Monday

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I am now in week seven of my medical leave, and I think that my recovery has jumped to an improved level after stalling out with some flare-ups of sciatica over the past two weeks. When I called to report the return of this nerve pain to my surgeon, he ordered some physical therapy which seems to have already helped more than I expected.

The physical therapy clinic suggested that working on the strength and flexibility of my hips could dampen my sciatic pain. I was tempted to dismiss this suggestion, which I guess would invest this therapy with the opposite of a placebo effect. Despite my lack of confidence in the capacity of this therapy to help me, I am happy to report that I am having less sciatic pain already.

I anticipate that my surgeon will release me to work in a week. I heard that this was the projected course of my healing before the surgery, and I am pleased that my recovery is proceeding according to schedule.

I also made a choice last week concerning the medications I’ve been taking that some may consider ill-advised, but the only advice I took on the matter was my own.  I had been taking prozac and gabapentin since mid-December to help ease the depression and nerve pain leading up to my back surgery, and my surgeon and primary doctor agreed that it was ok for me to stay on those meds during my recovery period. There was no plan for me to continue these prescriptions indefinitely, as was the case when I took antidepressants during my years of major depression.

Last week I considered that it was worth trying to discontinue these meds for three reasons: the 15-20 pounds I’ve gained while taking them (depending on the degree of bloat on a given day), the oddball return of my nerve pain, and memory issues. I wondered if it was possible that the gabapentin in particular had outlived its usefulness. As for the memory problems, last week one of the physical therapists took the time to prove to me (by reading from my session records) that I’d already been shown a particular exercise when I insisted that it seemed completely new to me. As she read the session notes to me, I suddenly remembered that I really had done the side-to-side squat walk with resistance band before. Such moments have happened to me all too often over the past four months.

I will preface the issue of returning nerve pain by saying that I believe that medications have a subjective experience that is particular to the patient, in addition to their clinical effects. I think of this as a quasi-placebo effect that endures over the course of treatment. Obviously, there are limits to how strongly one’s mind can influence the effectiveness of a medication. No one can make snake oil a true cure-all, and as far as I know, tales of Rasputin aside, a steel will hasn’t spared anyone the deadly effects of cyanide.

With that aside, I will disclose that my chief motivation in stopping the gapapentin was to see if this substance was perpetuating the need for itself. Was the return of my nerve pain a month after surgery, with no plausible reason such as injury, like a rebound headache? I have had this experience with over-the-counter pain relievers. Also, I had begun having flares of nerve pain in my hands, and there is no reason at all for that to be happening.

My nerve pain diminished rapidly once I discontinued the gabapentin. Where it seemed that I was having flare-ups of sciatica I am now just having ordinary, minor muscle pain. All the while I had been afraid of what this nerve pain would feel like without medication. I’m glad I decided to test whether the medicine itself was amplifying my perception of pain instead of dampening it.

Now that my time with gabapentin is done, I feel like it worked more on my anxiety than it did on my pain. I can see now that anxiety was a greater struggle for me than any of the physical symptoms I had with my back problems. I’m not sure why this medication is not considered a first-line prescription for anxiety. I felt almost no anxiety whatsoever during the four months I was on it, and I cannot overstate what a medical blessing this was for me. Better yet, I am not feeling any rebound anxiety or withdrawl now that I’ve stopped taking it, too. I had four months of experiences free from my usual fears, which was long enough to show me that my anxiety did not help me, even though it seemed to be the trusty advisor that kept me safe.

Now it is time for me to attend another physical therapy appointment. At least this time I can well recall what happened during the last session.

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