Pain Story

It's not been a good week. The last that I felt reasonably good was Monday. My wife and I went to the fitness center we belong to, did our typical routines, for me 20 minutes on an elliptical trainer, then some walking, a few upper body machine exercises. When I got home, resting on the couch, the pain began.

A strange pain, kind of gnawing in the perisacral area, but no tenderness. Didn't get worse with movement, but there wasn't any position where it felt better. I took a couple of OTC ibuprofen before going to bed.

A restless night followed. If anything lying down caused the pain to be worse, this gnawing, steady pain, punctuated by waves or sharp peaks of pain. So with hardly any sleep, I go to work the next day. Pain all day long, but actually better if I'm upright, walking around, rather than sitting, but still constant to some degree.

That night, Tuesday, again I can't sleep. Taking more ibuprofen, which seems to help only a tiny bit if at all. Finally, about 3am, I decide I can't take it and go to the ER. The ER doc was suspiciously thinking of kidney stone, since I'd had one 25 yrs ago. But my urine is perfectly OK. Thankfully he doesn't do some mega-workup, gives me some Dilaudid, which in a few seconds totally erases my pain while erasing my ability to drive home (I drove myself there). So I call my wife, she picks me up and I go to bed. I leave with prescriptions for naprosyn, Lortab, and methocarbamol.

I still don't know what the hell is going on; I'm thinking maybe sacroiliitis? There's no tenderness anywhere, generally moving around if anything makes the pain slightly better. But after a couple hours of sleep I go into work -- might as well, since this pain is not helped by resting. I take the naprosyn and methocarbamol, hmm, maybe it's better, but maybe it's better because I'm moving around upright. But still this gnawing is constant, just variable in intensity. I have the Lortab, but I'm reluctant to take it while working. The last time I had some it more or less knocked me out for a few hours. Late in the day, as the pain is creeping up, I take a Lortab.

It's interesting how something like pain soaks up effects of medicines, and this turned out to be the case here -- the Lortab definitely, finally, reduced the pain, and I could finish out the day. Wednesday night I'm able to get some sleep at least off and on, at one point taking two Lortab. I keep taking the naprosyn and methocarbamol but can't see they do anything.

So I'm able to make it through Thursday, with meds on board, and fortunately it's my "afternoon off" -- the term would imply that I leave at noon, but it never works out that way. Thursday night sleeping with meds again, I am awakened by the sense that knives are stabbing me in the right side of the pelvis. I get up, go to the bathroom and pull down my PJs to see some patchy vesicular skin lesions in a roughly linear distribution from the right iliac crest toward the midline, where they abruptly stop. They are exquisitely tender when touched. Eureka! I have a diagnosis -- herpes zoster (aka shingles).

Back at work Friday, I get one of my practice partners to write a script for some Valtrex. With this diagnosis, the naprosyn and methocarbamol make no sense, so I left these at home. I grab some samples of Lyrica, a fairly new medicine approved for postherpetic neuralgia. So Friday goes by with some variable swimmy-headedness from the combo of Lortab and Lyrica.

So here it is Saturday, my second day of Valtrex, which so far has not seemed to make a difference. In fact, this morning the vesicular lesions now trail all the way around my back to the sacrum. While the lesions are tender to the touch, the main pain still seems to be this gnawing sensation in the muscles, and even with the Lyrica/Lortab, the night was restless. I also haven't had a BM since Monday, so I'm a little concerned about that -- probably the Lortab, maybe some effect of this sacral nerve zoster. And yet I keep eating, my appetite is still there. I can't figure out where this week's worth of food is going, when the only output has been wind. I guess I must be making some very hard bricks in there. So I started some OTC sennosides-docusate to work on that aspect. I'm also trying not to take the Lortab, but it's hard to get sleep without it.

Fortunately, I'm not on call this weekend. Just hoping this starts to subside by Monday, if not sooner.