#I started lyrica but I’m already on cymbalta

[macncheesenibblers]

Hi guys I think I had/have serotonin syndrome today and yesterday. Started a new drug for el fibro

[princeofchronicpain]

I’ve been getting a lot of advice lately from people who are concerned about my wheelchair use. They said it could have “permanent negative effects” on my health to be “using one when it’s not ideal for the person’s diagnosis/doesn’t fit correctly”. Other people have told me that using a wheelchair that isn’t prescribed is the equivalent of self-medicating. My parents are firmly against it, saying that it will only weaken my body. If I just stoped eating this, or started eating that, or did such and such exercise, or stopped “pretending it’s worse than it is”. It’s really frustrating, because they don’t understand how badly I want to just follow their advice and have everything go back to the way it was before the pain.

The reason I know I have a chronic pain condition (aside from the chronic pain) is because I went to a neurophysiologist 3 times. The first time, he did all his poking and prodding and asking questions. The second time, he did a few different tests, told me it was fibromyalgia, and prescribed me Cymbalta. “You’re too young to be using a cane,” he told me with his warmest smile. I agreed with him. The third time, I told him that the pills were giving me too many negative side effects, and that I was going to stop going to him because even though he was in-network for my insurance, $160 per visit wasn’t affordable, not to mention $300 for the cost of the tests. In two months, I had to shell out more than $600. And I haven’t seen a single physician of any kind since then, which was in 2018. I can’t afford to, between my endocrinologist and my psychiatrist. Living with my mother means that her income is too high for me to qualify for government healthcare, and her insurance with her job is... well, as you can see from the $160 for a single visit, it’s not great. And boy has my health only gotten worse.

I couldn’t work part-time as a Greeter at Walmart anymore because it was too physically exhausting. I couldn’t stand for 8 hours every day. I would go home and cry. I would got to the bathroom after an hour of my shift and cry. I couldn’t sleep because of the pain, and my days off didn’t make the pain decrease. Probably because I was also a full-time college student. I started using a cane, and couldn’t quite decide if it was helping very much in terms of pain, but at least it helped me stay upright when my knees would sometimes suddenly buckle. They will just decide to stop working for 1 second, but that’s enough time for me to fall, and it happens several times a day. Then I went from a cane to a rollator walker. It helped that I had something to sit on when waiting for the bus, but none of the bus drivers would let me use the “wheelchair” lift, so I had to carry my heavy walker up the stairs, which was painful. Whenever the bus became standing room only levels of full, there was nowhere for my walker to go except pushed up against my legs by the person standing in front of me, especially hurting my awful knees. And then the walker wasn’t enough. I couldn’t stand for even short periods of time without quite a bit of pain. I didn’t want to get a job, or keep going to college, or go to the mall, or even walk my dog around the block. Right now my wrists are killing me from typing this.

I want to be a secondary social studies teacher, so I decided, I need to get a wheelchair. I need to be able to sit while I teach and move around with less pain. I got a cheap one off Craigslist and did my best to hide it from my family, then beg them to let me keep it when they discovered it. My chronic pain is full-body, but my legs are the worst so it was an alternative I wanted to at least try. I have been struggling to find a school at which to do my student teaching, since none of the schools that my college has agreements with are wheelchair accessible. One school even has a wheelchair ramp that leads to a door with a step! All the teacher’s bathrooms have steps, too! Who approves these things? I’ve been working as a substitute teacher, and can’t use a wheelchair doing that. In K-8 (where most of the subbing jobs are), you have to be able to lead the kids up and down the stairs, and anyway all the elevators in the school district require a key they don’t want substitute teachers to have access to. And none of the classrooms are maneuverable in a chair or walker. So, cane and pain.

All of this to say, I know using a wheelchair is probably going to ruin my body. I have to stand and walk around every hour or so, otherwise the pain in my butt and joints is unbearable. But what’s the alternative? To sit all day on my walker or a chair anyway? To have so much pain in my feet and knees that I pass out? I’ve completely abandoned over-the-counter pain medications. They don’t put a dent on my pain at all. I’ve had no luck with all the Cymbalta/Lyrica type of medications, which I’ve taken thanks to my psychiatrist being just affordable enough with my insurance. I go to the mall and museums with my girlfriend in a wheelchair, which I never would have dome with the walker let alone the cane.

