Monday, March 21, 2011

Pain Management/The pharmaceutical history of dainty bones

About third grade, well the summer afterwards, I'd begin getting severe pains on the top of my left foot. These would keep me up at night. The pain seemed to then move to my back and my head briefly, we're talking big time migraines. Eventually whatever it was settled in my left tibia. It was slightly swollen. But the pain has since been in my shine. Imagine being kicked there, and the feeling afterwards. This is how it would be if weren't meds and much hated big pharmacy (I take a neutral stance on that whole thing, but my quality of life seems to be better with it...until my internal organs fail).

The doctor's called it osteomylitus or just a metabolic bone disease. After my first surgery my tibia/bone got bigger than usual on the side. After the second one it stayed just about the same. It's why I wear pants.

Along the way I've been treated with numerous drugs.

The first one was Tylenol 2 (codeine) in about 4th grade. I felt relaxed watching Jay Leno fill in for Carson with my mom. Some "specialists" in the Pittsburgh community wanted to treat me with Gamma interferon. I think there is radiation involved in that. Fortunately my parents were wise enough to refuse. I assume they wanted to experiment on all of me. The doctors will do that.

My orthopedic doctor, I think around 6th grade put me on Indocine. This was used mainly at night. I'd eat lots of Tylenol during the day. I'm quite surprised nothing has showed up in the blood test yet about liver function. Indocin is rough on the gut but luckily I could take it.

After this, I saw an specialist that was in the Allergy Dept if Children's Hospital. He had the bright idea to put me on Prednisone (initially 40mg/day). On this dose, my appetite increased, I felt strong and energetic, and all of the pain was completely wiped out. This steriod also has serious side effects (bone density, etc).

We eventually had to ween me off. And we had to do this ever so slowly. We did this with the aid of a drug called Imuran. The more I went off, the more the pain came back. But this was necessary as Prednisone is a horrible long-term (even short-term) solution. This as well, messed with my head. I was approaching high-school with a fat face. We (me) eventually got off of this.

Around this time, 8th grade, we also tried electronic stimulation. This was really inconvenient, but worked, sort of. It would send waves to this sticky things I'd put near the shin.

The doctor that prescribed Prednisone, then Imuran, put me on another anti-inflammatory called Tolectin. This was mid to late 90's and took me up to 2001. Tolectin was an anti-inflammatory. A big white pill. I could take tylenol with this too.

I was now off of Prednison and Imuran. I was taking 6 Tolectin/day with minimal Tylenol.

Around 2001 I got my first job in this area and my boss recommended a local doctor that she went to. He recommended a drug called Feldene (Pyroxicam), which is what I'm on now. You take it for week, it gets in your system, and does a pretty damn good job. It's rough on the stomach, but so far so good. When I was recovering from my hip, I had to go off - because they had me on Cumadin and were worried about bleeding, and the shin pain came back pretty intensely. In fact it hurt way worse than the snapped hip. Really it did. So I was taking tons of acetametophin and drinking lots of water, along with the Darvocet which only seemed to last two hours.

Eventually I got back on the Feldene and off the blood thinners and Feldene has continued to work pretty well with minor dosages of Tylenol.

Feldene has given me pretty much a normal life and I'm not feeling any side effects yet. As with anything, you measure out the benefits and consequences. Without it, I wouldn't sleep and would be in really extreme bone pain. I hate the dependence though.

Yes, I do drink a little too.

1 comment:

  1. If ever these pharmacies could still improve their hospital pharmacy management, they could take advantage of the third-party pharmacists who would be more than willing to lend a hand to make some improvements in their management for a certain period of time.