I am at 200mg. At the same time, the pain consultant has recommended I try amitriptyline or duloxetine. I’ve already had a couple of spells on amitriptyline so I started on 30mg of duloxetine a day and will see how that goes. The GP can increase that to 60mg if necessary. Meanwhile I await an appointment with the pain team. They have also recommended I be referred to neuro rehab, so Dr Hashemi is going to organise that.