I’m at my wit’s end with all of this “using the wheelchair could permanently damage your health” nonsense. My health is permanently damaged already, that’s what a disability is! That’s what chronic pain does! It sucks all the joy out of your life as you become confined to your house! Don’t get me wrong, the wheelchair isn’t perfect. The butt and joint pain is bad, and my arms aren’t very strong, and roads and sidewalks are awful where I live, and I don’t own a car or have a driver’s license (since I am unemployed and can’t afford a car). But at least the wheelchair allows me to go places with my girlfriend again. I always have a place to sit, and my girlfriend pushes me when I get too tired or the roads are bad, and I go to the bathroom to stand up and stretch (I’m terrified of standing up from the chair where people can see me and try to start an argument).

What can I say except what other choice do I have???

[poetry-recovery]

SNRIs and lupus?

My rheumatologist has mentioned starting me on lyrica or cymbalta for my lupus flare up that I’m currently in. What are your thoughts/experiences with this? If I had to choose one I would rather take cymbalta cuz lyrica has a side effect of weight gain.... but idk.

I’m already on plaquenil and mycophenolate for my lupus. (And right now steroids). Do I need something else?

Help

[tocksickart]

Don’t take Lyrica

I have been prescribed Lyrica twice. The first time was two years ago and my insurance denied it, the second time I had not issues getting it approved. I started taking it last Friday night and it hasn’t been good. I am constantly tired, absolutely ravenous, my head won’t stop pounding, and the pain has not subsided. If I keep feeling like this by next Friday, I will definitely stop taking it. But then the fun part of that is that it can’t just be stopped cold turkey. Fucking cool. I’ve already been through this same shit with Cymbalta. After this, I’m done trying meds that are aimed at helping the nerve pains. It’s really not worth the money and side effects at this point. 

That’s really all I’ve got. My head hurts too bad to even write more. I just want to go home and crawl into my cave of a room.

[type2diabetestreatments-blog]

The 411 on Diabetic Neuropathy (Feet, etc.)

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/the-411-on-diabetic-neuropathy-feet-etc/

The 411 on Diabetic Neuropathy (Feet, etc.)

Since January, we've been presenting a run-down of everything you need to know about living with diabetes complications. So far, we've covered your eyes, your heart and your kidneys. Because let's face it: knowledge is power. It's certainly our motto here at the 'Mine. April is National Foot Health Awareness Month (yes, they pretty much have a month for everything — April is also National Pecan Month and Fresh Florida Tomato Month).

Diabetic neuropathy is one of the most common diabetes complications, affecting 60 to 70 percent of us PWDs. Of course, it's more likely to occur if your A1c (average blood glucose level) remains high over time, but simply having diabetes for decades can bring on diabetic neuropathy too. The highest rates of diabetic neuropathy occur in folks who've had diabetes for longer than 25 years.

Amy's writing a series of tips about foot health over at DiabeticConnect this month. But remember that diabetic neuropathy doesn't just mean your feet. There are actually four different kinds:

The most common is peripheral neuropathy, which causes pain, tingling, burning or numbness in the extremities, especially the feet, but also in the hands and harms.

Autonomic neuropathy, which causes problems in digestion, bowel and bladder function, sexual response (for both men and women), and perspiration. It can also affect the heart and blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, which possibly explains why people who have had diabetes for many years often stop feeling their lows.

Proximal neuropathy, which means "origin," causes pain in the thighs, hips, or butt and leads to weakness in the legs.

Focal neuropathy, which causes sudden weakness or pain of one nerve or a group of nerves anywhere in the body.

Ugh...

Many people assume that diabetic neuropathy stems from impaired circulation caused by atherosclerosis (or narrowing of the arteries), just as atherosclerosis in the heart and head can lead to heart attacks and strokes. This isn't actually true. While circulation changes certainly contribute, a larger factor is neuropathy itself, which means injury to the nerves—in this case to the small sensory nerves in the feet.

One of the biggest dangers here is that the numbness neuropathy can cause in your feet often goes unnoticed by you, so you may have small or large feet injuries and not even know it! If there are symptoms, they are usually painful, such as a tingling or burning sensations.

If you do have symptoms of neuropathy or suspect there is a problem, get thee to a podiatrist asap! Or, at the very least, to your endocrinologist, for a thorough examination. There are several tests doctors can run, including an electromyography, which checks how your nerves respond to electrical signals. Once you have a diagnosis, you can focus on treatment.

Treatment

Unlike other diabetes complications, diabetic neuropathy symptoms can often be alleviated through either better blood sugar management or through oral medication. There are two medications that are FDA-approved to treat diabetic peripheral neuropathy: Lyrica and Cymbalta. Anybody heard of these?

The American Academy of Neurology recommends Lyrica as the most effective treatment for diabetic peripheral neuropathy. However, both have risks for side effects, like weight gain, so keep that in mind.

There are also some alternative therapies, including:

- Alpha Lipoic Acid: an anti-oxidant found in foods like potatoes, spinach and broccoli, but also in over-the-counter supplements usually found in the vitamin section of your local drugstore. ALA has been known to help prevent certain kinds of cell damage in the body, and there's anecdotal evidence that it will also helps nerve damage caused by diabetes. But it is not FDA approved, so try at your own risk!

- Vitamin B-12: A specific form of Vitamin B-12 found in spinal fluid, called methylcobalamin, has shown to have significant effect treating diabetic neuropathy. But experts say more studies are required to prove real effectiveness. However, Metformin has been shown to cause low levels of vitamin B-12, which can cause peripheral neuropathy. So if you're on Metformin, you may want to get checked for that!

- Transcutaneous electrical nerve stimulation (TENS), which is a type of therapy that attempts to reduce pain by applying brief pulses of electricity to nerve endings in the skin.

A couple other tips that experts recommend (we know it's hard to forgo your flip-flops and cute shoes 😮 ) -

Avoid walking around barefoot, even if the weather is nice and the ground seems smooth and "safe." It's just too easy to injure your feet this way, or pick up tiny splinters that you don't notice until they cause real problems

Try to wear moisture-resistant socks and well-fitting shoes with flexible soles made from crepe or foam rubber and soft leather tops that allow your feet to breathe. They don't have to be clunky diabetic shoes, but they should fit properly and support your feet. To prevent pressure sores on your feet, make sure your socks don't bunch or wrinkle inside your shoes.

A Personal Connection

Last winter, I actually started noticing a sharp pain in my feet. I'm just 25, so this couldn't be happening! But sure enough, I'd feel pain first thing in the morning, when I would climb out of bed and put my feet on the ground. As soon as I stood up, the pressure of my weight as I walked made it feel like I was walking barefoot on rocks. By the time I got to the bathroom down the hall, the pain would be gone. Occasionally throughout the day the same pain would come back, but for the most part it appeared to be mostly in the early morning.

This was also around the time when my blood sugars were elevated more than they've been in the past. My A1c had jumped to over 8%, and it's probable that was the culprit. As a twentysomething diabetes advocate, I'll admit, I was a little embarrassed that I could have a complication. But I also knew that being embarrassed was not a reason to suffer in silence! So I scoured the internet for information and found many forums discussing possible treatments. I didn't feel that the pain was worth a prescription drug, like Lyrica, so on the recommendation of fellow patients and on the advice of my doctor, I gave Alpha Lipoic Acid a try, as well as working harder to get my blood sugars down.

After a few weeks of ALA, I did notice a marked difference in how my feet felt. However, this is not medical advice — I am not a doctor, nor do I play one on TV — but it is a word of advice to pay attention to what your body is telling you and to talk to your doctor quickly. If I had kept the pain in my feet a secret out of shame, who knows how long I would have suffered?

Prevention

Whether you are already dealing with diabetic neuropathy or you're looking for ways to prevent it, checking your feet regularly is very important. Here are some simple steps for keeping your feet happy:

Wash your feet daily in lukewarm water, including between the toes. Dry them gently and moisturize well.

Diabetes may cause you to sweat less, which can lead to cracked, dry skin. So when you trim your toenails, take care not to injure the surrounding skin.

If you have poor blood circulation in your legs or aren't able to see well enough to trim your nails, have your podiatrist do it for you.

Be sure to see your doctor if any sores on your feet don't start to heal in a few days.

Support

Finally, if you're dealing with diabetic neuropathy, you're definitely not alone. Pfizer, the makers of Lyrica, have a nice little microsite called Take the Next Step, that "walks you through" how to handle your diabetic neuropathy, including a video series on some fitness exercises for people who are facing limited mobility because of the pain. And even though it's Pharma-sponsored, it was co-created with Dr. Steve Edelman and the team at Take Control of Your Diabetes, so you know the info was vetted by someone who cares.

There is a Neuropathy Association, which offers resources for folks living with a variety of neuropathies. But I think the best place to find support for diabetic neuropathy is on networking sites like DiabeticConnect and DiabetesDaily.

With proper treatment, diabetic neuropathy doesn't need to slow you down. It can be painful, but taking action early on will help slow down and even reverse the symptoms. It's worked for me, and hopefully it will work for you. And remember, nothing replaces the advice of your medical team so please, if you're having an issue with your feet (or another body part), see a doctor asap.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

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